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Bipolar Ii

Incorrectly Diagnosed?

by Kristina Randle, Ph.D., LCSW June 9, 2024

written by Kristina Randle, Ph.D., LCSW

I wonder if I have been wrongly diagnosed. I have battled with my mental health for approximately 11years, Starting off with being diagnosed with chronic depression and post traumatic stress disorder after many years of bullying result in my being beaten up and put in hospital by the bullies. That was when I was 12 years old. As the years have progressed and I have matured I seem to have gone through many different illnesses.
1. Chronic Depression, PTSD and Anorexia Nervosa
2.Severe Depression,Anxiety and Anorexia Nervosa
3.Cyclothymia
4.Bipolar II
Recently I have been diagnosed with A-Typical Bipolar Disorder, Anxiety Disorder, Social Phobia and Recurrent Depressive Illness.

I am beginning to wonder if this recent diagnosis (and many of the past ones) is incorrect.
I have done a lot of researched about my symptoms traits etc and they seem to steer more towards Borderline Personality Disorder.
I will quickly explain me:
Usually I don’t know how I feel, people say “what’s wrong?” and I just don’t know.
I get flustered, and panic, mostly when things change, I don’t like change, I am often very disorganised, but don’t like it I am a very chaotic person.

I switch from one thing to another in a matter of minutes. I don’t like disorder, I think things to be right. I have a massive fear of abandonment, I always think my husband is going to leave me for someone “normal” someone “better”. I always second guess him and myself, my self – esteem is non existant, I have no confidence in anything I do. I don’t like being along, I don’t like doing things on my own, however sometimes all I want is to be left alone – I never know what I want!
I’m sad all the time and want to cry, soemtimes I think people are all against me and are purposly trying to upset me. I have no interest in most aspects of life. I don’t have any friends, or what I was class as “friends” I have being in crowds, I feel closed in and I can hear the blood pumping in my ears.

I’m all over the place. I Spend ridiculously..Usually stuff we/I don’t need but want to make me feel better…My sleep is all over the place..Sometimes I don’t want to sleep and it takes forever to go to sleep but then when the morning comes I don’t want to get up. I eat because I have to (my family make me!) My biggest problem is I’m good at hiding things, I have spent many years putting on a front and seeming “happy and ok” that I don’t know how to be “ME” the real me..I self harmed for nearly 10 years..and the only reason I don’t now is knowing how much it hurts my family…My CPN and Psychiatrist said this shows that my condition is no serious as people who were serious would not be able to control this. But I don’t want to control it, I want to be me and not live up to everyone else’s expectations…I am who I am to suit my family, not to suit me. I hide everything, and to be honest I don’t know how to be me….I have wierd thoughts that no one else seems to understand, I ask daft questions. I hate myself and everything about me. I think I’m worthless and pathetic and that there’s no point to my life. Oh I don’t know I just can not explain anything about me how I feel or anything I just don’t think that I don’t fit in with the Bipolar spectrum..I do have anxiety I know this and I am pretty sure on the Recurrent depressive illness…and as for the social phobia well that could be right….the other problem I have is I don’t know how to say to my psychiatrist I think he is wrong, afterall he’s the professional and in my experience with alot of professionals they don’t seem to care about your opinions only theirs and that what they think is correct…I’m all over the place I just don’t know what to do…I’ve gone from being on 600mg Lamotrigine,5mg Aripiprazole and 2mg Diazepam to 20mg Fluoxetine (with a 12month gap in between when I was pregnant and not on any medication) PLEASE HELP I don’t know where to go or what to say or anything..

Typically I try to steer people away from focusing on a diagnosis. For a mental health professional, it may be helpful to focus on a diagnosis but I don’t think that it is always helpful for the client to search for a specific diagnostic label. Many people simply do not fit diagnostic labels and categories. People are unique and complicated and they may have many issues that do not match a specific diagnosis or set of diagnoses. I urge you to shift your focus on treatment and away from diagnosis.

You mentioned that you are in contact with a CPN (which I take to mean community psychiatric nurse since you are not living in the U.S.) and a psychiatrist, both of whom likely focus on medication as a primary treatment. Medication can be very helpful and has saved the lives of many people. What may be lacking in your treatment plan is that you are not addressing your anxiety, the compulsion to spend, depression, self-harm, PTSD, and the other issues you are struggling with. That is where your treatment needs to focus. Maybe you have attempted treatment for those issues in the past and did not include that information in your letter. From what I can tell you have yet to address those issues.

The solution is to alter your treatment to include therapy. All of the issues that you have written about can be addressed with the help of a competent mental health professional. If you find the right help then I believe you have an excellent chance of overcoming all of the issues you are facing. Thank you for your question. Please take care.

June 9, 2024 0 comments

Torn about Diagnosis of Bipolar II

by Holly Counts, Psy.D. November 18, 2022

written by Holly Counts, Psy.D.

Hi there, I’m torn between accepting or rejecting a diagnosis of Bipolar II. A clinical psychologist diagnosed me with Bipolar II a week ago and now I am under a primary care physician to receive mood stabilizing medication this week. I don’t think I have bipolar disorder though. Can personality not sometimes resemble bipolar? I am sometimes hyperactive and able to take on a 100 projects, feel super smart and pretty and am at the top of my game. I need little sleep and in fact find sleep an annoying timewaster. Then I have times, probably more often, where I feel sorry for myself, feel ugly, stupid and can barely clean my flat or look after my pets. When I’m hyper, I harm no one, I don’t spend too much or gamble or drink or do anything that could be considered damaging. I just work really hard, accomplish a lot (I work fulltime as a project manager, am a freelance educational writer and am in the third year of a science degree for which I have had 18 distinctions so far). When I am down, I do feel very sad and think of killing myself every now and then, but I would never kill myself as I know logically this would be stupid and that I always feel better again. In my mind, I am just a highly functional individual who is able to achieve a lot, use my time to the max, sometimes feeling on the top of the world and sometimes not. I’m used to feeling like this and I have all sorts of coping mechanisms around it. I am completely alone, no family and few uninvolved friends, so my state of mood never affects anyone. I also have no support structure should it really be bipolar and should I need help. I don’t understand why I should go on mood stabilizers and antipsychotics. I’ve had no breaks with reality, just a few very minor private breakdowns where I have cried a lot. But I got over those and I was just overworked and under a lot of pressure and it didn’t affect anyone other than me. What do you do when you are torn between accepting a diagnosis and thinking it is total nonsense? I change my mind at least 20 times a day. I can’t imagine I will be able to be compliant with taking medication or accepting help. (age 38, from South Africa)

Based on what you have described here, I tend to agree with the diagnosis that the psychologist has given you. It does sound like you meet the criteria. Most people experience some ups and downs, and yes, some personalities can include some opposing traits and tendencies, but the swings that you mention here do hit some of the classic extremes that are included in Bipolar Disorder and/or Cyclothymic Disorder.

However, just because you meet the criteria for a disorder does not mean that you need to be medicated for it (or even treated). If you feel that you truly have the coping skills already in place to manage your mood and energy changes, you don’t have to pursue further treatment. But the fact that you consulted with a psychologist in the first place and state that you don’t have a support structure to rely on, indicates that you could at least benefit from the help of a therapist.

Most people with Bipolar love their highs and hate their lows, so you are not alone in this aspect. Deciding how much the mood changes impact your life and your ability to function, as well as affecting your “quality of life,” will help you with the decision to medicate. Mood stabilizers will not change your personality, they will level out the highs and lows so that you have more consistency in your state of being. But you have every right to seek a second opinion if you are still struggling with the decision whether or not to pursue further treatment. I hope this information helps.

All the best,

Dr. Holly Counts

November 18, 2022 0 comments

What Is Partial Hospitalization?

by Kristina Randle, Ph.D., LCSW September 5, 2011

written by Kristina Randle, Ph.D., LCSW

How do I know if it’s really necessary? I have Bipolar II and am on a mood stabilizer (Trileptal) and a small dose of an antidepressant (Lexapro.) I’ve been having a very rough time with depressive symptoms over the last few months – it started with just not being interested in anything, sleeping a lot, and eating a lot, and got up to crying at the slightest provocation and bouts of leaden paralysis.

At my most recent psychiatric appointment, I asked for an increase in my Lexapro dose, because it makes the most sense to me (I’ve been on doses up to 2.5 times what I was on at the moment, with no clear manic symptoms.) But my psychiatrist asked instead if I’d be willing to enroll in a partial hospitalization program.

We’re going to talk more about it at my next appointment, because we ran out of time. But I’ve been looking online at partial hospitalization programs in my area, and I’m confused. What are they, really? They sound like they’re just classes – not focused on adjusting my drug regimen so it’s perfect, but rather on the “coping with life” stuff that is basically impossible for me when I’m in the middle of an improperly medicated depressive episode. And how bad off do you have to be before they’ll let you in one of these programs? Yes, I need help, but do I really need that much help?

I’m also quite alarmed and sort of offended by the “you can’t have your phone and we take your shoelaces” stuff. I’m not psychotic or suicidal. Why on earth would they want to isolate me more, and make me feel more crazy than I already do?

Partial hospitalization refers to a comprehensive, short-term, intensive, clinical treatment program. With regard to level of treatment, partial hospitalization is a step below inpatient hospitalization but more concentrated than traditional outpatient care. Clients are generally referred to partial programs when they are experiencing acute psychiatric symptoms that are difficult to manage but that do not require 24-hour care.

Individuals in partial hospitalization programs attend structured programming throughout the day, three to five days a week and return home in the evenings. To ensure client safety, many of the inpatient hospitalization rules apply (i.e. no phones, no shoelaces) to partial hospitalization programs.

There are many advantages to participating in a partial hospitalization program. You are worried that the program may isolate you but the opposite would be true. Many partial programs provide group therapy which would allow you to interact with other people experiencing similar problems. You would also have the opportunity to interact with psychiatrists, social workers, nurses, and other mental health practitioners. The goal of many partial hospital programs is the development of skills that help clients better manage their lives and their symptoms.

Consider attending the program. Your doctor thinks it is necessary. I have worked with many clients that had expressed similar concerns about partial programs but who were later glad they attended. Remember that the program is short-term. It has the potential to help you tremendously.

At your next appointment, I would recommend discussing your concerns with your doctor. He or she may provide more information about the program which could give you a better understanding of what to expect. I wish you well. Please take care.

Dr. Kristina Randle

September 5, 2011 0 comments