My current, main goal is to take back over my life. This diagnosis has affected me on so many levels, it was so sobering that it took me a minute to process and sort of start taking a different perspective here. Part of my own fear is giving up control of anything that directly affects me.
Another issue I have struggled with is what my life would have looked like had the original psychiatrist wasn't bi-polar himself, had done a better evaluation, etc....I realize I wouldn't have my current wife and kids and that alone makes it "Ok" but on an intellectual level it really had me start thinking about my "care" or treatment. For any "new" readers, I was mis-diagnosed bi-polar from 1994-2006 by a Dr. who was also bi-polar, lost his license, had about 60% of his patients diagnosed bi-polar.
Well not much anyone can do about that. I wasn't the only person affected and itself isn't an indictment but rather a disturbed individual.
So...what caused the mis-diagnosis to continue for 12 years? Well here is what happened. From 98-06 I was gainfully employed, saw several psychiatrists and was comfortable with the lithium as it helped me sleep...I didn't "quite" fully meet bi-polar by my definition. So what happened....
Well about three times I saw a new Psychiatrist. Each would have needed to do an intake. That should have triggered something in someone but it didn't. I would walk in and say I was diagnosed bi-polar and was high functioning.
That's all they wanted to hear. Not one time did I have a full 60 minute intake. I realize with bi-polar one huge danger is thinking you don't need your meds when you are doing well. Thing is all they saw was someone who was self reporting a condition. No one ever checked my lithium levels. No one inquired as to specifics of my day to day life.
Really? What other life long condition could someone have that Dr's blindly accepted with no tests, documentation or anything. No follow up, no interview. Just "Thank you Mr Johnson, I will see you in 3 months"
This is a problem. If the very people treating you don't want to really get to the root of the issue HOW can we expect society to do the same? If the cookie cutter approach is the easiest and least invasive approach to a condition that by default difficult to treat and requires little work on the Dr's part then hey lets wrap this one up and move on to the next.
I saw a multitude of therapists. At least 5. They did deeper intakes and between that and the Doc's I worked with the incorrect diagnosis was removed and replaced with "Generalized Mood Disorder"
What does that mean? No clue except it sounds like they know you have a problem but either don't know what it is or don't care or have time? I can't think of another lifelong condition that is called "Generalized" and basically left untreated. I remember telling EVERY therapist "Something is just not quite right with me" and that was always shot down and replaced with "Your doing great", or "You need more sleep" or "You need more therapy" but even after bi-polar was removed I would hear from Psych Dr's, well you don't have bi-polar but there are some tendencies. Ok...well here is how NAMI describes BPD
What is borderline personality disorder (BPD) and how is it diagnosed?Borderline personality disorder is diagnosed by mental health professionals following a comprehensive psychiatric interview that may include talking with a person’s previous clinicians, review of prior records, a medical evaluation, and when appropriate, interviews with friends and family. There is no specific single medical test (e.g., blood test) to diagnose BPD and a diagnosis is not based on a single sign or symptom. Rather, BPD is diagnosed by a mental health professional based on sustained patterns of thinking and behavior in an individual. Some people may have “borderline personality traits” which means that they do not meet criteria for diagnosis with BPD but have some of the symptoms associated with this illness.
Individuals with BPD usually have several of the following symptoms, many of which are detailed in the DSM-IV-TR:
- Marked mood swings with periods of intense depressed mood, irritability and/or anxiety lasting a few hours to a few days (but not in the context of a full-blown episode of major depressive disorder or bipolar disorder).
- Inappropriate, intense or uncontrollable anger.
- Impulsive behaviors that result in adverse outcomes and psychological distress, such as excessive spending, sexual encounters, substance use, shoplifting, reckless driving or binge eating.
- Recurring suicidal threats or non-suicidal self-injurious behavior, such as cutting or burning one’s self.
- Unstable, intense personal relationships, sometimes alternating between “all good,” idealization, and “all bad,” devaluation.
- Persistent uncertainty about self-image, long-term goals, friendships and values.
- Chronic boredom or feelings of emptiness.
- Frantic efforts to avoid abandonment.
Now, I am not a Dr. Though I play one on this blog ;-). But how hard would it be with an extensive evaluation to determine these 3 things
1) Client isn't bi-polar but has some tendencies
2) Pt has a generalized mood disorder
3) Pt reports 7 of the 8 symptoms (above) with unstable interpersonal relationships, anger and abandonment being the theme for each session.
Ok....maybe I am not being fair, but really how would you feel if they were treating you for kidney cancer and then they said "Well, its actually the liver but its like kidney cancer" and the reason we missed it is we didn't evaluate you fully.
I'm sure there is a case to be made by the Doctor's. But to me I don't see it or really care
hear it. NAMI goes on to say
Medication treatment of coexisting medical and mental illnesses, such as anxietyor depression, is also very important in the treatment of BPD.
Here is where I begin to get angry. My whole life I was told at worst I had SAD (Seasonal affect disorder) and not full blown depression. How unfair is that? I mean this is their specialty. I wasn't depressed because I said I wasn't?
Mr. Johnson you have high cholesterol.
No I don't
Well the test says you do
Mr. Johnson are you depressed
No, not really
Ok keep up the good work
Folks...I am not exaggerating here. The people treating me were so focused on my "being better" that no one ever really stopped to take my temp along the way. Long before this diagnosis I stopped therapy as I saw it as pointless and frankly I knew something was up, I had NO idea how to verbalize it. I could grab what little history was recorded from various Dr's and I guarantee you the compilation would paint a very clear picture of BPD. Denial is part of MH illness. You don't just accept what they say. We don't always know how to verbalize correctly what we are feeling...that is the point of a good INTAKE visit.
So yeah, I'm a little pissed. Now lets look what I face going forward
Disability looks bleak. While women qualify at an alarming rate over men for MH reasons, our society doesn't look at how MH impacts the male, again to draw on Brandon Marshalls interview he says (paraphrased) "Until we change how we treat boys and girls as children, this [referring to bullying, richie incognito] won't change."
The Dr who finally suggested BPD turns around and tells me and disability "What do you need, a month or two?" Ok, that is an ignorant comment. He is a Resident so hopefully he learns, he also never addressed my sleep so the new Dr has a whole different take on everything and his med switch has worked. He clearly said the best case scenario was it would take up to 2 years to really "get DBT" he went on to say that some people don't get better and while he had hope for me he wasn't going to sugarcoat it and this would require a lot of therapy and hard work.
My current therapist has been the first one to really connect with me. She is a really good listener. What that means to me is she "hears" what I am saying, validates it but also doesn't excuse it. Monday she challenged me to do a better job on the homework. My immediate thought was well I am applying it to my life...but I realized she was right. I used some of it but in order for it to stick I had to use it every day. It would be like learning a new language so it takes time, practice, repetition, passing tests, etc...
All it ever would have taken is a little bit of digging, a few more questions. I can't change the past but perhaps you can now see why I have such a passion for how we treat MH. If I can be a voice I will. If I can be an example I will.