In order to receive a cancellation of a small student loan, I had to have my psychiatrist fill out a form detailing my symptoms. I know he has to make it look worse than it is, but that was quite a depressing document to read.
On the Threshold of Eternity (Photo credit: Wikipedia )
But now I'm confused. I was originally diagnosed with clinical depression and severe anxiety. Then about 16 years ago, I was diagnosed with Bipolar Disorder I, and in retrospect I can see that I've had some form of bipolar disorder all my life. I see it in my father and in his mother as well. And now I've passed those genes on to one of my daughters (except in the form of Borderline Personality Disorder ).
But the document my psych filled out now says I have Bipolar Disorder II, can a diagnosis change?
Bipolar Disorder I. Bipolar disorder I is characterized by at least one manic episode or mixed episode (symptoms of both mania and depression occurring simultaneously), and one or more depressive episodes, that last for at least 7 days.
Bipolar Disorder II. Bipolar disorder II is characterized by episodes of predominantly major depressive symptoms, with occasional episodes of hypomania, which last for at least 4 days. Hypomania is similar to mania, but the symptoms (typically euphoria) are less severe and do not last as long.
Patients with bipolar disorder II do not experience manic or mixed episodes, and most return to fully functional levels between episodes. However, these patients have a more chronic course, significantly more depressive episodes, and shorter periods of being well between episodes than patients with bipolar disorder I. Bipolar II disorder is highly associated with the risk for suicide.
I don't see how I can be accurately diagnosed as either one. I can understand how, at the time, I was given the diagnosis of BPI, and I can see how now my current psych can give me the diagnosis of BPII, but then what about rapid-cycling? Which is what I do as well.
Some people may be diagnosed with rapid-cycling bipolar disorder. This is when a person has four or more episodes of major depression, mania, hypomania, or mixed symptoms within a year. Some people experience more than one episode in a week, or even within one day. Rapid cycling seems to be more common in people who have severe bipolar disorder and may be more common in people who have their first episode at a younger age.... Rapid cycling affects more women than men.
Mixed Episode - The DSM-IV diagnosis of bipolar I disorder, mixed episode, requiring that the individual simultaneously meet full criteria for both mania and major depressive episode, has been removed from the DSM-5.
Instead, a new specifier, “with mixed features,” has been added, according to the APA, that can be applied to episodes of mania or hypomania when depressive features are present. It can also be applied to episodes of depression — such as in the context of major depressive disorder or bipolar disorder — when features of mania/hypomania are present.
(All italics added by me)
At one time or another, I fit all of these criteria. I suppose that's the difficulty with diagnosing a mental illness. There is no blood test, MRI, CAT Scan, or any other quantitative test to definitively diagnose something like bipolar disorder.
Depending on which psych is doing the diagnosing, it seems like it's all a crap shoot.