What’s My Diagnosis?

When I sat down to write this article I intended it to be about missing my animal friends. I haven’t seen them in a very long time. My cat, my dog and my donkey all went away years ago. None of us were all that close. In fact, I never touched them. The closest I’d get was to see them out of the corner of my eye. I would turn to look at them and they would quickly go away. No matter how real they seemed, they never were really there. It’s sad for me to say, but they were just hallucinations and I do miss them.

Years back, when I started seeing a pdoc, I was diagnosed as bipolar I, then changed to bipolar II, back to bipolar I, then back to II and so on. In the end, it was my understanding that the definitive answer was that I was living with bipolar II disorder.

For those unfamiliar with the difference between the two, here are quick and easy definitions from John Hopkins University:

People with bipolar type 1 experience mania consisting of distinct periods of persistently elevated, expansive or irritable mood. The mania may involve delusional ideas and impaired judgment. A manic episode is diagnosed if elevated mood occurs with three or more other symptoms for most of the day, nearly every day, for one week, or longer.

People with bipolar type 2 experience what’s called hypomania, a mild to moderate level of mania that is generally a less destructive state than mania. Hypomania may feel good to the person who experiences it and may even be associated with good functioning and enhanced productivity. Impaired judgment is rare.

My pdoc who first diagnosed me, moved out of the area so the county clinic switched me to a new doctor, who happens to be the head of the department. About two years ago, out of curiosity, I asked him if my diagnosis was still bipolar II and he responded with a chuckle and said, “Why does it matter if the meds are working?” I told him it’d just be nice to know and he just smiled. I’d forgotten all about that conversation, until now.

So I look at the page I have here that’s labeled, “Bipolar: What is it?” and I’m puzzled where I stand. On the surface I clearly fit the definition of a person with bipolar II, but there are aspects of bipolar I that apply to me. Not just any aspects, but ones that apply specifically to those who have bipolar I. In addition to hallucinations, I’ve stayed awake for days at a time, had delusions, and practicing risky behavior, such as promiscuous sex and gross overspending.

I feel silly at this point. I’ve been writing this blog about living with bipolar and it just dawns on me that I’m not even sure of my diagnosis. I’ve been living with what I believed to be bipolar II, but I’m not so sure anymore. Virtually every description I’ve found of BP I and BP II states emphatically that only BP I have hallucinations. Have I been wrong all this time? I think I’ll ask my pdoc again and see if I get a real response this time. What do you think? Does it matter?

13 comments on What’s My Diagnosis?

  1. I guess since my diagnosis has remained the same since age 16, I have never questioned it, so it hasn’t mattered too much to me, per say (other than *I think* making it easier to access services), but I can see how it would matter if you were unsure what it was.

    1. In the animated movie “Over the Hedge,” the animals come out of hibernation to find a new neighborhood has been developed and there’s a huge hedge that scares them because they don’t know what it is. One of the animals (a mother porcupine) says if it had a name she wouldn’t be so scared of it. So, the animals name the hedge “Steve.”

      That’s how I feel. As silly as it may be, knowing whether it’s BP1 or BP2 would give me comfort, despite the fact that it really doesn’t matter.

      BTW, If you haven’t seen “Over the Hedge,” I highly recommended it. It ranks up there with ” Ratatouille.” IMHO

      1. I haven’t seen it but it sounds right up my alley.

        I get wanting to know if you’re Bipolar I or II. There is a pretty big difference between the two and I can see it would be a peace of mind kind of thing. Press your doctor for a firm diagnosis — you never know what he might say!

  2. I’m not so sure the definitions are going to fit everyone forever. If, for whatever reason symptoms become more severe, someone might temporarily fit into a new diagnosis category. However a doctor who’s known a patient for years would recognize the change and increase meds, supplement and/or change them to get his patient to the base line they’d found before.

    1. He said something similar to that, Jean. He said that he’s never seen two cases of bipolar that were the same. Said he learned that from his mentor.

  3. But then it turns into a whole other animal when one is successfully
    medicated. So what did it used to be? What is it now? Kind of trippy.

    1. I’d say now that I’m medicated I’m definitely on the BP II side. My mania is usually hypomanic and I’m more prone to deep, dark depression. By todays standards I’m BP II but that’s only because BP I is masked by the medication. It does boggle the mind.

    1. That is kind of what my doctor told me, kat. Maybe I’m making a bigger deal of it than I should.

      1. anyone who has any bipolar, is eventually going to have more severe episodes, so maybe at first there is a difference…but eventually the symptoms get worse during episodes, and then they want to change the name/category…and then maybe you go back, to less intense episodes and they want to change the category back again. but really, we are all suffering from the same issues and challenges, and we all take a variety of the same meds from the same med bag, and we are all bipolar.

  4. Another great post, Bradley, that has me jumping on my seat! Here’s what I think…

    Here in the UK, diagnosing is very different from your neck of the woods. For instance, even if someone was displaying definite symptoms of DID, NHS Psychiatrists would never offer that particular diagnosis. “Oh, we just don’t believe in it”, said one (thick) Psychiatrist.

    In my own experience, getting any kind of diagnosis was extremely difficult. One particular Pdoc, Dr Potty, struggled to agree on a basic diagnosis of Depression secondary to PTSD. “What’s the importance of a diagnosis”, he’d say regularly, “We treat the person, not the diagnosis”. But how do you expect me to recover when I don’t have the faintest idea what I’m supposed to be recovering from? Needless to say, I was completely lost within my own head and never once felt like I was moving forward.

    Thirteen years later, he was eventually sacked and in a very short space of time, a new Pdoc, Dr Howler, had no hesitation in offering a multi-diagnosis of PTSD & BPD. The depression was initially diagnosed as Bipolar II, but we are now more comfortable with “Recurrent Depressive Disorder”.

    I don’t allow a diagnosis to define who I am and neither have I spent lots of time reading everything about it. However, having a clear definition has increased my understanding and set me on the road to recovery.

  5. Good post. I definitely get where you are coming from. I have a similar issue. In my opinion it helps to know exactly what we have so we can prepare ourselves for what to expect. In Bipolar I the manias are more extreme with the depressions less so and can cause one to put oneself in dangerous situations. We need to train ourselves to be aware when they are coming –learning to cope and when to get a special appointment with Pdoc for help. In Bipolar II, the depressive episodes are more prevalent, painfully crushing and can be deadly. Again, knowing what we have helps us know how to prepare ourselves. My Pdoc told me I have BD NOS with psychotic features. Later he said I lean more to BD II, but I still have hallucinations of various types. I had one “hypomanic episode” last year that came close to landing me in a hospital–per Pdoc’s words. You would think that would be BD I. A week ago, I had to see a different doctor and his diagnosis was BD I. I don’t know what to make of it. My take, we should be aware of both ends of the spectrum, BD I and II, become very familiar with both so that we are ready for whatever may come. My research has shown that it is not unusual for a BD II to eventually crossover to a BD I. The meds are the same basically, but the consequences of the 2 disorders aren’t. In my mind I treat them the same.

    Very thought provoking. Thanks, Bradley.

    1. Thank you for your always excellent feedback. Good to see someone else has gone through the diagnosis yo-yo as well.

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