Is My Diagnosis Correct

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17 Aug 2012

When I was told I was manic depressive, the psychiatrist took about an hour to do so. I never trusted him after that. According to one person who wrote me - "the doctor was either a genius or a quack."

I had being going to a therapist for a few months to deal with my problems in everyday life, never thinking I was manic depressive. It was only after a bout of mild depression that I asked to be referred to a psychiatrist so I could get drugs temporarily cope. I certainly never expected to be diagnosed as manic depressive.

I was shell shocked. I don't think anyone wants to hear the diagnosis that they are mentally ill. I certainly didn't.

But I think that caution in accepting a diagnosis of being bipolar is a healthy thing to do. If someone tells you that the rest of your life is about to be changed there is every reason to be skeptical.

They could be right, of course. But before I accept the diagnosis, I would want a bit more evidence than a one or two hour interview with a psychiatrist. I want to look at my past in detail so that I could see what might have been depressive or manic episodes. I want conclusive proof that those events weren't caused by stress or other events taking place in my life at the time. If I am manic depressive, I want proof that the medication works, and that I will be better in a few months time. And if I am manic depressive, I want it fixed so that I can forget about it and get on with my life.

I don't think anyone embraces the manic depressive diagnosis with open arms.

There is no medical test yet for determining if you are manic depressive. (The exception is a malfunctioning thyroid - hypothyroidism - which can mimic the symptoms of being bipolar and can be tested for. Ask your psych about it.)

As I found out, at the end of everything, the decision on whether you are bipolar rests with you alone. The psychiatrist's diagnosis is only the start of the process. You have to now finish the diagnosis and determine if it makes sense to you. The only way to do this is to check your behaviour and moods in your past to see if they match the symptoms of being manic depressive. The Am I Manic Depressive, Gathering Information page gives you some ideas on things to look for.

If you have checked into your past and it shows that you exhibit the symptoms for depression or mania or both, then you can seriously consider your psychiatrist's diagnosis as probably being along the right track. If the evidence does not seem to support the diagnosis, you should go back to the psychiatrist and argue your points until you are satisfied or convinced that you are either bipolar or not bipolar. Or get a second opinion from another psychiatrist.

Do not leave the dissatisfaction with the diagnosis unanswered, because if you are actually pretty all right you will always have a nagging doubt about your abilities and your worth and you will always wonder if you are living up to your potential. Alternatively, if you are indeed manic depressive and you are not comfortable with the psychiatrist's diagnosis, you are going to downplay its importance and delay treating this medical problem. Either way you lose.

Whichever way to decide, your decision on whether or not you are manic depressive can be changed. It is definitely not a "set in stone" kind of thing. Since there is no definitive test, you will be deciding on the information you have at the moment. As this information changes, you may change your mind as well. There is nothing wrong with that. And it is hard to know sometimes. As late as two years past my diagnosis, I used to wonder if I was bipolar or faking it.

Whatever your decision, the people around you are going to have to accept that if you make a decision you might change it abruptly and for no reason other than YOU no longer feel it is working in your best interests. This is particularly so in the first few months when you are really coming to terms with the diagnosis. My experience has been that I switched back and forth in how I felt about the diagnosis and experimented to see if it was right until I felt comfortable. I think this is a normal part of the acceptance process and is not my being wishy-washy or indecisive.

Whatever you do, don't go into denial about the diagnosis. Keep an open mind until you have gathered enough information. This is particularly so if you have family or friends around you who tell you that there is nothing wrong with you, that you are just lazy, or weak willed, or looking for attention. Such people aren't looking after your best interests, they are looking after theirs and they are in denial.

When I was told I was manic depressive, instead of denying that anything was wrong I took a positive step to monitor myself to see how I was doing. I constantly checked on how I was feeling and what I was doing and kept asking myself - Is this good? Is this healthy? Is this what I should be doing? Am I overdoing it? By monitoring myself for signals for mania and depression I was able to gather information about myself. I kept a mood chart. It was this combination of checking my past and monitoring myself in the present that allowed me to rather reluctantly come to the acceptance that I was manic depressive.

It took a few months to do all the checking before I was satisfied, it was not a simple decision I made after a week. Ignore the persons who want a quick decisive answer from you - it just does not happen that way.

About Your Current Diagnosis

I know this sounds a bit out of character, but I would strongly recommend that you follow the psychiatrists advice, and if you have been prescribed medication, to take it as directed.

The reason is fairly simple. You've been to the psychiatrist's office because there are problems in you life now. Whether you think the diagnosis is right or wrong, the advice given is still good advice. It is worth following.

If you have been given medications, take them. If you are manic depressive, you will probably feel better than you currently do after a week or so. If you don't, you can always go back to the psychiatrist and complain. In any case, I think that taking the medications even for a short while has its own value (check the Worries about Taking Medication page).

Whatever you do, until you are more of less sure of what is happening, keep in touch with your psychiatrist. I think in the first month or two after diagnosis you should be seeing your psychiatrist about once a week to ask all the questions you have and get advice and reassurance you need.

As I found out, at the end of everything, the decision on whether you are bipolar rests with you alone. The psychiatrist's diagnosis is only the start of the process. You have to now finish the diagnosis and determine if it makes sense to you.

And Finally

My biggest problem with being manic depressive initially wasn't with being manic depressive. It was trying to deal with the shame and guilt and anxiety of not functioning properly on a day to day basis. And of having gotten myself in the mess my life was at the time.

But even while I was deciding if I was manic depressive, I learned to say to myself - "Jinnah, even if I've screwed up, I don't need this extra burden of shame and guilt and anxiety." That's when my then life started to get better. Getting rid of the the shame and the guilt and the anxiety took away more than half of the problems I had when trying to get my life on track again.

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