November 15, 2023 • 12 mins
Couch Talks is the bonus episode of You Need Therapy where Kat answers questions listeners send to kathryn@youneedtherapypodcast.com.
Follow Kat on Instagram: @Kat.Defatta
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Have a question, concern, guest idea, something else? Reach Kat at: Kathryn@youneedtherapypodcast.com
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Produced by: @HoustonTilley
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:10):
Hi guys, and welcome to a new episode of couch
Talks on You Need Therapy Podcast. My name is Kat.
I am the host, and if you are unfamiliar with
what couch Talks is, it is the special BOTUS episode
of You Need Therapy where we answer or I answer
the questions that you guys send in to me at
Catherine at You Need Therapy podcast dot com. Now a
(00:31):
quick reminder before we get into today's episode that although
I am answering your questions, this still does not serve
as a replacement or substitute for any actual mental health services. Now,
per usual, we do one question episode and we always
keep them anonymous, and we're actually answering the second question
(00:52):
from the listener from last week who wrote in asking
about some spirituality stuff and how to tell a difference
between mental health issues and spiritual issues. And here is
her second question. During a recent appointment with my psychiatrist,
the doctor stated that my history strongly suggests the presence
(01:13):
of bipolar two and recommended I follow the treatment plan accordingly.
He said it typically takes over ten years to properly
diagnose patients with bipolar two, and that most are misdiagnosed
and treated for depression slash anxiety, as I have been.
He said that it typically takes over ten years to
properly diagnose patients with bipolar two, and that most are
(01:35):
misdiagnosed and treated for depression slash anxiety, likely due to
the fact that hypomanic episodes are subtle and not as
intense as manic episodes with bipolar one. I'm still wrapping
my head around this and trying to do as much
research as I can. I am also trying to understand
certain patterns of my behavior to see if this diagnosis
(01:56):
resonates with my lived experience. It's a lot to take in.
Do you have patients who struggle with bipolar two? Do
you have any resources you can recommend for this specific topic.
Most of the information I'm finding out there is reverlent
for bipolar one, but not as much for other diagnoses
on the spectrum of bipolar all right, So for anybody
(02:16):
who is not familiar with bipolar disorder, there are two
main forms that most people who are familiar with bipolar
disorder of any form are familiar with. So there's bipolar
one and bipolar two. Now, they can be similar, but
they also are very different. So bipolar one includes having
(02:38):
at least one manic episode, and bipolar two will have
something that is called hypomania, which is a less severe
form of mania. Now, both may have bouts of depression,
so you're gonna see that with both. However, people who
are struggling with bipolar two might have more severe bouts
(02:58):
of depression, or their experiences of depression might last a
little longer. And also, not to make this more confusing
than it already is, people who have bipolar one also
might have hypomania, but they have to have had at
least one experience of mania as well. And somebody who
has bipolar two has not experienced mania, they are only
(03:19):
going to if they experience a form of this, they're
going to have hypomania. Now, it's also important to mention
here that bipolar does not look like what I think
a lot of people out there think it looks like.
It doesn't look like swift mood swings that happen like
within thirty seconds. They are longer lasting, more prevalent shifts.
(03:40):
And so when we say things like, oh my gosh,
he's so bipolar or she was being so bipolar, we're
very much mislabeling what we are experiencing with the people
around us, because that is not what this disorder looks
like at all. It's also worth mentioning here that something
I have found difficult at times is and i' mean
difficult as a practitioner, as a clinician, trying to differentiate
(04:05):
between borderline personality disorder and bipolar disorder, because a lot
of their symptoms can mimic the other. Now, one is
a personality disorder. Borderline personality disorder is a personality disorder,
and there is not specifically medication that you can take
that will take away some of these symptoms. There are
(04:25):
medications you can take that can help alleviate some of
the things that come along with borderline personal disorder, but
that is a disorder that is largely built and created
out of severe trauma, and that is a result in
symptoms of experiencing severe trauma. And so a lot of
the treatment for that is going to be more on
the therapy side. And like I said, you can take medications,
(04:48):
but there's not a medication to cure that. Now, bipolar
disorder is actually more of a chemical imbalance that is
largely inherited from genetics. In which which there can be
a large medication management portion of this in the treatment,
so they are very different. One is based more specifically
(05:09):
and strictly within the chemical imbalances in your brains, within
neuro transmitters and stuff like that, and one is a
result of trauma that it has more to do with
our own behavior and our beliefs and our own fears
rather than the chemicals in our brain. And I know,
as I'm saying this, this probably sounds very confusing, but
(05:30):
it is worth noting that as we're talking about the
difficulty in diagnosing it, that's another part that can be
really difficult is seeing these things that can look very similar,
seeing them as different, and being able to really take
the time to assess where the symptoms are coming from. Now,
I have not ever heard someone say specifically that it
(05:51):
takes ten years to diagnose a patient with bipolar disorder.
I think that it's probably true that it has taken
ten years for some people to be properly diagnosed, But
I do believe that it sometimes can take a good
bit to properly assess the symptoms. And that's connected to
what I just said above about how it can be
difficult to differentiate between certain things. And then the other
(06:13):
thing is it can take a good bit of time
to find the proper medication regimen because there isn't just
one regimen that works for everybody that has this disorder.
It's going to be based on a lot of things,
and you might have to try a lot of things
out and that can be exhausting, it can be just
kind of disappointing. It can be difficult and disheartening. And
(06:34):
so anybody who has gone through that or is going
through that, I want you to know that it is difficult,
not because you're being difficult or because there's something wrong
with you. It's just a hard process that hasn't been
easily nailed down yet. Because we are created so differently
and there are so many forms of our brains and
(06:54):
how they work and how they function, and that what
we do that might impact how they function. There are
a lot of symptoms within mental health disorders that cross
over between different disorders, and so it can take a
good bit, like I said, to understand the spectrum of
somebody's symptoms. So again I don't know that it necessarily
(07:17):
has to take ten years. It can take ten years,
but I think it's pretty fair to say it's okay
if it takes a little longer, because we want to
really sit down and be intentional about what we're looking at,
versus just being like, oh, this sounds like this, let's
give them that now. As far as resources, I don't
have a lot of specific things that I would recommend
(07:38):
for you other than something like using the Bipolar two
workbook that you can get off of Amazon. But what
can be really helpful, I believe, is to just keep
a journal for yourself so you can look back and
assess how your symptoms show up in different times, so
you have an accurate description from where you were and
how you felt in that moment, versus having to go
(07:58):
back and think about what things were like, think about
what certain moments were like, or think about where your
headspace your head was at in certain spaces. I would
also recommend seeing a professional who can take time to
sit down with you and explain what you're experiencing and
what this diagnosis means, because there's a lot of stuff
out there on the Internet that sometimes it is confusing,
(08:19):
but also sometimes it's just wrong, and you shouldn't have
to do cartwheels to find a description of something somebody
has diagnosed you with Now, what I would want you
to know about this diagnosis, if this is to be
an accurate diagnosis for you, is that it doesn't have
to be a bad thing. It can be a very
helpful answer, and someone who is living with bipolar disorder
(08:41):
has the ability to live a full and wonderful long life.
It doesn't mean you're going to be written with horrible
mood swings and instability for the rest of your life.
And with the true understanding of what's going on, you
get to have the opportunity to find out what medications
are right for you, what behavioral changes might be right
for you, what therapy isan be the best for you,
(09:01):
so you can balance that imbalance that you have been
experiencing in your brain. However, with that, I would definitely
talk with your doctor about things that might impact this,
so things that you wouldn't want to be doing while
you're trying to figure all this out, things like drinking, smoking, etc.
Because the right medication regimen can be easily ruined by
something like that. And I also want to add that
(09:24):
this disorder has really received a stigma that it does
not deserve, and that is what I was getting at
with the they are so bipolar comment that I made above.
It paints this disorder in a light that is just
so inaccurate. And you can actually be best found with
somebody with bipolar disorder and never know it because they're
taking care of themselves well and they found that medication
(09:46):
that works for them, and they do the things that
they have found that help them maintain stability. And so
those comments can really hurt somebody that you would have
no idea they would hurt because you actually don't know
those people actually have that disorder. And it also just
paints people struggling with this or people that have this
(10:06):
in a horrible light, and they are just people like
any other people. We all have things that we have
to work on pay attention to. I mean, think about
somebody who coulds cancer. Isn't a bad person or isn't
a crazy persons. We don't get these things based on
any moral compass. They are just things that happen in
the world, and there's no moral or value reasoning behind it.
(10:29):
So I really just always feel the need to say
that when we're talking about specifical really all mental health diagnoses,
because they all can have a pretty wrong stigma, but
specifically ones like this because you didn't do anything to
get this, and even if you did, I mean, even
if you did do something and that's why you have this,
it doesn't mean that you deserve to suffer. People with
(10:52):
this disorder don't deserve to suffer, and they're not trying
to create suffering for themselves or other people, and so
I think that's important to keep in these conversations. So,
as always, I hope this was helpful. I know I
didn't have a lot of resources, but I just really
do want to encourage you to ask the people that
you are working with the things that you want to know,
and if they can't give you the answer, then you
can say, Okay, well I'd like to speak to somebody
(11:14):
who can. Because if somebody's treating your mental health disorder,
they should be able to give you these these kinds
of answers. And that is going to do it for today.
If you guys have any questions, feedback, comments, if you
have resources that you've used and you have bipolar disorder,
then please send them to me. You can send them
to Katherine at nitherapy podcast dot com. You can send
(11:34):
me really anything there questions, feedback, all the things. You
can follow us at you Therapy Podcasts on Instagram and
at cat dot Defada, And I'll be back with you
guys on Monday for a very fun episode of You
Need Therapy that I am excited about. So until then,
I hope you have the day you need to have
and I will talk to you soon
Hi guys, and welcome to a new episode of couch
Talks on You Need Therapy Podcast. My name is Kat.
I am the host, and if you are unfamiliar with
what couch Talks is, it is the special BOTUS episode
of You Need Therapy where we answer or I answer
the questions that you guys send in to me at
Catherine at You Need Therapy podcast dot com. Now a
(00:31):
quick reminder before we get into today's episode that although
I am answering your questions, this still does not serve
as a replacement or substitute for any actual mental health services. Now,
per usual, we do one question episode and we always
keep them anonymous, and we're actually answering the second question
(00:52):
from the listener from last week who wrote in asking
about some spirituality stuff and how to tell a difference
between mental health issues and spiritual issues. And here is
her second question. During a recent appointment with my psychiatrist,
the doctor stated that my history strongly suggests the presence
(01:13):
of bipolar two and recommended I follow the treatment plan accordingly.
He said it typically takes over ten years to properly
diagnose patients with bipolar two, and that most are misdiagnosed
and treated for depression slash anxiety, as I have been.
He said that it typically takes over ten years to
properly diagnose patients with bipolar two, and that most are
(01:35):
misdiagnosed and treated for depression slash anxiety, likely due to
the fact that hypomanic episodes are subtle and not as
intense as manic episodes with bipolar one. I'm still wrapping
my head around this and trying to do as much
research as I can. I am also trying to understand
certain patterns of my behavior to see if this diagnosis
(01:56):
resonates with my lived experience. It's a lot to take in.
Do you have patients who struggle with bipolar two? Do
you have any resources you can recommend for this specific topic.
Most of the information I'm finding out there is reverlent
for bipolar one, but not as much for other diagnoses
on the spectrum of bipolar all right, So for anybody
(02:16):
who is not familiar with bipolar disorder, there are two
main forms that most people who are familiar with bipolar
disorder of any form are familiar with. So there's bipolar
one and bipolar two. Now, they can be similar, but
they also are very different. So bipolar one includes having
(02:38):
at least one manic episode, and bipolar two will have
something that is called hypomania, which is a less severe
form of mania. Now, both may have bouts of depression,
so you're gonna see that with both. However, people who
are struggling with bipolar two might have more severe bouts
(02:58):
of depression, or their experiences of depression might last a
little longer. And also, not to make this more confusing
than it already is, people who have bipolar one also
might have hypomania, but they have to have had at
least one experience of mania as well. And somebody who
has bipolar two has not experienced mania, they are only
(03:19):
going to if they experience a form of this, they're
going to have hypomania. Now, it's also important to mention
here that bipolar does not look like what I think
a lot of people out there think it looks like.
It doesn't look like swift mood swings that happen like
within thirty seconds. They are longer lasting, more prevalent shifts.
(03:40):
And so when we say things like, oh my gosh,
he's so bipolar or she was being so bipolar, we're
very much mislabeling what we are experiencing with the people
around us, because that is not what this disorder looks
like at all. It's also worth mentioning here that something
I have found difficult at times is and i' mean
difficult as a practitioner, as a clinician, trying to differentiate
(04:05):
between borderline personality disorder and bipolar disorder, because a lot
of their symptoms can mimic the other. Now, one is
a personality disorder. Borderline personality disorder is a personality disorder,
and there is not specifically medication that you can take
that will take away some of these symptoms. There are
(04:25):
medications you can take that can help alleviate some of
the things that come along with borderline personal disorder, but
that is a disorder that is largely built and created
out of severe trauma, and that is a result in
symptoms of experiencing severe trauma. And so a lot of
the treatment for that is going to be more on
the therapy side. And like I said, you can take medications,
(04:48):
but there's not a medication to cure that. Now, bipolar
disorder is actually more of a chemical imbalance that is
largely inherited from genetics. In which which there can be
a large medication management portion of this in the treatment,
so they are very different. One is based more specifically
(05:09):
and strictly within the chemical imbalances in your brains, within
neuro transmitters and stuff like that, and one is a
result of trauma that it has more to do with
our own behavior and our beliefs and our own fears
rather than the chemicals in our brain. And I know,
as I'm saying this, this probably sounds very confusing, but
(05:30):
it is worth noting that as we're talking about the
difficulty in diagnosing it, that's another part that can be
really difficult is seeing these things that can look very similar,
seeing them as different, and being able to really take
the time to assess where the symptoms are coming from. Now,
I have not ever heard someone say specifically that it
(05:51):
takes ten years to diagnose a patient with bipolar disorder.
I think that it's probably true that it has taken
ten years for some people to be properly diagnosed, But
I do believe that it sometimes can take a good
bit to properly assess the symptoms. And that's connected to
what I just said above about how it can be
difficult to differentiate between certain things. And then the other
(06:13):
thing is it can take a good bit of time
to find the proper medication regimen because there isn't just
one regimen that works for everybody that has this disorder.
It's going to be based on a lot of things,
and you might have to try a lot of things
out and that can be exhausting, it can be just
kind of disappointing. It can be difficult and disheartening. And
(06:34):
so anybody who has gone through that or is going
through that, I want you to know that it is difficult,
not because you're being difficult or because there's something wrong
with you. It's just a hard process that hasn't been
easily nailed down yet. Because we are created so differently
and there are so many forms of our brains and
(06:54):
how they work and how they function, and that what
we do that might impact how they function. There are
a lot of symptoms within mental health disorders that cross
over between different disorders, and so it can take a
good bit, like I said, to understand the spectrum of
somebody's symptoms. So again I don't know that it necessarily
(07:17):
has to take ten years. It can take ten years,
but I think it's pretty fair to say it's okay
if it takes a little longer, because we want to
really sit down and be intentional about what we're looking at,
versus just being like, oh, this sounds like this, let's
give them that now. As far as resources, I don't
have a lot of specific things that I would recommend
(07:38):
for you other than something like using the Bipolar two
workbook that you can get off of Amazon. But what
can be really helpful, I believe, is to just keep
a journal for yourself so you can look back and
assess how your symptoms show up in different times, so
you have an accurate description from where you were and
how you felt in that moment, versus having to go
(07:58):
back and think about what things were like, think about
what certain moments were like, or think about where your
headspace your head was at in certain spaces. I would
also recommend seeing a professional who can take time to
sit down with you and explain what you're experiencing and
what this diagnosis means, because there's a lot of stuff
out there on the Internet that sometimes it is confusing,
(08:19):
but also sometimes it's just wrong, and you shouldn't have
to do cartwheels to find a description of something somebody
has diagnosed you with Now, what I would want you
to know about this diagnosis, if this is to be
an accurate diagnosis for you, is that it doesn't have
to be a bad thing. It can be a very
helpful answer, and someone who is living with bipolar disorder
(08:41):
has the ability to live a full and wonderful long life.
It doesn't mean you're going to be written with horrible
mood swings and instability for the rest of your life.
And with the true understanding of what's going on, you
get to have the opportunity to find out what medications
are right for you, what behavioral changes might be right
for you, what therapy isan be the best for you,
(09:01):
so you can balance that imbalance that you have been
experiencing in your brain. However, with that, I would definitely
talk with your doctor about things that might impact this,
so things that you wouldn't want to be doing while
you're trying to figure all this out, things like drinking, smoking, etc.
Because the right medication regimen can be easily ruined by
something like that. And I also want to add that
(09:24):
this disorder has really received a stigma that it does
not deserve, and that is what I was getting at
with the they are so bipolar comment that I made above.
It paints this disorder in a light that is just
so inaccurate. And you can actually be best found with
somebody with bipolar disorder and never know it because they're
taking care of themselves well and they found that medication
(09:46):
that works for them, and they do the things that
they have found that help them maintain stability. And so
those comments can really hurt somebody that you would have
no idea they would hurt because you actually don't know
those people actually have that disorder. And it also just
paints people struggling with this or people that have this
(10:06):
in a horrible light, and they are just people like
any other people. We all have things that we have
to work on pay attention to. I mean, think about
somebody who coulds cancer. Isn't a bad person or isn't
a crazy persons. We don't get these things based on
any moral compass. They are just things that happen in
the world, and there's no moral or value reasoning behind it.
(10:29):
So I really just always feel the need to say
that when we're talking about specifical really all mental health diagnoses,
because they all can have a pretty wrong stigma, but
specifically ones like this because you didn't do anything to
get this, and even if you did, I mean, even
if you did do something and that's why you have this,
it doesn't mean that you deserve to suffer. People with
(10:52):
this disorder don't deserve to suffer, and they're not trying
to create suffering for themselves or other people, and so
I think that's important to keep in these conversations. So,
as always, I hope this was helpful. I know I
didn't have a lot of resources, but I just really
do want to encourage you to ask the people that
you are working with the things that you want to know,
and if they can't give you the answer, then you
can say, Okay, well I'd like to speak to somebody
(11:14):
who can. Because if somebody's treating your mental health disorder,
they should be able to give you these these kinds
of answers. And that is going to do it for today.
If you guys have any questions, feedback, comments, if you
have resources that you've used and you have bipolar disorder,
then please send them to me. You can send them
to Katherine at nitherapy podcast dot com. You can send
(11:34):
me really anything there questions, feedback, all the things. You
can follow us at you Therapy Podcasts on Instagram and
at cat dot Defada, And I'll be back with you
guys on Monday for a very fun episode of You
Need Therapy that I am excited about. So until then,
I hope you have the day you need to have
and I will talk to you soon
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