Psych Central

Bipolar diagnosis and trauma

By Dr. Marie Hartwell-Walker

Recently my friends and my partner all told me that my behaviour (ie my mood swings) was worrying them and that they thought I might have bipolar disorder. As I looked up symptoms on the internet a lot of them rang a bell, so I booked an appointment with my gp who then referred me to a psychiatrist.
He, in turn, took an assesment and then told me that even though I showed most symptoms, I couldn’t possibly be bipolar, because there was no major trauma in my life. I was dismissed with the words, “Your behaviours aren’t normal, but there’s nothing I can do for you.”
I’d love a second opinion, but I’m too ashamed to go back to my gp, as I feel I’m considered an attention-seeker. Does the psychiatrist have a valid point? Do you have to have been severely traumatised in order to be diagnosed with bipolar, even if you show a large majority of the symptoms?

A: I really, really hope there was a misunderstanding between you and the doctor. I don’t like to think that a psychiatrist would rule out bipolar disorder because of lack of an identified trauma. I also would hope that an alternative diagnosis would be considered and treatment offered. That’s just good practice. Since you didn’t get any new information or practical suggestions from your visit, by all means, get a second opinion.

One does not have to have been traumatized to develop bipolar disorder. I can’t offer you a diagnosis, of course. But I can tell you this: If you are uncomfortable enough to seek help you should be given the benefit of a complete assessment and then presented with some alternatives for helping you manage what you describe as mood swings. Treatment might include medication, some behavior management skill-building, or talk therapy – or some combination. It’s not reasonable, in my estimation, to tell someone that her behaviors aren’t normal but, oh well, that’s just too bad.

Please don’t be too embarassed to go back to your doctor. Simply explain what happened and ask for a second opinion. It’s neither unusual nor inappropriate for a patient to ask for a second opinion, no matter what. You are trying to understand and obtain treatment for something that is giving you distress and that is worrying those who love you. It’s also important that your gp get feedback about the referral. That may influence whether he or she refers patients to that psychiatrist again.

Please follow through. You deserve to get the help you need.

I wish you well.
Dr. Marie

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Last reviewed: By John M. Grohol, Psy.D. on 24 Sep 2010

APA Reference
Hartwell-Walker, D. (2010). Bipolar diagnosis and trauma. Psych Central. Retrieved on April 20, 2014, from http://psychcentral.com/ask-the-therapist/2010/09/24/bipolar-diagnosis-and-trauma/

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