Q. I was diagnosed with bipolar with psychotic features in March of 2008 after several years of experiencing symptoms. However, I have come to believe that perhaps schizophrenia would be a more accurate diagnosis.
When I was diagnosed, the doctors seemed to ignore the fact that my mood swings are directly related to changes in what seem to be hallucinations or delusions. For example, I’ll begin to believe that my family is about to die or that I should be harming people, and that will cause me to feel depressed. Or, on the other hand, I’ll feel invincible and that will cause me to become “manic”. The mood swings can be directly attributed to these changes in my mental state, not the other way around.
Recently, my paranoia and other symptoms have become so severe that I can barely leave my house. I skip classes and work because I’m so afraid of people trying to harm me outside. My sleep is abnormal and erratic. I’m having nightmares awake and asleep. These things don’t seem to me like anything I was told about bipolar disorder, even when it has psychotic features. The medication doesn’t even touch these symptoms. How can I get my doctor to reconsider the diagnosis? I don’t want to be misdiagnosed and get worse without even trying to figure out whether something else is the problem.
A. Be less concerned with getting an “accurate diagnosis” and focus more on finding the right treatment or medication. It matters less what your diagnosis is than it does finding a treatment that brings you relief from your bothersome symptoms. I say this because it can be difficult to ascertain an “accurate diagnosis.” Studies have shown that if 10 doctors are presented with the symptoms of the same patient there may be 10 different diagnoses. The same patient could see 10 different doctors for a diagnostic opinion and each doctor might give that patient a different diagnosis.
Your energy might be better spent if you go to your doctor and tell him or her that the medication that you are currently on is not decreasing your symptoms. This information should prompt your doctor to try a different medication. It can be difficult to find a medication that works effectively so do try to be patient. If your doctor is not willing to prescribe a new medication or work with you to find one that works, then try another doctor.
Randle, K. (2008). Misdiagnosed Bipolar?. Psych Central. Retrieved on April 27, 2015, from http://psychcentral.com/ask-the-therapist/2008/09/22/misdiagnosed-bipolar/