Q. I have been seeing psychiatrist(s) for over 5 years now and feel I have progressed into other illness categories. At the time originally, I was diagnosed as Bipolar Atypical w/Psychotic fea. I was hospitalized 6 or 7 times since then with a past history of substance abuse (usually related w/hospitalization). I have since been clean for 1 year which I know is only a short time. I feel depressed every single day even if I have a somewhat good day, I still feel that rotten feeling inside as I have complete low self esteem issues. I have beat myself up over and over for the past and have had life threatening traumas happen which I consistently keel over about now knowing this is PTSD. I am constantly paranoid that people are conspiring and planning an event to kill me when I am alone and found. Have discussed this DR’s and thus put me on Risperdal. This has never gone away. I am paranoid outside as I feel people are “looking at me” like they know something is wrong with me, I have difficulty making eye contact (I feel very uneasy, shameful when I do), i sweat profusely when i talk to someone in fear, feel like any conversation I hear outside is about me (no matter how far away). When I go out ie. to a public place I feel I am ‘on guard” because it never fails someone is “strangely” checking me out and thus I leave in fear as I feel completely alienated and all Alone. I am always wondering if I have been misdiagnosed with someting else as i too feel I am BPD and not TRUE Bi-Polar. The Dr’s say this paranoia is related to Bi-Polar and I have it more intensely than some others. I dont know. It really is ruining me. As for my mood it fluctuates daily still every hour or so, I feel fine and then “crash” like an hour later with a completely diff thought process and zero energy. I currently take an ssri, epival and seroquel @ night yet symptoms are still here. There is so much more I would like to say from the daily anxiety, paranoia, thought changing, mood changing and feeling diff. personalities. I have also a real hard time in any sense of who I am anymore and go through many identinty changes which involve money spending on complete new clothing styles, shaving my hair, not caring how i’m dressed and feeling completely disgusted with myself and wishing this would all end. So if you could provide any feedback that would be helpful as I have been to many Dr.s, feel misdiagnosed and maybe not even being properly medicated. Feel really confused. Pls Help!!

A. I am sorry you are having such difficulties. It really must be difficult to live with the problems that you have described; especially the paranoia and believing people are conspiring to hurt you.

Misdiagnosis is unfortunately very common is the psychiatric world. While the Diagnostic Statistical Manual (DSM) for mental health disorders was created to provide guidelines for a diagnosis, it’s not an exact science. There are studies that show doctors and clinicians can have very different diagnoses for the very same case. I have had clients who, like you, each time they went into the hospital, came out with a different diagnosis. In one specific case I am familiar with, the client was diagnosed with schizophrenia during one hospitalization and during the next stay at the hospital, a different doctor diagnosed the same client with depression. Some will argue that finding the exact diagnosis is key to finding the correct course of treatment. But at this point, I am not sure how important finding the exact, correct diagnosis really is for you. What seems more important in your case is to find a doctor you like and a medication combination that can help you relieve some of your symptoms. As you might already know, finding the right combination of medication is not always an easy process. It can involve much trial and error. Instead of focusing so much on getting a diagnosis that you feel fits you, instead, focus on finding a doctor you feel comfortable with. Look for a doctor who is willing to work with you to find a medication regime that can help you feel better and not cause too many side effects. You might also want to try therapy for additional support. I know you said you have been to many doctors already, but I recommend that keep going until you find one you really like and can trust. It could make all the difference in the world. Good luck.