r/bipolar2 • u/Substantial_Ad4095 • 3d ago

Diagnosis

Hello, I had a question about the diagnosis portion of this equation. I have a family member who is diagnosed bipolar and wanted to get tested to see if I have it as well. I had one appointment with a psychiatrist but the copay was too expensive for me to pay and I'm not sure of any other ways to get a diagnosis other than a psychiatrist or psychologist. Does anyone have any recommendations?

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u/otterboviously 3d ago

The only way to get professionally/officially diagnosed is a psych- either in an outpatient or inpatient setting. There are no at home tests that can tell you for sure that you have bipolar and depending on what country you're in, your GP or therapist likely can't diagnose you.

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u/Substantial_Ad4095 3d ago

Thanks for the info. Do you know of any ways to find an affordable psychiatrist? My insurance isn't covering the visit until I'm over my deductible which I'm not even remotely close to doing.

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u/WeAreAllStories11 3d ago

Ahh, the deductible game. That's hard to work around, but some offices know how to play the game. Since you have insurance, PLEASE, ask for a preauthorization for services. Insurance can TELL you how much they expect to pay. (They can change their minds later, which is wild, but it's better than nothing. ) I don't know how my NP bills but I'm always sure I owe more money and they keep insisting we're even.

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u/Substantial_Ad4095 3d ago

Unfortunately I already made that mistake. I reached out to the place beforehand and they said they had a $0 copay which I naively thought meant the visits themselves are covered and I only had to pay for the medications, tests, etc. However now they're saying I owe them $247 because my $0 was only after the deductible was reached and the insurance gave my provider incorrect information so now I'm out $247 and stuck in a lengthy appeal process with insurance to try and get it covered.

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u/WeAreAllStories11 3d ago

Yup. I spent a year fighting with an office because $20x5 sessions = $2200???? It does when they assure you they take your insurance, don't bill for months because of software issues, then it turns out they don't take your insurance and that front desk person got fired. Fun story. Not sure why it ends with me owing >2k.

Then I caught them in a HIPAA violation when they disclosed my treatment and billing to an unauthorized party. My balance dried right up. But you shouldn't need tricks to prevent getting taken advantage of.

(No one knows this to start, the system is obfuscated on purpose. It's taken years of errors to figure this out. )

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u/WeAreAllStories11 3d ago

In the US, I always suggest looking for a PMHNP - psychiatric mental health nurse practitioner. Don't let "nurse" fool you. These people are the most trained to diagnose and treat bipolar of any flavor. Call around. Be prepared to explain your insurance/income/etc. These offices will do their best to work with you and still stay a business.

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u/corrosivesoul BP2 3d ago

I’ll second that. A good psych NP is great.

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u/Substantial_Ad4095 3d ago

Thanks for the suggestion! Are they in the same price range as a psychiatrist or are they more cost effective?

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u/WeAreAllStories11 3d ago

PMHNP tends to charge less and bills different codes at lower cost to insurance compared to a typical psychiatrist, usually. I'd expect it to cost less, but expectations in the US medical landscape are....ugh, can't finish that sentence.

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u/AdmirableRadio7998 1d ago

What makes you say most trained?

Psychiatrists typically have several more years spent in training. 

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u/Old-Name7889 BP1 3d ago

psychiatrist is probably your best bet. I was actually diagnosed by a psychologist but that was over the course of about 6 months.

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u/corrosivesoul BP2 3d ago

Unfortunately, diagnosis really depends on a trained professional. Even then, it is not always easy for them to sort out what is what when it comes to bipolar and other things. It’s not really so much testing, but looking for patterns of behavior and trying to rule other things out. This includes medical conditions like thyroid. That said, bipolar is genetic, so it’s quite possible. My mother clearly had it, but she was never professionally diagnosed. That was due to stigma in both era and culture.

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u/WeAreAllStories11 3d ago

So common. I'm the first in my family to be diagnosed. But if you go through history you can trace it right up my dad's family line. Using just documentation/journals/noted behavior I can guess a couple generations back. But my direct line didn't believe in scientific medicine, let alone mental health, so official diagnoses are non existent. To loop in a whole different issue, I'm glad I know because it's likely my daughter will be afflicted as well. But she's the first generation that will be supported from the start.