Hi all,
I'm new to this site and quite impressed by the postings I've read.
So, I went to my new general doc today and am a bit surprised and worried.
A little about myself... I'm 24 years old. I was diagnosed with depression and ADD when I was 16. The "depression" wasn't really depression at all (or so I believe). I was just a brat who had been spoiled her whole life. After the parents took my car away for a day, I acted out, and was diagnosed with depression. My first (and only) psychiatrist diagnosed me as borderline personality disorder and gave me 200mg of zoloft and 36 mg of concerta right off the bat (crazy, right?)
After slowly weaning myself off the zoloft (3 years later), I quit the concerta, quit the psychiatrist, and switched to just adderall and a new general doc. I've been taking 20mg of adderall a day for the past 5 years. It has done its job. I've successfully graduated college, live on my own, have a great job... so today when my new general doc (I recently moved and had to find a new one) diagnosed me with bipolar disorder and prescribed me to 25mg of lamictal twice a day and my usual 20mg of adderall... I can't help but wonder if this too is a misdiagnosis. She even said that I may not be ADD. What do I do? I know I'm ADD. I told her that I was irritable at night (when I'm coming off my adderall) and that's when she said I was bipolar. I'm thinking of not even filling the lamictal and just continuing my adderall. Should I get a second opinion from a psychiatrist or a different general doc? If I were bipolar, wouldn't I be more than just irritable at night?
Thanks everyone!

Yes - I would get a second opinion if I were you. If I'm understanding you correctly, this is the first time you've even MET with this doctor and talked to him/her? Ya - that seems nutty to me. AND - lamictal and other bipolar drugs can be "heavy drugs" for some people (meaning they cause some people MAJOR side effects). THAT is where my concern is. Just sampling bipolar meds - just in CASE you could be bipolar - does NOT seem like a good idea.

Did you mention anything ELSE (other than irritability at night) that would suggest bipolar?

I guess what I most want to express to you is that if you are NOT comfortable with the diagnosis, don't feel compelled to blindly follow this doc. Get a second opinion and/or have someone attend the appt with you. Also, you might try calling this doc back or at your next appt tell him/her how you are feeling about the dx and ask for reasons WHY the dx of bipolar - and write them down for both of you to see.

Best wishes,
Sue

P.S. Welcome to the forums! Hope to see you around often.

Thanks for the advice, Sue!

This is my 2nd time meeting with her. I went last month because it was time for a refill on my adderall. I moved and had to get a new doc on my new insurance plan. I randomly picked one. Just thought I could transfer my records and she would write me an adderall script every month, as my past doc had.

I told her today that I was focused and content throughout the day (with my 20mg of adderall) but by 4-6pm... I was irritable. The smallest things (other drivers, my boyfriend, etc.) could really set me off but it would only put me in a bad mood (and this only happens sometimes, not everyday). I snap out of it by 7 or so. I honestly feel that this feeling is me coming off the adderall. I go to bed every night around 11; I'm at work by 7am. I never miss work. My life is very stable but if I started taking Lamictal... I don't see how any good could come of it.

I asked my doc if I should schedule an appointment with a psychiatrist... She said "psychiatrists overmedicate and usually make things worse." What she's doing is no different.

Why do you think some docs are so quick to medicate?

I've had experience with a doctor that wouldn't listen very well. My new doc is much better. Regardless of the diagnosis or prescription, I think it's important to find a doctor that you are comfortable with. I wouldn't waste any more time with this doc, but that's just me.

2nd opinion. do you have any other symptoms of bipolar? manic episodes? low times? read up and see and get a 2nd opinion...maybe you do, and it will be helpful, maybe not and it won't

He can't force you to fill the prescription. I get irritible at times without meds but the difference between ADD and bipolar with irritation is usually with ADD it's irritation due to things ADD related like low patience with other drivers, not something pervasive and continuous.

Thanks everyone! To answer your questions, reesah... I went through elementary and middle school always struggling to pay attention. I always made A's and B's but had a hard time organizing myself and my thoughts. When I entered high school, I started taking concerta and was able to finally concentrate. Adderall helped even more.
When I was 18, I got a speeding ticket for doing double the speed. My parents (thankfully... looking back 6 years later) sold my brand new car and I learned an important lesson. I never sped again, but it's thrill-seeking activities like those that have gotten me in trouble.
My low times are only in the evenings and they never last more than 30 mins or so. They also seem to be brought on by hunger? Ever since Thursday (when my doc diagnosed me as being bipolar), I've really been paying attention to my moods and analyzing every little thing. I know I may sound like I'm in denial by the diagnosis... but I honestly believe that I'm ADD and that is all. If I were truly bipolar would I a) get up and go to work everyday at 7am? I haven't missed a day in over a year, b) graduate with my bachelors degree in 4 years with only the help of 20mg of adderall a day, c) have good relationships with past employers, friends, my boyfriend, and family?
Yes, I will get a 2nd opinion and will not get the Lamictal filled.

Oh boy.. your story reminds me of my own hah.. Never had a manic episode in my life and they label me bipolar and put me on it.. prior to that I was on SSRIs (5-6 different SSRIs in total were tried) for anxiety and took concerta and/or ritalin LA for ADHD
Please dont take the lamictal.. I dont know how that drug can be of benefit to anyone.. I think it caused me neurological damage.. I still twitch from it and have vivid, violent hallucinations when falling asleep from time to time (hadnt ever happened to me before i was put on lamotigine and stopped taking it somewhat abruptly)

Thanks everyone! To answer your questions, reesah... I went through elementary and middle school always struggling to pay attention. I always made A's and B's but had a hard time organizing myself and my thoughts. When I entered high school, I started taking concerta and was able to finally concentrate. Adderall helped even more.
When I was 18, I got a speeding ticket for doing double the speed. My parents (thankfully... looking back 6 years later) sold my brand new car and I learned an important lesson. I never sped again, but it's thrill-seeking activities like those that have gotten me in trouble.
My low times are only in the evenings and they never last more than 30 mins or so. They also seem to be brought on by hunger? Ever since Thursday (when my doc diagnosed me as being bipolar), I've really been paying attention to my moods and analyzing every little thing. I know I may sound like I'm in denial by the diagnosis... but I honestly believe that I'm ADD and that is all. If I were truly bipolar would I a) get up and go to work everyday at 7am? I haven't missed a day in over a year, b) graduate with my bachelors degree in 4 years with only the help of 20mg of adderall a day, c) have good relationships with past employers, friends, my boyfriend, and family?
Yes, I will get a 2nd opinion and will not get the Lamictal filled.

The thrill-seeking totally is a big sign of bipolar. THE biggest symptom from what I know.

and yes, I know many bipolar people who get up at 7 everyday and go to work, have grad degrees, and have great relationships. Usually they've been able to keep their manic episodes limited in some way, or have had the benefit of other treatments for co-existing disorders. Or they have manic episodes and are able to hide them. Not everyone is debilitated completely by the disease.

I'd get a second opinion but keep an open mind. It may be denial or it may be that your first doctor was wrong. Only one way to find out!

My low times are only in the evenings and they never last more than 30 mins or so. They also seem to be brought on by hunger? Ever since Thursday (when my doc diagnosed me as being bipolar), I've really been paying attention to my moods and analyzing every little thing. I know I may sound like I'm in denial by the diagnosis... but I honestly believe that I'm ADD and that is all. If I were truly bipolar would I a) get up and go to work everyday at 7am? I haven't missed a day in over a year, b) graduate with my bachelors degree in 4 years with only the help of 20mg of adderall a day, c) have good relationships with past employers, friends, my boyfriend, and family?
Yes, I will get a 2nd opinion and will not get the Lamictal filled.

I am no professional, but it clearly sounds much more like a very mild case of cyclothymia. Were you diagnosed with Bipolar I, or II? The following excerpts are very interesting (and refute your diagnosis) provided this information is accurate (it's from wikipedia):

Bipolar I Disorder: (http://en.wikipedia.org/wiki/Bipolar_I)
The essential feature of bipolar I disorder is a clinical course that is characterized by the occurrence of one or more manic episodes (http://en.wikipedia.org/wiki/Manic_episodes) or mixed episodes (http://en.wikipedia.org/wiki/Mixed_episodes). Often individuals have also had one or more major depressive episodes (http://en.wikipedia.org/wiki/Major_depressive_episodes). Episodes of substance-induced mood disorder (http://en.wikipedia.org/wiki/Mood_disorder) (due to the direct effects of a medication, or other somatic treatments for depression, a drug of abuse, or toxin exposure) or of mood disorder due to a general medical condition do not count toward a diagnosis of bipolar I disorder. In addition, the episodes are not better accounted for by schizoaffective disorder (http://en.wikipedia.org/wiki/Schizoaffective_disorder) and are not superimposed on schizophrenia (http://en.wikipedia.org/wiki/Schizophrenia), schizophreniform disorder (http://en.wikipedia.org/wiki/Schizophreniform_disorder), delusional disorder (http://en.wikipedia.org/wiki/Delusional_disorder), or psychotic disorder (http://en.wikipedia.org/wiki/Psychotic_disorder) not otherwise specified.Bipolar II Disorder: (http://en.wikipedia.org/wiki/Bipolar_II)
A. Presence (or history) of one or more Major Depressive Episodes.
B. Presence (or history) of at least one Hypomanic (http://en.wikipedia.org/wiki/Hypomanic) Episode.
C. There has never been a Manic Episode (http://en.wikipedia.org/wiki/Manic_Episode) or a Mixed Episode (http://en.wikipedia.org/wiki/Mixed_Episode).
D. The mood symptoms in Criteria A and B are not better accounted for by Schizoaffective Disorder (http://en.wikipedia.org/wiki/Schizoaffective_Disorder) and are not superimposed on Schizophrenia (http://en.wikipedia.org/wiki/Schizophrenia), Schizophreniform Disorder (http://en.wikipedia.org/wiki/Schizophreniform_Disorder), Delusional Disorder (http://en.wikipedia.org/w/index.php?title=Delusional_Disorder&action=edit&redlink=1), or Psychotic Disorder Not Otherwise Specified.
E. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
And, even if it was cyclothymia:
Cyclothymia (http://en.wikipedia.org/wiki/Cyclothymia)


During the first two years of the disorder, the patient has not fulfilled enough criteria to qualify as having either bipolar disorder (http://en.wikipedia.org/wiki/Bipolar_disorder) or major depressive disorder (http://en.wikipedia.org/wiki/Major_depressive_disorder).
Symptoms are present for at least two years: periods of hypomanic symptoms and periods of low mood that do not fulfill the criteria for major depressive disorder (http://en.wikipedia.org/wiki/Major_depressive_disorder).
The longest period the patient has been free of symptoms is two months.
The disorder cannot be better explained as schizoaffective disorder (http://en.wikipedia.org/wiki/Schizoaffective_disorder), and it is not superimposed on schizophrenia (http://en.wikipedia.org/wiki/Schizophrenia), schizophreniform disorder (http://en.wikipedia.org/wiki/Schizophreniform_disorder), delusional disorder (http://en.wikipedia.org/wiki/Delusional_disorder) or psychotic disorder not otherwise specified.
Symptoms are not directly caused by a general medical condition or the use of any substances such as prescription medicines.
The symptoms cause the patient clinically significant distress or impair work, social or personal functioning.
A person with this disorder may experience euphoric highs, boosts of energy and require less sleep in one phase, followed by a severe mood swings into a depressive state coupled with negativity & sadness for no particular reason.
These mood swings are not as severe as bipolar I disorder (http://en.wikipedia.org/wiki/Bipolar_I_disorder) or bipolar II disorder (http://en.wikipedia.org/wiki/Bipolar_II_disorder).
Cyclothymia is to bipolar disorder (http://en.wikipedia.org/wiki/Bipolar_disorder) as Dysthymia (a mild form of clinical depression) is to major depressive disorder (http://en.wikipedia.org/wiki/Major_depressive_disorder).

If you can get a hold of a DSM-IV-TR copy, and take a few copies of the Bipolar I, II, and cyclothymia pages, and circle the criteria that clearly discredit a diagnosis, then I think you'll be able to at least make a very good argument to your doctor. But, I would bother, just go to a new doctor.

If you are concerned about bipolar I, or II, or cyclothymia, then see if you meet the DSM-IV-TR criteria. It looks to me like you don't, but I don't have nearly as much information as you or your doctor have.

P.S. I think I had too much focalin, but it's good for doing research :p

Your doctor really scares me. To stop the irritability you just need to eat something, the adderall is just supressing your hunger. If you go long enough with out food your blood sugar will fall to a point where you will feel iritable. Don't even bother with a second opinion if you don't want to be treated for any symptoms. You get to choose your treatments; this has always been the way doctors work.

The way it's supposed to work is you asking them to get you pills, not them asking you to get you pills. Also, I read somewhere something about doctors getting their drug education from drug sales reps that basically advertise their drugs to these doctors in the hopes that they will prescribe them to a wider range of people (some of which whom are in fact mentally well).

Also, ask them to give you several months worth of perscriptions so you don't need to frequent as often -assuming you're saticfied with the way your life is going. Even if your insurance is paying for it, making a trip every month burdenfull on society and self.

You might try experimenting with the extended release formula of Adderall. It's claim is that it lasts 10-12 hours. Also experiment with higher-fat breakfasts. This changes your digestion of the medication.

My mom is bipolar. I remember her once having a lengthly spell of yelling profanities over too much nonstick spray in a frying pan, stopping abruptly, then 5 seconds (no kidding, could have watched the clock) later she was singing. She had no memory of the non-stick spray episode.

This is my best understanding of bipolar. But not everyone's symptoms are the same, like with ADD/HD. I'm constantly keeping track of my symptoms. I'm so scared to think I might slip into bipolar like my mom.

Does anyone know much about bipolar?