In a few weeks, I have my next Psychologist appointment.  We meet every 3 months.  To give you some background, I was diagnosed as bipolar II a few years ago.  I used to suffer from cyclical depression and really no mania.  But I had a long lasting manic episode about 10 years ago, hence the diagnosis.

The depression was crippling and lasted the better part of a decade.  We tried MANY medications with little to no success.  Fast forward to a year ago and we found a med combo that works.  I have felt great for once over the past year.

Though I haven't had an episode in so long, my Psychiatrist is always on high alert for the potential of mania.  He always seems concerned that the current med combo could trigger a manic episode.

So, my concern is that when I share this with him, his mind will likely jump to mania as a cause.  I need him to understand that this has been a part of me since I was a young boy, but that in my misery, I just pushed it down.  Now that I have been well, I can finally be happy and be me.

My aim is to A) NOT switch meds which have been a God send and B) be referred to a gender therapy specialist.  Any opinions or recommendations on how to effectively share this side of me with him and meet these two goals?  He's been a great pdoc, I just fear that in this case he will jump to conclusions that will have a negative effect on my healing.  Amazingly, I am more nervous about telling him than I was telling my wife...

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Quote from: Danielle834 on February 19, 2017, 03:15:52 AM
In a few weeks, I have my next Psychologist appointment.  We meet every 3 months.  To give you some background, I was diagnosed as bipolar II a few years ago.  I used to suffer from cyclical depression and really no mania.  But I had a long lasting manic episode about 10 years ago, hence the diagnosis.

The depression was crippling and lasted the better part of a decade.  We tried MANY medications with little to no success.  Fast forward to a year ago and we found a med combo that works.  I have felt great for once over the past year.

Though I haven't had an episode in so long, my Psychiatrist is always on high alert for the potential of mania.  He always seems concerned that the current med combo could trigger a manic episode.

So, my concern is that when I share this with him, his mind will likely jump to mania as a cause.  I need him to understand that this has been a part of me since I was a young boy, but that in my misery, I just pushed it down.  Now that I have been well, I can finally be happy and be me.

My aim is to A) NOT switch meds which have been a God send and B) be referred to a gender therapy specialist.  Any opinions or recommendations on how to effectively share this side of me with him and meet these two goals?  He's been a great pdoc, I just fear that in this case he will jump to conclusions that will have a negative effect on my healing.  Amazingly, I am more nervous about telling him than I was telling my wife...

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Hallo Danielle! I think that if indeed you suffer from a bipolar disorder type 2 and if this will be the first time you mention your gender dysphoria, she/he will likely try to exclude a possible bout of mania. I can think of at least two things that could dissuade her/him from coming that conclusion. If you do not present any other symptoms suggestive of an episode of mania (unreasonable spending, insomnia, disinhibition... you know them for sure) while you feel the dysphoria AND if you keep having the feelings of dysphoria on a persistent basis... If she/he thinks its premature to send you to a gender specialist, perhaps you could ask for more frequent visits, so she/he can assert the consistency of your feelings... That's what I'd do.
Good luck!
Warm hug,
Sarah

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Just be yourself, be honest and say what's on your mind:)

The psychologists job is to help you resolve issues, not create them or judge you. They have a duty of care and are trained to spot if you're having a manic episode or not, which is a good thing.

Because I've suffered from severe anxiety and depression for years I was referred to a psychologist before being given a green light for the gender clinic. It's common practice, and was grateful for it, because It resolved a lot of doubt I was having that there may have been other underlying mental health issues at play. I too was having the same worries as you are now, it's only natural.

Turns out I was fine. He was fine. It gave me the confidence to move forward without any nagging unresolved fears surrounding mental health.

shy

I had been diagnosed with cyclothymia prior to my transition. The funny thing is that after HRT, the cyclothymia went away. Something about testosterone messed with my mood.

Therapists generally look to rule out MPD, and body dysmorphia before they can diagnose gender dysphoria. Being bipolar is an issue, but it won't preclude them from taking you seriously about your trans-ness.

It can be hard to come out to people, but remember that it's their job to listen to you. You're literally paying them to both pay attention to you and take you seriously. Plus, there's nothing wrong with being transgender, so just be yourself and tell him want you feel you need to as calmly as you can.

Ask if they have any experience with transgender people first. If not, ask if they'd be willing and able to work with you, or if they'd be able to refer you to someone who will.


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Thanks Everyone!  Yeah, fortunately I am not exhibiting any manic symptoms.  Again, I never have in the 3 years with this p-doc and not ever except for about a 6 month period in '06.  It only takes one episode to be diagnosed.  I'm no psychiatrist, but I think that one episode was just an anomaly and I was really suffering from severe cyclical depression.  Fortunately that has remained in check for a year for the 1st time in over a decade.

I appreciate the advice and the words of encouragement.  You're all right.  It will occur to him, but I need to be an advocate for my own health and well being.  I the coming weeks, I will solidify my back story to share with him and I'm sure we'll find a way to the right direction.

Quote from: Danielle834 on February 20, 2017, 05:11:23 AM
Thanks Everyone!  Yeah, fortunately I am not exhibiting any manic symptoms.  Again, I never have in the 3 years with this p-doc and not ever except for about a 6 month period in '06.  It only takes one episode to be diagnosed.  I'm no psychiatrist, but I think that one episode was just an anomaly and I was really suffering from severe cyclical depression.  Fortunately that has remained in check for a year for the 1st time in over a decade.

I appreciate the advice and the words of encouragement.  You're all right.  It will occur to him, but I need to be an advocate for my own health and well being.  I the coming weeks, I will solidify my back story to share with him and I'm sure we'll find a way to the right direction.

Your Psychiatrist is going to be able to see really quickly if you are in either a manic or depressive phase. Clearly from what you have told us you have been stable for a least three years and then 7 years. IMHO don't be too concerned, I think the more relaxed and yourself you are the better your answers will be to anything he asks you. I am sure you are right and will end up in the right direction.

Liz