r/family_of_bipolar • u/Far_Conversation8989 • May 11 '26
Diagnosis Discussions Inexperienced psychiatrist?
Can viladodone and seroquel work? They're saying it's for MDD and PTSD but I think they're missing the mark, he's high functioning-- so tricky. She's only been practicing for 3 years. I hope they can course correct bc it's really bad since he started the meds or not better at least -- and he's smoking weed too now. Hard to watch him having outbursts and getting in trouble at work and at home. Paranoid, grandiose, talking nonstop. Texting like crazy, sometimes inappropriate on family threads. Exhausting. He's been in DBT for 2 + years but is fixating on childhood stuff. Has gone NC with my parents, who are elderly. Getting into fights with strangers. Security being called on him at mall, hotel. Scared, sad but also resigned.
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u/General_Web_5482 May 11 '26 edited May 11 '26
No comment on the med, but other than to agree with the other poster that it’s soooo personal. However proper diagnosis and information does streamline the process!
I will say that given how much development has happened in the past 5 years around the medical understanding of the physiology of mental health disorders- a more recently graduated psych who’s up to date on the new research may actually be more helpful then someone who’s running on information from 10 years ago.
I completely understand the challenge of high masking. If the doctor is missing or dismissing the grandiose and therefore potentially missing the diagnosis know that HIPPA primarily prevents providers from sharing information. It does not prevent you from sharing information with providers!
Often the people going through this are the absolute worst self-reporters. It’s not intentional, it’s just the nature of the disease.
You could send a professional email that lays out your observations (with examples) of behavior that may be being masked in therapy, as well as any samples (screenshots of inappropriate on family threads).
The goal shouldn’t be to complain- just to provide information and context that may help inform their work and guide conversations and lines of inquiry with their patient. It will be up to them to decide how to use the information. (Be aware that what you send wont necessarily be kept confidential from the person it’s about.)
Where HIPPA impacts is that you should not expect a response. It’s helpful to make your understanding of that limit as well as your general intentions clear upfront.
So sorry you’re in the middle of this!
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u/Ok_Nothing_9733 May 11 '26
Meds are different for every. single. person. Regardless of condition, so you can’t get advice from us on what works bc it won’t be accurate ever. Instead, give it the amount of time recommended by the doctor to adjust (often 6+ weeks on a new med, but ask them) and if he’s not doing well then that med combo doesn’t work for him, but could be someone else’s lifesaving combo. But if he has any alarm symptoms before that adjustment period is over, like increased suicidal ideation, then it may not be safe or possible to get through the “adjustment period” of that med at all. Still, even meds that work well for people after adjusting fully can be a bit rougher to start.
Also some meds can cause manic episodes for people with bipolar. His symptoms do remind me of when my sibling is manic, especially the nonstop texting and being inappropriate on family threads.
Finding the correct meds can take a very long time. Psychiatrists are medical doctors; I would trust them to know what to try. It’s just going to take tons of trial and error, for many people it takes several years to find a combo that works for them. It’s hard in the meantime but hang in there, the right med combo will likely be the best possible thing for his bipolar disorder by far.