• 💖 [Donate To Keep MyPTSD Online] 💖 Every contribution, no matter how small, fuels our mission and helps us continue to provide peer-to-peer services. Your generosity keeps us independent and available freely to the world. MyPTSD closes if we can't reach our annual goal.

Bipolar A dual diagnosis - bipolar with ptsd - seeking advice

Status
Not open for further replies.

linasmom

MyPTSD Pro
Hey guys,

I know it's been awhile - I hope everyone is doing okay. I wanted to find out if anyone here, after being diagnosed with PTSD, has also been diagnosed with bipolar disorder AFTER their PTSD diagnosis.

Here's the backstory - basically, nothing has changed for me. The last three weeks I was experiencing suicidal ideations every day. I couldn't get a therapist to call me back (I stopped seeing the one I was seeing earlier last year). My only option at this point was to go to the Psych ER because I knew something bad might happen if I waited another day. So - I go there, and they spend hours assessing me. Obviously, I told them that I have complex PTSD. However, the psychiatrist there diagnosed me as having bipolar disorder, as well. She explained several reason why - (one of them being that I hallucinated on Wellbutrin and it is supposedly well known that certain antidepressants "unmask" mania in bipolar disorder).

So, anyway - I'm just not sure what to think. I mean, we all know that the symptoms of both bipolar and ptsd mirror each other. I just don't know what I should believe. The psychiatrist said she is not debating my PTSD diagnosis but that she believes I have bipolar, as well.

She wrote me a script for Lithium and I've started taking it, along with Klonopin. (bye-bye xanax)

Has anyone else experienced this, and if so, what became of it.
 
Oh, I should probably also clarify - This is my first time seeing an actual psychiatrist. My CPTSD diagnoses all came at the hands of therapists, not psychiatrists.
 
Oh, I should probably also clarify - This is my first time seeing an actual psychiatrist. My CPTSD diagnoses all came at the hands of therapists, not psychiatrists.

linasmom,

Sorry for what your going through, no one needs another diagnosis. What's most important is do you feel it's right? I just want to draw your attention to the word "unmask" bipolar. I think if you research this, you will find three important facts:

1. Antidepressants can cause a manic episode (therefore not unmask it) So if someone who is bipolar takes an antidepressant, that antidepressant can cause the person to go from a depressive episode to a hypomanic or even manic one.
2."Certain other medications can produce a “high” that resembles mania. Appetite suppressants, for example, may trigger increased energy, decreased need for sleep and increased talkativeness. After stopping the medication, however, the person returns to his normal mood." Wellbutrin is an appetite suppressant. (When I was on wellbutrin, it gave me all the above)
3. you cannot be diagnosed with bipolar if you have not had a manic episode. See DSM-IV

I think you will find the above three facts well adopted by the psychiatric community.
So, how is it possible that someone with complex ptsd can be diagnosed with bipolar while on Welbutrin? Should not the welbutrin be stopped to get an accurate baseline for the assessment? How can they say for certain what is pathological and what, if anything, is being driven by the Welbutrin? (and what about what the ptsd is contributing as you pointed out)

Sorry, but I think I would get a second opinion.

Cec
 
Cec,

Thank you so much for responding. I have had a manic episode - in fact, quite a few in my lifetime. These manic episodes are a direct result of my impulsive personality - something I thought, again, was a reaction/symption of CPTSD. I've also "rapid cycled". However! I've been under the impression that mania is also a symptom of PTSD - do we not just call it "hyperarousal"? Maybe I'm confused. I guess I've been under the impression that my drastic mood swings were a direct result of my Complex PTSD.

I am no longer on Wellbutrin, in fact, I quit taking the med immediately after experiencing the hallucinations. Up until yesterday, I haven't been on any meds in 6 months.

The main question is: Do I feel it's right.

Unfortunately, I don't know. I'm SO confused and frustrated and angry and just, exhausted. I dont' know who to trust anymore. I trusted my doctors to prescribe me medications taht would help me - and after taking almost every antidepressant on the market with no progress, I took myself off. I'm also most appreciative of the information regarding antideppressant withdrawal that was not provided to me when the prescriptions were written - but I digress.

The answer is: I don't know.
 
I had BiPolar disorder before my PTSD Diagnosis. Manic events and hyperarousal are two different animals.

Mania includes fast talking, inability to concentrate, hypersexuality, spending sprees, loss of impulse control, difficulty sleeping and/or staying asleep, irritability and impatience. For me the elevated mood is more than just "feeling good" it is feeling on top of the world. Like I am super woman, the life of the party, the "it" girl that everyone wants to be friends with. These are all classic charecteristics of mania and I have and them all.

Hyeprarousal includes symptoms that stem from experiencing high levels of anxiety, such as having a difficult time falling or staying asleep, feeling more irritable or having outbursts of anger, having difficulty concentrating, feeling constantly "on guard" or like danger is lurking around every corner, and being "jumpy" or easily startled.

Hope that helps,
SG
 
I was diagnosed with bipolar after my PTSD. I received the diagnosis similarly to the way you did...from a doctor at a psych hospital. The diagnosis followed me and subsequent doctors just assumed it was accurate and continued to treat me accordingly. I do not believe it is an accurate diagnosis. My current psychiatrist, who knows me pretty well as I've been seeing him for over seven years, also disagrees with the diagnosis. He strongly feels that bipolar is commonly misdiagnosed/over-diagnosed.

Whether or not it is an accurate diagnosis for you is impossible for us to know. But I do think you owe it to yourself to get established with a psychiatrist that you trust and get a second opinion. On the surface it may seem to fit without the benefit of truly knowing you and understanding all of your symptoms. If you were to establish a relationship with one psychiatrist who is able to get to know you and the nuances of your symptoms, he may or may not concur with the diagnosis.
 
I was diagnosed with being bipolar BEFORE my PTSD Dx. My current Pdoc says he's not so sure. See, I haven't had true "mania" in the absence of an anti-depressant (even then it was mild hypo-mania). I have, however, been hyperaroused, which is typical of PTSD. I am still on my mood stabilizer because I have horrible problems with mood regulation.
 
I would seriously be discarding a bi-polar diagnosis in conjunction with PTSD unless the bi-polar was absolutely clear before trauma. Otherwise, the two simply have far too many similarities that are confused. If trauma is present, PTSD. If not, more likely bi-polar.
 
I completely understand your position on this, Anthony, and like I said I tend to lean toward bipolar being misdiagnosed. However, one of the problems that comes into play is when a person's PTSD is a result of a trauma that occurred as a young child. Typically bipolar isn't diagnosed until late teens or early 20's (although I believe there is a growing trend of earlier diagnosis but I don't know how much I really trust the reliability of such situations). Just because someone has PTSD does not mean that they cannot have bipolar but the symptoms of the two become so inextricably mingled that it can be nearly impossible to sort them out. It definitely requires a psychiatrist that knows the individual well and has a good deal of experience treating both bipolar and PTSD.

I'm not disagreeming with you, per se, just pointing out that it's not nearly so cut and dry.
 
cat- those are my exact feelings about it, as well. My first big trauma occurred when I was eight, and I started showings signs of CPTSD around 12 years of age. There's no way for me, or anyone for that matter, to ever truly know if I had bipolar disorder prior to the onset of my CPTSD.

My therapist in Florida, who was fantastic, thought that my mother suffered from bipolar disorder - obviously, we can not take this as "fact" because my therapist never SAW my mother. But, this just adds another little layer to this issue. People whose parents suffer from bipolar disorder are 6 times more likely to develop the disorder themselves.

Almost all of my "manic" episodes have occurred while I was not "under the influence". HOWEVER! I do not know if these "manic" episodes are actually caused from bipolar disorder or CPTSD. Impulsivity and Irritability are both symptoms of "mania" AND cptsd. If you look at the diagnostic requirements for bipolar disorder, irritability is a substitution in the manic field:


  1. A distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days, that is clearly different from the usual non depressed mood.
  2. During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:
These reasons were given to me by the Psychiatrist. That's not to say I believe it. I'm just saying that I'm not going to fully dismiss the idea.

This is so very complex and confusing for me right now.
 
Cat, I actually agree with you, and was trying to say something similar. Yes, you can have it, though 99.99% unlikely if it wasn't present prior to trauma. There are people here who where diagnosed Bi-Polar prior to PTSD, then PTSD after a traumatic event. Their lives are often quite hectic, more so than a person with just PTSD even. I totally agree with what you are saying, though I do not believe it to be the case here because it is now only one physicians opinion vs. the professional opinion of other physicians prior. If the overwhelming opinion was both, I would go with that. When one goes different from the others and is alone on their opinion, I would steer with the majority all the time as they are more often to be 99.99% correct.

It is very common within the world of physicians to misdiagnose PTSD with Bi-Polar... it happens every day. I have spoken with some leading specialists on this from around the world to whom they advised me that unless Bi-Polar is diagnosed before trauma, it would be near impossible to actually give such a diagnosis in conjunction with PTSD because the two are simply far to identical. The consensus I believe is to treat for the worst, being PTSD, and if it is the lesser of only Bi-Polar, then that diagnosis would be downgraded and treated specifically at that time. I believe it to be quite rare though that a person would have both, being more it is misdiagnosed than actually correctly diagnosed.
 
Bipolar???

I was diagnosed PTSD 1.5 yrs ago then Bipolar about 8 months ago. This diagnosis is comfired by both my Psyciatrist & councelor. Stress triggers bipolar symptoms {deppression or mania} what is stress PTSD. Your right, from what I've learned they do mirror each other I call that feed, trigger and look alike. Both have like symptoms and for me either or can trigger the other. I stongly feel their right however. I have a great book Take Charge of Bipolar Disorder- a 4 step plan for you & you loved ones to manage the illness and create lasting stability by Julie A. Fast & John Preston, PsyD.

How's the Litium going an what dose? I take 300mg am & 750mg pm I think it helps. I don't know much about the wellbutrin so can't help ya there.

Most peolpe are misdiagnosed for years. Bipolar [DSM-IV} has more than just depression & mania{2 types} there are other common symptoms anxiety,anger & ADHD just a few. There are also different types of Bipolar I, II, III still all are affected by stress{PTSD}.

write if you have any ? any time
Thank You lilcuda1
 
Status
Not open for further replies.
Back
Top