Posted by Racer on October 17, 2007, at 17:15:08
In reply to Difficulty in Diagnosis? Bipolar II??, posted by andsoitgoes on October 17, 2007, at 16:04:48
Hi, Nick,
Well, I'm having concentration troubles today, so I'm not sure I have much useful input, but here's a try:
First of all, I'm not entirely convinced that all of that adds up to bipolar to me. If you're being literal when you say "Sometimes I'll have a few hours to where I think I'm a genius and what I type is pure gold, but it never lasts for an extended period." -- a few hours does not a manic episode make. Also, some of your other descriptions do not sound like bipolar -- the social issues, the work issues, etc.
Yes, you do have symptoms suggestive of ADHD -- the disorganization, etc -- but I'm not sure I'd go for that, either.
Honestly, it sounds like some combination of depression, anxiety, and probably one of the anxiety-related personality disorders -- or more likely Cluster C personality traits, since it doesn't sound like a personality disorder, either, really.
(I'm sorry for being so skimpy on comments -- I'm having an allergy attack today, with burning skin, fever, nausea, and I can only think a little bit... I will try to get back to this when I'm more myself.)
As far as treatment goes, I would very strongly recommend psychotherapy as a main focus -- a lot of what you've described can be approached behaviorally, and it's more likely to be effective than any medication on its own. You won't necessarily need to discuss how you were potty-trained, just learn some more adaptive coping strategies. (Although I'm a big fan of psychodynamic therapy -- I get to talk about myself for fifty minutes? And no one says I'm being selfish? WHOOHOO!)
In terms of medications, I'd think in terms of cocktails -- a lot of the issues you've brought up would likely improve with serotinergic drugs, so maybe include Zoloft into the mix -- or pick your favorite SSRI -- add in some Provigil for focus, and if that doesn't help, try Ritalin again; and add something in to augment the antidepressant effects, while maybe offering a bit of stabilization in case I'm totally off base about your dx -- I'd say Lamictal is pretty helpful for a lot of people, Seroquel is also quite helpful. A lot of people seem to be finding Abilify helpful, too.
Good luck!
poster:Racer
thread:789780
URL: http://www.dr-bob.org/babble/20071009/msgs/789807.html