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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 2 of 2. This is the beginning of the thread.
Posted by Marc Dyer on November 16, 1999, at 20:57:28
I am having some difficulty in my life with who is correct, 20 years of psychiatry being treated for bipolar II or some doctor I had for a year saying I'm not Bipolar but Dysthymic.
It started 3 weeks ago, when I wanted a med change from Lithium to Depakote, and the psychiatrist refused. When I told him I was bipolar, he said I was dysthymic, and gave me the reasons. I was a little shocked, but he made sense saying that I had no hallucinations, delusions, and I reacted to situations, whereas a bipolar would become moody out of the blue. Although he told me, I felt that he should have told me at the time he noticed I wasn't bipolar. I quit the doctor, and went to the clinician. He believes I'm bipolar from the charts, and me talking a lot at times.
I am having a problem getting a 2nd evaluation because I have Medical/medicare in other states, and not many doctors want to go thru some diagnostic tests
that easily. Since I don't have the doctor, I have to go to the county for meds.
I am upset, want to get this 2nd opinion done, and was wondering what other people would do. In the meantime I am taking Lithium, Prozac and Trazedone for Bipolar II. And although the clinician that I'm seeing says that Lithium can be used for Bipolar II, I don't want to take Lithium if I don't have too.
Any suggestions on what I might do?
Marc in San Francisco
Posted by Elizabeth on November 18, 1999, at 1:22:41
In reply to 2nd Opinion re: Bipolar II vs Dysthymia, posted by Marc Dyer on November 16, 1999, at 20:57:28
> When I told him I was bipolar, he said I was dysthymic, and gave me the reasons. I was a little shocked, but he made sense saying that I had no hallucinations, delusions, and I reacted to situations, whereas a bipolar would become moody out of the blue.
I don't think that's evidence. Bipolar II's do not have psychotic features (hallucinations and delusions). There is also a condition called cyclothymia characterized by frequent low-grade mood-swings. Finally, bipolar states (including, most likely, bipolar II [hypomanic] states) may be "mixed," having features of depression as well as mania or hypomania.
I'm not clear what you mean by "you react to situations." Exactly what sort of mood swings do you have?
Another question: what have your neurovegetative symptoms (eating, sleeping, feeling and acting slowed-down or sped-up, etc.) been like?
Another differential dx would be ADHD, BTW. (I thought of this because you mentioned being overly reactive and talking a lot. You might ask your doctor about it.)
> I am upset, want to get this 2nd opinion done, and was wondering what other people would do. In the meantime I am taking Lithium, Prozac and Trazedone for Bipolar II. And although the clinician that I'm seeing says that Lithium can be used for Bipolar II, I don't want to take Lithium if I don't have to.
What about Lamictal? It's been used with success for depression as well as bipolar. 2 birds, 1 stone?
This is the end of the thread.
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