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"Bipolar" -- or cocaine?
Q: My significant other has recently been diagnosed bipolar. She is
currently in a drug treatment center at Glenbeigh Hospital. From what I
have researched im finding that many of the actions or reactions of a bipolar
person are very similar to that of a person with a cocaine habit should
we get another opinion of this diagnosis. She has been placed on an antidepressant
and mood stabilizer. Im wondering if they are truely warranted. She will
be coming home soon and will have to follow up with a local doctor, where
or whom i do not know as of yet. Please advise....
Dear Violet --
You're right: if you know she's using cocaine, she can't be reliably
diagnosed as "bipolar". The two can look basically identical: highs,
lows, racing thoughts. On the other hand, using cocaine doesn't mean
she doesn't have bipolar either. She can have both problems; in fact
that's pretty common. But her "prognosis" is radically different
dependent on which explanation is used: no cocaine, no "cycling" -- unless
she's got the bipolar piece too, in which case she'll continue to cycle
but may have great difficulty stopping her drug use. It gets pretty
tricky sometimes trying to tease these two apart. You'll have
to decide if you are going to tell her doc' about the cocaine use, with
or without her permission -- also tricky. But her doc's treatment
could be pretty "off" if she/he doesn't know about the cocaine, as you
point out. Sorry, can't really advise beyond that.
Dr. Phelps
Published September, 2000
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