Second opinion psych: what to expect?

[Cacoethes]

Hey guys

I have an apointment with a private psych for a second opinion on my diagnosis/treatment on th 24th.

Has anyine had one?
What kind of things do they ask?
Do they need to know lots aboiut your history and previous diagnoses?

thanks in advance

[Epicene]

I'd imagine it's probably much like a comprehensive first assessment. If they are private and you have referred yourself, there may not be much of a focus on previous diagnoses. I'd guess they would want to go in fresh and hear how things are for you right now, rather than having the potential of bias.

Good luck!

[Cacoethes]

thanks :)

I haven't had a proper assessment of my mh for 10 years when I was first picked up by services, since then, they've just carried on from other peoples opinions. It's a bit like Chinese whispers!

So I suppose they'd ask questions about moods, 'weird' experiences and stuff?

[sherlock holmes]

I dont think I've ever had a second opinion... oh yes I did, in hospital, but the second opinion psych got a load of notes from my other psych.

I remember being asked a LOT of questions about my mood, my appetite, my sleep, if I heard voices or saw things that other people couldn't, self harm, suicidal thoughts, anxiety etc.

I hope your assessment goes well. I'd write a list of all the symptoms you experience, even if you think it's not mental health related, and bring it with you to read from. Don't leave anything out because often what we think is irrelevant is actually very important.

My only concern is that an hour (or however long it is) might not be long enough to give you a definite diagnosis, but at least it'd give you a general idea of what's going on.

[Cacoethes]

Thanks Sarah

I think I'll ask some close friends if there is anything that's important to tell her about because some people think things are mh related when I don't, so I suppose I should mention those things too.

Yeah, I wouldn't think an hour would be long enough for anything definite, but she might at least be able to see what might need looking into or whatever. And I could always try to save up for another appointment if it would be useful.

[Angelina]

When I had mine (on NHS) it was 2 appointments 1.5 hours long, one alone and one with my carer where he poked and prodded in depth into my history, behaviours, experiences, life story...just everything.

It was just like being assessed the first time, just getting another persons perspective on it.

Good luck. xx

[Unbreakable.]

Not sure I have anything productive to say, just wanted to wish you good luck with the appointment as I know it is pretty important to you. <3

[Cacoethes]

Thank you Angelina, that's helpful :) (I don't know why I didn't see your reply before this!)

Thanks Lana x

[CagedBird]

Depends what you want out of it. Why you are requesting a second opinion etc.. I'm assuming if you think your diagnosis is wrong, it may be worthwhile explaining how you understand it, why you feel other professionals may feel you have that diagnosis but why you don't believe it to be the case for you personally. Built into this it may be useful to describe some of the issues raised to you by your friends and how they perceive them to be MH related but then offer your understanding of it.

Also, in respect to treatment it may be worthwhile explaining what you've been through previously and be honest about what treatment you have been offered, been through, but didn't actually fully commit to at the time. In particular it may be useful, for you personally, to explain your epilepsy and difficulties adhering to your medication regime for this. It may be that a lot of your 'symptoms' require untangling.

I've had a private assessment completed before. He initially asked why I was there, so essentially asked what my main issue was, as I perceived it to be. For me, I didn't explain this through past diagnoses or using mental health language but what I felt my issues were preventing me from accomplishing. E.g. exhaustion meant that I couldn't socialise with friends so I'd become isolated and lonely etc. I can't imagine a consultation that doesn't ask about your history and past mental health experiences. With 8 years in-patient, or at least closely linked to mental health services, I'd assume this would be a significant aspect you'd want to discuss!....hence the 2nd opinion you're requesting (at a guess).

[tiptoes]

I think one thing that to maybe get across is how fluxional your symptoms are, at least how you present across le interweb from one week/month to another is quite varied.

Maybe make a note the symptoms that generally present together. If there are any triggers/life events etc that can prelude the symptoms.

[Cacoethes]

CagedBird- I do think my dignosis is wrong and so do plenty of other professionals, like the CATT doctor who was aware of my history and what I was presenting with, he said I didn't fit a diagnosis, but he said that I didn't fit the BPD diagnosis.
I have no doubt that I fitted the diagnosis when I was originally diagnosed at 18, but how normal is my personality going to be when I grew up in hospital anyway?! But that's a different story!

Basically, I want an unbiased opinion on my symptoms, not necessarily diagnosis. I would expect that she would ask about my history but I would be reluctant to tell her my past and current diagnoses because that's an automatic bias and my past diagnoses have been so different to my current one. It was psychotic depression, then schizophrenia and then BPD so it would just complicate things I think.

Recently, because I've become a bit of a hopeless case, the MH people have kind of given up, like they will come to see me and chat and stuff but nothing is ever suggested or really talked about, I've pretty much been written off.

Sarah, I'll make sure to make some notes, Chels is here this weekend and she knows me better than I do! So we're gonna think of some stuff to bring up.

Thanks both :)

[Wonderland.]

I'm glad Chels is going to help you with the list of symptoms. It can be helpful to find out things from another persons point of view. Sometimes it can be hard to see our symptom as they just become normality after some time.

I really do hope seeing the psychiatrist helps :-)

[Copernicus]

It's worth making clear early on what you're asking for - it sounds you want suggestions for how to treat things, more than another look at the diagnosis?
Hope it goes well, let us know.
x

[Cacoethes]

Thanks Ames and Copernicus :) x

Yeah, I just want to know what is going on, if anything, diagnosis isn't majorly important although I would like to get rid of it completely as I and some other professionals believe it is wrong and I'd rather not have an inaccurate diagnosis, if I have to have one at all.

[Copernicus]

Yeah I can see why you'd wonder. Just going on what I read on here BPD doesn't seem to quite fit.

[Cacoethes]

Thanks :) Hopefully she will be able to suggest some helpful things, I'm going to be discharged from the CMHT soon anyway but I just want some answers for my own benefit really.

[CagedBird]

I have no doubt that I fitted the diagnosis when I was originally diagnosed at 18, but how normal is my personality going to be when I grew up in hospital anyway?! But that's a different story!

That was my point. Being institutionalised for 8 years during crucial teenage years when you develop your sense of identity and learn how to negotiate relationships and how to cope with intense 'negative' feelings, can't have been the best environment for all these. It's interesting you feel BPD, which is a collection of fundamental beliefs and ways of interacting with the world, can fit you are 18 but not at 22.

I'm not suggesting you aren't right and you don't have BPD. Nor am I suggesting there isn't more going on. Just suggesting we're saying the same thing but from different perspectives.

I've pretty much been written off.

I thought this was what you wanted. You are rather ambivalent!

I hope you find what you are searching for.

[Cacoethes]

A lot has happened since I was 18. I've been out of hospital (bar 2 days in October) for 18 months and I had to 'grow up' fast. I formed friendships for the first time and began to live independently, a lot has changed.
I can't remember the exact point that I think I changed, but at a guess, I would say a couple of years. I think when I came out of my 2 year section.

One of the reasons I want discharge is because I've been written off. If the CMHT were able to suggest something, or if I thought they could offer something, I wouldn't be so desperate to be discharged.
I don't resent it, I've got to a point where I think I'm the best I can be and there is nothing that MH teams can help with anymore.
Even my CPN said last year that if I was convinced nothing would help, then I'd be written off as untreatable. Which I suppose I am!
But I'm ok with how things are.

[sherlock holmes]

If your second opinion assessment gives you a new diagnosis, would you take it back to your CMHT and ask them to treat you for it?

[tiptoes]

Hope your appointment has gone ok today x

[Fire Fly]

Hope it goes well and it comes up with some ideas how to help you better within the nhs. That's annoying that it's been a bit like Chinese whisper but hopeful this will help enable you to get the right help and support you deserve! Xxx

[sherlock holmes]

How did it go?

[Cacoethes]

It went ok thanks :) xx

She came up with cyclothymic disorder and recommended something like sodium valoprate or depakote on top of lamotrigine.
She said if I hadn't of been on Lamotragine already, she would have recommended that. Which is good because my MH team were adamant that meds would not help, it was only because of the epilepsy when we found that meds did actually help, so I'm pleased that she agreed with that.

So I think it was positive and she said I'm not schizophrenic or bpd which is good to know!

I'm seeing my cpn on Thursday and I told her I had the appointment so I'll tell her what happened, although I can't really see them taking much notice!

I feel better for the appointment though. I was a bit worried that I was pretending everything was worse than it is, so it was reassuring that she didn't think so, she also acknowledged that I'd done really well considering the past which is always nice to hear, I do forget sometimes quite how far I've come.

[random.swirls]

Cyclothmia makes sense

Did you talk about the did stuff

[Wonderland.]

I'm glad to hear it went okay lovely.

I hope your CMHT do listen, as there is hope things can improve for you.

[CagedBird]

Yeah what did she say about 'the voices'?

[Cacoethes]

I did mention the DID type stuff, but didn't get to go into much details much detail about it because we already went over the hour.

Thanks Ames :)

She didn't say much about the spirits/others. I think because I've been functioning well then it's not a huge issue. Although she decided that I had delusional tendencies or something. (Can't remember the word she used) anti psychotics were mentioned but as I'm coping well there isn't really much point.

[sherlock holmes]

I'm glad that you have more of a sense of what is going on, and some medication options.

I've been on sodium valproate before. I'm guessing that if your Lamotrigine isn't controlling your seizures so well then adding in another anti convulsant might have the added benefit of helping your seizures and stabilising your mood- might be worth talking to your neurologist about it.

[Cacoethes]

Yeah, I told her that they were thinking of adding another one and she said one of those two would be best, especially since I'm nearly at the max dose of lamotrigine anyway.

I think I'll be seeing the neurologist soon as I had a seizure last night/this morning which would be the second one i've had while on meds so A&E doc said to get GP appointment asap because it's getting concerning now apparently.

I'm hoping that the psych I saw today will send a written report or something, I forgot to ask but I signed something at the start to say I'd be fine with a written account being sent to me and my GP.

[Cacoethes]

Also, does anyone know what 'mild elation' would entail in comparison to hypomania/mania?

[random.swirls]

From what I know cyclothmia is a mild form of bipolar. From what I know of you I'd say you were verging on hypo mania but I've never seen you so it can be hard to truly tell. I also know cyclothmia can become bipolar II so you may find as you age this becomes true for you especially as it sounds like the highs are gettin longer and stronger.

[Cacoethes]

The highs seem to be getting longer and more intense.

I don't really know anything about cyclothmia apart from it's a mood disorder. And I only found that out today!
I can't even pronounce it :p
Hopefully the CMHT will at least take it into account so something can be done before it gets worse. Although I enjoy the highs, no one else around me does :p

[tiptoes]

Cyclothymia seems for a casual observer to be a good fit.

Mood disorders are on a scale. Cyclothymia usually is mild depression and hypomania. Bipolar II depression and hypomania and bipolar I depression and mania.

I'm diagnosed bipolar II so like those with cyclothymia I get hypomanias rather than full blown mania. For me "mild elation" is feeling sped up, thoughts tumbling over one another, I talk quickly and often flit from one topic to another and/or see random connections between things. I get rather fidgeting and fiddle with things persistently. I spend money on lots of random crap. For me these are on the mild end of the hypomania scale. There have been times when my mood has progressed towards the top end of the hypomania scale and I start to lose touch with reality to a degree, I get thoughts about being invincible and wanting to test this theory. At this point the biggest difference between hypomania and mania is that I am still able to function, I still attend work, socialising with friends and do mundane things like do a food shop (just about) although it usually looks like a 6 year old has done the shop full of cake and goodies and lacking in actual food!

Does any of that ring a bell?? From my reading and also my experience people's paths to elevated and depressed moods do vary from person to person but when looking at a single persons paths the same route is taken from one episode to another so learning what you do on your way to a depression or a hypomania can help you to put things in place to minimise the impact of the mood.

[tiptoes]

Oh one other thing.

Cyclothymia and bipolar II in some books and websites are referred to as "soft" or "light" bipolar. Personally I think its a rubbish term. The impact mood disorders have on your day to day life doesn't necessarily correlate with where you are on the scale of cycling moods. There are some people with cyclothymia that have little time when they are not in one mood state or another and others with bipolar I that spend much longer times "well" just when things go wrong they implications are greater.

[Cacoethes]

Thanks Sarah, that's really helpful :)

That does indeed ring a bell!
I think Chels is the only one that's physically seen me when I'm a bit high and she said I'm impossible to deal with. She once had to follow me around on a walk at 4am once because I needed to keep walking and I think we ended up walking like, 10 miles!
I can still function, but people find me exhausting to be around because I won't stop talking and can't keep to one subject and I think it gets annoying!

I would say that the intensity of the highs are worse than the intensity of the lows. But I don't get as many of the highs it seems.

'soft' and 'light' bipolar are pretty crap terms!

On a barely related note, cakes and goodies are the best kind of food shopping :tongue2:

[Cacoethes]

I just read that out to Chels and she totally relates to that :tongue2:
I think people find my depressive 'episodes' much easier to deal with.

That makes a lot of sense!
I tend to use the far less technical analogy of a thousand multi coloured bouncy balls bouncing around in my head!
I mix up words a lot and get frustrated when people don't know what I'm saying!

I don't really want to stop having the highs though, if I could have them without pissing anyone off!

[tiptoes]

I can only speak personally but my medication doesn't remove all of my mood swings I just experience them with about a third of the intensity and they get in the way of my life less. I've also learnt how to channel my mood state more productively. I'm grateful that my team are allowing me to stick with minimal medication, my target isn't to not experience mood swings but for the mood swings not to negatively impact my life.

[Cacoethes]

In that case, maybe more medication wouldn't be such a bad thing!

[sherlock holmes]

I have hypomania as opposed to full blown mania, and I get impulses to spend lots of money on stuff I don't need, I think my life is wonderful and perfect and I'm happy with absolutely everything, I talk louder and faster, I'm excitable, I tend to talk about the same thing over and over.

Sometimes I get mixed depression and hypomania where I feel irritable, angry, agitated. It's like having depression but with energy.

My depressive episodes seem to be the worst of my mood swings. Everything becomes bleak and I always think the worst. I have intrusive thoughts about killing myself, I obsess over my boyfriend leaving me, I worry about everything, I don't want to do anything etc.

Apparently my bipolar is rapid cycling as my mood swings can change within a day. My depressive episode can last up to a couple of weeks but my hypomania rarely lasts more than a couple of days.

From an ojective point of view I'd say your elated spells seem more like mania than hypomania, from reading how you've been on here when you've been high and the sorts of things you talked about.

[Cacoethes]

I get irritable and agitated sometimes but it's mainly because I feel people are being boring and not understanding how wonderful everything is at the time!

I wouldn't say my depression is bad, I get very low and don't want to move and I sleep too much, cry for no reason and get thoughts of suicide, but I can still function well.

With the 'high' kind of episodes, I am the same in 'real life' as I present on here.

When talking to the professor yesterday, I didn't really put in much description of the highs, so it probably did come across as quite mild from what I said.
Saying that, I had a psych appointment while in the middle of an episode and although my CPN thought I was a mess, my psych said in the care plan that I was in a good mood! Although he was very set on sticking to the 30 mins of the appointment!
But it can't have been that bad if the psych didn't see anything wrong? Tbf, he didn't know lamotrigine is a mood stabiliser sooo....

I'm rambling now! Just trying to make sense of things really.
If it was so clear to the professor yesterday that I did not have BPD but I have a mood disorder, then how is it not clear to my MH team?
I suppose I felt more able to be honest with the professor and she asked different questions and more in depth than anyone before.
I have no idea :/

[tiptoes]

The line between severe hypomania and mania is quite blurred.

The team I was under during my worst hypomania had requiring inpatient as one of the factors for reclassifying it as mania. They were suggesting an admission but I refused so the episode remained as hypomania but had I agreed to go in it would probably have been changed to mania.

To a certain degree the labels are just semantics.

[Cacoethes]

I suppose it can be quite difficult to tell sometimes.
And I guess it depends on the team as well and what they think is an episode or not?

I don't really fully remember what happens during an 'episode' so it's hard for me to tell what kind of level it gets to. I'm reluctant to use any terms like hypomania or mania because I'm still not sure if I just make it up, or if I'm just acting a bit erratically and maybe that's just how I am, personality wise.
I may just be over-thinking it all though!

[tiptoes]

Yeah, I once had a GP tell me I seemed in a good mood whilst I was sat there crying. A bit of a dark art rather than an exact science.

I don't think you are alone in being reluctant to use terms, I tend to use terms like elevated and low rather than hypomania and depressed.

Did you get a mood checker app in the end? Rating my mood is the main way I got my head around my illness. When there is a clear number indicating a mood I have found it easier to acknowledge it properly rather than shrugging it off.

[Pomegranate]

To be honest I can't tell the difference between me being 'mildly elevated' and hypomanic, at least not when I'm hypomanic. I'll agree with them that I'm a bit high but seem to lose insight into how high. I guess the main difference for me is that things seem more physically different. So not only do I have lots of ideas and can't sit still and want to do ALL the things but colours are brighter, if I'm sat still I have to rock because the energy literally feels like its bursting out of my skin, I also talk very loudly as well as quickly and stutter. My friends often tell me they prefer me low as I'm easier to deal with and more predictable. An in regard to doing stuff, I kind of lose the thought process before it or don't really connect it. For example, thought: I should go to Cologne tomorrow. The fact I can't afford it or would have to pay for it out of my rent money either won't occur at all or will occur but have very little influence. When I'm more mildly elevated I'll still have the thoughts of wanting to do stuff but the practicalities play much more of a part. I've just realised ie rambled on about my own experiences and not really answered your question! Sorry Beckie! Tiptoes speaks good sense though. I'm glad your consultation went well.

[Pomegranate]

Apparently I have phrases I use when hypomanic as well. Like 'calm and serene' and I swear an awful lot more.

[Cacoethes]

How on earth could someone say you're in a good mood when you're crying? :eyeroll:

I did get a mood checker app but I keep forgetting to use it *facepalm*
I should probably put it on my phones home screen so I don't forget.

I can relate to that a lot Emma!
I tend to think that I'm just excited about life and everyone else is being really boring and slow and just don't want me to be happy and that it's all completely normal happiness. And that because I'm miserable all the time, people aren't used to me being happy so just assume I'm too happy. Also using the phrase 'ordinary people can't deal with extraordinary people' (this is what I've gathered from threads here!)
Chels says the same, in that I am a hell of a lot easier to deal with when I'm low because I just sit there and don't do anything :tongue2:

Although I'm pleased that the appointment went well, I'm a bit worried that my MH team are going to dismiss it completely. I'm not sure why they would but it's very possible. Like how could one person make these suggestions when they have all my notes? Although it seems better that she wasn't biased by other people's opinions of me from my notes.
Just that I'd be pretty annoyed if I spent the money on the appointment if the MH team are going to dismiss it, that's the main worry! Or the worry that I made things sound worse than they are or didn't talk enough about other things.
The professor was aware of my diagnosis and previous diagnoses.

Sorry, I'm rambling on again!

[sherlock holmes]

I was frankly amazed that when you went to your CMHT psych appt extremely high, your psych didnt pick up on it. But as you say, if he doesn't know Lamotrigine is used as a mood stabiliser then I question his ability as a psychiatrist...

Could you email or phone the professor you saw to make sure she is going to send a report to your GP and CMHT? Then they can read it hopefully before your CPA.

Would you still want to be discharged if they take it on board?

[Cacoethes]

The psych made it very clear that he only had 30 mins for the appointment, just kept saying that they weren't going to discharge me and ended it when I got distracted by a plastic mango....
Chels asked to speak to my CPN afterwards but I can't remember what she said because I had a mouthful of popping candy and was pacing. But I think my CPN thought something wasn't right.

I think I will do that :)

I don't know, I know my GP or neurologist could prescribe sodium valporate or depakote. I'll see what my CPN says about it.

[CagedBird]

She didn't say much about the spirits/others. I think because I've been functioning well then it's not a huge issue. Although she decided that I had delusional tendencies or something. (Can't remember the word she used) anti psychotics were mentioned but as I'm coping well there isn't really much point.

I'm surprised by this since from what you have written over the last month or two, these spirits/others have been the dominant theme. I thought you felt your life was highly dictated by what they instructed you to do, and that this had led you to self harm, either to avoid the dire consequences or to follow the instructions. Are you reassured that she didn't consider them to be a significant issue for you? Do you feel you're coping well with them? Are you reassured that it has been categorised as delusional tendencies - will it help you to deal with them knowing this? It's interesting because from what you have written they aren't linked to your mood (as such), did she mention that they may linked to the cyclothymia or is it separate?

To a certain degree the labels are just semantics.

Totally agree with this!

Just that I'd be pretty annoyed if I spent the money on the appointment if the MH team are going to dismiss it, that's the main worry! Or the worry that I made things sound worse than they are or didn't talk enough about other things.

That's probably normal to feel that way afterwards. I'm glad you have felt it points you in the right direction. It might be that your current MH team aren't interested in your 2nd opinion, but if you feel empowered to know how to better understand your 'illness' - you can start to advocate for what you need to keep you out of A&E.

[Cacoethes]

To be honest, I was surprised that she didn't see the spirits/others as a big issue. I've been told by several professionals that I don't 'seem psychotic' but I'm more inclined to think that maybe she knows something and knows they are real. That she can't suggest anti psychotics because if I did go back on them then the spirits/others would be dulled and I wouldn't be able to save the world.
Sometimes I cope with them ok. If the instructions are relatively simple and not too damaging like a cut then I will do it and they'll be happy. It's when the instructions are more serious, like setting myself on fire is when I struggle to cope.
So it's reassuring in a way, because they aren't symptoms of a psychotic illness. I think the delusional tendencies came from when I said I was invincible and I'm meant to save the world. :/

I do feel like I've made a step forward. The diagnosis isn't hugely important, but I said at the end that the CMHT didn't seem to believe me about my 'symptoms' and were always attempting to pick holes in the things I told them and she said 'well I can definitely don't think you're. making this up'.
That was reassuring. It was like, finally, someone is listening!

[Ktulu]

I'm glad that you're moving forward and hopefully now your regular team will sit up and pay attention.

It was mentioned earlier about the lines between hypomania and mania being blurred at times and I couldn't agree more with this. It's possible for hypomania to become mania if it goes untreated for a long period of time. I was hospitalised for hypomania as it was becoming clear that I was rapidly progressing up the rungs towards mania, I was losing touch with reality and putting myself in dangerous situations and being taken advantage of. I'm quite sure it would have become mania (if it wasn't already) very quickly if I didn't have the safety of hospital. I do sometimes wonder if I could have come to real harm if my doctor hadn't been so insistent that I was admitted.

Also, about the colours? What is the deal there?! That happens to me too, they become vibrant and inviting, it's like I can feel them or something. One time I was in my psych's office and she had a nice painting of some boats on the wall, they were red, and it was like they were talking to me and I had to get up and touch the painting! The colour thing is meant to be my warning sign to ask for help but...it's so much fun!

It was also mentioned about cyclothymia becoming BPII and BPII becoming BPI, this is very possible. I'm at the upper range of BPII and I wasn't always, going back to my teenage years I would say I was closer to cyclothymia and as time goes on, while my episodes get further and further apart (years), the severity and impact they have on my life is greater. My psych says these are the signs of classical bipolar (as she puts it) and suggest the possibility of worsening episodes as I get older. Just something to be conscious of.

And Stephen Fry has cyclothymia, so you're in excellent company!

[Sunshine]

Just a warning about sodium valproate if you get pregnant on it it can cause spine abiphiada. I was on it for 3 years and was taken off it with the words "a women of child bearing age should not have been put on this drug" so just make sure you defiantly do not have any chance of pregnancy

[Cacoethes]

Thanks Ktulu :)

My 'episodes' seem to fizzle out by themselves, either that or the meds start to kick in again after a while of not taking them.
Saying that, I think I get the episodes when I'm not on the medication....I can't remember... :/

The colour thing is weird, it's like life is suddenly in HD!!!

If the CMHT agree with the 2nd opinion, then maybe they will be more conscious of my mood changes and what they mean. If I am discharged then my GP is really good and knows me pretty well now.
I try to be aware of when I'm getting a bit elevated, but it seems I lose insight rather quickly!

Stephen Fry <3
:tongue2:

Thanks Polly, no danger of me getting pregnant anytime soon so I think that'll be fine :)

[Shoshana Rochel]

I don't really have much to add, but I'm glad that the appointment went well! :)

[Cacoethes]

Thanks Sasha :)

[Shoshana Rochel]

I do agree with the lines between mania and hypomania being very blurred though. Also, the colors thing happens to me as well. When I was manic, I was apparently talking too fast for anyone to understand me at all, bouncing between topics, half hour of sleep, etc. My therapist had no problems saying that I was manic lol. Not really adding much, just a little about my experiences with Bipolar 1. :)

Would you still WANT to be discharged if they recognize the second opinion?

[Cacoethes]

I don't think my team thought it was any kinda mania. Psych said I was in a good mood and cpn basically said I was a mess after chels basically forced her to acknowledge something was wrong!! Lol!! So it can't really be that bad.


I think I'll still wanna be discharged because I want to get a job and I have an interview soon and MH team won't let me get a job so need to get rid of them first!! That's priority!!

[Shoshana Rochel]

Did the second opinion psych think it is that bad?

Why won't the MH team let you get a job? If the second opinion is that you have a mood disorder, but are still functioning and functional, what would be their reasons for stopping you?

[Cacoethes]

I didn't really describe the episodes very well tbh! Like, not how intense it can really get!! Provably would have been convenient if I was elated at the time! Lol

Yeah, they don't want me working with vulnerable people or some other shitty excuse that didn't make sense!!
In the appointment when I was a bit high and chels spoke to my cpn then my cpn was like how could you work when you're like this?!??!!
I couldn't really defend myself cos I poured a load of popping candy in my mouth! ;D
But idk. They are sooo annoying!!

[tiptoes]

I have agree with the colour thing too. So weird but amazing.

I've worked whilst high, I do have to be careful to make those around me aware though. I was seen by an occupation health doctor at one job whilst high for another reason but brought it up so anyway and she said she thinks hypomanic people make good employees (up to a certain point anyway) although this was a place that finds the crazy pills!

[Cacoethes]

The colour thing is really cool!

Haha! Sounds like a good O.H doctor!
When I saw the doc for the job I applied for, she said she never refuses someone down to MH, at worst she'll say come back in a few months!
I'm not sure how good someone with hypomania would be as a phlebotomist though! (that's the job I have an interview for in a couple of weeks!)

[sherlock holmes]

To be honest, I was surprised that she didn't see the spirits/others as a big issue. I've been told by several professionals that I don't 'seem psychotic' but I'm more inclined to think that maybe she knows something and knows they are real. That she can't suggest anti psychotics because if I did go back on them then the spirits/others would be dulled and I wouldn't be able to save the world....I think the delusional tendencies came from when I said I was invincible and I'm meant to save the world. :/

I think that maybe she didn't think the spirits were a big issue because you don't believe they are a MH issue and so probably didn't talk about them that much. But she did mention you had delusional tendencies, which I believe covers the spirits/others, and from an outsiders perspectives it sounds delusional to say that the psychiatrist didn't suggest antipsychotics because she knows the spirits are real.

Also some people with bipolar and cyclothymia experience delusions as part of their illness.

[Cacoethes]

I can see how it would seem like that. That's why I don't tend to talk to the spirits/others out loud in public, I know what people think.
Is there even a type of medication for delusions?
Maybe she just thought it wasn't necessary seeing as I function well without meds, because I told her I'd been out of hospital for 18 months now and doing a degree etc.
She also didn't really understand why my psych wouldn't let me work!

I'm seeing my CPN tomorrow and reading a bit about cyclothymia and reflecting on how my moods actually are, I can't see her disagreeing with it. You never know!

[sherlock holmes]

If delusions get very bad and someone loses insight then antipsychotics are generally used. I would say you have been very unwell on a few occasions before where antipsychotics would have been beneficial but obviously I am not a doctor and have no medical training :p

I hope it goes well with your CPN tomorrow.

[Cacoethes]

I think some others would agree with you Sarah! :p
And I would have welcomed any kind of med the other week rather than have to induce seizures to get through it. But my psych still maintains that meds won't help despite the lamotrigine helping with my moods. :eyeroll:

Thanks :)