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Diagnosis Second Opinion

Question:

I have been seeing a counselor for almost a year and felt it was time to consider medication. I went to a psychiatrist who prescribed Lamictal and Klonopin for Bipolar 2, Cyclothymia. After looking this up on the internet, I feel that another diagnosis better fits my symptoms.

I am asking that you give me your opinion. Here are my major symptoms: anhedonia, rage, manipulation, splitting, issues with abandonment, severe anxiety, self-esteem issues, cutting, reactions of emotion, interpersonal sensitivity, situational incompetence and issues with control.

I don’t ever have times of mania.

Is this the correct diagnosis for me? Is there something else I should ask about? I just want to feel better and be able to love my children. I am not suicidal, nor do I have feelings to hurt my children; I just want to give them their mother back. What else can I ask my counselor/psychiatrist about? Thank you for your time.

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  • Dr. Schwartz responds to questions about psychotherapy and mental health problems, from the perspective of his training in clinical psychology.
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Answer:

While getting a second opinion is sometimes a good idea, seeking it on the Internet is not. The reason is that the psychiatrist saw you in his office, face to face. That forms part of his assessment and that is indispensible for any diagnosis, in my opinion. Also, whether you are aware of it or not, he gave you what is called a “mental status exam.” That means he asked you a variety of very targeted questions designed to focus in on possible diagnoses.

If you really want a second opinion, my advice is to go to a second psychiatrist. However, that can be costly and you may remain dissatisfied.

Your psychiatrist had reasons for making his diagnosis. He is in a much better situation to come up with a diagnosis me or you. Regardless of what information you found on the internet, neither you, I or anyone else can or should be their own doctor, whether physical or mental health is involved. For example, there is a category of Bipolar Disorder 11, called “A typical.,” or NOS, (Not Otherwise Specified).  In this, the patient has some but not all of the symptoms. A person with A Typical Bipolar can have the depression and anger, etc, without mania. Its a complicated diagnosis as most of them are.

If you do not have confidence in your psychiatrist’s judgment and skill, go to another one. Be aware that you should have solid reasons for not feeling confident, above and beyond the question of diagnosis. If you do have confidence, stick with him, at least that is my opinion.

Before you leave this psychiatrist, please remember that you say that control is part of your issues. It may be that the wish to be in control is what is causing you to question the Doctor’s diagnosis.

Good luck

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