Shrink Advice

[Kb3]

Like a lot of other people on this forum I have had multiple diagnoses over the years. First it was generalised anxiety and mild depression, then it was post partum depression and then, on the DX of one psychiatrist who I went to with mild depression and insomnia it became bipolar II.

I didn't know what it was at the time frankly, and I would have gone for a second opinion if I had. The last DX has caused me enormous difficulties in every area of my life. It is not accurate, I have never had a manic episode without being on multiple, extremely high doses of meds, including over the prescribing levels of two antidepressants at the same time.

I thought I had shaken the BP DX with my last psychiatrist. He has verbally agreed with my self DX of anxiety and depression for the last three years, reassuring me that I was overmedicated and only saying that some people are prone to multiple episodes of depression over their lifetime and that I would probably have to stay on meds for my life ( I didn't agree with him on that but kept my mouth shut). I have told him a little about my last trauma and alluded to my less than ideal childhood and even brought up PTSD w/him last winter. He accepted what I said without argument.

Imagine my surprise when I asked him point blank what my DX of record is about two months ago. Bipolar II was his answer.

So he has been humouring me for the last three years, and seems to be under the impression that 75mgs of Seroquel has been controlling bipolar disorder that three years ago was being treated with a combination of six medications including an antipsychotic and two mood stabilizers! WTF!!!??!!

As anyone involved with the psychiatric profession knows, it's very difficult to argue with a shrink - it's usually regarded as proof of your DX. My question is, how can I get the correct DX on my record when I go for my FIFTH opinion? It has stuck to me like glue, and I'm sick of being mislabelled. It has legal and medical implications for me and is wrong. Any advice on how to proceed will be very gratefully accepted:).

 

[anthony]

Four psychiatrists with the same diagnosis... that is a little more than possible misdiagnosis, and instead possibly on your part of what you think you have vs. what you do have.

Second and third opinions are warranted, absolutely... but if you get the same diagnosis across four psychiatrists, then I think that is safe to say that its accurate and possibly you're chasing something that four doctors don't believe you have.

Bipolar is often misdiagnosed for PTSD, yes... but you are talking singular traumatic events typically and if you have told them all the same thing, what has happened, etc... and they have all assessed you the same, that is a little more than coincidence IMHO.

Just because you have trauma, does not mean you have PTSD. It is a rare minority that actually get lifetime PTSD from trauma... and that trauma is typically long duration, ie. severe and complex ranges, not just normal old PTS that is classified as PTSD after experiencing abnormally traumatic events, that goes away mostly by itself over the following six months without any intervention... a minority requiring intervention for it to go away, and then a minority again that actually endup with it as lifetime of those diagnosed with PTSD. That is a really small number globally overall.

 

[Kb3]

Four psychiatrists with the same diagnosis... that is a little more than possible misdiagnosis, and instead possibly on your part of what you think you have vs. what you do have.

Second and third opinions are warranted, absolutely... but if you get the same diagnosis across four psychiatrists, then I think that is safe to say that its accurate and possibly you're chasing something that four doctors don't believe you have.

Bipolar is often misdiagnosed for PTSD, yes... but you are talking singular traumatic events typically and if you have told them all the same thing, what has happened, etc... and they have all assessed you the same, that is a little more than coincidence IMHO.
.

Thanks for your comment Anthony, but I respectfully disagree. I am from the US and the criteria for diagnosing bipolar disorder is "loose" to say the least. The psychiatrist who originally dx'd me runs an insurance and pharmaceutical company pill mill and has a reputation far and wide for diagnosing virtually everyone with bipolar disorder of some flavour(it's a spectrum!) based on a 15 minute assessment. That I accepted her diagnosis in the first place speaks of my tremendous naivety about the psychiatric system in the US.

Once you have that DX, it sticks, whether you are symptomatic or not. I have certainly been depressed and anxious since then, It has been years since I have had a "hypomanic" episode, which I mentioned was almost certainly drug induced, and only occurred after I had been given this very questionable assessment. I had NEVER had anything happen to me like that before becoming completely overmedicated.

I suffered abuse as a child which I believe interfered with my ability to regulate my emotions and killed my self esteem. The psychiatrist who dx'd me with bipolar never asked a single question about my past, and I didn't tell her, thinking it was unimportant. None of the following four asked either, with the exception of this last one who asked in a superficial way during my assessment with him. He was taking over my case from his colleague who was subsequently struck off the UK registry for gross misconduct. I believe that it was in the facility that I was being treated at best interest to keep my DX the same to avoid any legal exposure should I want to sue for mistreatment.

So I certainly believe that it is quite possible that I was misdiagnosed originally and the DX was kept by subsequent psychiatrists for either an abundance of cautiousness or possibly laziness or outright apathy in at least one case.

The reason I believe that I have full blown PTSD is because I was wide awake during major surgery three years ago. It was a terrifying experience which has resulted in virtually every symptom on the list, all of which remained active for a couple of years longer than a PTS DX warrants. I have only had relief using Somatic Experiencing in the last seven months and a fractional amount of medication to help me sleep. It has never been prescribed in doses which would be considered mono therapy for bipolar disorder of any sort.

I should also add that three therapists with the last three years have agreed that I do not have bipolar disorder, and two that were treating me for trauma specifically have concurred on the PTSD DX. The reason that it is important for me to have the correct DX from a psychiatrist is because that is what appears on my medical records with my GP.

So I appreciate what you are saying, but I don't believe that it applies to my case. If I go for my next assessment and tell them everything that has happened to me over the course of my life and how I have reacted to it, and still walk out with a bipolar DX then I will certainly believe it. Until then, I think I deserve yet another look at my case.

 

[Srain]

Eat0429, I certainly understand your skepticism as far as the psyche drs, Dx's, insurance company coding guidelines, and medications. I've heard this labeling issue before. I've had my share of misdiagnosis myself. I've been labeled many things along the way by several pdocs. It's taken a well trained Trauma Specialist and an engaged Psychiatrist to be able to get the right Diagnosis, this is including my being more open about/with myself and family history.

Being in the hospital with several things going on being passed from pdoc to pdoc I had 2 handfuls of diagnosis I had never heard uttered before. I got out and the next pdoc I saw threw them all out and chose "Bipolish". The next threw that out and called me "Schizoeffective with GAD, and PTSD, Chronic Migraines", the next threw those out and called me"Bipolar I I, GAD", the next "Bipolar I, GAD, Dissociation, Chronic Migraines, ED" and on and on. Each time (and I lost count how many I've seen due to a lot of reasons) a different dr, each time a different fight over meds and diagnosis and what fits.

The system here is about Dx and what $$ that brings in. It's not about the client. I would see a Trauma Specialist to see what their take on the Dx is. My question was answered there. It was then confirmed with my new pdoc afterward. If you have the means, that's where I would go. Just my opinion on it.

((((((((Hugs)))))))))
peace,
Rain

 

[Deaf Global Nomad]

I agree with Eat and Rain on their comments. Here it is not about the patient when you see a psychiatrists (with a few exceptions to the rule). Most psychiatrists get old records from the previous psychiatrist, and throw in additional diagnoses that warrant more prescriptions. If you go into any larger clinic around the lunch hour, you will see lunches served by different prescription medical companies for the psychiatrists. I have been extremely lucky with my prescriptions and I guess I only stay with doctors who listen to me. I have friends though who leave with boatloads of different meds for years. Those meds differ drastically depending on who is prescribing. One friend was not given a medication because the new psychiatrist only prescribed meds from one specific company. I'm not sure how this kind of stuff happens... It seems way more outrageous in real life than portrayed in any of the documentaries or mockumentaries...

 

[Kb3]

Thanks Rain and Deaf Global Nomad, I appreciate you sharing your experiences with the American psychiatric system. It is pretty dismal.

DGN, I have had my charts follow me around two countries (remember the Seinfeld when Elaine is labelled "difficult" by her doctor and finally ends up in a vet's office for treatment? That's me).

Rain, thanks for the suggestion, I agree that I need to be assessed by a trauma specialist. I need to find a good one in London and am not sure who will be best. I didn't see one listed on this site, but will check back periodically. I will also ask my GP, but have little confidence that she will know one.

Like I said, if it didn't affect me medically and legally I wouldn't even bother pursuing it. My confidence in psychiatrists is subzero, especially after this last winner basically lied to me for three years. I'm getting to the point where I am resolving my issues and am having less and less need for medication, which means less and less dependence on these quacks. I am convinced that that is truly the way forward. Wish me luck:).

 

[Srain]

Eat, I keep my set of own records now due to this issue.

Luck! :)

peace,
Rain

 

[le020]

I agree with the above, you should keep records. I even do this with my general doctor and track everything myself from my core temperature to what medications I take during the year, and their affect upon me. This proves helpful when changing doctors! However, I do distrust those who claim authority on a diagnosis as the medical assumptions are not always correct. No one can know your more than yourself, so keep diaries. I have friends studying masters in psychology and medicine and I know that they even have their own anxieties and personal problems in regards to their health! I do not ask them for help because I prefer to keep these things to myself, online or in a diary.

 

[Deleted member 1860]

Technically, you have NOT gotten a second, third or fourth opinion as the psychiatrists you subsequently consulted with knew about your previous Dx. To get a TRUE, UNTAINTED second opinion you must have a thorough assessment by another doctor and allow them to reach their own conclusion without knowledge of your previous Dx. Why? Because many doctors will just take a previous doctors assessment as given and not question it. This means you dont tell your Dx, and you don't transfer records.

 

[milbert]

I'm curious about what the legal and medical ramifications are of having this diagnosis? It sounds like the medication you are on is helping you.

 

[Kb3]

Legally you have to report a bipolar dx to the driving authority in the country that I live in. You can invalidate your license and insurance without doing so. Insurance premiums are also harder to get, and are more expensive with a bipolar dx as it is seen as higher risk.

Medically I can be treated with high levels of the wrong drugs and be expected to stay on them for long periods of time. Bipolar is virtually always treated with drugs as the first line intervention, with PTSD drugs are used in conjunction with therapies. This issue has been very, very damaging to me in the past. I want to be a compliant patient, but I also need to protect myself from bad practice.

The medication I am on helps me to sleep. I take it voluntarily for my PTSD insomnia, not because I am worried that I will become manic.

I do not wish to be lied to, patronized or have my finances and driving freedom jeopardized. If I am going to a doctor I expect them to tell me what they have diagnosed me with so I can agree or not and take the appropriate steps to manage my life. Humoring me because they don't think that I'm going to like the DX does not qualify as helping me even if the medication that they have prescribed works for my symptoms. That is a happy accident, not good practice.