The nurse practitioner I’m seeing about my ADHD diagnosed me with bipolar disorder

She literally could not have surprised me more if she tried

This makes no sense to me but it’s scaring me a lot :(

I don’t really remember having manic episodes? Depressive maybe but it’s usually after something bad happens to me and not really consistently…

I told her I put off making this appointment cuz I’ve been feeling really bad recently, then she just asked me a few questions like if people say I talk too much sometimes or if I do things impulsively and prescribed me an antipsychotic (aripiprazole) wtf

I asked some family and they haven’t noticed anything like this… idk :(. Has this happened to anyone else? Am I just in denial? I’m afraid to take this drug she gave cuz I really don’t need to be even more tired all the time… or tardive dyskinesia or something (unlikely, worst case)

      • ReadFanon [any, any]@hexbear.netM
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        Not to come off as dismissive of your concerns but it’s basically a rite of passage for a late-diagnosed ADHDer or autistic person to collect at least one mood disorder before arriving at the correct diagnosis. If you’re AFAB or PoC then you can pretty much expect to run a gauntlet of mood disorders before you reach the finish line.

        Try not to invest too much in the label - it’s just a descriptive term but the condition that you have, whatever it happens to be, and the symptoms you experience are the same today as they were yesterday. You could call yourself haunted, you could call yourself bipolar, you could call yourself mad; that doesn’t have a determining effect on what you’re dealing with.

        Obviously I’m not saying that you should go collecting diagnoses or that there isn’t a degree of impact that a prior diagnosis may have on the type of treatment you receive but try not to get too caught up in the whole thing.

        As a personal example, my psychiatrist has broached the idea of a diagnosis of chronic fatigue with me on multiple occasions. Each time it has been mentioned I have expressed my reticence towards it - I am not in the business of collecting diagnoses, a chronic fatigue diagnosis doesn’t open up opportunities for better management or treatment of what I’m dealing with than what I already have, and I don’t really need clinical validation where it’s basically saying that I’m tired all the time, except it’s Medically-Approved™. For me it seems as though getting diagnosed with chronic fatigue would serve no purpose and so I see no use in it. Whatever it happens to be you can name it, you can choose not to name it, but ultimately if naming it doesn’t create opportunities for you - whether that’s a better way of understanding and managing the condition, more avenues for treatment, access to supports and accommodations, or that sort of thing - then a label is not a useful thing and in that situation I’d seriously consider whether I need to carry it with me at all.

        • PaX [comrade/them, they/them]@hexbear.netOP
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          Yeah, you’re right. I guess I’m just harboring such a bad attitude toward this purely out of anxiety tbh. Like you said, the label itself doesn’t change anything about the experience.

          it’s basically a rite of passage for a late-diagnosed ADHDer or autistic person to collect at least one mood disorder before arriving at the correct diagnosis. If you’re AFAB or PoC then you can pretty much expect to run a gauntlet of mood disorders before you reach the finish line.

          Oh yes, 100-com% lmao, it took me years going through the gauntlet of medical bureaucracy on and off to even get this far

  • ReadFanon [any, any]@hexbear.netM
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    7 months ago

    Definitely echoing the need for a second opinion on this one.

    I’m afraid to take this drug she gave cuz I really don’t need to be even more tired all the time… or tardive dyskinesia or something

    Aripiprazole isn’t too bad. Obviously it’s a psychiatric med so there’s going to be some people who don’t vibe with it, naturally. It’s unlikely to knock you out like quetiapine - some people find it activating and some find it to be a bit sedating depending on how you happen to respond but it’s very unlikely that you’re going to be a zombie on it.

    There’s a chance that it might have an effect on your ADHD symptoms but evidence supporting this is pretty slim.

    Honestly I’d be looking for a different prescribing professional. A hasty bipolar diagnosis is sketchy, aripiprazole as the first treatment is very questionable… I think that’s a fair indication that you’re going to be pushing shit uphill trying to get an accurate diagnosis and a coherent approach to treating symptoms.

    Without knowing more, this is the kind of situation where I’d expect it to take at least 3 months, likely longer, to eliminate bipolar and to move onto a more accurate diagnosis. Then you have to cross your fingers and hope that they land on ADHD. Then I wouldn’t be surprised if they prescribed you something wack like guanfacine monotherapy or atomoxetine straight off the bat, which could easily blow out your timelines by another 6 months before you might be able to get around to the first-line treatments. Idk if I’d be willing to piss a year up the wall trying to chase down an accurate diagnosis unless it was my only option.

    Obviously this is just speculation but it’s what I’d expect from a nurse practitioner who is apparently so haphazard in their clinical practice.

    • PaX [comrade/them, they/them]@hexbear.netOP
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      7 months ago

      I actually got an ADHD diagnosis from a psychologist at this clinic. It’s weird, this is my 2nd visit with her (nurse practitioner) about it and after the atomoxetine she gave me didn’t help she wants to treat me for bipolar (she didn’t specify what type, idek if she actually diagnosed me cuz idk if she can even do that but she prescribed me the aripiprazole). I’m just really confused about this whole thing :(

      atomoxetine straight off the bat

      yea Yeah, that’s what she did during our last appointment and it didn’t help

      Idk if this keeps being weird I’ll have to see if I can extract my ADHD diagnosis docs from them and go somewhere else :(

      This bipolar thing is really scaring me though, “looking into it”, as they say. I asked some friends and family and they said they never noticed anything like manic or depressive episodes from me

      Thank you for your input, tbh I’ve just been stressing about this all day I’m gonna go try to relax

      • very_poggers_gay [they/them]@hexbear.net
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        actually got an ADHD diagnosis from a psychologist at this clinic. It’s weird, this is my 2nd visit with her (nurse practitioner) about it and after the atomoxetine she gave me didn’t help she wants to treat me for bipolar

        Sorry I’m double replying to you, but it sounds like the nurse is abandoning your ADHD diagnosis and assuming bipolar because your current ADHD meds weren’t working? If so, why not try a different medication for ADHD if that is what your psychologist (an actual mental health professional) diagnosed you with?

        Most psych meds, including those for ADHD, are kind of random with how much they work for different people. I don’t know the statistics for ADHD meds, but I know like 50% of people who try an antidepressant don’t experience any favorable effects. Not responding well to a specific treatment doesn’t mean you don’t have the thing you’re trying to treat. I have a few friends with ADHD who had to experiment with different dosages from different medications before finding what worked for them.

        Sorry i get kinda frustrated hearing about shitty mental healthcare, it can be such a brutal process but it shouldn’t be guts-pain

      • blipblip [he/him, they/them]@hexbear.net
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        +1 looking into treatment elsewhere, if they aren’t starting with trialing stimulants for an ADHD diagnosis I don’t trust them to ‘get’ it. To start with a non stim and then when it didn’t work to diagnose you with something else is highly suspect. I wouldn’t really put stock in their diagnosis.

        If you’re able to find a psychiatrist who specializes in adult ADHD, or even better HAS ADHD it’s honestly so much easier.

      • ReadFanon [any, any]@hexbear.netM
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        7 months ago

        Well if people around you haven’t ever noticed any manic or hypomanic episodes in you and you didn’t report having these to the nurse practitioner then I feel like the bipolar diagnosis probably isn’t a good fit.

        Atomoxetine

        I really shouldn’t gloat by saying that I called it. Suffice it to say that your post set my expectations for this clinic at that level and this tracks.

        Sorry you’re having a bad time with it. Go rest up and come back to this post/situation/both of them when you’re feeling up to it - there’s no time pressure.

      • Rx_Hawk [he/him]@hexbear.net
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        Everything these other comments have said is pretty accurate. Diagnosing bipolar after 2 visits, no history of mania, and a single depressive episode is dumb. People have depressive episodes, does not mean you are bipolar.

        TD normally takes years to present (not always) if it even does, so if you do decide to take it, I wouldn’t stress too much about it.

        I’m guessing you’re already on an SSRI. I would look at a different provider and see if they want to alter depression therapy instead of adding an antipsychotic.

    • Rx_Hawk [he/him]@hexbear.net
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      aripiprazole as the first treatment is very questionable

      Hey at least it wasn’t lithium. What do you think is best first line, lamotrigine, divalproex? For an accurate diagnosis, that is.

      • ReadFanon [any, any]@hexbear.netM
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        The gold standard for treating the “classic” bipolar symptoms is still lithium but valproate is also very effective. It depends on the prescribing doctor and other things like lifestyle factors and how that person is managing their symptoms; because lithium has a especially narrow therapeutic window, at least in the mainstream literature, this means that in order to get an effective dose you have to be skimming just below a dose that is toxic.

        Obviously if it was incredibly risky they wouldn’t prescribe it at all but if you have someone who is manic/hypomanic and you aren’t able to supervise them closely, or if they are in the pits of crippling depression, then you can risk a person not eating and drinking enough (or getting blind drunk and dehydrating themselves, for example) or accidentally taking too much lithium because they’re on a bit of a rampage or because they can’t remember if they took their dose and suddenly you can have someone who is quite seriously sick from lithium. Of course as you’re titrating up you need to carefully monitor the lithium levels of the patient and so for someone whose mood is way too high or way too low, that can be difficult to manage.

        (Caveat to say that there’s at least some indication that sub-“therapeutic” doses of lithium may be effective especially for depressive symptoms, but I wouldn’t expect to take a low dose of lithium and have my depression cured or anything like that.)

        So yeah, I wouldn’t be surprised if a patient comes in with well managed bipolar, or what the practitioner presumes to be bipolar but they’re in their 20s with no history of hospitalisations for manic episodes, and for them to prescribe valproate because it’s easier to manage and if you’re working with someone who isn’t at imminent risk because they aren’t on that really textbook Bipolar I rollercoaster ride then you probably don’t have the urgent need for lithium to stabilise them and so valproate is likely a decent choice.

        Lamotrigine is really useful but I still think that the best first line treatment is really lithium and then next is valproate.

        Obviously it depends on the individual and their particular flavour of bipolar but the broad brushstrokes are that lithium is the first port of call for Bipolar I whereas for Bipolar II or BD-NOS etc. it seems as though valproate tends to be preferred and then lamotrigine is really good especially for treating bipolar depression, so if someone is probably bipolar but they are mostly experiencing depressive symptoms or if it’s a person whose depression isn’t responding to conventional treatments like antidepressants (where there’s suspicion that it might be bipolar depression rather than the typical depression) then that’s where lamotrigine can really be effective, as well as where there is insufficient response to lithium/valproate or the side effects are not tolerable.

        But it really depends on different factors and how a person responds to the meds in question. (Obviously with lamotrigine there’s a slim chance of causing SJS/TEN 😬 so if anyone’s considering taking it make sure that you’re aware of those symptoms and that you have made your prescribing doctor is aware of any allergies.)

        I guess it’s also a tricky thing because once you step outside the classic Bipolar I then it gets very murky with differentiating between the other bipolar diagnoses and MDD or schizoaffective disorder etc. and so the treatment is often a bit of guesswork and a lot of understanding that the map =/= the territory; just because a patient doesn’t report symptoms that indicate something like psychotic depression or schizoaffective disorder doesn’t mean that isn’t what they’re dealing with; my armchair expert opinion is that there’s a significant amount of blurring and there’s sub-clinical symptoms or symptoms that go unreported and so you might have a person whose diagnosis is bipolar but who doesn’t respond to the typical mood stabilisers much/at all but who responds really well to an anti-psychotic. And then you’re left to ask whether the diagnosis is accurate, whether there’s something else like comorbidity that hasn’t been identified, or whether there’s something else that the antipsychotic is hitting that the lithium wasn’t which would explain the response. (And I think a good psychiatrist is one who treats a patient not as a diagnostic label but who works to understand the symptoms that a person is dealing with and to determine their etiology, and who takes a very strategic and scientific approach to how a person responds to meds rather than having a very mechanistic “Bipolar In -> Lithium Out” sort of approach.)

        But yeah, that’s a long way of saying that lithium really is the closest we have to an ideal medication for textbook Bipolar I and that outside of Bipolar I it quickly gets very murky trying to know what will work/how well it will work/what’s going on.

        • Rx_Hawk [he/him]@hexbear.net
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          Huh I’m driving rn so I’ll have to read this whole thing in a bit, but we were taught the toxicity of lithium kinda outweighed the benefits. I’ll give this a read though thanks

          • ReadFanon [any, any]@hexbear.netM
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            Yeah, it’s definitely a balancing act and it needs to be weighed against other factors but often it’s a compromise between quality of life and mitigating other risk factors for health outcomes (especially life expectancy) that comes with bipolar vs the potential consequences being on lithium long term.

            But with all of those other considerations aside it’s still the gold standard for bipolar treatment, even if it’s imperfect. (Shit, it’s not like going down the antipsychotic and polypharmacy routes don’t also bring their own complications and potential negative impacts from long-term use, and this is absolutely where I defer to psychiatrists as experts because there’s a whole lot of considerations that need to be weighed against eachother that I cannot do from behind a screen and I neither want to take on that responsibility nor do I get paid enough to do that.)

    • AdmiralDoohickey@lemmygrad.ml
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      7 months ago

      Abilify has been linked with increased impulsivity, usually gambling but also sex, food etc (you probably already know this, just adding to your post). Anecdotally, I definitely eat more without feeling hungry and I think it made the impulsive ADHD symptoms worse in general

  • very_poggers_gay [they/them]@hexbear.net
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    Heyo, I’ll share some thoughts because I’m a psych trainee working at a clinic atm.

    ADHD can result in behaviours that look like mania (or hypomania, which is like mania but less intense), and you can have both, but they are very different.

    I don’t really remember having manic episodes?

    I feel like this is a big thing. Especially because you said your friends and family haven’t noticed any changes either. To get a bipolar diagnosis, you need to have a confirmed history of at least one manic or hypomanic episode. These episodes should be an obvious difference from your typical self, beyond your typical up or down. For a “manic” episode, it should last at least 1 week and must result in major impairment or disruption in your life, for example, being hospitalized. For a “hypomanic” episode, it should last at least 4 days and also cause notable impairment. If you can’t point to a time in your life when you might have had an episode like this (i.e., where you were uncharacteristically energetic (like not sleeping for multiple nights in a row or sleeping only one or two hours), speedy, or impulsive for about a week or longer), and neither can your family or friends, I really can’t see a justification for a bipolar diagnosis…

    And If you talk fast, have lots of energy, are impulsive or unorganized all the time, that just sounds like ADHD.

    Her diagnosis and prescription seem way out of pocket and unjustified, imo. Was your appointment supposed to be related to medication for ADHD?

  • LeopardShepherd [none/use name]@hexbear.net
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    Not a knock on nurse practitioners but I personally wouldn’t be getting a mental health diagnosis from anybody except a clinical psychologist or a psychiatrist. Preferably one that has a special interest in whatever you are seeking help for as well as age group. I know this can be prohibitive but diagnostic criteria for this stuff is so much more subjective than any other field in health I would want somebody at the highest level of expertise.

    I come from a healthcare background and while nurse practitioners are great I honestly feel their role is best suited to maintenence and tweaking of treatment with most of the diagnosis handled by a much more specialised practitioner.

    Also in terms of viewing a diagnosis as having been given “another chronic condition” : just remember that it’s something you have already been living with, it just now has a description and you can recieve targeted help.

    • ReadFanon [any, any]@hexbear.netM
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      Yeah, I definitely think there’s a role for nurse practitioners and I feel like some of the more commonplace psychiatric conditions like depression and anxiety is up their alley. Agreed on tweaking and maintenance work too.

      But if I had bipolar I’d be going to a psychiatrist, same for ADHD.

      The hasty bipolar diagnosis is iffy and then going to aripiprazole just doesn’t seem to have a good rationale behind it - we can presume that they didn’t give a Bipolar I diagnosis for obvious reasons. That leaves BD II and BD NOS, but if this is the first time seeing a patient then you can’t really eliminate schizoaffective disorder and messing with dopamine in this situation is simply ill-advised.

      Chances are if it was one of those 3 the aripiprazole would probably be fine but it’s just a bit of an unnecessary risk and tbh I’d expect a prescribing professional to want to stabilise the condition first before (potentially) introducing antipsychotics, all things being equal.

    • PaX [comrade/them, they/them]@hexbear.netOP
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      I see :(

      Maybe I have had hypomanic episodes? I’m not sure… some of this seems familiar but I’m not sure how I would tell it apart from ADHD. And I’ve never experienced anything like grandiosity or risky behavior or psychosis or anything…

      This really sucks

      • Frank [he/him, he/him]@hexbear.net
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        Get a second opinion. They shouldn’t be giving you a Bipolar I diagnosis without evidence of at least one full-bore manic episode. Bipolar II is harder to diagnose and certainly shouldn’t be diagnosed casually.

        For me, hypomania has the following symptoms

        • i have too much energy. I need to be in motion, walking around, pacing, playing with things. This goes beyond adhd distraction or stimming. There’s a strong nervous energy and a compulsion to stay on the move.

        • pressured speech. I want to talk, constantly, about whatever is on my mind. It’s more than just interest in a topic or excitement. I feel a strong pressure to just keep talking and talking and get agitated if i try to hold it back. Holding back speech requires conscious effort. My excitement and constant flow of speech is usually noticeable to friends and family.

        • hypersexuality - i’m thinking about sex constantly in a way that isn’t normal. I have to consciously remind myself not to txt all my friends and invite them in to bed. I think i’m the sexiest person alive. I’m aware that this is abnormal and it requires continual awareness and effort to keep under control. When i’m experiencing hypersexuality i’ll go to bed with almost anyone who asks nicely.

        • related to that, but not directly connected, i’ll flirt with everyone. I really enjoy wordplay and clever innuendo and the increased confidence and perceived competence, combined with the broad increased interest in sex and need to speak, brings this out strongly. I use a lot of overwrought speach in general during hypomanic periods.

        • lack of perceived need for sleep. I sleep less and perceive myself to be more awake and alert than I am. This often gives way to anxiety as the effects of sleep deprivation catch up. I’m often up all night and well in to the morning

        • i feel like the coolest, smartest person in the room. It’s never gone as far as grandiosity or delusion, but i feel very cool, smart, handsome, and capable in a way that is not normal confidence in my abilities or appearance.

        • lack of patience and low frustration tolerance. I have adhd so this is a thing normally. Hypomania takes it up several notches. People speak too slowly, loading screens in games are too slow, people move too slowly on the sidewalks. Anything that’s not moving at my too-fast pace feels frustrating.

        • impulsive spending. I buy stuff i don’t need, often just things I think are cool or that strike my interest in passing. I buy restaurant food more often. I buy large amounts of groceries thinking i’ll make new dishes, or because I misjudged how much I needed or was appropriate.

        • emotional volatility - i’m prone to getting very upset and either crying or writing angry diatribes. I do not become violent, to myself or others, i just feel negative emotions very strongly. It can go the other way, too. Movies and books become totally overwhelming because any emotional response i feel to them is so strong. I write sappy love poetry to my partners.

        • an awareness that this is all wrong. It took years to figure out what was happening, but once I understood what a hypomanic episode was I was able to identify episodes that I’d had going back to childhood, and to identify them when they happened. I can tell when my mood is elevated, when the world has too many colors and i’m talking too fast, and i can mostly tell when that trips over to proper hypomania.

        My friends can also tell, and will let me know if they think something is off or my mood is too elevated.

        Bipolar is different for everyone, and Bipolar I is very different from Bipolar II. But there are a lot of common and typical symptoms most people share.

        aripiprazole can be diagnosed to help with bipolar I depression, but the first-line treatment remains lithium. I’m not a medical professional, just a guy with Bipolar II, but immediately giving you abilify without trying you on lithium first does not sound like the usual course of treatment.

        Bipolar, adhd, and autism have a huge amount of overlap in the symptoms they present. But a Bipolar I diagnosis, as far as I know, requires at least one confirmed manic episode, while Bipolar II requires pretty solid evidence of hypomania.

        A lot of people diagnosed with bipolar struggle with accepting the diagnosis, that’s a real thing. But the diagnosis is weighed heavily on having had identifiable manic or hypomanic episodes. If you can’t define specific episodes of mania or hypomania i’d suggest getting a second opinion. Mania is almost always very obvious, it’s a very extreme state. Hypomania is less drastic, as people usually aren’t delusional or psychotic and have more awareness and control, but it’s still quite different from normal behavior.

        • PaX [comrade/them, they/them]@hexbear.netOP
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          Thank you so much for sharing your experience. I don’t understand why she jumped to this diagnosis after maybe a combined total of spending 30 mins talking with me (This was our 2nd appointment and I saw her for the first time in person today).

          Your experience of hypomania doesn’t really sound like me at any time… I think. Occasionally I will get very invested in topics or projects which brings me a lot of satisfaction and I might sleep a bit less than usual and use a lot of caffeine to stay focused but I don’t really feel more confident or any kind of all-encompassing euphoria or any desire to engage in any risky or impulsive behavior out of the ordinary. Idk :( I guess sleeping less is the most concerning… last time this happened I just felt “okay” as opposed to my usual “things are hopeless and I’m barely hanging on”. I have a lot of anxiety about my health normally so it’s hard to tell what’s a real symptom or what I have convinced myself I have. It’s hard to remember my behavior exactly too… I’m not sure if I was sleeping less or not last time.

          Do you have depressive episodes? What are they like for you? I have been feeling pretty bad in the last month or so (although I usually always feel bad these days, depression, anxiety, etc). That same NP gave me some medication for my ADHD that didn’t really help and made me feel a lot more anxious and maybe depressed around the same time. Then some other condition I have was getting worse. It’s just so confusing :( I guess I have good reasons to feel worse than usual?

          I’ll ask my therapist about it tomorrow. It could get weird though because they both work in the same small clinic and my therapist referred me to her. Maybe I could ask my primary doctor about it too.

          • Frank [he/him, he/him]@hexbear.net
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            7 months ago

            Do you have depressive episodes? What are they like for you?

            Yeah. I have Bipolar II. Depression is much more prominent than in BPI. I have extremely long periods of severe depression - Weeks, but more often months and sometimes years. Sometimes I can mostly function, other times it’s completely debilitating to the point where I’m just shuffling from bed to the bathroom to the kitchen and back to bed for weeks or months at a time. This is, afaik, typical of Bipolar II - Extended periods of depression that can last weeks, months, or longer. Then periods of euthymia, normalcy. And then there are also hypomanic periods that can last weeks or rarely months.

            Bipolar also tends to cause some serious cognitive problems with things like executive function, decision making, focusing on tasks. Part of the reason it’s hard to diagnose is that many of the day to day symptoms overlap with ADHD and Autism. You can have a lot of symptoms that most bipolar people have, but you have ADHD or Autism (or a combination) because they have many similar symptoms. Like ADHD and Bipolar both cause problems with sleep, so lack of sleep and poor sleep isn’t enough to diagnose one or the other.

        • ReadFanon [any, any]@hexbear.netM
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          aripiprazole can be diagnosed to help with bipolar I depression, but the first-line treatment remains lithium. I’m not a medical professional, just a guy with Bipolar II, but immediately giving you abilify without trying you on lithium first does not sound like the usual course of treatment.

          Agreed.

          I could absolutely see someone prescribing valproate instead of lithium because it’s a bit easier to manage the dosing of it. Same for lamotrigine but I would be questioning why a prescriber would reach for that first if they did.

          The only way that I can square aripiprazole-first treatment for bipolar is if it was a BD-NOS diagnosis, and even then…

  • NoLeftLeftWhereILive@hexbear.net
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    7 months ago

    As someone who has a family member with bipolar I would say that the manic episodes are such that they can’t be missed. He was always also self-aware of them after the fact. And the depressive episodes are so much beyond anything resembling depression in a depressed person that this night and day difference is hard to miss by family. Yet even he was misdiagnosed for years with just anxiety/depression because the care people never saw the mania/deep depression. This is just one example, but I also work with people who are bipolar and it’s different from ADHD.

    ADHD can mimic bipolar with its low and high energy phases, but it isn’t the same. Personally with ADHD I have these same phases too and as a woman I have had the GAD&depression label slapped on me when I was young (which in hindsight I obviously do not have and never felt I had). This however led me to taking medications for 20 years that just made me worse/never helped. This is why I would ask for a second opinion or challenge this nurse on this, because people do know what they are or are not and a misdiagnoses causes actual harm. Trust your gut and lived experience, diagnostic systems have a lot of problems and are always just estimates too.

  • Red_Eclipse [she/her]@hexbear.net
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    7 months ago

    Before I self-realized my neurodivergence, I went through a period of considering if I maybe had Bipolar 2, and took some antipsychotics. They did nothing, it was like taking a sugar pill.

    I took ONE pill of aripiprazole and it gave me akathisia (like restless leg but for your whole body) within hours. Never took it again lol.

  • Jenniferrr [she/her, comrade/them]@hexbear.net
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    Been diagnosed adhd since I was a child. My therapist brought up me having bipolar possibly because I said i was having anxiety after a messy mushroom trip. I’m like seriously… like half my family has anxiety issues lol. I was also accused of having bipolar last year by my ex because she felt that coming out as trans was out of character and may have been mania

  • damnatum_seditiosus [any]@hexbear.net
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    7 months ago

    CW : Story of suicidal thoughts and kind of self harm too.

    spoiler

    I too got diagnosed in the last few years with Bipolar with hypomania after I also did a test for ADD which was positive. I’ve struggled with suicidal thoughts since my teenage years but I knew that if I just waited it out, it would pass and I’d gain that sweet new will to live and a boost to my self esteem with it.

    But yeah I had typical depressed stuff, isolating, dropping everything and projects I had started and missing while days too. I’ve started with Aripriprazole too but I was getting some morbid thoughts racing in my head too and that kind of stopped using antipsychotics.

    But as other have noted, get a second opinion if you can, you know yourself better than anyone after all.

  • Hexbear2 [any]@hexbear.net
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    7 months ago

    She’s an NP, get a physician to diagnose you. Insist upon it. Board certified psychologist, with an M.D. (not a D.O.), graduated from an american school, and find out where they went to Residency and ask them how much time they’ve spent in the inpatient psych. NPs probably never had to spend time with inpatient psych. Trust me on this, it makes all the difference on being assured your diagnoses is accurate.

  • StalinStan [none/use name]@hexbear.net
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    7 months ago

    Alot of practitions, especially old fashioned ones, don’t like treating adult ADD patients and go out of their way to find other diagnosis to check. While it isn’t a terrible instinct it is entirely possible for them to take it too far and you often hear about that bias. Like, for my first diagnosis I don’t think my doctor believed that I had it but prescribed the pills anyway to see if I’d lose some weight.

  • rtstragedy [fae/faer, she/her]@hexbear.net
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    7 months ago

    A friend of mine went for years being told she was borderlinr, bipolar, went through a bunch of medications IIRC. Turns out it was just ADHD and years of her life were just wasted. Its so frustrating.

    I was diagnosed with ADHD as an adult as I was struggling (still do) to stay focused at work. But the psych also said I had OCD, possible bipolar, said there was no chance I was on the spectrum…

    I dont think there’s a science to the stuff at all and people can be seriously harmed by a misdiagnosis. A lot of mental health communities say that people shouldn’t self-diagnose and trust doctors, etc. But I think I dont entirely agree with that. I think only you really know yourself and you should try to weigh your own judgement against theirs, while not discounting either.

    Add to that that diagnostic criteria isn’t super clear and has a lot of subjectivity in it, and the extremely diverse ways people respond to the same medications, and its a miracle we ever diagnose people correctly without just asking them “what do you think is wrong?”

    Sorry, maybe I’m rambling

    • Shinji_Ikari [he/him]@hexbear.net
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      7 months ago

      I saw this the other day, a mapping of the symptom overlap in the DSM.

      My wife recently had a nurse practitioner put her on a couple different anti-depressants when she just went in for ADHD/autism type stuff. The anti-depressants sapped all joy out of life and she completely stopped doing any of her creative outlets. She just decided to stop and let the NP know.

      The NP was a little taken aback, but when my wife explained it, the NP was like “Interesting, i’ve had quite a few patients in similar circumstances express something similar”.

      The fear of being labeled a difficult patient often prevents people from advocating for themselves.

      • rtstragedy [fae/faer, she/her]@hexbear.net
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        7 months ago

        Wow, thanks for that image! The symptom overlap is something i remember from the psych 201 course i did in college, forgot the name, but yeah you notice it pretty quick once you need to write it out on tests.

        I was on antidepressants for a while too and I would say they helped since I was depressed, but only marginally, and it was so long ago I can’t remember clearly how I felt. I dont want to come across as anti-doctor and anti-treatment of course, just think that our opinions matter too as we know ourselves.

        I’ve had a couple people in my life accuse me of being borderline or bipolar or a psychopath or things like that as a way to hurt me, so I’m pretty sensitive about it.

        • Shinji_Ikari [he/him]@hexbear.net
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          7 months ago

          Oh I don’t want to come across anti-doctor either. Just expressing frustration over the gap of how medicine as a whole operates vs what is needed for people who need help.

  • TheDoctor [they/them]@hexbear.net
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    7 months ago

    I have also recently been blind sighted by a bipolar diagnosis when I went in to get an ADHD diagnosis. My first recommendation would be to read The Bipolar Disorder Survival Guide by David J. Miklowitz. It’s available in several formats on libgen. This book has really helped me get a firm grasp on what bipolar is and is not, as well as the similarities and differences between bipolar disorder and ADHD to really find my intersections between these two disorders within myself. My psychiatrist specializes in mood disorders and he recommends it to everyone who gets a bipolar diagnosis at his practice. It’s also helped me really separate bipolar disorder from the highly stigmatized perception that society has imprinted upon me. I’m really struggling with this period of grieving my sense of self and my sense of identity, and this book actually has a lot of exercises and information that has really helped me work through some of the difficult feelings and ruminations that I’m struggling with. Even if you don’t believe you have bipolar disorder, I still think this would help you clarify that understanding to be able to present that to your practitioners.

    Based on my experiences, my research, and my (admittedly new) understanding of bipolar disorder, I would assume that your providers are attempting to rule out the cause of your symptoms. So, the initial diagnosis was ADHD, and they gave you treatments for that which seemed to be ineffective. Now, they are starting to treat for conditions that are parallel, comorbid, and/or differential with ADHD. In doing so, they’re sticking with attempting to treat only the primary symptoms you are aiming to address, which are the ADHD-like symptoms. So, they are giving you a second-generation antipsychotic medication which would typically be prescribed to help a person with bipolar stabilize the manic sides of their mood disorder. I think that the thought process is that if you take this medication and you see results, that would confirm the diagnosis, or if you take this medication and it continues to be ineffective like the ADHD medication, then it would negate the diagnosis like the ADHD diagnosis was. I’m not a medical professional, but that is what it seems like to me their course of action is in determining what your overall diagnosis is and/or should be.