Common Mistake for Psychiatrist

[trish45590]

I am 45 year old woman. I had been seeing the same psychiatrist for 7 years. He knew that depression ran in my family. He also was aware that I had multiple problems- social inhibition, Trich, phobias, depression in my teens, OCD tendencies. He diagnosed me with GAD. He put me on Effexor. I ended up on 225mg dose. I felt at the time he had done me a great service. I had never felt better in my life. Well, I began seeing a new doctor 2 years ago. I suddenly began rapid cycling. Then, I was stable for a little while. But, I am just now recovering from a 3 month "in the bed" debilitating depression. My new psychiatrist has told me that I have Cyclothymia. She came to that conclusion after 2 years. She said doctors need to be careful with patients when putting them on antidepressants and no mood stabilizer. He also had me on Aderrall. The last 15 mg I can't kick or I go into a depression. Bottom line- Is this a common mistake Psychiatrists make? Misdiagnosing  a patient who has Cyclothymia with GAD?

[shay69]

I have read up before since I was diagnosed being bipolar and it is a common mistake in general practitioners and they may have new guidelines soon to help prevent this.

[Seph1212]

I was treated for depression for years (early to mid 20s) with tricyclics and SSRIs. I'm not sure what they officially diagnosed me with as I never looked at the notes. But the treatment caused agitated depression, mixed states, and hypomania rapidly cycling with depression.

I didn't really have the knowledge or language to describe this correctly to my psych. I also had trich since I was 15. He said I didn't and passed both off as anxiety.

Being young and moving all around, I had a series of psychs. The last one then put me on Depakote, and ta da, better. It's all trial and error more than an exact science, but I think they're getting better...I hope.

Then I avoided psychs for years. Many years later (late 30s) I went to my primary doctor for "fatigue and brain fog". I didn't think of it as depression (probably subconsciously) because I had had such a bad time in the past being treated for it. He ruled out any physiological causes.

I went back, still fatigued and foggy, but I was also bouncing back and forth between mixed states (I tore into his nurse like a monkey on a cupcake) and hyponania. He tuned into this quickly...smart guy. When he found out that I had been on Depakote in the past, he immediately got me in to see a psych ASAP.

She put me on Lamictal, and now my mood is excellent. I still have trich though. Have you had any success on that front?

[Xila31]

It is very common, pretty much the majority of bipolar people discover they are by being on an AD. Adderal can also cause mania because it is a stimulant.

But, there are some like me who go completely undiagnosed for many, many years despite depressions and erratic behavior. I think that although most people will whisper behind their hands about someone being "weird" or "crazy" they won't actually associate it with an illness.

As for doctors, the only doctor to even ask me if I was depressed was a family doctor. I'd seen psychologists, psychiatrists, and therapists before. But, never long enough to give them the chance to actually see what was going on.

[SurfRake]

How common? One study found it's surprisingly common: http://www.bipolar.com.au/new/misdiagnosis.cfm

I walked away from a couple psychs because they made conclusions based on little info or questions, were disorganized, failed to listen, and were even condescending.  The patient-doc relationship in mental health is critical.

Scouring as much information as possible on symptoms, diagnoses, and treatments is a necessity (the internet is incredibly helpful) and the value of trusting your instincts regarding psychs -- and interviewing THEM -- can't be understated.

Glad you've found someone better.

[adel_ezz]

I know you have remorse and regret had you seen another doctor he wouldn't have some such a mistake. And the "if then" is very bad. But half the people on this forum passed through the same experience. I am one of them, i had depression for 6 years and usually pts don't read literature on psych disorder and rely mainly on their pdocs. But the latter are not angels neither they have time to consider other possibilities. I was dx OCD and how come an OCD person suffer depression of course this happens except that my parents kept telling after i take my tricyclics i get hypomanic, but the guy didn't consider this. After finishing college i quit the meds except the AD so i went manic and the rest of the story is known.

So whatever disorder you have, cyclothymia, GAD, OCD, you always have pts ending in mania. I had thought that our docs do such a mistake but never thought it happens elsewhere and especially in the USA. Anyway cyclothymia is mild bipolarity. Keep your fingers crossed that this is your right diagnosis. I just am interested how she concluded this ? it is because you cycled i suppose?

well this disorder is the mildest of the bipolarity disorder and you got it at a later age, so IMO you will stabilize easily. Stick to this new pdoc

good luck