The Real Possibilities – Reaching Beyond a Diagnosis


I’d like to preface this with one thing.  I don’t usually post to Sunny about things in my life that are just developing or things that I would consider to be “in limbo”.  This is me, Lulu, reaching out into the community in search of some informed opinions and suggestions.  I want to hear from you to learn about your personal experiences and gain from the reader’s pool of knowledge.  Not every answer is clear cut, and most of the best answers can’t be found in a book somewhere.

The New Doc on the Block

I went into my psychiatrist’s office for my regular med check last Friday.  Except, there was nothing about this that was regular.  My psychiatrist Dr. K. wasn’t in, and another doctor I was meeting for the first time was filling in.  I figured it would be more of the same, you know, “How’s it going?”  “Fine, except a couple of things.”  “Okay, well go off into the world, be good, and take your medication.”

I was dead wrong.

He asked me a few typical questions, like “What’s your diagnosis?”  and “What medications have you been on?”  and things of that sort.  He asked me how I’ve been feeling recently, and I answered honestly.  Mostly, I’m alright.  My moods are pretty stable, and I’m in a pretty good place most days.  I’m still pretty irritable and the anxiety I’m experiencing is just unmanageable anymore.  But, those are the constants.

I’m not fighting depression or mania at the moment, or living inside the confusing anguishing hell that is a mixed episode.  I’m alright.  Just alright.  Probably the best I could expect to be doing being someone with this condition.

This part shocked the hell out of me.

The doctor goes into a long explanation of why I’m still experiencing symptoms, being that I’m apparently not on medications that actually treat the disorder.  He tells me that Lamictal is not a mood stabilizer. Since I’m not on a mood stabilizer or and an antipsychotic, and since I have a lot of options, I should be on both.  In his medical opinion, I should not be on Wellbutrin or even really any antidepressant at all.  And Xanax and Halcion are not supposed to be for long term use to manage anxiety.

I fought him on the antipsychotic, explaining that those types of medications and I don’t get along well.  He insisted it was because I’ve never been on an actual mood stabilizer.  He kindly smiles and promised that as soon as my meds were fixed, then my bipolar would be fixed, and I’d be right on track.

He advised me to take a look on the internet at my treatment option throughout the next month, and then discuss with Dr. K. when I came back.

It was like getting slapped by someone in a moving vehicle.

As quickly as I went in, I was back out again.  I was disoriented and confused.  For a minute, I actually considered his words might be the truth to the whole thing.  Then I remembered what being on antipsychotics was like.  That created a whole host of problems that were unlike any I had ever experienced before.  And I don’t care to EVER go there again.

So, Xan and I got in the car, and I laid the whole thing out for him.  He was completely on my side.  He said, “I don’t see why they are trying to fix something that isn’t broken?   Why are they trying to dope you up like this?  What did you tell him?”

I replied, “Nothing out of the ordinary!  I told him that I’m having difficulty keeping a job, but I have no idea what that’s all about.  I’m struggling socially and have been, well, pretty much my entire life.  And that irritability, insomnia, and anxiety have been a constant for me.  I mean, for my ENTIRE life, before all the mood stuff started.”

And we both agreed.  Whatever throws down, that cocktail is not happening.

To Be Bipolar, Or Maybe Not Bipolar?

I’ve been thinking about this for quite awhile now.  My moods have been pretty stable for about a year now.  I mean, that is cause for celebration here.  I’ve had some minor snags here and there, but all in all, I’ve been pretty level.  The episodes I do have are not nearly as deep as they once were, even if the duration might be seemingly longer.  So, why am I still seeing significant dysfunction in certain respects?

Is it possible that I might not even have Bipolar Disorder in the first place?  Could it be something else?  Borderline Personality Disorder and Bipolar share some diagnostic traits.  Could there have been a mixup?

Or, perhaps, the mood episodes were actually solved, as I suspected, and we’re now uncovering something underneath the mood shifts?  I have long suspected that the anxiety that I’m reporting hasn’t had anything to do with my mood shifts, although I did describe them as having the ability to spark depression or mania, depending on the context.

Xan and I sat down later, and I said, “You know, if Dr. K. is going to cause trouble and shift medications around, I’m going to request that we do a complete reevaluation.  I’m talking about starting from scratch, covering it all from A – Z.”

He answered, “I think that’s a good plan.”

My Homework Assignment

So, I’m doing my homework assignment right now.  I’m doing my research on the internet.

BUT!

I’m going beyond all of the articles, medical websites, and online assessments.  Sure, I’ll have those tucked under my belt, but I’m not a person who half-asses anything.

I’m taking it to the people.

Tell me about your experiences.  I’m open to all suggestions, ideas, theories, and everything and anything all open minds would like to add.

Thanks ahead of time readers.  I’m counting on you!

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20 thoughts on “The Real Possibilities – Reaching Beyond a Diagnosis

  1. I don’t have experience of all that you have described but when there is any doubt in your mind I would do exactly as you are doing and look for a reassessment based on what you come up with.
    I had been on anti-depressants back and forth for years. It was always worse in winter and I had thought of SAD as a possible reason, bought a lamp, followed the treatment and it helped a good deal. But not entirely. Almost two years ago I started to have pains all over my body – symmetrical, which I found odd – blurred vision, constant debilitating tiredness. Felt like shit, basically!
    I started doing as you are, researching for myself, googling all symptoms and possible answers started to present.
    Doctors don’t have the time or inclination to do that for you and they’re not experts on every area, even as good as some of them are. GPs I mean here.
    I presented myself to the doctor, told her my findings, requested blood tests, particularly for possible Vitamin D deficiency. For some reason, they never offer that one. But when my calcium level came back low they proceeded to do the blood test for Vit D and it was way, way down. Below what they measure.
    I was prescribed high dose Vit D and after months of taking them (it takes months to get the levels up) I felt like a different person. The symptoms disappeared. But, just as importantly for me, I no longer seemed to need anti-depressants. I felt well again.
    That was well over a year ago and I still have felt no need for them despite the fact that stress is still a factor in my life.
    Whether it’s coincidence or not (I don’t believe in coincidences) I’m extremely glad that I took my own health into my hands.
    I say all this to say to you that no one will care for your well-being as much as you. No one wants to feel better more than you do yourself. Doctors don’t know everything and sometimes the best way is to go searching and it was through others’ sharing of their symptoms that the light began to dawn for me.
    I do hope that you find more answers and that, even if medication must be part of the answer, that it is the right one for you.
    I hope this helped even although it is not exactly to do with your exact situation. Best of luck and good health to you.

    • Well, within the last year I went in complaining to my Pdoc about headaches, extreme fatigue to the point of narcolepsy BUT having trouble sleeping at night, and generalized pain, particularly in the neck and shoulders. I had quit smoking for a little while, and I put on a lot of weight in very short time. I experienced severe depression in the short two months I quit cold turkey.

      So, I got my blood work done and was able to review the results for myself. Although my Vitamin D was down and my B-12 was on the verge of falling over the edge, I was still just prescribed a heavier sleeping medication and sent on my merry way.

      I decided to take things into my own hands at that point. I started taking a prescription strength Vitamin D, Calcium, Iron, and Vitamin C. I saw a slight improvement in the energy level, but not what I considered to be enough (although I am still taking them because it does help).

      And while I was trying to sleep one night, tossing and turning, it hit me. I have a sizable cyst in my back near my neck that has been there since I was about 8. Except now, it’s about the size of a walnut and hurts anytime any pressure is put on it.

      I don’t know why it didn’t occur to me that I might have some physical ailments that could be the source of it.

      I’ve been to my PCP in the last week to get poked at. She ran a battery of tests, because we’re concerned about my cholesterol and sugar levels. They both look a little too high for my age. Seeing as how my dad had an emergency quadruple bipass when he was only 50, and now my brother has high blood pressure, well, I need to be on high alert about these things. A woman’s odds of surviving a heart attack are much lower than that of a man.

      I’ve been able to explain my physical symptoms now, because they seem to be connected to real physical problems. That part is not in my head.

      I’m loath to start switching up my medications so completely for several reasons. First, I’m not experiencing any severe symptoms that are calling for it. And second, I’m afraid to lose the functionality I actually still have while we’re playing what might not be a very fruitful game of Medication Roulette – all based on a suggestion by a doctor who met me once for fifteen minutes.

      I feel like the medication that I’m taking is really taking care of the bulk of it. My mood episodes are not what they used to be, and I think that one doctor failed to realize that I’ve come so far in 5 years. Though, that one doctor insists that the medication switchup would take care of ALL of it, and that I would essentially be living a symptom free life after that, which I think is complete BS.

      For a long while now, I’ve felt like bipolar disorder might not be the end of it. I feel like we’re just peeling off the first layer and finally getting a peek of what’s being masked underneath. And I’m curious to know what might be there.

  2. Talk about throwing you for a loop! Personally, I think it’s important to remember that all these labels/drugs/diagnoses have only been around for an infinitesimal fraction of human history. Without this vocabulary, who are you, Lulu? Really, truly. When was the last time you went deep and asked the question?

    I see a super cute, courageous, curious, loving woman with a volatile biochemistry. This shake-up is the perfect opportunity to really get in touch with that part of you that can sit still in the midst of the madness. This part can be strengthened and trained through meditation and simple, unrelenting self-compassion. Some people call it the “impartial observer” but I prefer “conscientious objector” ~wink.

    I’m not saying to abandon the medical side, not at all, a gal has to function! But just know that you have a hell of a lot more power over your brain than the medical field is currently willing to explore. TRUST ME.

    • Let me preface this with one thing. The only reason I’m interested in any label is for “treatment” purposes. Autism Spectrum Disorder and Obsessive Compulsive Disorder are on deck now as possibilities as I make contacts related to this matter. But, when I say “treatment”, I’m not talking about the kind that happens behind office doors with wall adorned with credentials. It’s not that I don’t believe in conventional therapy. It’s just that I’ve found other methods that better fit my needs. If these things are possibilities, then I need to reconsider how I handle my own “treatment”, because whatever I’m doing at the moment is not encompassing those things. Mainly, because I haven’t researched them enough to understand them.

      Yes, though I have two people directly related to me with autism, I still can’t grasp it. But, that doesn’t matter anyway. As a professional once told me, when you’ve met one person with autism, you’ve only met one person with autism. The presentation is that unique.

      The entire point is beyond defining myself. No, actually, that’s not entirely true. It’s defining the things I can help and the things that I really can’t. When I was grappling with the realities of mood shifts with bipolar disorder, I had to come to terms with the fact that there is no stopping a mood episode. There is making them more shallow, shorter, and building adaptive strategies to cope.

      So, it’s a point now of wrapping myself around the realities of what I’m dealing with now.

      LOL, I ask myself pretty frequently who I think I am, who I want to become, where I think I’m going, and what I want to be when I grow up. I don’t necessarily think it’s a bad thing that I come up with varying answers. I’m, um, not great at taking compliments, as I sit here in my scarlet skin. I do appreciate the sentiments. But, knowing the past, the darker ends of it, and so forth – well, it’s difficult to define any of that in absolute terms, seeing as how they’re so contradictory.

      Do you know what I want most of all? I want to be. Why can’t I just be? Of course, I know all of the practical reasons about why I can’t indulge the urge to become an agoraphobic recluse. But, I just feel like …. like everyone is demanding that I do things I’ve been unable to do my entire life. I’ve finally said, “Screw you” to all of the folks who demand that I fit a mould, because that’s just not happening, not now, not ever. It hurts too much to deny myself the right to be me. But, I can’t say it hurts any less when I’m rejected for doing exactly that.

      I know I have to have some semblance of functionality in terms of socialization and fruitful employment for the sake of my family. I feel like I’ve attempted to go about this from pretty much every angle, and it just always ends up the same. I feel alienated and rejected by the public at large, because they recognize that I’m not like them. Someone I’m employed with starts to bully me. I start having panic attacks about going to work, in an employment setting that already drains me at a threshold that is maybe a quarter of a typical person. And, well, it usually ends up with some explosive incident, followed by a quick departure into obscurity.

      My son is going to face significant social challenges of his own, although oddly enough, he’s incredibly popular and well liked for a kid who has a temper and a speech delay. I know that I’m going to have to model appropriate social behaviors. How am I going to manage that when I don’t even know what they are? And I’d like to be friendly with his friend’s parents, even if we’re not exactly close. I don’t want my kid to face any more difficulty because his mom is “weird”.

      See? Incessant worry. I can’t turn this off.

      • To be or not to be? Dear Gawd just to BE!!! That would be a treat, wouldn’t it? Sigh. Some of us lucky ducks are coded to live in worlds of crippling intensity. Such sensitivity and volatility are totally out of sink with our current paradigm of “gainful employment” and rigid social responsibility. But I say F*ck em’. So what. As long as we can carve out soft, gentle moments – be they days or even hours – with our closest supports and learn to accept (without judgment!) the dynamic parts of our personality along with our root static selves (so hard to pin down), we’ll keep on truckin’.

        But never give up the search for peace! I’m all about developing conceptual abstractions into practical lifestyle tools – Blank Canvas Living baby! I use my disconnect with the status quo to give me the freedom to define/design my healthiest life/worldview. Keep giving yourself permission to explore your gifts to see if they can serve you in your search. You really are an excellent writer. Maybe this talent could someday lead to a way to create your own personalized employment set-up? In the meantime, let’s both keep dreaming, searching, and loving our wild n’ wonderful selves 🙂

        • I think that’s a fantastic idea, continuing on with dreaming and searching with love and gratitude.

          I’m having a difficult evening, because tomorrow morning I will be faced with the unemployment board and their task force for re-employment services, as if they are doing me some kind of favor. However, if I don’t “play the game” as they say, then they’ll cut me off.

          Personally, I don’t want to be indebted to any government agency. Unfortunately, unemployment is currently supplementing the family income just enough to close the gap.

          I’d like to be completely blunt with them and explain that there is no job that they can “place” me in that would actually suit me. Can I be a mostly autonomous creature with minimal oversight? Would I have job where it would be completely appropriate to isolate myself and work alone on days where I’m not up to it all? Can they work around a hectic schedule that requires me to take at least a half a personal day a month to see a doctor, attend an IEP meeting, or be at home for one of those random days they give the kids off of school? Would they be able to provide some kind of transportation? And what of child care? Do they provide some kind of program that will attend to my child with special needs?

          To the onlookers, it sounds like a cop-out. But, those are the challenges that I face from the get-go. That doesn’t include things on the horizon that I can’t account for just yet.

          And maybe I will be totally blunt with them. I’m not resistant to the whole process of returning to the workforce at all. It just has to be on my terms, or the whole thing will fall apart again.

  3. When on Wellbutrin I had major irritability and anxiety, but when I stopped Wellbutrin the irritability, insomnia, and anxiety went away or were dramatically reduced. Even though they may have preceded the more dramatic symptoms of mood swings, don’t discount the fact that the right medical mix can mean you don’t have to experience these other symptoms anymore. So it might be worth considering what the substitute pDoc said. Trying a mood stabilizer with other meds. After resisting for months, I finally reluctantly tried Lithium (the classic mood stabilizer) with really good results. I researched and found that most peopel with bipolar are taking a combo of several meds. So I worked with my pDoc to add other meds to address certain symptoms. Am now on LIthium, Lamactil, Latuda (a newer antipsychotic) and Seroquel PRN. Really small dosages work for me. Almost sub-clinical, on all but the Lithium. Abilify is another of the newer drugs which works for many – but caused some side effects for me. Hope this helps

    • I tried to respond this a few days ago, but my mind kind of blanked out. It does that a lot when I’m surrounded by too much going on, a house full of rowdy boys…

      I’ve been on the Wellbutrin since an antidepressant was even added to the mix. The reason for the Wellbutrin was pretty simple. Most of my episodes leaned more toward the dangerously depressed side. I’ve had bad reactions to several before when I wasn’t on Lamictal, so we tried this one out.

      That was… geez, years ago at this point. I can’t see how it would be the source of the irritability and anxiety. I was irritable and anxious before any medications. That part has always remained pretty consistent.

      I’m pretty resistant to any medication that has known side effects of substantial weight gain and diabetes. I’m in the midst of the most significant weight problem I’ve ever had in my adult life, and it’s been a struggle to even maintain where I’m at right now. My family has a significant history of early heart disease and diabetes, as well as lifelong obesity.

      Not in terms of vanity, but in terms of my health where I’m already bordering these diseases prior to turning 30, I’m not inclined to take the risk of even more weight gain.

      I’m glad your medication changes worked for you, and I’m considering temporarily lowering my dose of Wellbutrin. I’ve actually moved my Xanax around during the day, and it seems to working out fairly well, minus the afternoon crash I experience. The anxiety isn’t nearly as extreme, but considering that I’m sitting here at 11:48PM writing on a night where I should be getting extra sleep, well, that tells you that anxiety, no matter how medicated I can be, often gets the best of me.

      Probably, it’s more of a matter of having to take things into my own hands. But, like I’ve mentioned before, I don’t think that bipolar disorder is the end of the story. And if it’s not, then I need to start taking additional conditions into consideration when I’m working with my adaptive strategies.

  4. Sorry for all your troubles… BPD, from my understanding is very hard to dx (diagnose)… Have you ever had Lyme disease, or have been in a position to have been bitten by a tick? There are plenty of neuropsychiatric effects that can be traced to tick borne diseases. You may know that Lyme disease is a very contentious area. If you have ever been hiking, on a farm or in the woods, had a fever or any physical trouble afterwards, you may want to seek out a LLD (meaning, Lyme literate doctor). The good ones take a detailed history way back to childhood. They also use special labs for blood tests… Testing and test interpretations are also tricky.

    In other words, it is very possible that you do have an infection that is causing you all these problems. I know this from personal experience.

    Also, don’t let drugs be thrust at you. At the very least, get the reasoning behind the prescription and ask the doc why s/he feels you have the dx s/he comes up with.

    Best of luck.

    Jack

    • I recently had a physical, although I know that doesn’t mean much. I’m still waiting for the results of the battery of tests that were done. Although I do live in a particularly wooded area, I don’t think I’m at any risk for Lyme disease. My childhood was pretty incident free, illness wise.

      Accident wise, well, different story entirely. Four concussions by the time I was 7. Now, I’ve had talks with doctors to see if they thought that all of those blows to the head (five by the time I was 10) in childhood had anything to do with anything. Apparently not.

      I’m not okay with these proposed medicine changes. As far as I knew, there was no “standard treatment” for folks with bipolar disorder. Again, why would I need antipsychotics when I’m not psychotic? I’ve only ever experienced bouts of psychosis once, two years ago in a bout of mania. I think it was mania anyway.

      Besides, antipsychotics and I don’t get along at all. Last time I attempted it, I ended up with some very bad and very odd results. Have you ever felt like you weren’t real? I can’t even describe it now, because it was so strange. I felt like I was slipped out of the real world, and being pulled under this wet blanket that muffled all of my emotions and thoughts. I hardly spoke anymore, and I could barely write. Most of the time, I made graphic art, because that was the only way I could get anything out.

      I can’t afford to play medication roulette for reasons that I wouldn’t even consider to be warranted. I could see if I was hospitalized, or was having some kind of episode. But, really, is this necessary for agitation and anxiety? I am like this with or without the medication. There is no difference. Xanax helps take the edge off most of the time, but sometimes it’s just not powerful enough.

      I’ve been telling him for awhile that I feel like bipolar disorder is not the end of it, and we might be uncovering something hiding underneath. But, I feel like I’ve been ignored. *Huff* Maybe I need to push this harder? Or maybe it’s time to give it up and get a second opinion?

      • Blows to the head have been known to cause epilepsy years later. Sometimes the feeling of “not being yourself” can be caused by siezues in the brain’s temporal lobe (called TLE – temporal lobe epilepsy). I’m not a doc, but this is something you may want to check out. Of course you should get a second opinion. I can’t imagine how tough this must be for you. I wish you the best.
        Jack

        • Thanks Jack!

          You know, I had considered going to a neurologist to get it checked out. I’ve had sensory disturbances for as long as I can remember. But as I’ve described them, no doctor seems to think it’s an issue. I can hear the tiniest sounds, and it drives me nuts. Or, I’ll often find myself overwhelmed by what I perceive to be a noisy area. I really despise that feeling, like there are electric tingles running through me and the sound is drowning me somehow.

          Florescent lighting sets off something strange in me, like an Alice in Wonderland thing where things change sizes and colors. I’ll stop recognizing people and my surroundings. I try to avoid it when I can.

          The idea of going to Walmart or the Mall sends me into a roaring panic. If I know I’m going, I’ll take some medication ahead of time.

          Eh, I should have probably already been to the neurologist about this transient migraine episodes. They come and go, mostly unprovoked. It’s enough to take me out.

          But, I do have a question. If I’m taking Lamictal, which is an anticonvulsant, then shouldn’t these things be taken care of? At least kind of, right? I don’t see any difference between before and after…

          wait, not entirely true. I notice it more now than before the medication.

        • You may need a different anticonvulsant. I know someone who feels better when taking clonopin, a drug in the same class as xanax. You should try seeing a neuropsychiatrist, someone familiar with TLE.
          J

  5. Sounds like this temporary doctor was just feeding you the same BS many other psych doctors do to quickly get you out of their hair. Considering he was a one-off visit, I am not surprised that he said what he did. He was not going to invest any time in your health and welfare.

    DO NOT GIVE UP YOUR FIGHT FOR SOMETHING BETTER!

    Although I suffer from BPD, I was also prescribed the same types of medication as you have. The side effects were so difficult to deal with, it actually made me put me in a state where I began to believe that, if this is all there is to help treat my condition, then maybe death really IS my best option.

    Not wanting that, I refused to take anymore of those kind of meds. I am like you. I have good days, months, etc. yet I am not well enough to get myself stable enough to re-enter the workforce. I am a social misfit. People do not understand, and I expect they never will considering how much more shallow society has become and continues to be, irrespective of the drive to have the public understand. They are afraid of us, and I suspect they always will be.

    Too many individuals in this profession are lazy, too. They really do not want to help in the way you think they should be, considering the amount of training they must go through, and the compassion that is required for such a job.

    My hope for you is to continue to look for a compassionate therapist/psychologist/psychiatrist. They are out there. I may be suffering deeply, but I am no fool. I will not be brow-beaten into taking something that I know does not work for me, nor brings me a better quality of life. I would rather take my chances by trying to maintain my sense of stability on my own.

    You must feel comfortable with the diagnosis you have been given. I have been given many, but after seeing one therapist for approx 4 years, he gave me his diagnosis. It felt right. Then I went back in my psych history to see if any other professionals I saw had the same thoughts or “feeling” about being a potential BPD. Sure enough, it was there. Quite frequently, I might add.

    And as you know, living it is difficult to actually see it (it’s not like we can step outside of, and look at ourselves objectively). It took a long time before I could “see” that my behaviours actually matched the majority of behaviours required to be a BPD. Although it may have felt right when that final diagnosis came, I had to “see” as it manifested in my personality and in my recurrent behaviours. I had to be sure this was the right one. It took more than a few years to fully see it.

    I may be a difficult patient, but I am not a stupid patient. I suspect you are the same. We deserve the best treatment we can find. It may take forever, but don’t give up.

    And cherish always the friends and family that choose to stick it out with you through the harrowing times, for we are not easy people to be around. Continue to let them know how important they are to you and how much you appreciate their dedication. They need to know this much more than you may realize.

    I pray that you find the help you want, need and deserve.

    If you would like to ask me any more questions, please feel free to reply to this message.

    M

    • One more thing, Lulu, for you to consider: if you have not already done so, learn about the distinction between a mental illness and a personality disorder. I think it will help you tremendously in your research.

      M

    • Thanks for your thoughts M! I’m going to try to address them without rambling too much or getting off topic.

      This is the first time I’ve had a fill in doctor pull that on me. Most of the time, they ask if I’m in bad shape, and even if I am, they throw the same pills at me and reschedule me in a month to see my regular doctor. A waste of a copay, if you ask me.

      BUT I wasn’t saying that I was in bad shape. I went in telling him that I was doing better than the last time, but still having some of the same issues with anxiety! This anxiety stuff has been going on for more than a year. It’s just been unbearable this year.

      I’ve never been on a classical “mood stabilizer”. Why? Because I have a weight problem that will hurt my health drastically. I tried antipsychotics, and I agree with what you said about death or insanity being the preferable alternative.

      That stuff was deadly in itself. You know, I’ve had these odd dissociative states here and there before, usually related to stress or really unpleasant situations I’ve had to live through. But, I felt like those antipsychotics were robbing me. Like I was related to Jack in another comment, I felt like I wasn’t real. I felt like I walked the earth as some ethereal being who maybe never existed in the first place. It robbed me of most of my intellectual capacity. And it didn’t do anything for my emotional state! It made it worse by feeling like I threw a wet blanket over the whole thing to just smother it!

      I do feel fairly comfortable with bipolar, because bipolar II fit me to a T. One of the reasons I think these doctors don’t get it, well, they don’t have a good history on me. I’ve only been with this practice for about a year now, since the practice before screwed me over with some stupid attendance policy. I didn’t like the that doctor anyway, and she wasn’t my choice. They thrust her on me when my doctor went into retirement.

      Personally, I think they were dumping me because my insurance changed. They probably weren’t getting nearly as much money for me anymore.

      But, I’ve told Dr. K. repeatedly, I don’t think bipolar is the be all, end all. I’ve felt like this for awhile. Now, I’m probably moving farther away from the personality disorders realm. It was just something I was exploring because it was something that was once suggested way back before I was medicated and treated.

      I just feel like there are symptoms that have some different root. Anxiety is not criteria in bipolar disorder, and I keep hearing it over and over that it’s actually agitation and irritability. Yes, I’m agitated and irritable, sensitive and emotionally reactive. I was pissed off before medications, and I’m still pissed off today. I was terrified of the world before medication, and I’m terrified MORE today.

      It’s like when we fixed one thing, we broke another.

      I was talking with another friend, and she wanted me to consider something in the anxiety disorder realm, more like OCD or something of the sort. Not extreme or disabling or anything. But, it might better explain the quirks and other things that cause me significant discomfort.

      • I think your friend’s suggestion to consider anxiety disorders, in particular (because of how you describe what you are feeling and experiencing). I also have an anxiety disorder, and it indeed was brought on, as you so eloquently put “by trying to fix something, but ended up breaking another” (for example: I never suffered from anxiety until I tried Paxil after fluoxetine (Prozac) had stopped working. I was only on it for approximately 3 – 3 1/2 weeks. I took myself off of it because the anxiety it induced was so intense I thought I was literally going to die of fear! After a reasonable amount of time (approx. 1 week, I went back on fluoxetine. I knew that, although this medication (which I found had the least side effects), did not lift me out of my depression, it did stop me from spiraling down into those deep, dark cavernous places that are so very difficult to bring oneself out of.

        It was at this time I came to the conclusion that this may be the best I may ever feel, and I began to work hard to come to terms with what was now considered untreatable depression and my “new” normal. The anxiety I had felt on Paxil, however, did not go away, and remains to this day. I am now on anti-anxiety meds to help control that now. Again, it does not work completely, however, I am able to go out into the world without freaking out too much. I also know what my limit is and I just remove myself from situations until I can either calm myself, and if I cannot, then I just leave the place/situation entirely.

        You must know that many people have coexisting conditons that must be treated in tandem with your Bipolar Disorder. Again, this is not easy to do because there is a mixing of different meds. So, using myself as an example, I have BPD coexisting with depression and (thanks to Paxil) anxiety. I deal with them sometimes separately and sometimes together, depending on how messed up I am.

        At this particular time in my life, I am dealing with several very stressful events, so I have had to increase my anxiety meds a little bit, and I am now going back into one-on-one therapy. It has been suggested that I also retake the DBT program as a refresher to again, help restablize myself. (I didn’t seek help quickly enough and I slipped quite a ways off the best path that I could make for myself).

        I do not know if you are getting the same or conflicting information from other people, because I am only focusing our OUR particular responses to this one particular blog posting. I do, however, hope you find this information helpful.

        And as before, if you would like clarification, or more information, and even if you would just like to continue our discussion, please feel free to reply!

        Take care Lulu,

        M

        Oh yes, and I know how hard it is to respond without thinking or feeling that one is rambling on. These are difficult issues that cannot be expressed with just a few words. 🙂

        • Well, I started to kind of get an idea of anxiety disorders in a different light. Anxiety disorders are much like other disorders in the way that it’s not a “one size fits all” situation. It emerges differently in people and is coped with in different ways that might not make it particularly obvious at first.

          My brother has OCD, but they’ve lumped it in as being a component of autism spectrum disorder. I’d say my mother has a more generalized anxiety that she displays in hyperactivity. Almost no one in my family has an official diagnosis, though they are pretty neurotic.

          I started remembering things from my childhood recently, and I think I am going to go in an request a formal evaluation, right from scratch to explore the idea that I might have a co-morbid condition. What is that the going to solve?- a lot of people ask me that. After doctors have told me for so long that anxiety often comes with both mood episodes, I’m just not buying.

          My anxiety can sometimes have situational triggers, like going to a crowded store. Sometimes, it’s an upcoming meeting with people I don’t know well, or a social situation I am not familiar with. But, then there’s the seemingly innocuous stuff that sends me into a panic. It’s hard for me to talk about, because I think it’s particularly strange.

          Maybe, when I get the courage, I can write an article about my “eccentricities” as manifestations of my cloaked anxiety.

  6. My main diagnoses is schizoaffective disorder bipolar type and borderline personality disorder. I take Lamictal daily along with an anti-psychotic, I take Valium for anxiety when needed but prefer to work with it behaviorally when possible because I take so many meds. I was misdiagnosed again and again for years, a lot of the diagnoses being derivatives of Bipolar Disorder. I’ve been on almost all mood stabilizers, and yes Lamictal is one but more often offered for those who have a more depressed bipolar. The Dr. is probably talking about Lithium or Depakote both of which I have had reactions to and don’t work. I take the anti-psychotic for my psychosis but I know it’s all the rage right now to use them for anything and everything including an adjunct to mood stabilizers. I say if you are comfortable without an anti-psychotic to stay away from them because of side effects like blood sugar, cholesterol, weight gain, and sedating. Most doctors will tell you that ANY anxiety medication shouldn’t been taken long term because of addictive and tolerance issues. I personally think it should be up to the patient.
    As for the diagnoses Borderline Personality Disorder and Bipolar II have a lot in common and are commonly misdiagnosed with in each other. Here are two good articles from PsychCentral http://blogs.psychcentral.com/bipolar/2010/08/borderline-personality-bipolar-disorder-differences-diagnosis/ and http://pro.psychcentral.com/differentiating-borderline-personality-disorder-from-bipolar-disorder/005080.html

    • Thank you so much! I actually looked over the articles, and I’d like to discuss.

      The onset:
      I developed symptoms at the age of about 12-13. Yes, I know that personality disorders are not diagnosed in adolescents, due largely in part to continuous development. But, I would say that there wasn’t much of a difference between me at 13 and me at 21, other than the fact that I wasn’t an alcoholic or sexually active at 13.

      Bipolar can present early too, which is probably why I was pegged with Major Depressive Disorder at 15.

      The onset wasn’t really acute, though it kind of felt like it and largely presented like it too, like someone flipped on the switch on the glorious day I became a woman. I feel like in some way, I’ve always been this way. I can remember being anxious and depressed as a child. My mother recalls me having strange reactions to things, like being melancholy or anxious when a kid would usually be over the moon.

      Baseline:
      This is an odd one, because I’ve always felt like there were two. There were seasons, which was the state I was in. And there was weather, which was the way I would react to something.

      A depressed episode could put a damper on anything joyous and prevent me from feeling positive emotions.

      A manic episode would throw a wild card for how I handled negative things. My reaction would vary from a switch from euphoria to something very dark and sinister to completely blowing the negative thing off. It largely depended on other factors.

      There is a baseline in between, kind of like neutral weather in the spring or fall. It’s not too hot or cold. The world is almost completely still, like frozen in time, sort of. And I’m aware that the clock keeps marching on, but it’s just this kind of blank space where life occurs. I wish I could refer to it as a “stable” state, but I have yet to actually experience something that is not laden with landmines.

      (Some people accuse me of “stirring the pot”, when I feel it’s quite the contrary. I sit and anxiously await the other shoe to drop).

      Impulsivity:

      This is an interesting one. I am not impulsive by nature. I am indecisive and careful, always trying to plan every little detail out so that I don’t get blindsided. I don’t want to start trouble, because I know there is enough trouble in this world that can find me on its own.

      This doesn’t not mean that impulsive things do not happen. This means that *most* of the time, when I get an urge, I don’t indulge it because I’m too terrified to. I don’t like change, and I don’t like inviting the unknowns into my life. This is especially the case when it comes to knowing what I could lose from indulging the urges.

      Impulsive reactions do happen, and when they do, it’s way too quickly for my brain to have even caught up with. The deed is usually done before I have time to process. These things usually happen when I’ve been pushed too far emotionally, like I’ve cracked or something.

      But, those aren’t like the ones that happen in the hypomanic states. Hypomania is like something else entirely. There is nothing else that’s like it. There is no terror or anxiety. It is the only time I’ve ever been freed from those bonds. I don’t even really know what I’m doing until it’s done anyway.

      Psychosis:

      Interesting stuff here. Being bipolar II, you wouldn’t think that I’m qualified as being able to have “psychosis”. I tried to explain my paranoid episodes to doctors before, only to have them dismissed. I’m always kind of paranoid about something, whether it’s something simple like people talking about me or something a little more complex, like the belief that I’m sick and dying or someone is plotting to take my kid away from me.

      If I’m stressed out, like I feel like a part of my life is falling apart, I will become incredibly paranoid, to the point of where I cannot be talked out of that belief.

      The last time this happened was in an employment situation. They just hired a new person, and my hours were cut. I started freaking out, screaming about how they were trying to replace me and how my manager never liked me and everyone there lies to me about everything. I was going and on about how they were secretly hiring people and training them behind my back during the hours I couldn’t work.

      Yeah, well, when stuff like that actually comes true, then it just reinforces that kind of thing.

      The worst time was when I was convinced that my husband was having an affair, because he took on longer and different work hours. I was convinced that he was trying to start a relationship with a woman that he worked with so that he could kick me out of his house, steal my son, and build a new family while he tried to get me locked up.

      That was outrageous. But, I believed it, constantly accused him of it, alienated him, and put him through this hellish misery for months.

      Inappropriate anger:

      All of the freaking time. I am angry almost all of the time. That’s my emotional response to just about everything, anger. It gets out of hand when someone hits a pressure point. I will make it a point to take it to the next level.

      Martial arts took that from an all the time kind of deal to just a generalized irritability when things aren’t going right. I make a joke when my family starts upsetting me for whatever reason, “Come people, ease up on me. It’s not like you get a prize for pissing me off, it’s just that easy!” Shooting fish in a barrel.

      I’d write a little more, but I think that’s probably enough for now. Plus, I’m a few minutes late going to get my kid from the bus stop. That’s okay, because I build an extra 15 minutes into every task to account for possible setbacks or disasters.

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