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From: Maggie on 25 Jul 2006 12:15

Harry wrote:
>
> It wouldn't have be likely,as Axis 1 & Axis II.Many therapists misdx
> the two,no surpise.If they did "coexist",it would be an unhappy
> mess.Bipolars do coexist with some others,like avoidant and
> dependent.But the doctor is presribing only most of the time,so he/she
> is thinking bipolar

Okay, Harry, as someone who actually practiced in this field, maybe
youand or Pablo can clear this up.

I seem to remember that the DSM clearly excludes Borderline Personality
disorder when the patient is BP.....because the symptoms of BPD can be
explained by the manifestations of BP.

I am sure this is the same with ADHD......excluded because symptoms can
be explained by manifestation of BP.

Professional opinions welcome.

thanks,

M


From: Harry on 25 Jul 2006 17:14

Maggie wrote:
> Harry wrote:
> >
> > It wouldn't have be likely,as Axis 1 & Axis II.Many therapists misdx
> > the two,no surpise.If they did "coexist",it would be an unhappy
> > mess.Bipolars do coexist with some others,like avoidant and
> > dependent.But the doctor is presribing only most of the time,so he/she
> > is thinking bipolar
>
> Okay, Harry, as someone who actually practiced in this field, maybe
> youand or Pablo can clear this up.
>
> I seem to remember that the DSM clearly excludes Borderline Personality
> disorder when the patient is BP.....because the symptoms of BPD can be
> explained by the manifestations of BP.
>
> I am sure this is the same with ADHD......excluded because symptoms can
> be explained by manifestation of BP.
>
> Professional opinions welcome.
>
> thanks,
>
> M

You're probably right,that would make sense.I don't have a DSM-IV
about,since writing & music take the time.I always told them you are
smart.Harry


From: Harry on 25 Jul 2006 17:23

Maggie wrote:
> Harry wrote:
> >
> > It wouldn't have be likely,as Axis 1 & Axis II.Many therapists misdx
> > the two,no surpise.If they did "coexist",it would be an unhappy
> > mess.Bipolars do coexist with some others,like avoidant and
> > dependent.But the doctor is presribing only most of the time,so he/she
> > is thinking bipolar
>
> Okay, Harry, as someone who actually practiced in this field, maybe
> youand or Pablo can clear this up.
>
> I seem to remember that the DSM clearly excludes Borderline Personality
> disorder when the patient is BP.....because the symptoms of BPD can be
> explained by the manifestations of BP.
>
> I am sure this is the same with ADHD......excluded because symptoms can
> be explained by manifestation of BP.
>
> Professional opinions welcome.
>
> thanks,
>
> M

you're likely right.That would make as much sense as the DSM IV does.


From: Maggie on 25 Jul 2006 21:29

Pablo wrote:
> In article <12ccj32d88iead6(a)corp.supernews.com>, MaggieSheridan(a)aol.com
> used fingers to say...
> >
> > Harry wrote:
> > >
> > > It wouldn't have be likely,as Axis 1 & Axis II.Many therapists misdx
> > > the two,no surpise.If they did "coexist",it would be an unhappy
> > > mess.Bipolars do coexist with some others,like avoidant and
> > > dependent.But the doctor is presribing only most of the time,so he/she
> > > is thinking bipolar
> >
> > Okay, Harry, as someone who actually practiced in this field, maybe
> > youand or Pablo can clear this up.
> >
> > I seem to remember that the DSM clearly excludes Borderline Personality
> > disorder when the patient is BP.....because the symptoms of BPD can be
> > explained by the manifestations of BP.
>
> The DSM does not exclude Borderline Personality Disorder for people with
> Bipolar Disorder. It states: "Borderline Personality Disorder often co-
> occurs with Mood Disorders, and when criteria for both are met, both may
> be diagnosed. Because the cross-sectional presentation of Borderline
> Personality Disorder can be mimicked by an episode of Mood Disorder, the
> clinician should avoid giving an additional diagnosis of Borderline
> Personality Disorder based only on cross-sectional presentation without
> having documented that the pattern of behavior has an early onset and a
> long-standing course" (DSM IV-TR, p. 709).
>
> > I am sure this is the same with ADHD......excluded because symptoms can
> > be explained by manifestation of BP.
>
> No, there can be co-occurrence.
>
> An important phrase you use here (in both situations) is "because
> symptoms can be explained..." ADHD should not be diagnosed if symptoms
> are better explained (but not "because symptoms can be explained") by a
> mood disorder, more accurately, manic, mixed, or hypomanic episodes.
> ADHD does not involve expansive/elevated mood.
>
> Pablo

Okay, thank you for clearing this up....i knew one of you could.

As to ADD i am a suspect.....spacy, zone out, miss things right in
frount of me and have always tried to minimize the damage by being
extreemly well organized....with a view to having my life run as idiot
proof as possible. Even to the point of being described as a person
with amazing pockets of organization in anotherwise chaotic life.

of course,,,,,this stategy is a must when hepressed and i tend to let
things slide.
I think they just won't put me on any ADD meds that might trigger
hypomania?
Can you make any suggestions?

As to BPD.....the closest i've ever come to having had that suggested
to me is when my whacko sister...the worst one...tell me that she had
discussed me with her therapist and she reports that the therapist, who
has never met me or had any communication with me, told my sister that
i must surly be BPD.

That was a thrill....which of course i (and my shrink) chalking up to
my sister being her usual whacko self. who knows what the therapist
actually said....or how qualizied she was to be making armchair
diagnosises of 3rd parties unknown to her.

Thanks for the infor, Pabs. You are a chammpion!

M


From: Harry on 27 Jul 2006 17:50

Pablo wrote:
> In article <1153877394.660914.20220(a)m79g2000cwm.googlegroups.com>,
> MaggieSheridan(a)aol.com used fingers to say...
> >
> > Pablo wrote:
> > > In article <12ccj32d88iead6(a)corp.supernews.com>, MaggieSheridan(a)aol.com
> > > used fingers to say...
> > > >
> > > > Harry wrote:
> > > > >
> > > > > It wouldn't have be likely,as Axis 1 & Axis II.Many therapists misdx
> > > > > the two,no surpise.If they did "coexist",it would be an unhappy
> > > > > mess.Bipolars do coexist with some others,like avoidant and
> > > > > dependent.But the doctor is presribing only most of the time,so he/she
> > > > > is thinking bipolar
> > > >
> > > > Okay, Harry, as someone who actually practiced in this field, maybe
> > > > youand or Pablo can clear this up.
> > > >
> > > > I seem to remember that the DSM clearly excludes Borderline Personality
> > > > disorder when the patient is BP.....because the symptoms of BPD can be
> > > > explained by the manifestations of BP.
> > >
> > > The DSM does not exclude Borderline Personality Disorder for people with
> > > Bipolar Disorder. It states: "Borderline Personality Disorder often co-
> > > occurs with Mood Disorders, and when criteria for both are met, both may
> > > be diagnosed. Because the cross-sectional presentation of Borderline
> > > Personality Disorder can be mimicked by an episode of Mood Disorder, the
> > > clinician should avoid giving an additional diagnosis of Borderline
> > > Personality Disorder based only on cross-sectional presentation without
> > > having documented that the pattern of behavior has an early onset and a
> > > long-standing course" (DSM IV-TR, p. 709).
> > >
> > > > I am sure this is the same with ADHD......excluded because symptoms can
> > > > be explained by manifestation of BP.
> > >
> > > No, there can be co-occurrence.
> > >
> > > An important phrase you use here (in both situations) is "because
> > > symptoms can be explained..." ADHD should not be diagnosed if symptoms
> > > are better explained (but not "because symptoms can be explained") by a
> > > mood disorder, more accurately, manic, mixed, or hypomanic episodes.
> > > ADHD does not involve expansive/elevated mood.
> > >
> > > Pablo
> >
> > Okay, thank you for clearing this up....i knew one of you could.
> >
> > As to ADD i am a suspect.....spacy, zone out, miss things right in
> > frount of me and have always tried to minimize the damage by being
> > extreemly well organized....with a view to having my life run as idiot
> > proof as possible. Even to the point of being described as a person
> > with amazing pockets of organization in anotherwise chaotic life.
> >
> > of course,,,,,this stategy is a must when hepressed and i tend to let
> > things slide.
> > I think they just won't put me on any ADD meds that might trigger
> > hypomania?
> > Can you make any suggestions?
>
> I will let Nom make med suggestions. There might be some ADHD meds that
> do not trigger manic/hypomanic episodes. I would suggest, however, that
> you continue to stay organized if you find that it helps you. Many
> folks with ADHD find that keeping lists is helpful. Visit the ADSD
> usenet group for lots of suggestions. Tell them I sent you. (Hopefully
> they won't throw eggs at you!)
>
> I will also say that many people zone out from time to time. This does
> not have to be chalked up to mental illness. We live in busy times,
> with overstimulation at nearly every turn. It is no wonder that many of
> us are chronically stuck between fight and flight. Perhaps this is a
> trite statement, but we need to be gentle with ourselves and accept that
> sometimes we will feel overwhelmed.
>
> One thing I have tried to do is simplify my life as much as possible.
> In this age of instant communication, I do not have a cell phone. I
> make use of a fax machine at work, but I have no home fax. No instant
> messaging. (This is one reason why I do not use multiple accounts/socks
> on Usenet.) My kids have all the fancy gadgets, but I don't make use of
> them. Ipod? No thanks. A relative gave me a DVD player one Christmas,
> and it is still in the box. I am a man of nature. Simple is better for
> me.
>
> > As to BPD.....the closest i've ever come to having had that suggested
> > to me is when my whacko sister...the worst one...tell me that she had
> > discussed me with her therapist and she reports that the therapist, who
> > has never met me or had any communication with me, told my sister that
> > i must surly be BPD.
>
> If indeed the therapist said this, it is poor clinical practice. A
> therapist cannot properly diagnose someone she/he has never met. It
> might be that your sister's therapist told her this to mollify her. It
> might also bee that your sister said this to get you riled.
>
> > That was a thrill....which of course i (and my shrink) chalking up to
> > my sister being her usual whacko self. who knows what the therapist
> > actually said....or how qualizied she was to be making armchair
> > diagnosises of 3rd parties unknown to her.
>
> Yep.
>
> > Thanks for the infor, Pabs. You are a chammpion!
>
> You are quite welcome, Maggie.
>
> Pablo


Knowing the DSM IV is admirab,I suppose .Also,when it comes to practice
I prefered learning about therapy(like Laing,Frankl & Janov)-I get the
picture of "what's the matter here"-& do not try memorize "the book","a
compendiumof social antropology" at that time..Same for the Big Book,I
like the Red Book better.I'd never offend one(just ask Maggie).You
would have great to work with,Pablo.Good to meet ya again -Harry


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