woman-1146386_640Something has been bothering me immensely the last week or so, to the point I am up at 5:30 a.m. on a Saturday morning. When I left the hospital (this is discussed in my post called “Four Days in Grey”) I had several diagnoes by a medical doctor who took days, including social histories, exams, and discussions with him and several nurses.  He diagnosed me with Borderline Personality Order, Depression with Suicidal Ideation and PTSD. When released from the hospital I went to our local clinic to make an appointment to follow up with what I thought would be another psychiatrist. Moving on…..

Several weeks later I met with who I originally thought was a psychiatrist, but found out she was a nurse practitioner who did a lot of typing, diagnosed (from a book) and prescribed. Only when I saw my actual prescriptions did I realize she wasn’t the doctor.  Here is one thing that bothers me, she changed my diagnoses within meeting me after a 3 minute talk and the paper that only listed the original doctors diagnoses and medications he had placed me on.  She started typing and did most of the talking, she agreed with many of the diagnoses but did some changes and proceeded to changed all my medications, even though I had not been on them long enough to be effective.

Then, ta ta da da…………….she said the magic words, “you do not look like you have Borderline Personality Disorder, so I am changing it to Bipolar 1. It looks better on paper, even though no one should ever see your files because of HIPA”. What? I had just came from work wearing a dress, heals and make up, yes I fit in with society…..but I don’t “look” like I have BPD, said without any examinations or social history.  So what does BPD look like; what does any mental illness look like?  Having Lupus I have heard words “you don’t look like” so much that at that particular time it went over my head, I took the prescriptions and filled the new medications and started taking them.  The next 2 times I went to her she increased the dosages of all the medications because they were not helping me.

So I decided to do my own research; hell if she can use an old dusty book then I can use the internet. Let us start with my original diagnosis of Borderline Personality Disorder. I obtained my information from NAMI-National Alliance of Mental Illness. According to NAMI, Borderline personality disorder is a condition characterized by difficulties in regulating emotion. This  leads to severe, unstable mood swings, being impulsive, poor self image, and trouble in personal relationships. BPD also causes one to have a huge fear of abandonment and can manifest into destructive behavior and suicide attempts.  It’s estimated that the people with BPD may be as high as 5.9%.  The majority of BPD diagnoses are women, but it is believed that many men may have the illness but have been misdiagnosed as PTSD.

Symptoms Include but are not limited to: 

  • Strong efforts to avoid being abandoned.
  • Unstable personal relationships that alternate between idealization—”I love you” to “I hate you”, sometimes within the same day.
  • Negative self image which can cause issue with relationships and personal goals.
  • Impulsive behaviors, such as excessive spending, unsafe sex, substance abuse or reckless driving.
  • Suicidal and self-harming behavior.
  • Periods of intense depressed mood, irritability or anxiety lasting a few hours to a few days.
  • Chronic feelings of emptiness.
  • Inappropriate, intense or uncontrollable anger.
  • Disconnecting from your thoughts or sense of identity, or “out of body” type of feelings.
  • Stress-related paranoid thoughts.
  • Severe cases of stress can also lead to brief psychotic episodes.

I will admit, because the entire reason for this blog is awareness, that I have at one time suffered all of these symptoms.  Yet, instead of accepting what the psychiatrist said, the nurse practitioner  took some of the symptoms such as the inappropriate anger and anxiety (which are listed in BPD) diagnosed me with Intermittent Explosive Disorder and two types of panic disorders.  Now how does this “look better on paper?”

On to Bipolar 1 Disorder. Web Md states the following:

Bipolar 1 is also known as manic-depressive disorder .   To be diagnosed with Bipolar 1  a person affected by bipolar I disorder has had at least one manic episode in his or her life. A manic episode is a period of abnormally elevated mood and high energy, accompanied by abnormal behavior that disrupts life. I cannot remember the last time I have had any energy.

Often, there is a pattern of cycling between mania and depression. This is where the term manic depression comes from. In between these episodes many people can live normal lives.

Symptoms of Bipolar are but not limited to:

During manic episodes:

  • Jumping from one idea to another
  • Rapid and loud speech
  • Increased energy and decreased need for sleep
  • Inflated self-image
  • Excessive spending
  • Increased sexual activity
  • Substance abuse
  • May become delusional and behave in bizarre ways

If left untreated, an episode of mania can last from a few days to several months. Normally depression can follow shortly after or appear a few weeks or months after a manic episode.

Many can have a lack of episodes for a long period of time. Others have “rapid cycling” in which the patient has four or more episodes of both mania and depression within a year.

Symptoms of depressive episodes in Bipolar Disorder are:

  • depressed mood
  • loss of pleasure
  • low energy and activity
  • feelings of guilt or worthlessness
  •  thoughts of suicide
  • depression symptoms can last for months but rarely longer than a year

Here is where my problem lies, I do have some of the symptoms of Bipolar, but I have been depressed my entire life so that part is definitely not a symptom.  I also do not have but a few of the symptoms of the mania.  The rapid cycling mentioned above, which the nurse practitioner says is what I experience when I go from feeling somewhat normal to very depressed several times daily, does not match the above symptoms.  So why change a diagnosis where I meet every symptom to one that “looks better on paper?”  Luckily for me they are treated with most of the same medications minus one or two.   I will be looking for a 3rd opinion soon, who ever I can find that is an actual psychiatrist that my insurance will allow.

Feel free to comment and express your feelings on the subject.

Thank you for taking your time to read.