Bipolar NOS and dx confusion

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My diagnosis history goes something like this: Depression, AD/HD, Asperger's Syndrome. When I first met my current therapist and I told her about my history, she asked if anyone had ever suggested I had bipolar. She never brought it up again, though, and when I asked about it some months later she said I didn't have bipolar, just serious anxiety related to Asperger's traits. Okay. But then today my psychaitrist decides to add Bipolar NOS to my diagnosis laundry list. I probably shouldn't care about this as much as I do, but this was confusing and now I don't quite know what to think or believe. My therapist definitely knows me better. She says that someone with BPD has serious mood swings because of biological reasons, but that my problems with emotional regulation are related to situations and the environment. When I get very upset, which I do moderately often, it's because something unexpected has occurred or something has gone "wrong" or some other kind of stimulus has triggered it. These periods often don't last that long, and I also don't really seem to have manic episodes, or if I do they are extremely mild and short-lived in comparison to what others describe. I've been taking Lamictal for the past month and it's helped me, but I'm still not sure my psychaitrist's diagnosis is appropriate. Is there a reason why I should believe her? Has anyone else had "Bipolar NOS" suggested to them? What would a very mild version of bipolar look like with Asperger's?

1. I understand that your "therapist" and your "psychiatrist" are two different people, the former being a psychologist or social worker?

2)"Mania" or a "manic episode" is necessary for Bipolar dx. Mania is a very extreme state where you are "out of your head" like spending all your money or getting enraged (from inside, not from an external trigger), being risky, going out of bounds. You might appear like you're on coke to someone else, talking really fast, going from euphoria to irritation. I believe you only need one episode to be diagnosed with Bipolar.

3)check "cyclothymia" or "soft bipolar", it is depression with phases of "hypomania". Hypomania is a state of euphoria, creativity, or heightened mood. I believe I have this mood disorder. My hypomania comes with irritation if my wants aren't met and I get selective memory, where I don't "remember" my depressive phases. But I can also plan and make goals and be productive in this state. My depressive phases are bad but I've never been completely shut down, just a real Eeyore. But like Bipolar, the triggers are internal; hormones, chemicals out of whack, cycles.

4) Autistic people express emotion differently than NTs. We may not always present an in between emotional expression. We can go from happy to mad or frightened really quickly. It's like a switch. This may look like like bipolar to someone else but it's not. It's just extreme expression or lack of expression. It can also be due to black and white thinking where we feel we have to decide something "Right Now!" and so we get fired up over a topic others aren't so enthusiastic about.

Kim - you just described my son & me perfectly!

My son has been put on mood stabilizers (Depakote)
He is seeming much better (Last 2 weeks)

Thanks for the information. To clarify, my psychiatrist is an MD with a specialty in psychiatry while my therapist is a clinical neuropsychologist with a PhD. The psychiatrist claims that people with "very mild" bipolar only go into very slight "up" periods, but I'm really not sure she's right about this one. I've sometimes been hyper and super-focused on something which excited me, but I don't think that fully qualifies as a manic episode. Even though it's not in the DSM, I think KimJ is right in saying that aspies can have extreme emotions sometimes and can switch back and forth quickly. That fits with some of my experiences. I'm not sure the psychiatrist knows a lot about the spectrum. She tried to re-diagnose me with "Asperger's NOS" which doesn't actually exist. When she figured that out she thought "PDD-NOS" would be more appropriate than my current Asperger's dx. Never mind that the AS dx was from a psychologist who specializes in AS.

Well, the psych sounds like she wants to dope you up and she'll find a label that suits her purpose. Cyclothymia/soft bipolar can be treated without meds. I'm trying right now and I'm very optimistic. But if it's your AS that is making you "appear extreme" you may just need counseling for anxiety and disorganization.

I stay with this psychiatrist because I think the med is helping me and my partner very much agrees. I don't think she understands the source of a lot of my problems and her diagnostic method irritates me, but my (aspie) partner very much wants me to stick with the medication program regardless of all the labeling stuff. I do think I've done better with mood-stabilizers than without them, though I hope to eventually develop my natural coping mechanisms to the point where I can do well without meds. I'm in counseling to work on these problems. I know diagnoses are probably irrelevant in the larger schemes of things, but I just don't like the thought of a loose diagnosis being recorded on my insurance records or something like that. I guess I'll just have to see about that.