Last week I shared that my pdoc has on my file that I have schizoaffective disorder. It was a surprise to me and I haven’t talked with him about it because he’s out sick. It was the doctor on call who mentioned it. After this news, I discussed it with my therapist, who was equally surprised by this diagnosis. I decided to do a little research. Based on what I learned, I am fully confident I do not have schizoaffective disorder and will need to ask him about it. While I was researching, I read some things that made me to wonder if I really have bipolar. Yep, I have gone to that dangerous place called self-diagnosis. I am questioning my bipolar diagnosis.
Lots of Questions
Why have I self-diagnosed? Well, things just weren’t adding up. I’ve mentioned it before that I have only been told that I have bipolar disorder, yet I’ve never been told whether I have BP I or BP II. My pdoc told me it’s not important since the meds are working. At first I agreed with him, but when I thought about it later, that answer wasn’t enough for me, so I drilled deeper into my research. I read quite a few articles that compared the differences between schizoaffective and bipolar, and based on what I read is why I’m questioning things.
I found a handy article on the Bipolar Village website that simply breaks down the two. The first paragraph of the site does warn,
Please do not use the following article for self-diagnosis or the diagnosis of others. We cannot diagnose ourselves. It is intended instead for information and to provide useful subject matter to discuss with a psychiatrist or therapist.
Don’t worry, I’m well aware that I cannot diagnose myself. I’m simply trying to understand my current diagnosis and have questions to ask my pdoc when I see him next month.
Do I have Bipolar I
I feel confident that I do not have schizoaffective disorder, so lets get to bipolar I. At one time I was certain I had Bipolar I because I had hallucinations. Hallucinations is one of the symptoms that a BP I patient may have, but not a BP II patient. Let’s talk about the donkey. He used to show up regularly. I found it funny and fun that he kept showing up in my living room. Since hallucinations are a possible symptom for those who have BP I, I was fully confident that I must be BP I. However, I had a discussion with my husband Maurice, and he said the hallucinations didn’t start until after I was on medication. Apparently it was a negative reaction to one of the drugs I was trying. Friends of ours confirmed this for me as well. Okay, so no hallucinations. (I do wish the donkey would come back though.) I can’t rule out bipolar I altogether, because hallucinations are not something that BP I definitely have, it’s just a possible symptom.
A more clear distinction between BP I and BP II is hospitalization. Bipolar I patients typically wind up hospitalized at some point because of severe manic episodes – bipolar II patients do not. It’s not uncommon for a Bipolar II patient to be hospitalized, but it’s for depression, not mania, and is usually linked with suicidal tendencies. I have been taken to the emergency room three times due to depression, but never for mania.
There are other symptoms that distinguish bipolar I and bipolar II, but that seems to be the biggy. Based on that alone, I feel fairly confident saying that I do not have bipolar I.
Do I have Bipolar II
So, do I think I have bipolar II? The National Institute of Mental Health defines BP II as,
a pattern of depressive episodes and hypomanic episodes, but not the full-blown manic episodes
It’s pretty clear that I don’t experience full mania, but what about hypomania? For that I looked a little deeper and checked the Harvard Medical School website to see what they have to say:
The formal DSM-IV diagnostic criteria for hypomania require at least three of the following symptoms for at least four days: inflated self-esteem or grandiosity; decreased need for sleep; increased talkativeness; racing thoughts or ideas; marked distractibility; agitation or increased activity; excessive participation in activities that are pleasurable but invite personal or fiscal harm (shopping sprees, sexual indiscretions, impulsive business investments, and the like).
Let me do a checklist here:
Inflated self-esteem or grandiosity – I don’t think so. Others may disagree with my assessment
Decreased need for sleep – Check
Increased talkativeness – Check
Racing Thoughts or ideas – That’s for sure
Marked distractibility – Squirrel!
Agitation or increased activity – Yep
Excessive participation in activities that are pleasurable but invite personal of fiscal harm – Oh yeah
Do I Have It?
What was the criteria? I believe it was three of the symptoms. I just scored six. Based on my depressive episodes and the hypomania, I think it’s safe to say, at the very least, that I do have bipolar disorder and more specifically, Bipolar II.
What does all this mean to me? Does it mean I’ll stop or start taking certain meds? Hell no. Does it mean I’m going to stop taking my meds altogether? Hell no. Does it mean I’m going to tell my pdoc that he doesn’t know what he’s talking about? Hell no. What it means is I have enough info to talk intelligently to my pdoc and see if he’ll help me to get a fuller understanding. It’s been around ten years since I was first diagnosed, it’s about time I take ownership of my mental health.