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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10643
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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I have over 10 years of dealing with depression, ADHD &

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Hi I have over 10 years of dealing with depression, ADHD & anxiety. I experienced 3 relapses when anti-depressants stopped working, especially these 2 are related to my post-births. Anti-depressants were changed due to these relapses. Recently, I found out I am DXed with Bipolar Type 2, mild by my psychiatrist that I am seeing for the past 3 yrs. I also went thru several major life stressors that affected the severity of my depression. I am in a shock right now and scared. I researched on hypomania and don't see myself experiencing these before. With mood swings that I have within a day is associated to my ADHD. I researched online and it seems as if I have an atypical depression. I am very confused. Should I seek for a 2nd opinion?
DoctorZ :

Hello I believe I can help you with your concern

DoctorZ :

I am so sorry that you have been experiencing these symptoms, I can imagine how distressful this must be for you

DoctorZ :

You are right that symptoms of ADHD may mimic certain symptoms of hypomania, but I would like to ask you some questions so I can give you the best information if that is okay with you

Customer: Sure thing, I will be happy to answer some questions..
DoctorZ :

What specific symptoms is does your psychiatrist believe is related to the hypomania?

Customer: When I asked him, he told me to check I did and didn't not get enough info. So, I googled on other bipolar websites and got good amt of info
DoctorZ :

So he did not actually tell you what specific symptoms though, but there are a number of symptoms associated with hypomania, but it is rare if a person has all of them.

Customer: Yes, correct, he didn't tell me specific symptoms.
DoctorZ :

Okay, well that is definitely not a good sign that I would want you to stick with this psychiatrist, but I want to ask a couple more questions. Do the "hypomania symptoms" only last for around a week or two and then go away for a sustained period of time or are they there pretty much everyday, like they would be if they were associated with ADHD?

Customer: Not really, as for hypomania symptoms, I may be talkative at some sessions with the psychiatrist bec I thought the meds were working well. As for behaviors with hypomania...nope...I am trying to remember hard. When I have a good day with energy, it usually happens once in a while. I usually have fatigue due to other health issues.
DoctorZ :

Did you feel excessively happy during these periods of energy at all, or just felt the extra energy and talking fast?

Customer: More likely having an extra for talking fast...I don't think so. I would be more talkative.
Customer: Like I was able to do more chores around the house...being productive
Customer: But my sleeping patterns would be varied. Some months, I'd sleep well. Some months, I don't sleep well. I also take Ambien to help me to fall asleep.
DoctorZ :

And during these periods of being full of energy and with the insomnia, you are still taking the Focalin XR?

Customer: Yes, I take them daily in the mornings
DoctorZ :

When you get those feelings of energy, are you easily distractable too?

Customer: No, I would end up "hyper-focusing"
Customer: When a person hurts my feelings, I tend to get very upset and dwell on that issue for few days then move on.
DoctorZ :

Well that is the ADHD medication helping you to "hyper focus." I think you are right that you may have an atypical depression and ADHD. But there is a possibility you may have Bipolar 2, but I do not believe so. Still there is a medication where you can get at both of these disorders accurately. It sounds like your depression is pretty bad, so I would recommend Lamictal, it is a mood stabilizer that is specific for Bipolar Depression episodes and can be prescribed for Atypical depression. So that may be the best treatment for you and I would ask your psychiatrist that.

Customer: Hmmm....I can look up on Lamictal and try to figure out on what to do next. I can ask my psychiatrist for further avenues to deal with my depression....sounds good...thanks again!
DoctorZ :

Anytime, but if your psychiatrist will not consider your symptoms more or tell you to look them up, you are well within your rights to ask for a second opinion. I will acknowledge that it is hard to differentiate between ADHD and hypomania, but he still should have went through the list with you to give you a better understanding that is why you are paying him for your services

DoctorZ :

I wish you the best of luck. My goal is to provide you with excellent service, so if you ever have any further questions or concerns please do not hesitate to contact me at anytime.

Customer: Sure thing, I might have as well as write him a letter to ask for specific symptoms on what he sees in me. I am in due to see him in 2 months. Again, I appreciate your input and feedback. Have a good day.
DoctorZ :

You have a great rest of your weekend :)

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