Ask the Therapist
Grief and Bipolar
This week, I went to a therapist for the first time in many years per a recommendation of my family practitioner. In the past 6 months, I've had two family members pass away and been ill with stress-related stomach problems (IBS). I've lost 20 pounds, I sleep all the time -- when my insomnia isn't kicking in -- and I knew I was depressed, which is why I went to the therapist. My family doctor had prescribed Prozac 20 mg for mild depression, but it hasn't helped. I've been on that for over 6 months.
This new therapist and I went through my symptoms and she thinks I am not depressed, but Bi-polar 2. I sincerely doubted the diagnose and told her so. So, we went through the DSM-IV and sure, enough, I do look Bi-polar 2. I am still not sure if I agree with her, but I am willing to explore the idea. She is going to do some testing and I will see a psychiatrist in 2 weeks to another evaluation.
I am a strange case, because I have worked in the mental health field, have worked with persons with Bi-polar disorders, Borderlines, Conduct Disorders, etc., and studied for over a year in graduate school to be a family therapist -- before dropping out and going into another field. I know about Bi-polar 1, I have seen it in some of my patients where I worked; but have never seen a Bi-polar 2. Basically, my therapist is going to have to prove to me, I am Bi-polar 2, I won't just readily agree with her. My younger brother is Bi-polar 1, I have experience with that disorder. Bi-polar 2 I've never seen.
So, my question to you, is, why after all these years, at 35, is now someone just seeing that I might be Bi-polar 2? Until the recent deaths in my family, I hadn't been on any antidepressants in about 7 years and was doing fine. I've never had what I would consider a maniac episode until this past year. (Excessive spending, talking too much, distraction, irritability problems.) Yes, I've been severely depressed in the past, but never to this extent and medications like Paxil and Zoloft have always helped. This recent event, I just chalked it up to grief and other things going on in my life.
Could you please explain the difference between Bi-polar 1 and Bi-Polar 2? Maybe this would help me better understand my own situation.
First, I am truly, truly sorry for your recent losses.
As for your questions...you can look like anything, any of us can. I had an Abnormal Psych prof in college who took an entire class to do a DSM diagnosis of a patient who was a paranoid schizophrenic. At the end of the class (and please take no offense, but in the spirit that the story is intended) that the patient was Jesus of Nazareth -- and I went to a Catholic University!!! Point taken?? The DSM is a guide, not a prophetic text. While it's all well and good that, within her frame of reference your new therapist went toward BiPD 2, it's her frame of reference. If you want to scrutinize things, I can show you a dozen other diagnoses that fit. I'm not being jaded here or even condescending to your therapist...my point is to show that a therapeutic relationship is probably the most intimate that you will ever enter into and if your instincts tell you something, LISTEN!!! In this case, get a second opinion -- and not the
psychiatrist's. My opinion (which you must recognize is not a diagnosis and of no value to you) is that you are grieving. BiPD 2 looks a lot like grief. Question to ask: How much experience has this therapist had with grief and loss?
