How do I know if I am diagnosed correctly? Depression/ADD or Bipolar??

[Sam I Am]

Dr. J, or anyone else,

13 years ago I was diagnosed with depression. I was subscribed Paxil, which I stayed on for 10 years, during which time I was also diagnosed & treated for hypothyroidism. Then I crashed and burned hard. I was feeling suicidal and luckily have a very supportive friend who took me to the hospital. I checked myself in to the short stay unit at the psychiatric hospital. I was taken off the paxil and put on effexor. This was my first ‘Major’ depression. I had just turned 41. I feel like I have been suffering off and on from depression since I was a teenager. I self medicated, mostly with alcohol, since the age of 14. Once I decided to grow up and be responsible….well, that’s when all my true colors started to shine. Back to age 41……recovery started, I then was diagnosed with breast cancer, had 2 lumpectomies, followed by radiation, and a few months later had a breast infection, that led to an open wound with the VON coming to my house for 3 months. Stressful, but hey, at least I wasn’t depressed. Short lived, though. I could feel that something was wrong with me…..I didn’t feel right. Back to seeking help. I was then diagnosed with classic Adult ADHD, inattentive type. Whoa! Why now? Why in my 40’s? okay, so it made sense. Suddenly everything was fitting together. Or so I thought. Just after I turned 43, I left my husband. I have been gone a year now and it has definitely been a year of ups and downs. For the ADD, I started with Ritalin, then Concerta, then back to Ritalin, then on to Biphentin. The Biphentin worked the longest….about 6 months. Everything is short lived, it seems. All the while, I continue to get depressed. So then I am diagnosed with dysthymia. Okay, again, no big surprise to me. I have always felt that way. I spoke to my psychiatrist and told him that the Effexor didn’t seem to be helping at all. In January of this year, I felt like I was slipping back to that ‘dark place’, like when I went to the hospital. I was even starting to figure out which pills I had in the house and which I could take to go to sleep and not wake up. I stayed in bed for a day and half because I was scared to stay awake to ‘think’. This dark phase passed fairly quickly. So my doc, weaned me off Effexor and onto Citalopram. It has been about a month now. Who knows? I am terrible at time management. After a couple of weeks, I went back to my psychiatrist and said I was starting to feel better for my depression, but the biphentin didn’t seem to be doing anything. I had been off of it for 5 days, and didn’t feel any difference at all. He suggested Adderall. Yesterday was my first day of the adderall. I have a dosage schedule to follow to help with knowing the right dose. Meanwhile, I keep going through depressive days.

Is it possible that I have been misdiagnosed and I am really bipolar? I talked with my close friend who has seen my ups and downs and she also has ADHD and anxiety issues. Tonight I called her and asked her if she has ever considered the possibility that I am bipolar. She didn’t even hesitate to say yes! She thinks I am. She thought that I had talked to my psych about this. Nope, I haven’t yet.

Should I call my psychiatrist and talk to him about this or should I just keep on the schedule and talk to him in 2 weeks at my scheduled time? If I was bipolar, but being treated for depression and ADD, could this be why nothing seems to stick. I was on Effexor for a year and a half, when I started seeing my doc, and he was amazed at how depressed I was still. I didn’t even realize that I was so depressed still. I guess that I am so used to it, I sometimes fail to notice. Given my history, especially in the last 3 years, that scares me. I have a family history of diagnosed mental illness, and I am sure there is many undiagnosed as well. My 17 yr old nephew is bipolar. My dad’s cousin is schizophrenic. My grandfather (mom’s dad) was depressed, an alcoholic and an abuser/child molester. He committed suicide at age 53-54. His son, my uncle, followed the same path, and abused his daughter. i have a cousin who committed suicide as well. (dad’s side) My brothers and I all have/had issues, ranging from substance abuse, anger problems, depression, anxiety/panic attacks, trouble with the law (ironic, since the oldest is a cop) to many failed relationships. And don’t even get me started on my mother. She is an undiagnosed melting pot.

So, you see, I am a little worried. Had I known the stuff I know now, I don’t think I would have brought kids into this world. I don’t want to feel guilty because I had kids….I love my kids. But, I also wonder what they will be up against. It doesn’t seem fair. And that’sjust my family. Not much different on my husband’s side.

So here I am at age 44, still depressed, unhappy, confused, totally unfocused, clueless, and sometimes just wondering if I will ever be happy again. I am not sure what to do………….I tend to really ramble…….so to recap. I am currently diagnosed as having depression, hypothyroidism, dysthymia, possibly SAD, ADD. Will the real me please stand up?

I would appreciate any feedback. I realize I gave a very readers digest condensed version, but it would be a book otherwise. Feel free to ask any questions. I have no secrets…..lol

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[Anonymous]

Sam I am,

I’m not a doc, and can not address your questions. But I would call the doc and discuss it. If the doc thinks it can’t wait for 2 weeks, he/she will want to see you earlier. If it can, at least you don’t have to wonder about whether you should call or not.

Take care.

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[ADDled]

When I first started investigating ADHD for myself, the Psychiatrist investigated Bi-Polar disorder. I thought that was a little odd and when I asked he said sometime the symptoms can be similar. So in order to get an accurate diagnosis, I had to keep a “mood log” for several months. And, unfortunately, it may take that long to to find out if you are indeed bi-polar. Some bi-polars can “rapid cycle” between states, some longer…even months.

In my case, being bi-polar was ruled out, but was prescribed Lomotragene as a mood stabilizer , Wellbutrin for depression and Concerta for ADHD. I’m a mess, a perfect storm of anxiety, depression and ADHD. But I now can tell the difference when my mood isn’t stable and take counter-measures.

Most of my adult life I was fighting depression with little success and it was only after being diagnosed with ADHD, that everything fell into place. The treatment for ADHD certainly eased my other symptoms: they still exist, having less impact than before. But as I said, I can now basically tell the difference when something is not right, and that’s half the battle. Adult ADHD has only recently become recognized as a condition. It was unheard of when I was first diagnosed with depression. Who knew?

Realize this may take time to sort out, but your doctor needs to sort out exactly what he is trying to diagnose and to prescribe the correct medication.

Hope this helps…and good luck.

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[Tim]

I too have had a lot of downs and downs in the half century that I have been on this planet.

About 1988, after wrapping up my post doctoral work, I sought help and was diagnosed with depression. After a couple of years of useless talk therapy I asked my GP to refer me to a psychiatrist and started taking antidepressants. Unfortunately the psychiatrist died about six months later and my GP took over my drug (mis)management. For the next seven years I was in an antidepressant as he ramped up the dose of one drug the max only to admit defeat and try the same thing with another. All along I was suffering physical side effects and, especially on the last one, Serzone, visual and auditory hallucinations. At one point my GP took me off the maximum dose of Effexor one day and onto another drug the next. The crash was so bad I almost killed myself. After that he sent me to another psychiatrist to keep writing the scripts. All through this episode I never felt any relief from the depression. In fact I had never suffered so much in my life.

Fortunately my intellectual side is strong and has been my friend all along. I looked carefully at my life and saw that my career was in shambles, I was broke, I was lonely and very very unhappy. I also saw that there was no good future in the direction I was headed.

At this point I told the MDs that I was going to stop taking the drugs and they predicted disaster. My feeling was that things could hardly be worse than they were. I tapered my dose to zero over two weeks and noticed that each day as I took less I felt better. I sought help with a CBT therapist and I have never looked back. It’s pretty clear that ADHD was the issue all along and I’m starting on a new journey here.

I do have an important point to make that I think “Sam and I” and others should hear. It is your life and no one else’s. You need to keep yourself informed and ask yourself if what you are doing is helping you. I went so far as to make an appointment with another GP and got referred to a psychiatrist who is also a researcher at a major teaching hospital. I needed to talk to someone with a fresh mind, recent knowledge and no interest in justifying my original diagnosis and ongoing drug therapy. The problem for me is that antidepressants fog the mind — I became very complacent and compliant for far too long. Also, in some people, me for example, they cause depression and none of the MDs ever picked up on this.

Sam, you sound desperate and confused which is where I was many times. My friends and my cat were a big help in these times and so was the local pub. As a student of science, I bumped into Albert Einstein quite often, metaphorically of course. He is said to have defined insanity as “doing the same thing over and over again and expecting different results”. Perhaps the key to your recovery is there.

I hope this gives you something to think about and I wish you all the best.

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[Anonymous]

Sam,

I wish I could say something helpful to you, but I feel I would need to be close to you physically, or at least in contact, on a daily basis over a longer period before I could really have a properly based opinion about how to change your situation.

I am writing anyway because I need to say something to DrTim.

But Sam, I wish you the very best of Luck in the future!

*******

DrTim,

what you say in the second last text block is so close to precisely how I experience these things. It’s simply just so great to see one other person who has the same thoughts, and even some experience to back it up!

One thing though: You’re right of course, when you say: “You need to keep yourself informed and ask yourself if what you are doing is helping you”, but there is a “but” and it is this: Not all people have the intellect necessary to do this. I suspect you must know this, and I can definitely say that I have plenty of experience to back my statement up because I’ve suffered from a tendency to try and get all and everybody around me to do just that: Keeping themselves informed and asking themselves if what they’re doing is helping themselves or not”.

But I want to emphasize that everything you wrote was great to read, and it gives me a renewed feeling that I’m right about these things (which you say in your text).

I really, really hope it can be helpful to others.

I’m not saying nobody should be on medication or even that just few should be so. But I find it important that as many options as possible are addressed, because we do tend to focus on what we hear or read from others. After all we do live in a world of consensus, and at the same time it’s just as certain that no two persons are exactly the same (just take a look in the various threats about different medications and see how different the individual experiences are. It’s rather amazing, really).

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[Sam I Am]

Thanks to all who replied to my post. At the present time, i have not bothered with the Adderall. It is too hard to worry about ADD when I am in this ‘state’. It is like the bottom of the totem pole. At this point, I feel like I need to get this depression under control more than my ADD. So, I have gone back to square one. I called the community mental health dept and to do a ‘self’ referral, it is 7 days to get some help if it is urgent, 28 days for semi-urgent, etc….. I was so disgusted that I told them, “7 days if it is urgent? God, people could be dead by then!” and then I hung up. I called the dept where I went when I was discharged from the hospital after my breakdown and was told that my file was closed and I need to see my doctor for a referral. Okay, then, I called my GP and as luck would have it, she is going to be off work for the next 6 weeks. Fortunately, my doc knows me well and before she left, she did the referral up for me. We’ll see how long it takes. No wonder people don’t seek help when they need it.

For me, I am just hanging in, taking things day by day. I am trying to control any impulses I may have, such as making the moves on my husband, whom I have been separated from for a year. lol. This is what happens……I get these big ideas in my head and I want to act on them. The intelligent part of my brain knows that this could be disaster. What good would it do? Besides risking hurting my whole family again, I don’t even know if what I am feeling is real. Part of me just wants my family back, but how long will it last until I go wacky again. I feel like I have been climbing a mountain my whole life, and the relief I feel when I am cresting the hill, when I look around and realize that all that is there is more…….mountain. No matter how happy I can feel, it never lasts and I am always searching for the way to something better. It’s my job, it’s my relationships, it’s my geography………sometimes I think my whole life is one big fantasy. It’s so frustrating. What am I looking for? Why can’t I just stay happy? Is something really wrong with me or is it just a personality defect? Last year, I went home for a visit to BC and when I came home, within a month, I had a plan. The kids would stay with their dad, I would get them after Christmas, march break and 6 weeks in the summer. Had it all planned out. Holy shit! Thank God, their dad fought me on it, and I think the sane part of me realized it was wrong. I love my kids more than anything. I have hurt them alot. How could I even consider that leaving them would be even beneficial? That is just one of my ‘great’ ideas I have had this past year. So now I am acting on nothing. When I am not depressed is when I get even more worried. That’s when I get my brainstorms. I am just trying to keep it together and make no ‘big’ decisions about anything, and wait to get in to see someone. The psychiatrist I go to see, well, I don’t feel comfortable opening up to him. He will probably just be mad that I am not taking the Adderall.

Sorry for the long post. When I get on a roll, I vent and ramble on.

Thanks for listening.

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[Anonymous]

First of all, SAM I AM, you have lots of courage to keep going and you can see it in your writing. You have a tenacity of spirit and a clear survivor mentality. However, at the minimum you would meet the criteria for what is referred to as a Dysthymic Disorder, chronic depression. Sometimes this is partly a combination of your environment and your genes taking a whack out of you. The meds will only address some of the story and even then, you may need to be on combination treatments. Who is addressing your coping strategies, your self esteem, your occupational story etc? There are many different components here and, frankly, it can be a bit overwhelming.

Take a step back and focus on one symptom. Maybe it is anxiety, self esteem, clutter, motivation, etc. Now, create a treatment plan on one thing and make it a holistic plan. Knock off one symptom, it gives you hope you can manage the rest of them. You stated you wanted your depression managed first more than your ADD. OK.

If necessary seek out a specialist in depression to help you. Always remember, that if things get so bad you can’t go on, go to any ER and they will always assist you.

Focus on the positives, count your blessings and surround yourself with people who care about you and distance yourself from the things that make you feel unsafe. Step out of your soap opera (we all live in one, incidentally) and gain new perspective. A professional therapist can show you the way. Hope, Spirit and Love. Start here and the rest follows. Don’t make things more complicated than they have to be.

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