Psychologist and psychiatrist not aware of indifference

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Well, I told my psychiatrist I was getting a second opinion on my bipolar diagnosis. Her mannerisms suddenly became more animated, and she said in a much more cheerful voice, "Okay!" I gave her the reasoning: Concern over whether diagnosis really fits and also the implication that I need lifelong prophylactic mood stabilization. She then said (paraphrasing), "Well, I spoke about it with the other doctor and we agree bipolar is best, and yes with bipolar you generally need lifelong treatment." This was stuff I already knew and I was kinda annoyed that she was saying it again; it was almost like she was trying to put me in my place.

My mum was present at that session, and she mentioned how I was often not very social. My psychiatrist then asked how long that had been going on, and my mum said pretty much my whole life. My psychiatrist then conceded that the asociality might be due to the PDD, but she "reassured" my mum, "I'm not saying he's autistic!"

It seems that my psychiatrist had long been under the impression that all my problems with asociality, not meeting my goals, etc., were all due to bipolar disorder. Just stabilize the moods and I'll be fine!

God. I hate my psychiatrist. I can't wait for that second opinion. I fully expect him to say something other than bipolar disorder, and more like anxiety and depression, at least, because looking through my records, I never exhibited hypomania or mania. I exhibited agitation, panic, and insomnia, but those are not symptoms of (hypo)mania, no matter how much some doctors would like to make them out to be. I've read the blog of the doctor I'm seeing and he has a much more narrow view of bipolar disorder and considers agitated depression to absolutely not be a sign of bipolar disorder.

Explain it to them.

I had a similar problem. I've trouble focusing, but I can also hyperfocus when I find something interesting. I was tested how good I can concentrate, several times over the year. Just the only problem is that I find those tests highly intersting and always start hyperfocusing then. So my results on those tests were always way above average. Just my psychiatrist now got suspicios and so it took several years that I was dx with ADD.

Thanks. I think I have, to both. My psychologist actually seems to listen to me more and I think understands it better that I have autism, now that I've talked to him. My psychiatrist, on the hand...

My psychiatrist was once frustrated with me because I never told him much. He then told me that he can't know what I think and feel when I don't tell him.It actually sounds totally logical, but I guess with lower (or not natural) social understanding you keep forgetting that actually, at least I do.
So especially when you learned to act quite NT and don't tell them what's really going on or how you feel and so one they don't know that.

I personally have huge difficulties with that, expressing what's really going on and saying the right stuff that matters to a psychiatrist.

Well, that's the thing. She diagnosed me after a 15-minute interview way back in November. She ordered testing, which involved things like the Bender, Draw a Person, the Beck Depression Scale, the MMPI (on which I gave too many unusual answers, producing an invalid protocol), and the Rorschach. From that, somehow, a diagnosis of "bipolar affective disorder" was determined, along with "personality disorder NOS with histrionic, borderline, and schizotypal features." Honestly, though, when I looked at the test, I didn't find anything specific to hypomania or mania, except possibly for "restlessness" (which was probably put down because I was bouncing my leg up and down or was fidgeting, stuff I do a lot of the time). Now, back in December, she said that it was just provisional, that what she observes clinically would take precedence. Well, she went back on that back in August/September, when (after I wanted to poke my eyes out) she said my diagnosis would be bipolar NOS, because of what was put in the test results. It seems that she's not actually that interested in finding out more info from me; she sees me as just this "bipolar guy" who just needs to stay on medicine for the rest of his life--and yes, I've read what she's written about me: it would be "his." Hence, why I'm going for a second opinion from someone who I know would actually go for a good thorough diagnostic interview.

I've tried telling her stuff, bringing up stuff at as appointments as much as I can, and I've brought her old paperwork. I even brought her something from 3rd grade (elementary school) showing the social problems, but the way she talked to my mum suggests she didn't read it, or not very well. The problem is, the appointments are 15 minutes long and she's usually pretty quickly running me out the door. I've told my psychologist lots of stuff, who works in the same office as my psychiatrist, but that never seems to get back to her. Now, my psychologist doesn't seem too sure about the bipolar diagnosis, but he says he would rather leave the diagnosing up to the psychiatrist--who of course can only see you 15 minutes.

Now I've read on the blog (either that or a related blog) of the psychiatrist I'm going to for a second opinion that you need at least an hour for a good diagnostic interview. Anything less is selling the patient short. I agree with this sentiment, and that's why I'm going for a second opinion with him.

Welllll.... just my opinion of course, but most psychiatrists don't want to let go... they don't heal you, they just gobble up your time and your money... or the state's money. And diagnosis is pure art... you could go to a dozen of these "doctors," and get a dozen different dxs. I think that you can't go to a psychiatrist and NOT get a dx and a prescription and a follow up appointment. The real problem is how to get them out of your life... and how to stop thinking you need their pills to feel better.

To my way of thinking these doctors are pretty much like fortune tellers, or astrologers. You present a problem, and they give you a diagnosis, and a treatment plan. You reach in your wallet and give them money, they give medicine or chants, or prayers, or herbs, and an appointment in the near future to see "how you are doing."

That seems to go against my experience. When I was a teenager with a high dose of Zyprexa, my doctor demonstrated that willingness to let go. I had gone off the dose on my own, but I did well anyway. He said that I didn't need meds anymore and that was that.

Also, I do think diagnosis can be valid, but you need a detailed history of the patient before making the diagnosis. Doing what my doctor did, diagnosing after 15 minutes, was a no-no.

The psychiatrist I'm seeing is someone who generally thinks that issues like what I'm dealing with are largely psychosocial issues and does not want to keep someone like that on medication indefinitely.

Good. Good luck with them!

I find psychiatrists frustrating and generally unwilling to get to the root of your difficulties - I've even had one totally avoid the subject of Aspergers even though he claimed to know what it was. I did have one for a while who first diagnosed me, and she was VERY good and insightful in helping me. But I also had one before my official Dx, who seemed almost flippant when I attempted to describe my problems to him...it was something like this:

ME: "I don't know what it is, but I seem to have trouble socializing with people, and they don't seem to welcome my attempts to do - as well intentioned as they are."
DR: "Well, then you must learn to properly socialize."
ME: "But I don't know how."
DR: "Well, then you must learn how." (with a stupid half grin)

Pretty much one of those "big picture" responses you get from NTs, where they expect you to implicitly know the details.

All I can say is, if you find a good Dr/psych, then hang on to him or her...you will feel more confident in all aspects of life from that alone. But I would still be discrete in telling others, including someone you're dating, about any visits to a psychiatrist. It still has stigma even in 2013.

Yes I agree and I also think you should get a second opinion.
The one time I was miss-dx also happened like this in a psychiatric hospital even were psychiatrists just wanted to dx something fast. I was totally scared there and they even dind't noticed. I was looked up in a psychiatric ward in a very old building and we were 4 ppl in one small room with barns in front of two small windows.
Outside were a lot of noise, because they were constructing a new psychiatric building right next to it.
I still suffer from anxiety attacs out of this time.

I stayed there for some time afterwards in the ambulant part of that psychiatric hospital, but either freaked out or couldn't say something at all because I was so scared. It was disasterous and the psychiatrists didn't realise the situation. After I got a ten pages long independent expert report who also stated that they had done mistakes I was kicked out and after that everything changed. I found a really nice psychiatrist and my anxiety got a lot better, but I still suffer from anxiety related to my past experience there.
Okay, that's a bit extreme, but that's one of the reasons why I personally think psychiatrists should be carefull and dx something within a short period of time and then just sticking to it can even be harmfull. In less severe cases than mine with the wrong meds and the wrong treatment plan, but that can be already harmfull enough.