therapist says maybe not bp

[hell1971]

After months of strugling to come to terms with the diagnosis 3 doctors have given me plus one assesment nurse my new talk therapist has said maybe its just stress and not bipolar. I dont think I can cope with this, she said today that she only thinks bipolar when you are looking at bipolar 1 and pure mania, bipolar 2 etc.. she thinks doesnt really count? what am I supposed to think and do now, do I listen to her, ignor her but carry on with her program or say I dont want her and take the doctors diagnosis.   Please help yet again im sent into turmoil.

[ILADVOCATE]

Best to speak to a psychiatrist about it. A person can sometimes be rediagnosed but only a psychiatrist can make a conclusive diagnosis and every day stress is highly different from bipolar. She may not understand what is going on and a psychiatrist in noting fully what has happenned in your life might very well disagree.

[hell1971]

Thanks for responding you always do, I decided to call her back and clarify what she was saying. From the conversation I had I would say she doesnt beleive anyone has bipolar unless they are at the extreme end. I will see how things go with her and if it doesnt work out I will ask to change to someone who has bipolar knowledge or at least agrees it exsist because it took me a long time to come to terms with the diagnosis and I dont want to go backwards. I have also had a much longer relationship with my physchiatrist whom I trust and also had two other physchiatrists who diagnosed me too. I will talk to my physc doc at my next appointment about it. Thanks again for always being there.

[Xila31]

You know, I think that it might be wise to think about if this therapist is the best person for you. If she doesn't even believe in bipolar 2 or cyclomania then that means if you start having trouble she might not be there when you actually need her. I know other people who only believe in sever bipolar and I tell you that if I need them they are not there for me. It is not safe for me.

I know this seems strange as a comparison, but when I had my first child I wanted to do a natural birth. The first OB/GYN I saw, I told her I was going to do the Bradley Method. She looked right at me and said, "Oh no, you don't want to do that. The Bradley Method is for farm animals, and you're not a farm animal, are you?" So I walked out of her office and never returned. Because, you always need your doctor to support you. That is your right as a patient.

If you trust your psychologist and what you were diagnosed then that is the relationship you need to uphold.

[adel_ezz]

you may have traits of bipolarity but not yet clinically bipolar i.e. you didn't cross the barrier. you wil,l if you take an antidepressant. so be cautious in this regard. because once one mania occurs it will reoccur.

better check with a psychiatrist but as i said don't take an AD alone. Of course this is the test, but not advisable You can have only some mood swings.

my pdoc dx me OCD and i was taking AP's along my AD once i stopped the AP turned manic and became clinically BP with all the complications of mania then depression then mania rapid cycling and all you hear about afterwards

good luck

[hell1971]

That is how I got diagnosed, I was depressed for a long time / overwhelmed, I went to my gp and took an antidepressent then I went hypomanic in four days then when I came of the antidepressant I still carried on escalating into mania I was given meds and the rest is history as they speak. i sat down last night and wrote what I think hypomania is to me but I still feel my mind is fragile and easily influenced, so im not sure if im making it fit, that i talked myself into this reaction. im so confused again, it has really upset me and i feel it has taken me back a few steps.

[adel_ezz]

I am glad I was able to dx you

BP is not easy to dx and can TRICK the best of pdocs (wikipedia). The subject also is controversial (done some research in this) so whereas Akiskal et al (famous researcher in BP) consider those who become manic under an antidepressant (antidepressant induced mania) NOT BP pts (calling them cyclothemic or mild bipolar or BP3) others consider them BP. Why because the meds ARE the same. The story is simple the illness starts as follows

1. depression because no hypomanic consults a pdoc as a matter of fact some enjoy
    it, but it's the depression which send them to pdocs.
2. now the pdoc cannot differentiate between a unipolar depression and a bipolar
   depression (not exactly his fault) so he gives the pt an AD, especially you went to a
   GP
3. the pt turns manic

so the classical cycle becomes:

depression->AD->manic->antipsychotic (to stop the mania)->crash into depression again (unless you make a smooth landing but not often) etc.. etc..….

Now once the mania occurs it will REOCCUR again and that is the danger involved, mania is a DESTRUCTIVE phenomenon each time it occurs the brain loses something (in my view) it's like an insulator that becomes a conductor under a heavy surge (voltage) – I am an engineer. So the idea is NOT whether you are originally BP or not, that is NOT important, but the important thing is to stop the above cycle i.e. to break the chain to reduce the brain damage. i.e. try to avoid the mania

For example I was dx OCD at first taking risperidone (an AP) and an AD, I stopped the AP for a while so i turned manic under the AD. My brain changed and got mania several times later even under AP's. Your brain becomes weaker and vulnerable.

Now I've posted before here saying that if the above cycle can be broken somewhere, then one can with confidence say a farewell to bipolarity. But how can one do this?

Now the classical approach is to give both an AD and to cover it by an MS. That is the usual worldwide trend especially with BP2 as depression is pronounced, so in general you need an AD. I am however in favor of 2 other approaches (after some thoughts) as MS usually contain serious side effects and still under an AD you CAN at times become manic/hypomanic even under MS.

1. either to give lamictal only in substitute to the AD to lift depression, true it's an MS
   but having the least side effect between all the other MS. Usually you give along an
   AP antimanic like seroquel
2. to watch for the depression by giving the weakest AD in order not to get mania
   because if you give an AD and not become manic it's finished you are a unipolar only,  
   and BP is gone. Now all the AD's bring mania, right now I am trying stablon a
   French one non-existant in the English speaking countries. Till now I didn't turn manic
   and am adding 50 seroquel.

So in your case whether with an AD or not you've become hypomanic, you have to stop the above cycle i.e. not to have another mania (the world couldn't find till now another way except through an MS). Unless you can lift depression without an AD, gymnastics, st john's wart (they say it can bring mania also), have a love affair (am joking) try innovate on this, etc... because if you lift depression without an AD, then you are cured from BP. If you find a way please tell us.

Good luck  

[Twelvesgirl]

I know I'm late! But I just want to comment too!
I know that you have been diagnosed 3 times over. I'm not sure I understand if Adel ezz is using sarcasm or what, I don't understand. I have also been diagnosed 3 times, because I was in denial. I feel that when this is the case, and we are being completely honest, the psychiatrists are probably the people to count on. Unless someone has had a hypomanic experince they will never truly understand what it is like. For her not to "believe" in it seems quite uneducated to me. I have had people still tell me constantly that I'm not BP and every time I feel like well maybe I'm not. Maybe I should just go off my meds and move on. I can only imagine how I would feel if my therapist told me that I wasn't. Of course you're stressed, I'm stressed everyday, but your not going to be thrown into mania or hypomania everyday. I don't know why, but for me it just doesn't happen. One day, many months from now, probably years, it will, my brain will just say "OK, its time". I think I would just change therapists if possible, and not worry about hurting the original ones feelings. Its not good for you to doubt the diagnosis, that is what makes people go off their meds, or atleast that is what has made me go off my meds in the past. My thoughts are with you right now, and I'm so sorry you are going through this, I'm sure it is so hard on you. Best wishes.

[hell1971]

Thanks for your comment, im like in too minds, one minute I know I am then the next im in doubt and think I will tell my doc I want to come off my meds, it really has put a spokes in the works and put me a bit back. I sat and wrote everything I thought hypomania means to me, I would very much like any comments, I have decided to have a week off from her to get my head straight before I see her again. Sometimes I wounder if my mind is just vunerable and somehow I have made the shoe fit, I definatley had some sort of mental breakdown, no one disputes that, have I just been manipulated into beleiving it and made my behaviour tag to a symptom. ahhh im so confused.

Here goes - what I think is hypomania to me

Dont sleep - Dont need sleep, not tired, wait in bed getting frustrated I cant get up and get on a do stuff.

High energy always start big projects and at same time complete lots of little projects in between flitting from one to another, cant stop even if its raining, dark or midnight, get annoyed if anyone tries to stop me

sexual desires - have increased sex drive, have sexual desires even if I dont act on them, say sexual inapropriate things to other men and become reall flurty

24/7 thinking im aware of my mind, doesnt stop, its like constantly talking to myself, cant concentrate, have rehearsal conversations I may or may not have

urges to shop - shop for my projects - become very generous and shop for gifts for others - even when I clearly cannot afford it.

Driving - Drive really fast - normally I drive like a Nanna

Sense of Humour - Laugh at things people dont find funny or is exagerated
                             say innappropriate things

Obsessive become obsessed about the house - start sorting drawers cupboards etc..
     Obsess over what ever project or thoughts im having, read everything I can about it, go online etc..

Get creative have heaps of ideas, start sewing only sew when im in this state, become highly motivated

Excitement I get an excitement in my tummy and I feel like I will explode

Organisation  Become highly organised and plough through stuff, then all turns to custard and I start to fluster feel like someone else is controlling me bump into things because im not calm, bull in a china shop
become dyslexic, transpose figures and letters, normally quite capable

then panick sets in, become anxious,paranoid, flicky and think I see things moving around me that dont exsist like a mark on the wall suddenly looks like a bug and moves

Then Depression - well we all know what thats like so I dont really need to explain but I can usually tick all the boxes for that

that will doo, im sure theres more but thats what I could come up with

    

[CrzyBeautiful1]

All of that stuff u just explained sounds like me. In fact, there were things u just described that I actually have or do, and I never would have associated it to BP. Never thought the BP makes me do that.

I would find a different therapist, IMO. You have been dx'd with BP, and talking to a therapist who doesn't agree with that dx only confuses a person with dx...hence the reason ur posting this. I haven't been dx'd yet, but I'm willing to bet ANYONE $1000 that BP is what I am. My pdocs in the past have all told me I seem to have it, but I totally brushed the idea off once mentioned, and so apparently they did too in good faith I knew what I was talking about I guess. (I can sound really convincing at times). I too was having problems with my therapist believing that my mood swings and all my silly feelings I experience were part of just "stress". I told her I knew it was more than this, and if I was just stressed, then why do I, all of a sudden, do a 180 and flip out for no reason, when everything is going good.  

The thing is...if ur therapist doesn't believe in BP, then she is going to be giving u insight and advice based on whatever she thinks u have, and we all know that coping strategies for someone who is simply stressed, isn't just going to work for someone who is BP. I get sooo mad when someone tells me, "Just take a deep breath and count to 10 and that will calm u down."  Well I don't know about u guys, but thats a joke to me! Once I'm off my rocker, theres no stopping me. I have tried EVERYTHING. I just have to let it run its course. Mind u, I haven't been dx'd yet and am not on the appropriate meds...only AD. BTW...reading this post has given me a lot of helpful info, because I've been given ADs all my life, and I've noticed, and was just making a comment to my family the other day about it, that my hypomania has gotten so much worse over the years. And not the good mania, they one where I'm on fire and extremely hot tempered and finding things to yell about. <--- (assuming that is also hypomania).

Anyway, I'm rambling again. Think of it this way...In physical health, its important to have the right dx, because u have to be on the right meds for it and the right treatment path. (U wouldn't want to take a pill for an overactive thyroid, if u have an underactive one, etc...).  So the same rule applies with mental health. You need to be talking with a therapist who is familiar with BP and what UR specific needs are. Good luck and I hope it works out.

[hell1971]

Thanks for responding, good luck with you getting the right dx as well.
My therapist said she cant say im not bipolar because she didnt see me when I was apparently manic but that because of my childhood she thinks I have triggers from back then that make me act the way I do and it may be my way of coping with stress, I know this is plausable but it doesnt aswer why my mood flips when I have no reason for it I guess. I know that the docs must be right they saw me when I was really in the brink of it and it wasnt flash so I know in my heart I will stick with what the docs say over her as I dont want to risk my family.

[CrzyBeautiful1]

I know how u feel because I too am very easily persuaded. VERY easily. And what ur therapist is very true in some cases, but if u've been told by a pdoc that ur BP, then u most likely are. She just needs to go with what ur pdoc says and not be suggesting different to u. Things like that persuade us easily, and make us feel like we're not being taken seriously. Sounds like ur on the right track of doing the best thing though

[adel_ezz]

of course i am NOT using sarcasm. how can i in such a serious subject and i see someone suffering like we all do.

i'm just saying diagnosis of BP is tricky even to pdocs. 2nd, hell1971 described hypomania correctly. most probably she is BP2 (more than 50% of all BP are 2, BP1 get mania mainly and sometimes with psychosis). 3rd, better not to experience several of these hypomanias to save the brain. 4th about the meds also is difficult to chose. of course it's the pdoc business not ours. but one has to discuss it with them because pdocs sometimes use trial and error and we see this very often in different forums

thx

[hell1971]

Thanks all so much for responding, I feel great support when I come on here and I really needed it, to talk through what I already new, I feel very supported thanks again