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Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
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Experience:  Dr. Mark is a PhD in psychology in private practice
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I have been diagnosed with bipolar about 3 years ago. I am

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I have been diagnosed with bipolar about 3 years ago. I am not sure if I have been misdiagnosed considering through out my life my main problem has been depression. I have been on antidepressants before. Zoloft and Lexapro and celexa. When I was diagnosed with bipolar I was on celexa and aderall and going through a divorce. The only time in the past 10 years that i can remember being at all happy was when I was on Lexepro. My doctor has me on lemictal and has given me Lexepro but then after he gave the Lexapro and before I took it he questioned himself and called and said maybe the Lexepro is not a good idea because if I really am bipolar it could have a bad affect like the celexa and aderall did. I'm so confused.

Hi! I believe I can be of help with this issue.

First, let me say that I can imagine how confusing and distressing this must be for you. You are taking powerful psychotropic medications but you're not sure how the diagnosis was made that you have Bipolar Disorder (BD). You're also not sure if the diagnosis is accurate.

And this is actually the key to my answer to you that you need to consider and think about. You need to discuss with your doctor that you are not confident about the diagnosis of BD. That it was made during a difficult life situation and that you are not convinced that it is accurate. And that you would like to get a new psychiatric evaluation for BD.

I'd like to give you some resources to prepare for such a new diagnostic evaluation. This should start with your tracking your moods throughout the day for a period of time. Here are three resources: the first are computer programs for tracking moods:

They are both popular; Moodtracker is perhaps more well known, at least here in the US. Here, though, is a simple printout with charts that you can copy and fill in by hand and that may be enough:

Let me paste in for you the Diagnostic Criteria for BD. Then I'll continue.

Symptoms of mania or a manic episode include:

Symptoms of depression or a depressive episode include:

Mood Changes

  • A long period of feeling "high," or an overly happy or outgoing mood
  • Extremely irritable mood, agitation, feeling "jumpy" or "wired."

Behavioral Changes

  • Talking very fast, jumping from one idea to another, having racing thoughts
  • Being easily distracted
  • Increasing goal-directed activities, such as taking on new projects
  • Being restless
  • Sleeping little
  • Having an unrealistic belief in one's abilities
  • Behaving impulsively and taking part in a lot of pleasurable,
    high-risk behaviors, such as spending sprees, impulsive sex, and impulsive business investments.

Mood Changes

  • A long period of feeling worried or empty
  • Loss of interest in activities once enjoyed, including sex.

Behavioral Changes

  • Feeling tired or "slowed down"
  • Having problems concentrating, remembering, and making decisions
  • Being restless or irritable
  • Changing eating, sleeping, or other habits
  • Thinking of death or suicide, or attempting suicide.

What do you think? Does this sound like it describes your situation? The idea is that the mood swings back and forth unpredictably, with some quicker than others. Here's a quote from the DSM-IV: "Sometimes individuals experience severe mood swings from periods of extreme depression to periods of exaggerated happiness. This is known as bipolar disorder or manic-depressive illness, an illness that involves episodes of serious mania and depression. The individual's mood usually swings from overly "high" and irritable (mania) to sad and hopeless (depression) and then back again, with periods of normal moods interspersed."

Let me end off with this because it may be of use to you if you do indeed have BD:

In my practice, I use the resources with people with BD from Mary Ellen Copeland. I have found her work easy for people to use and easy to keep up with. The biggest problem is forgetting to keep to the plan when times are good and then something happens! Copeland also had BD and was hospitalized. She's a therapist and developed a BD treatment protocol called Wellness Recovery Action Plan (WRAP). First let me cite one of her books for you.

The Depression Workbook: A Guide for Living with Depression and Manic Depression by Mary Ellen Copeland. Amazon:

Now here's a YouTube search I've put together on the WRAP program. I want you to look at the videos and see what you think:

The video with Mary Ellen is a bit strong but worthwhile. It gives a real view of what the full blown BD is like. Here's an analogy:

Most people are like cars with automatic transmission. They tool around the day going from a little sad and then they feel a little glad and if they get to too high a gear, the emotional transmission just automatically sends them back to a lower gear and if the low gets too low, the transmission clicks into a higher gear. Rarely are they thinking about it. They are usually within their normal range.

People with BD are like a car with a manual transmission. They start having a racing mood and unless they downshift manually, you're going to be out of control soon until they can't maintain that and they cycle down and then get too far down, etc. So they have to continually use the clutch and manually adjust the emotional gear.

That's what a program like the WRAP plan is about. It gives you the tools to notice what's going on and to make adjustments. So along with medications (psychiatrist) if you do have BD you may want to find a therapist to work on a mood management program.

If you don’t have a good referral source, here is the web address for Psychology Today's therapist directory. You can sort by zip codes and when you see someone who seems like they might be helpful (they have a photo of the therapist) look at the listing and see if they list BD as one of the disorders they work with.

Good Therapy is a non profit directory. Same idea as the one above:

I wish you the very best and be hopeful and confident for the future!

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