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Q:  Hi David i am wondering if you can help me !  I was diagnosed with Suspected bi polar 2 on 23/12/04 I have not taken any meds for this as yet but my doctor wants me to try lithium. I am pretty sure that the diagnosis is now correct as my symptoms have recurred since the diagnosis and i feel i have identified a pattern and the triggers which set of my manic episodes. (over spending reduced need for sleep ,irritability over talking ,over emotional crying. etc. my question is this. Stress really affects me. I have lived a life of stress due to several reasons.  I am a 48 year old male.

1. I was asthmatic as a child
2. I believe that i have had attention deficit all of my life.
3. I am addicted to helping others and being thier caretaker even if it hurts. (co dependancy).
4. I suffer from Severe Seasonal Affective disorder and am mentaly and physically disabled during winter. My friends have described me as being nearly schitzaphrenic at times.
5. Due to my co dependant behaviour i allowed a man 38 to live in my house a few years ago. he suffered from severe anxiety attacks and did not seem to understand  humour,and other non verbal communication. He was extremely jealous and manipulative and did his best to sabotage my friendships and lifestyle. His acute attention seeking and manipulative behaviour eventually sent me into a deep depression. when i heard from a friend that he was trying to get me out of my own house. i threw him out !.
 
I have suffered with obsessive and intrusive thought about him ever since and have heard that he managed to get someone else to sell thier house and that he prays on people who are mentally unstable.

 1.Have i been suffering from PTSD or OCD ?
 2.Do i report his behaviour to the Police and social services. 
3. I am just starting to get over what happened to me but cant get him out of my mind. What sort of therapy should i be seeking ?  Trauma ? 
4.Is it common for Seasonal affective disorder to be co morbid with Bi Polar
5. I feel i have to relocate to a hot sunny climate next winter to avoid these recurring symptoms. What do you think ?

Your advice on these matters would be very much appreciated as i am finding it difficult to access expert treatment and counselling. thankyou



Dear H,

     My best advice is simply this.....select a physician or  psychiatrist who is knowledgeable about bipolar disorder and be relentless in getting the correct diagnosis which it sounds as though you may have already done.  Communicate openly about all of your behaviors and symptoms and again, make sure you are dealing with a doctor/psychiatrist who is persistent in getting as much accurate information from you as possible.

     I really believe it would be inappropriate and unethical to attempt to diagnose without a complete psychiatric evaluation/interview and a great disservice to you.  There are some obsessive qualities to your writing and I'm sure you have been traumatized by your past experiences as you describe them; however, I would recommend therapy to manage your bipolar disorder and it's ups and downs, triggers etc.  in addition to the other issues you have mentioned- this could best be dealt with by someone familiar with bipolar disorder who can also provide a wholistic approach to counseling.

     Your concerns and questions are very precise and detailed.  In my opinion, the management of your symptoms matters more than the labels.  It is NOT uncommon for bipolar disorder to vary according to seasons and if you are aware of these fluctuations, you can coordinate these changes with medication adjustments along with your doctor.  You need not necessarily  relocate in order to avoid climate changes.  You may also inquire of your doctor about "light" therapy during the winter.

    Try not to prolong your agony by further dissecting your situation.......this is a situation that is very familiar to me.  With all due respect, the patient who tries to diagnose  himself has a fool for a doctor.  Good luck in your future and I hope things look better for you soon.

David Schafer, M.Ed.
Staff Psychologist


Published June, 2006
 

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