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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by chand2407 on November 9, 2005, at 22:54:52
i do have mood swings i be happy one time and depressed the next. i have racing thoughts all the time but the particular very serious racing thought was from the mix of two meds that did not mix. at the age of 11 i have been withdrawn from people. i know i have social anxiety. but i wonder if i have some bipolar and psychotic depression mixed in there. how can my psychiatrist tell. i need the right diagnoses. please help. it like i want things to be done my way and if not i get mad. i get mad at other people for my mistakes.
Posted by Racer on November 10, 2005, at 12:35:33
In reply to i could be bipolar please read, posted by chand2407 on November 9, 2005, at 22:54:52
Take a deep breath now, and repeat after me:
"I am the Patient. I am not the Doctor. It is not my job to tell the Doctor my diagnosis, nor to prescribe my own Treatment. That is the Doctor's job, and it is OK for me to let him do it."
I've read a lot of your posts, and it looks as though you're trying to figure all this out, and that's great. While it's a subject of debate, I think it's better to be involved and informed as a patient, rather than simply relying on a doctor to make every decision. On the other hand, it can be taken too far, and that can have negative consequences for us.
By the way, I do the same thing, although I'm trying very hard not to.
As for your question, the answer isn't as straightforward as it might be, because diagnostics is an inexact science. Right now, there's a growing sense amongst psychiatrists that ALL patients with both depressive and anxious symptoms are actually bipolar. Thankfully, there are still some hold outs who say that those are two separate conditions. Whether your doctor decides that you are bipolar, or both anxious and depressed, will likely be affected by where he stands on this debate. The bottom line, though, isn't so much what your diagnosis is, but whether the treatment you receive for it is effective. And the treatments for both have a lot of overlap.
I'm pretty definitively diagnosed with both anxiety disorder and depression, and my doctor has talked about trying things like Lithium, rather than anti-depressants. He says that it can be quite effective for unipolar depression. It could be that you respond well to a treatment generally used for one, despite a diagnosis of the other. What's more, the anti-psychotics are very useful for anxiety symptoms, so whether you're truly psychotic, or suffering very severe anxiety symptoms may not matter much, either.
Remember: Give the doctor a chance to do his job, and let the effectiveness of the treatment trump the diagnosis. Good luck.
Posted by chand2407 on November 10, 2005, at 14:39:10
In reply to Re: i could be bipolar please read » chand2407, posted by Racer on November 10, 2005, at 12:35:33
thanks so much for the information you are definitely right
Posted by xjs7 on November 10, 2005, at 15:56:18
In reply to Re: i could be bipolar please read » chand2407, posted by Racer on November 10, 2005, at 12:35:33
Hi Racer,
You may be right about diagnosis not being that important in the mental health field 95% of the time, but sometimes it is extremely important--literally a life or death situation. For example, take my case. I presented to a psychiatrist in 2001 with auditory and visual hallucinations. I was diagnosed with schizophrenia and put on an antipsychotic. Well, there were these periods where parts of my body would jerk around. So, in trying to diagnose myself, I decided that I might have partial seizures. So I went to a neurologist, and had an MRI. Well it turns out I had a rare brain tumor that causes psychosis, a rare kind of seizures, and a lot of other symptoms. Now, this tumor was benign and would never have killed me. But what I am saying is that if I had had a malignant tumor, being diagnosed with anxiety and not searching out for the correct diagnosis could have lead to death. I too play doctor but in my case this really helped me. I encourage all patients to seek the right diagnosis. This will take years (unless you get better), but it is necessary. If I had just kept going to that psychiatrist who diagnosed me with schizophrenia I would still be having partial seizures all day and be even more disabled than I am now.
And, another data point--the antipsychotics work great on me. But, I do not have schizophrenia, bipolar disorder, or major depression. I am all in favor of this poster taking her antipsychotic, but she needs to determine the true cause of her symptoms. In my case no doctor could do that.
xjs7
> Take a deep breath now, and repeat after me:
>
> "I am the Patient. I am not the Doctor. It is not my job to tell the Doctor my diagnosis, nor to prescribe my own Treatment. That is the Doctor's job, and it is OK for me to let him do it."
>
> I've read a lot of your posts, and it looks as though you're trying to figure all this out, and that's great. While it's a subject of debate, I think it's better to be involved and informed as a patient, rather than simply relying on a doctor to make every decision. On the other hand, it can be taken too far, and that can have negative consequences for us.
>
> By the way, I do the same thing, although I'm trying very hard not to.
>
> As for your question, the answer isn't as straightforward as it might be, because diagnostics is an inexact science. Right now, there's a growing sense amongst psychiatrists that ALL patients with both depressive and anxious symptoms are actually bipolar. Thankfully, there are still some hold outs who say that those are two separate conditions. Whether your doctor decides that you are bipolar, or both anxious and depressed, will likely be affected by where he stands on this debate. The bottom line, though, isn't so much what your diagnosis is, but whether the treatment you receive for it is effective. And the treatments for both have a lot of overlap.
>
> I'm pretty definitively diagnosed with both anxiety disorder and depression, and my doctor has talked about trying things like Lithium, rather than anti-depressants. He says that it can be quite effective for unipolar depression. It could be that you respond well to a treatment generally used for one, despite a diagnosis of the other. What's more, the anti-psychotics are very useful for anxiety symptoms, so whether you're truly psychotic, or suffering very severe anxiety symptoms may not matter much, either.
>
> Remember: Give the doctor a chance to do his job, and let the effectiveness of the treatment trump the diagnosis. Good luck.
Posted by Racer on November 10, 2005, at 18:00:09
In reply to Re: i could be bipolar please read » Racer, posted by xjs7 on November 10, 2005, at 15:56:18
You make a really good point, and I agree that all physical causes must be ruled out before diagnosing a mental disorder, and that as patients it's in our best interest to be informed.
In this case, I was basing my answer largely on having read many of chand2407's earlier posts. It seems as though much of his/her anxiety right now has a focal point right around the drugs/diagnosis, and feeling as though he/she has to make the diagnosis and treatment decisions on his/her own. While, again, when it comes to a drug that is going into our bodies, it just makes sense to do some research on it, it's also not our job to do all the work and present it to a doctor. Sure, doctors are wrong in real life, but it's still in our best interest to let them give it a try, isn't it?
Besides, I've had troubles of my own due to trying to work out what the problem is on my own. If I can help someone else benefit from my hard-earned knowledge, without having to experience the sort of difficulties that I have, then I'm gonna offer that advice.
So, we agree, and we disagree, I guess. I'm very, very glad that you had that scan, and that the tumor is benign. Have you had it removed, or are the seizures being treated with medications?
Posted by Phillipa on November 10, 2005, at 19:18:41
In reply to Re: i could be bipolar please read » xjs7, posted by Racer on November 10, 2005, at 18:00:09
Racer you make a good point. I will be posting my own Thread below about possibly being Bipolar ll. Fondly, Phillipa
Posted by xjs7 on November 10, 2005, at 23:38:32
In reply to Re: i could be bipolar please read » xjs7, posted by Racer on November 10, 2005, at 18:00:09
Racer, my neurologist told me a story about a man who had dizziness. He went to his neurologist and the doctor told him it was probably nothing and wouldn't do anything. Well this man felt there was really something wrong. So he went to one of those places where you can pay for an MRI personally. He had the scan and it revealed an acoustic schwannoma. It was malignant and he would have died if he had not taken the initiative and done the scan. Ruling out medical causes generally involves inspecting the person's arms for needle tracks. At least that's how my doctor "excluded" medical causes. To get my referral to see a neurologist, I told my doctor "I want a referral." I did not ask him his opinion, but he offered it anyways. He thought my seizures were drug side effects. Never mind that the drugs I was on almost never cause seizures.
xjs7
Posted by gardenergirl on November 11, 2005, at 17:17:03
In reply to Re: i could be bipolar please read » Racer, posted by xjs7 on November 10, 2005, at 23:38:32
> Ruling out medical causes generally involves inspecting the person's arms for needle tracks. At least that's how my doctor "excluded" medical causes.
Sounds like your doctor did not do a very thorough exam. Sounds like he formed an opinion based on your history (?), that colored his perceptions from that point forward. That's a shame. Checking a person's arms for needle tracks is not even close to completing a phsyical exam.
gg
Posted by chand2407 on November 11, 2005, at 20:07:48
In reply to Re: i could be bipolar please read » xjs7, posted by gardenergirl on November 11, 2005, at 17:17:03
please read my comment to you at the bottom on lunesta please read
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