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Am I Bipolar? Could Be Medical

Question:

Comment from reader:

This is just a thought. I’ve suffered from what I thought was just depression. Had other physical symptoms that I attributed to other things. Came down with diabetes and the doctor did labs before he put me on an oral medication. Liver enzymes were elevated. A year later, I asked my new doctor about the elevated enzymes. He repeated the liver panel and then referred me to a GI doctor, whom then ran a bunch of lab test, that I would’ve never thought of, and had many abnormals. Then on to the rheumatologist after my regular doctor said the labs suggested Lupus. Finally ended up with a diagnosis of Sjogren’s syndrome, an autoimmune disease, in which there are few clear symptoms, the possibility of having other diseases along with it, such as lupus, rheumatoid arthritis, etc. It now makes some sense. The depression, anxiety, fevers, joint pain and generally not feeling all that good. Most of the time I couldn’t and still can’t pinpoint specific symptoms when I don’t feel good. It’s just a thought. Remember, doctors are human beings who want to help, but there are so many diseases out there that are similar, it’s hard to diagnose them properly.

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Answer:

In response to someone who wrote us about a possible Bipolar Disorder one of our readers made a wonderful observation the nature of which that all of us should be fully aware when being there is a question of a psychiatric diagnosis. Here is what the reader wrote. The entire sequence of the Ask Dr. Schwartz question, my answer and comment by the reader can be found at this URL:

http://www.mentalhelp.net/poc/view_doc.php?type=advice&id=1583&at=7&cn=18

It is always essential to rule out possible organic or disease possibilities as the root cause of symptoms. Many illnesses carry depression as one of the symptoms. For example, it is usual for someone who has Parkinson’s disease to experience depression. Also, I have seen several people over the years with Systemic Lupus who were anxious and depressed without knowing they had Lupus or why they were feeling so very upset. While no one wants to learn they have an immune system disease at least such a diagnosis comes as a relief when it clears up the reason for the symptoms.

Physical pain can be thought to be a symptom of depression. However, Lupus causes immense amounts of pain as well as other types of diseases. Recently, someone I know finally learned that she suffers from Fibromyalgia after years of being told there was nothing wrong with her and that it must all be in her head.

We know that mind and body are not separate and for that reason it is always necessary to look at both psychiatric as well as physical causes of symptoms. To dismiss something as being "merely psychological" can be dangerous. That is why second opinions are recommended.

The practice of medicine, psychiatry and psychology are not perfect.

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