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SRS with bipolar?

Started by umop ap!sdn, December 18, 2009, 01:49:05 PM

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umop ap!sdn

So this year I was diagnosed with BP and attention deficit disorder. My surgeon has a requirement on his website that patients can't have SRS if they're being treated for any psychiatric disorder, and if they're found to have one then their surgery is immediately canceled. I know this can't be absolute because I knew someone personally with bipolar who went to this surgeon for her SRS (sadly she and I parted ways a long time ago and haven't spoken since, so I can't ask her for advice or information). I have no idea if she was diagnosed before or after her surgery.

So I'm stuck with a seeming conundrum... tell my surgeon that I have this and risk him canceling my procedure right away, or not tell and risk him canceling it upon my arrival at which point I'd be stuck in a foreign country for an extended stay with nowhere to go. My counselor thinks having BP wouldn't stand in my way, and I can definitely ask both her and my psychiatrist for letters to the effect that I'm stable enough to decide on and undergo this kind of surgery.

Anyone been in a similar situation to this? How did you handle it?
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rejennyrated

I have never had to face anything like that, boringly I never had any other problems. I think this is the sort of thing that you probably need to discuss with those who are treating you and take their advice. I suppose there is a chance that the surgeon may not find out if no one tips him off, but my reasoning would be this:

If you are honest then either, a) you can find another surgeon if you need to (there are plenty of competent SRS surgeons and they won't all have that kind of restriction), or b) you can be confident that you won't have any problems.

If you aren't honest then there is a chance that things could go horribly wrong at the last minute with no time for you to sort out or negotiate a solution.
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gothique11

I have Borderline Personality Disorder, depression, and I've got ADD as well as a dash of OCD. They used to have me listed as Rapid Cycling Bipolar, but are now leaning on Borderline because my mood cycles seem more related to what's going on vs not (that's the difference... borderlines have up and downs, the manic and depressive, but don't last long, hours to days, and are more related to their environment, triggers, and things that are going on). Bipolar, is also a mood disorder, but the depression and manic cycles are longer (at least two weeks) and are not triggered or affected by events, people, or the environment they are in.

I guess the shift in my diagnosis has to do with more modern psychology and some of the newer information, studies, and updated stuff being put into the new DSM. I guess they also are including Axis stuff, now. I was considered rapid cycling bipolar for the longest time, until this year. Bipolar was just recently tossed out of my diagnosis, and I'm confirmed BPD (Borderline Personality Disorder) based on 10 years of psych info on me. o_0

Anyway, yeah, I've had SRS. They only requirement my psych doc had before writing the letter was that I was at least stable and in treatment. My SRS surgen, Brassard, never asked if I had any mental issues.

I think the other requirement to fit into GID is that it is consistent over time, and not something that is a product of another illness. For example, if one had schizophrenia and was he believed he was really a woman -- They have to figure out if that's just a delusion (which is canceled over time and with treatment), or if that's GID, which is consistent and doesn't go away with anti-psychotics. A schizophrenic, if treated and stabilized, can have SRS if it is proven that that person has GID as a co-morbid psychological diagnosis.

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umop ap!sdn

Quote from: rejennyrated on December 18, 2009, 04:05:29 PMIf you are honest then either, a) you can find another surgeon if you need to (there are plenty of competent SRS surgeons and they won't all have that kind of restriction), or b) you can be confident that you won't have any problems.
I'm thinking the same thing. This particular surgeon though has his own technique which sounds better to me than any of the others. I'd hate to have to settle for something different.  :-\

Quote from: gothique11 on December 18, 2009, 07:46:42 PMborderlines have up and downs, the manic and depressive, but don't last long, hours to days, and are more related to their environment, triggers, and things that are going on
I'm rapid cycling myself - my ups and downs are a few hours to a day and are sometimes but not always triggered. I wonder if the disorders are on the same continuum... my initial diagnosis was atypical mood disorder but from what I'm told that's synonymous with bipolar not otherwise specified.
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gothique11

Quote from: nerdychick on December 18, 2009, 08:36:50 PM
I'm rapid cycling myself - my ups and downs are a few hours to a day and are sometimes but not always triggered. I wonder if the disorders are on the same continuum... my initial diagnosis was atypical mood disorder but from what I'm told that's synonymous with bipolar not otherwise specified.

There seems to be a lot of similarities between Borderline and Rapid Cycling Bipolar. My psych doc says many borderlines are usually called Bipolar at first. Both Borderline and Bipolar both share the mood disorder spectrum. My doc said one clue is if you're being treated for bipolar and the treatment isn't helping much. Ie, they put you on a mood stabilizer, like lithium, and the lithium isn't working like it should. It can be hard because Borderline and Bipolar share a lot of things, especially the mood cycles. There are differences between the two, however, that are used to diagnose the differences. All or nothing, or black and white thinking is the major one -- it's a type of thought distortion that is common in borderline. Borderlines might not always be aware of it; even doctors sometimes don't realize it unless they have the right training.

My psych doc at the hospital, who specialized in borderline, was able to recognize my borderline very quickly. I've had other psych docs in the past who haven't been able to, however. My current psych took a long while before she clued in after doing research and up date training while on maternity leave... before that she was going along with rapid cycling bipolar that past doctors said. After looking at her notes, she was able to see it, as well as after talking with me.

Some doctors don't even want to deal with "borderlines" 'cause of lots of misunderstanding and stigma. For example, when I went to the hospital after trying to hang myself the on site doctor dismissed my attempt because of her mis-belief that borderlines only lie and look for attention. I then was sent home still suicidal and five hours later I was back in the hospital with an OD. Her misunderstanding almost cost me my life. If I were taken in for a couple of days to stabilize, then I probably wouldn't have OD and possibly died. The truth is, that suicidal thoughts and attempts can be very serious in borderlines and a big warning sign. Also, "lying" and "seeking attention" is also a misunderstanding, and an untruth about the disorder.

A lot of it has come a long way with recent research trying to piece together what borderline really is and isn't. A lot has changed over the years with the diagnosis. There's also a lot of doctors who aren't up to date, and there's still a lot of misconceptions about borderline floating around. Like above, it can (and has) cost lives, as well as being given ineffective treatment. Ineffective treatment means suffering and a higher risk for borderlines. Sadly, good treatment and good doctors familiar with borderline can be hard to find. Treatment here, for example, is lacking.

In some places, borderline was also used a junk diagnosis in the past, so some still don't want to take it seriously (although it is very serious). Just as bipolar and schizoaffective have/are been used as the waste basket diagnosis by doctors who don't know what they are doing, and decide to throw a label on someone that they don't know how to treat or help -- these waste basket ideals, product of uninformed and lazy doctors, 'cause more harm than good leaving people with incorrect treatment.

Even the term "Borderline Personality Disorder" is being debated at the moment. The psych doctor at the hospital I went to, who also specialized in it, said he didn't like the term. He liked to say that it was a mood disorder and an adjustment disorder.



Post Merge: December 19, 2009, 02:11:08 AM

Oh, and fun fact: Princess Diana was BPD (Borderline).
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umop ap!sdn

I wrote and told him and turns out it's perfectly fine. :)
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gothique11

Awesome! I'm glad it worked out.
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