Bipolar or ADD or both

[Anonymous]

Is it common for someone to be misdiagnosed as bipolar and successfully come off medication if ADD medication and diagnosis seem to fit?

I may have been misdiagnosed 14 years ago and have gone from heavy meds (lithium) to epival 1250 mg twice a day to now just 500 mg twice a day plus my Concerta which is working really well. Reason for the change is 14 yrs ago I was under incredible stress with two young children (1 1/2 yrs apart), financial strain and husband away working. Mom had severe post partum depression and I probaly just had severe depression, but I was diagnosed as bipolar.

Epival, anxiety drugs, sleeping pills and self medicating on alcohol still didn’t fix the anxiety, foggy brain, scattered thoughts. I had lost ability to focus at work. When I reentered workforce when kids turned ten, I had no self-confidence. I have a BA and went back as a receptionist. (before kids had worked in city as customer service rep for large corp in really fast paced industry)

My GP and Psychologist (who I’ve been seeing for four years) both feel I may have been misdiagnosed as they have never seen me hypermanic. The idea of ADD came up when my Psychologist saw me one day a couple of mo. ago ranting and raving about a family caffufle and jumping from thought to thought so quickly he couldn’t keep up.He asked the typical question, did I ever have trouble sitting still at school?

No, but hyperfocus, racing thoughts, interrupting, lack of impulse control, inability to stay on task – your survey pegged me as ADD.

I reduced, without my Psychiatrists approval, from 750 mg to 500 mg epival, after one month of starting 18 mg Concerta and my thoughts are so much clearer. They were the first day I started the Concerta, I was able to focus and stay on task. I feel able to stay on task at work and am excited about new career opportunities! I have lost 40 lbs through Weight Watchers in the last 2 1/2 years, and I am sure that part of that is do to reduced Epival. I still have to work on reducing the alcohol, but I am becoming much more physically active and that is a huge factor in keeping me calm.

My fear is facing my Psychiatrist who loves to push drugs, “can’t sleep? Here’s zoplicone!”. Ugh!! She has almost threatened me with having a hypermanic episode and my whole life crashing, losing job etc., if I go off the epival. Fortunately, my GP is supportive, and my job has great benefits so I am able to continue seeing the Psychologist.

What do you think?

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[ashockley55]

My knee jerk reaction? Dump the psychiatrist. Of course, I can’t in good conscience tell you to do that, but…..

I would at least rely more heavily on your GP and your Psychologist – they seem to have a fair amount of interest and insight into you.

Which I admittedly don’t having not ever met you, and having no interaction with you other than reading this post.

I will say that my story is a lot like yours – diagnosed Bipolar (also, at one point, Borderline Personality) and, lately, after some stressors in my life have been reduced, also after having been off of Bipolar meds for a couple years now, have come to believe that I struggle with ADD, depression, anxiety and just risidual (sp?) stuff from crap that happened in childhood.

But not Bipolar. or a personality disorder.

Whatever you do, do stay in close contact with your GP, so in case Bipolar symptoms do come out, he can send you to a psychiatrist, maybe not even the one you have now, but someone who less “loves to push drugs…”

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[Anonymous]

Thanks so much for the feedback. It’s always good to hear what I think reconfirmed as I never trust myself. I will, and am, relying more on my GP and Psychologist. I need to stay with the Psychiatrist for quite a while, unfortunately, as I aim to wean off the epival slowly and if anything goes wrong it takes forever on the waiting list to get another one. That being said, maybe I should ask to go on a waiting list for someone else..

Isn’t it a bummer to have been in the fog of the wrong meds? I am struggling with not being angry over the lost years when my capacity was so reduced. But – it is, on the other hand, exciting to be where I am now and really exciting to have found this forum.

Big thanks to Rick’s film. My Psychologist recommended it and it was in trying to find how to buy it I stumbled across TotallyADD. Can’t wait for more time to read and learn more.

Thanks again and thanks to the whole group!! Looking forward to Dr. J’s feedback. :0)

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[ashockley55]

I would say, yes, do try to go about finding a new psychiatrist. Might your GP or psychologist have any recommendations?

I was initially diagnosed with Major Depression, recurrent, Obsessive-Compulsive Disorder and Social Anxiety. I was on Lexapro, and became highly agitated. I couldn’t sit still.

At that point, I was switched from Lexapro to PaxilCR, and they added Risperdal. Over the next few years, I tried several different anti-depressants and atypical anti-psychotics. I eventually settled on a tiny dose of Seroquel (25mg), which essentially acted as a sleeping pill. I don’t know that I was getting any other benefit from it concerning my mood.

The side effects I suffered, however, included a 100 pound weight gain.

A couple years ago, I went off the Seroquel as a result of a switch in my insurance which meant that I couldn’t afford it.

When I didn’t flip out, nut up, or otherwise have symptoms of a serious mental disorder such as bipolar disorder, I began to suspect even more strongly that my problems were a) more situational (concerning my depression) and b) less severe than bipolar.

All along, I knew there was something up other than depression and anxiety, I just didn’t know what it was.

I feel pretty confident that ADD is one of my issues, along with depression, anxiety, etc. more common stuff.

I’m glad you found someone to listen to you, and that you are on a path that feels right.

It’s a revelation, idn’t it?

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[Anonymous]

Well it is a revelation in progress. Thanks for sharing. It gives me confidence to move forward! You take care too and enjoy your new life ! I am. :0)

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[nanaimo]

I hate to stereotype…but how old is your psychiatrist? The first psychiatrist I saw was in her mid 70s and just about to retire. My mother happens to be bi-polar and that’s all she needed to hear. Immediately she was convinced I was bi-polar despite my complete lack of manic episodes (I was mildly depressed…because having untreated ADHD for years is indeed depressing!).

I knew in my gut that she was wrong though I didn’t yet know about ADHD. I had a very thorough psychological evaluation including looking at my childhood history which even dug up a test I took as a child that showed markers of ADHD. I then was referred to a psychiatrist, who independently confirmed the diagnosis. Both pretty much called me an open and shut case (politely).

I asked about your psychiatrist’s age because the older they are, the more likely it is they don’t even believe that ADHD can persist into adulthood.

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[Anonymous]

You are right the psychatrist is older. :0(

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[nanaimo]

Perhaps you should talk with your family doctor about getting referrals going for a freshly graduated psychiatrist in your area (as Dr. J has been recommending, they graduate in June so now’s the time to start putting out feelers).

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[Anonymous]

I’m so glad you shared your story. I have just recently been put on Lithium as a trial for Bipolar. I believe ADHD fits me better. My psychologist is older and close to retirement as well. I do have mood swings but they are very short lived and never manic. I think I will continue to push the point. After

all medicine is just educated guess work. It’s not a total shot in the dark but somtimes it takes a few shots to get it right.

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[Scattybird]

Queeny – I have mood swings. I am not manic but my outbursts might look that way to an on-looker sometimes. Certainly when someone at work imitates me then I can see how it must look. They are short lived and are really more of a drama-queen outburst rather than anything nasty.

I had a follow up meeting with my Psych (who is thankfully completely lovely) and she commented that mood swings are common in those with ADHD yet they don’t really appear on the criteria for ADHD.

I take Ritalin and it controls my emotional outbursts completely. I still think stuff but I don’t actually come out with it.

So it is very possible you have ADHD. But there are similarities between the two disorders apparently. I believe that stimulants used to treat ADHD can be harmful if you have bipolar. But if you have ADHD then taking lithium is not ideal? Just thoughts.

I hope you get the correct meds for the correct problem.

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[Tiddler]

Hi

Another mood swinger here too.

I read and reread the criteria for bipolar many times over the years when i was trying to work out what was wrong with me. It never quite fit though. My moods swing in seconds or minutes and can swing back immediately after, whereas bipolar, I think, tends to be episodes of emotional extremes which last much longer.

Having started on concerta I’ve noticed a marked change in my mood which seems much more stable at least for a few hours a day.

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[Ginniebean]

Russell Barkley has stated (and darned if I can actually find the quote) that there should be no diagnosis of bipolar II if the main diagnosis is adhd, because ALL of the symptoms of bipolar II can be accounted for by adhd.

My guess, yes, there’s a whole lot of people who have been misdiagnosed.

http://www.corepsychblog.com/2009/04/adhd-and-bipolar-controversy-explored-at-corepsych-radio/ The reference to Dr Barkley can be found here, he’s being referenced by another ADHD specialist Dr. Charles Parker who is legit, it’s in the comment section where he states this.

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[Anonymous]

I can relate to alot of the issues brought up here. I had been dx as bipolar II and none of the bipolar drugs worked, and I took them all! At one point I was diagnosed as ADD but the adderall didn’t interact well with my wellbutrin, so I went off the adderall. Recently I changed psychiatrists in a snit and lucked out! I found one that not only is pushing 80, but as a neuropsychiatrist got the ADD right off, mentioned the misdiagnosis of bipolar, and when I mentioned having complications of measles when I was 30…well he amazed me, told ME what my residual effects were.. A staff member told me that adderall/wellbutrin is frowned upon by some of the community (not sure who) and at first had a problem getting the combo filled.

Later she told me that my reporting of pain levels decreasing was also something that was abuzz. I now wonder if this Dr. is new to their office because I had this experience almost 10 years ago. That psychiatrist was young but had already established himself as an expert in forensic psychiatry for adolescents. I had to choose between the adderall and wellbutrin because everytime I saw a doctor, I ended up in the ER with arrhythmia. May have been another drug causing the problem.

I wish I could get my 18 year old to see my doc, but he refuses to admit he has ADD, but that’s for another post.

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[BuxomDiva]

I just tripped over this thread and I don’t buy Russell Barkley’s statement. I have heard Dr. J. say that it is becoming more and more common for people to be diagnosed with both ADHD AND bipolar disorder.

About 9 years ago the Effexor I had been taking to manage my ADHD symptoms triggered a hypomanic episode. In reading up on the difference between unipolar and bipolar depression the latter does seem to be a better fit for the depression that I have struggled with since childhood.

While it may be true that for SOME people bipolar is a misdiagnosis, for some of us there is comorbidity.

All kinds of info out there about the depressive side of the pendulum, not so much about the difference between being hyperactive and hypomanic. For me, the difference is that my hyperactivity takes the form of racing thoughts, talking a mile a minute (and nonstop!), that kind of thing. During my initial hypomanic episode (at least the first one that I acknowledged as such!) I was driven to clean my apartment at 2 AM! I had to be physically active, very atypical for me.

Anyway, just my two cents.

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[Anonymous]

Ah ecokayaker,

I was once upon a time diagnosed as bi-polar ll by a well-meaning psychiatrist. I could understand her ‘call’ since I’d been feeling rather depressed for a long while. I was a stay-at-home mom with 3 little kids (one being LD and ADHD) with a husband that travelled far and wide about 40 weeks of the year AND no family within a 1000 miles of me. Eeek! I felt lonely, depressed and was about to go crazy!!!

After a couple of years of meds for bi-polar the psychiatrist pulled me off meds since she had decided I was ‘not’ bipolar. She still wanted me to come in to see her but I cut that out after about 2 years since we had nothing to talk about and I didn’t use meds of any type. (Why the heck was I seeing her?)

Then I had a great ‘aha!’ moment after reading an article on adult ADHD. That was me and the ‘symptoms’ were the exact things that resulted in my bi-polar diagnosis.

I found a new psychiatrist (BTW, who is NOT ancient like my previous one) and he promptly diagnosed me as ADHD. This time, the meds made a difference in how I felt and functioned. This psychiatrist told me that ADHD and bi-polar ll (as opposed to bi-polar l) are often confused for each other. He did also say that a person can also be both ADHD and bi-polar but it is not common.

Hope this helps!

.

Hope the info helps

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