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I'm Not Bi-Polar Please Help!!!


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I was diagnosed with POTS in 2001 at the Cleveland Clinic. For years I have been seen by several psychiatrist due to being depressed. Over the years I have been depressed simply because I do not feel well and I'm not able to do the things I need or want to do. I do not get adequate sleep therefore there are times that I am moody. Once in awhile I have a good day, when I do I'm happy and enjoy the moment. My psychiatrist has done some research on POTS and I know he understands it better than I do, but I don't feel he is listening to me. He has diagnosed me with bipolar 2. My chief complaint has always been extreme fatigue, depression, dizziness, brain fog, and not being able to sleep well, all these are symptoms many POTS patients have. Below is a list of bipolar symptoms; beside each one I have typed in if it applies to me or not. I would greatly appreciate it if you'd read the symptoms of bipolar and respond to the symptoms I said applies to me could relate to my POTS symptoms or if they apply to you as well. Thank you!

Manic phase of bipolar disorder

Signs and symptoms of the manic or hypomanic phase of bipolar disorder can include:

  • Euphoria (no)
  • Inflated self-esteem (no)
  • Poor judgment (no)
  • Rapid speech (no)
  • Racing thoughts (no)
  • Aggressive behavior (no)
  • Agitation or irritation (sometimes)
  • Increased physical activity (only when I push myself)
  • Risky behavior (never)
  • Spending sprees or unwise financial choices (I'm a penny pincher)
  • Increased drive to perform or achieve goals (I wish)
  • Increased sex drive (don't have the energy or drive)
  • Decreased need for sleep (I want to sleep all the time)
  • Easily distracted (yes)
  • Careless or dangerous use of drugs or alcohol (never used drugs or alcohol)
  • Frequent absences from work or school (yes)
  • Delusions or a break from reality (no)
  • Poor performance at work or school (yes)


Depressive phase of bipolar disorder

Signs and symptoms of the depressive phase of bipolar disorder can include:

  • Sadness (yes)
  • Hopelessness (yes)
  • Anxiety (yes)
  • Guilt (no)
  • Sleep problems (yes)
  • Low appetite or increased appetite (sometimes)
  • Fatigue (all the time)
  • Loss of interest in activities once considered enjoyable (yes, only because I don't have the energy)
  • Problems concentrating (yes)
  • Irritability (yes)
  • Chronic pain without a known cause (no)
  • Frequent absences from work or school (yes)
  • Poor performance at work or school (yes)

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Oh goodness, how awful for you. I understand why your questioning. If you never have symptoms of the manic phase, how could it be bipolar, depression or anxiety maybe!! From what I understand there are definitive laboratory testing that can show bipolar, one of them I think is a thermal brain scan. Have they done any kind of testing on you that assisted the doctor in coming to this conclusion?

There is also a genetic test that I recently found out about that if you test for it in a certain pattern you are more prone to depression and bipolar disease. The treatment for it mainly is taking the active form of folate called methylfolate, also adding in methylb12.

The test is called the MTHFR gene test. They also check for recurrent miscarriage and those at high risk for cardiac disease. It can also cause birth defects like spina bifida, cleft palate, I think.

Trust your instincts, I think we all no intuitively what is right, as long as we are willing to be honest with ourselves. The good news if it does turn out to be bipolar they are very good at treating it now and there is all kinds of support. But, who would want to take those medications if the diagnosis was incorrect. Life changing though if you do need them.

If it were me I'd insist on unsubjected diagnostic testing before excepting this life alter diagnosis. Have they prescribed you meds yet?

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"Bipolar" is the popular psychiatric diagnosis of our times - more and more people (especially women) are being labeled "bipolar" simply because it is convenient and covers a myriad of symptoms. Before being diagnosed with AAG (the proper diagnosis), I was diagnosed as "bipolar" and given a cascade of medications that made me sicker than I already was. Luckily, I had a psychiatrist who recognized I didn't fit the profile and he began researching - his conclusions were correct: I did not have a psychiatric condition but, some undiagnosed disease process - probably autoimmune related. I found out later that often the first symptom of AAG is...depression that mimics bipolar. Go figure! So, I look with skewed eye at anyone conveniently diagnosed with bipolar that has previously not exhibited symptoms and has no genetic history that would suggest mental illness. - not judging...just saying may need to dig deeper......

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This is a touchy subject for me - I hope I don't offend anyone with my comments. I really believe the "science" of psychiatry has set real science back 100 years. Most of the "symptoms" you listed I believe are a normal response to chronic illness and some of them are POTS symptoms. If you go to a psychiatrist, they're gonna try to find a psychiatric diagnosis. I saw a psychologist before I was diagnosed to get help coping with all the symptoms. After several sessions, she told me I don't need her, I need a good neurologist- and she referred me to someone. This was the responsible thing to do. If you're not happy with this Doctor, maybe you can find someone else who will help you cope emotionally, without trying to pin a psychiatric label on you.

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imho, it sounds like it's time for you to fire this doctor. He's not listening, ignoring your pots dx and has diagnosed you with an illness that's going to affect how other medical professionals view you.

Have you tried supplements for sleep ? Melatonin, 5htp and theanine help me. Or ask your gp for

a sleep med. I need klonopin for nocturnal myoclonus.

5htp helps with mood but I've read that taking too much can make you euphoric. I seem to need 100 mg at bedtime for mood. I've never felt euphoric from taking up to 300 mg if I'd done too much.

Tc ... D

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I completely agree with the other posts here. Why do psychiatrists find it difficult to believe that we may be depressed and anxious because we are so limited in our physical abilities?? And given how in recent years every other person I know has been diagnosed as bipolar (my niece, my brother in law, my sister in law, two friends, etc.), I'm really starting to be a bit cynical about it. Don't get me wrong - I'm sympathetic to their respective issues - but ALL of these people are now bipolar??

I also read something recently about how one of the symptoms in women of a heart attack is severe anxiety (apparently women's symptoms of heart attacks and heart disease tend to differ from those experienced by men). I'm not suggesting that you have heart disease or are having a heart attack(!), but it seems to follow that if a malfunctioning heart - a measurable physiological problem - can cause anxiety, then doesn't it follow that it's quite possible that POTS, which is obviously heart-related, can similarly cause anxiety, rather than the anxiety being caused by some psychological/emotional thing?

Hope you find some answers soon. IMHO - time for a second opinion.

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I was lucky with my psych too....she was the only one who actually believed me out of all my initial doctors.....she laid the groundwork for my eventual diagnosis thanks to referring me to other specialists. She was thrilled when I finally got a diagnosis. If it wasn't for her I would still be told its all in my head ;)

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My opinion is that many doctors will refer to a psychiatrist to rule out a psychiatric cause for symptoms. A medical cause should be ruled out prior to a psychiatric cause. Often, on referral of a patient a psychiatrist will assume their must be something psychiatriac there in my opinion. The symptoms listed above are seen in bipolar manic/hypomanic. A diagnosis requires distractability, increase in goal directed activity, grandiosity, flight of ideas, increase in activities that are pleasurable but with painful consequences, pressured speech, and decreased need for sleep or 5/9, incl. an elevated, expansive, or irritable mood according to the DSM-iv psychiatry manual. I cannot say if you do or do not have this.

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Speaking as a bipolar person with dysautonomia too... I obviously can't diagnose, but what the original poster describes sounds a lot more like chronic illness-induced depression (the type that dani says, where the illness tires you out and you get depressed, but wouldn't be depressed if you were well). I get (well, got, my bipolar is well controlled with medication, which is one of the ways bipolar can be diagnosed) many of those manic symptoms, and it's definitely distinct from (predates!) my dysautonomia. Obviously not everyone is the same, but the bipolar I experience (bipolar II with mixed states) is definitely much more obviously bipolar than what other folks describe above.

(for what it's worth, there are still no definitive lab/imaging tests for bipolar, although some of the imaging tests are looking somewhat promising)

I'd be tempted to dump the psychiatrist and find a psychotherapist that will work with you concerning strategies for chronic illness-related depression symptoms. If you don't need medication for dealing with the depressive symptoms, you arguably don't need a psychiatrist anyways, but a therapist might help you cope with the rest.

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Thanks everyone for your response!

Anna...There are no family members with Autism.

Since my psychiatrist would not give me sleep medication I went to the ER a little over a week before my doctors appointment. I was so surprised that in the small town in which I live the intern at the ER was well informed about POTS. :) My psychiatrist is also well informed and certainly knows more than I do. What was upsetting to me on the 16th my psychiatrist told me that POTS is very rare and that Bipolar is very common, I felt he was indicating that I couldn't have POTS because of how rare it is. I have told him several times I was diagnosed with POTS at the Cleveland Clinic and that a tilt table test was done. Getting back to my ER visit, I was given a prescription of Xanax to help me sleep, the next morning I woke up a different person, I actually felt like getting out of bed. I was able to do several actives that usually are very difficult for me. I went 11 days without any POTS symptoms. I have never had 11 normal days in a row for at least 13-15 years. The 12 day I had an appointment with my therapist, he went over the doctors notes and I was upset about them as he made it sound like I was refusing treatment. I had told the psychiatrist that I really feel the lack of sleep for so many years is causing my POTS symptoms and I wanted to try the Xanax for 4 weeks, if I crashed in that time period I'd take his advice and go on a mood stabilizer and back on the Cymbalta. I told him I didn't need a prescription of Cymbalta since I had enough if I felt I needed to go back on it if I felt depressed again. The stress from the my appointment today brought on a few slight POTS symptoms, dizziness, anxiety, and of course depression. Since the prescription of Clonazepan he prescribed isn't work as it's just after 1am I feel I will probably crash again soon.

Thanks for reading my post.

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  • 3 weeks later...

1st off i agree 100% with Naomi's comments! But I do feel that if you don't have someone close you can talk over issues with who wont judge you then a psychologist is good just to get things off your chest and give you some positive reinforcement. Problem they sometimes think they are rocket scientist and want to give you labels like you are some broken tool.. Chronic illness causes depression and our good days and bad days are more pronounced then non ill people. So it may seem like bipolar to the untrained person but its not. Now i'm not a psychologist and I don't know your whole background, but if you only started seeing him after becoming ill, i would think its mighty hard to distinguish the two..

I'm already majorly depressed from this Illness and I can see that if it doesn't improve I could get even worse. My sleep is so messed up. Its 6:45 am and i'm still up. I get 1-2 hours day light max.. Its turned me into a bat..

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