Previous BP Diagnosis & New Pdoc
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Q:  Previous BP Diagnosis & New Pdoc

Hello. My question pertains to one Psychiatrist that diagnosed me with bipolar disorder, mixed. She saw me when my stepdaughter was needing help due to her loss of her sister and mother in a car accident. We had a rough year and both I guess broke down. She triggered me off by her mood swings, biting my child, throwing a knife at my child and bad behavior, lying, etc. Turns out both of us have PTSD and anxiety disorder, and, yes, obsessive/compulsive behavior. At the time of the child's breakdown, the  Psychiatrist noticed how agitated and hyper I was, and depressive at the same time. So she wanted to see me alone one time. I obliged knowing full well I was not acting normal. I could not sleep, I'd have anxiety attacks, bad ones. I I do not hit my own  child, and this stepdaughter of mine was pushing me to my limits. I verbally abused her as I did not want to touch her and hurt her. So I was diagnosed with bipolar disorder mixed. I am taking zyprexa, and my dose was cut down from 5mg to 2.5mg after about 7 mos. During this past year on the medicine I was also put on Serzone. I understand the reasoning of trying Serzone after reading much about it. I know it affects more than just Seratonin. Maybe that is why I felt lightheaded and blah and tired. Can you imagine an antidepressant making one feel blah? But it did. I cut the dose down and admitted it to her. Instead of trying to switch me to something else she kept insisting I try to go back up to 200mg a day. I tried. Hated it. So, I switched Psychiatrists and guess what? This doctor doesn't necessarily think I am bipolar. I wrote him a letter after my first visit and told him how I was last summer. And other things over the years. I went back and he still insisted i had for sure PTSD ( many reasons, one major reason being my first husband died of AIDS and our child was only 8mos old at the time of diagnosis. I feared for my life and hers, and thought I was doomed. It took 3weeks to get the results. It was awful. He died in my arms, and suffered very much). I also for sure had GAD. So now I am on Zoloft. Everyone agreed on the obsessive also, especially with thoughts. I asked this new doctor why he didn't think I was bipolar, even though I'd have racing thoughts, energy of many people, so it seemed, working out, swimming, moving constanstly and not being able to sleep, for example. He says nervousness and hyperness is part of anxiety disorder. So is being agitated and the PTSD this is true for that as well. I did not go to the extremes of spending sprees, or wreckless behavior, so to speak, so therefore he didn't think I was bipolar. Let me ask you this: I do a lot of reading, am an educated woman. I have been reading a lot about bipolar disorder and it so to speak can go into remission. If I am taking zyprexa for it, and am doing fine and not really manic, how can a Psychiatrist diagnose me now for this disorder? He agreed to keep me on the zyprexa since it is such a low dose and helps me honestly to not have nightmares, or at least not remember them. I have finally been able to sleep this last year on it. I was afraid to get off of it and so for now he is keeping me on it especially he said until he gets the records from the other Psychiatrist I was seeing. He will decide as he gets to know me.

What do you think? I know me. It took a long time for me to admit I probably am bipolar. ( I am also on now Zoloft 50mg and have been on it for 6 weeks and have just started to feel really well).

Dear Michele -
Iíve gotten way behind on replies so am opting for now to be "short and sweet" (hopefully, and hopefully still useful):

Obviously I shouldn't be offering you a diagnosis in a situation as complex as this.  So I'll just offer this: read this site about BPII if you haven't yet; not because I think you have it, but because I think you might and for all the work you've done so far, you will end up being the one to decide, not a doctor who won't catch up to you for a year of seeing you or so. 

You can't say you don't have it while taking zyprexa, which treats it. 

If you have it, Zoloft may help and later make things worse, as you'll read on my site. 

GAD and BPII have 100% overlap, as you'll also see on my site. 

Move from "do I have it?" to "how much of it might I have?"; and focus more on the treatment options than the diagnosis, keeping the "how much?" question in mind each time you make a choice (e.g whether to add Zoloft).  In the long run it will get clearer. 

Dr. Phelps

Published November, 2001


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