Which doctor is right?

Question

My pyschiatrist says i have unipolar depression and ADD. my pyschologist says that i have bipolar II depression with narcissitic and boderline features as well as ADD but not comorbidly. six months ago i was addicted to shoplifting and lying. she think it was a hypomania induced by the combination of lexapro, wellbutrin xl, and focalin. my pyschiatrist thinks it emotional immaturity.

Answer 1

It took me a long time to figure this out, but a diagnosis doesn't mean much of anything. I mean, if you take the set of symptoms from either set of diagnoses, it would give you the same description of. . .symptoms. When you take pills, you are targeting specific symptoms, like sadness, low energy level, irritablity, poor concentration, etc. There is no pill for depression, bipolar or ADD, these pills are targeting certain symptoms. And in counseling, you work on specific skills, like controlling your temper, better communication, anxiety reduction, etc. Your counselor ought not be spending loads of time working on a diagnosis with you, she should be teaching you skills.

So I wouldn't worry about your diagnosis too much. Who cares? It's only an issue if you are applying for disability or something. I've been labelled depressed, then borderline & bipolar I or bipolar II now it's no borderline and bipolar NOS (not otherwise specified) plus PTSD.

Answer 2

What is "but not comorbidly" supposed to mean? Comorbid disorders are any chronic disorders that occur simultaneously in a single patient, so if you have multiple disorders, then they're comorbid by definition. If your psychologist really did tell you that you have both bipolar II and ADD but they're not comorbid, then I'd be inclined to say that the psychiatrist is more likely to know what she's talking about simply by process of elimination.

Shoplifting and lying on their own aren't enough to diagnosis a hypomanic episode. Also, my understanding is that if the episode was drug-induced, then it would not meet the diagnostic criteria for bipolar II depression, as that requires that there be no other explanation for the symptoms. If there were other indicators of hypomania, and one or more previous episode before you started taking the meds, then that's a different story entirely.

From what you recounted of the diagnoses, I'd be inclined to go with the psychiatrist's opinion except for one thing... giving antidepressants to a bipolar patient without a mood stabilizer a really bad idea. I'm not sure it's great to give mood stabalizers to a unipolar patient, either, but I'd say that treating bipolar depression as unipolar depression is more likely to cause major problems than treating unipolar depression as bipolar would.

Also, psychologists generally have more background in assessment than psychiatrists, so in general the psychologist diagnosis is more likely to be accurate. So normally I'd say go with the pyschologist's diagnosis, but the comorbidity issue kind of throws things off.

But the important thing isn't so much what you "really" have as want treatment works. How are your current medications working out? If they're working, and they're controlling all your symptoms, let the various doctors call it whatever they want, just so long as the meds they give you work. Diagnoses of psychiatric illness are just a matter of matching symptoms to definitions anyway - it's not like they know exactly what causes the symptoms and are treating the cause. The goal is to make the symptoms go away, and the diagnosis is more of a starting point for what treatments to try, and a way to allow your doctors to more effectively communicate with each other about what's going on.

If the current treatment isn't working then talk to your doctors about it. But it's less important that they agree about whether it's bipolar II or unipolar depression than that they find a treatment program that works.

Answer 3

what is behind door number 3? I mean.....thats quite a lot to absorb and take in...How can anybody here know what you are as we dont know you? I would say maybe you have ADD or maybe you are biploar but I really cant see all of thrse thinsg wrong with you...Its their job to tell you you are mentally messed up and to make a diagnosis to explain all of the problems you have..but..what if you are just acting out because of something that happened to you in your life and need a good friend...or are bored....too much to consider here without knowing you.....

Answer 4

Psychologists find out why we behave the way we do, but they cannot prescribe medication because they are not medical doctors.

Psychiatrists have a medical degree, plus a specialist's degree and they deal with mental illness. His diagnosis has more validity than that of the psychologist, while the narcissistic and borderline features may be a part of your illness.

Good luck. It's a tough row to hoe.

Answer 5

I don't know I'm not a shrink try hanging out with responsible friends for a while and see if they notice anything odd

Answer 6

Don't be so stuck to labeling. It is not an exact science. Focus on managing the issues instead.

Answer 7

i doubt anyone on here will be able to tell you which of them is right...we haven't diagnosed you or anything. i think you're just messed up and should stick with that.