Fun with ICD-9 codes

I came across a situation recently in which a woman was described having mania in bipolar disorder, but was “diagnosed” with 296.2. And the recommended treatment? Venlafaxine (Effexor).

I swear, sometimes doctors themselves don’t even know what to prescribe.

UPDATE:
Okay, maybe I was wrong?

2007 ICD-9-CM Diagnosis 296.2
    Major depressive disorder single episode
        * 296.2 is a non-specific code that cannot be used to specify a diagnosis
        * 296.2 contains 72 index entries
        * View the ICD-9-CM Volume 1 296.* hierarchy

    Alternate Terminology
        * Depressive psychosis, single episode or unspecified
        * Endogenous depression, single episode or unspecified
        * Involutional melancholia, single episode or unspecified
        * Manic-depressive psychosis or reaction, depressed type, single episode or unspecified
        * Monopolar depression, single episode or unspecified
        * Psychotic depression, single episode or unspecified

So it’s totally possible to have a bipolar episode and be depressed? WTF? Am I depressed with bipolar symptoms or am I bipolar with depressive episodes? Ugh, none of this diagnosis stuff makes sense. Glad I’m not a doctor now.

Loose Screws Mental Health News

A new Canadian study has found that most workers who struggled with depression had job performances were affected. (Nothing new here, right?)

“On average, the study says, depressed workers reported 32 days in the past year during which symptoms had resulted in ‘their being totally unable to work or carry out normal activities.’”

Seems like people really are taking ‘mental health’ days these days.


Bahrain is having a problem with Indians committing suicide in the country. In January, so far, three Indians have killed themselves. Triggers leading up to the suicides are theorized to be “mental or economic depression, stressful working conditions, low wages and poor housing.”


According to Dr. Brian Doyle, people with ADHD are at a higher risk for mood disorders such as major depressive disorder.

“In a recent study, 38.3% of individuals with a primary diagnosis of ADHD during the previous 12 months also had a mood disorder, compared with 5% of subjects who didn’t have ADHD.   The reverse is also true; individuals who have major depression are likelier to have ADHD than other persons.   In a Massachusetts General Hospital survey, 16% of adults with a primary diagnosis of major depressive disorder had a lifetime history of ADHD.”

Maybe I’m tired right now, but I couldn’t wrap my head around those statistics. Basically, if you’ve got a primary diagnosis of ADHD, you’re likely to have a mood disorder; if you’ve got MDD, you’re likely to also have ADHD; and if you’ve got a primary diagnosis of MDD, you probably have had ADHD for pretty much your whole life. That’s a lot to swallow.

“I am trying to screen more of my depressed patients for ADHD — especially if the patient’s depression is not responding well to treatment. The standard ADHD rating scales are a good place to start.”

I’ve heard it’s hard to screen adults for ADHD; on the flip side, I’ve also been told that it’s more difficult to find ADHD in women than in men. Dr. Doyle’s definitely on the right track here in keeping his eyes open for better ADHD screening. Perhaps I really do have ADHD.


While many celebrities are “outing” themselves on their depressive episodes, Dr. Deborah Serani’s got a list of other well-known people who have either admitted to or speculated to have experienced depression.


I’m late on the bandwagon with this but a study released in December shows that displaced women in Darfur suffer from severe depression. According to an article in Ms. Magazine:

“The International Medical Corps (IMC) posits that women’s multiple roles in society, along with constant stressors like low socioeconomic status, domestic violence, and the threat of rape when venturing outside, may account for the poor mental health of these displaced women. Women’s restricted access to education may also affect their ability to access proper care and make informed decisions about their own physical and mental health.”

And to think those of us in developed countries have problems.

“Almost one-third (31 percent) of women surveyed met the criteria for major depressive disorder while 63 percent reported suffering the emotional symptoms of depression. Five percent reported suicidal thoughts, 2 percent had attempted suicide, and another 2 percent of households had a member commit suicide in the past year. Nearly all of the respondents (98 percent) felt that counseling provided by humanitarian agencies would be the most helpful way of dealing with these feelings.”

It’s good to see that an overwhelming majority of women feel that counseling would help them. Sometimes, people in Western/developed countries take therapy for granted.

“Though depression rates are comparable to, or even lower than, those of other populations displaced by similar conflicts, the rates of suicide and suicidal ideation are ‘alarmingly high in contrast to general rates worldwide,’ according to the report.”

This, unfortunately, makes sense. Suicide is a reaction to ending constant pain. I admire women in Darfur who choose to live despite never-ending pain.  This article puts me to shame somewhat. I am incredibly blessed to have all the amenities of this country and encouragement and love from family and friends. However, I feel pretty stupid when I fall apart over minor things compared to the women in Darfur. It’s an awful cliché, but “I really do have a lot going for me; why am I depressed?”


ViagraFor men: Are you depressed and can’t get an erection? Don’t worry – Viagra can kill two birds with one stone!

A Canadian study (yes, another one) says that Viagra (sildenafil) can help improve mild depression and, of course, aid impotence in men.

“Dr. Sidney Kennedy and his team studied 184 men who had had erection problems for about four years and also met the criteria for minor, but not major, depression.

[After six weeks of treatment], the 98 men who received sildenafil had a 47 per cent reduction in their depression scores, indicating a change from mild to minimal depression. In comparison, men taking placebos had only a 26 per cent decrease in their scores, which remained in the range of mild depression.”

Pfizer’s getting their sales reps started on this one. Expect to see reps carrying Viagra brochures and info to psychiatrists eventually.

Bipolar disorder

“Avalanche is sullen and too thin / She starves herself to rid herself of sin / And the kick is so divine when she sees bones beneath her skin / And she says /Hey baby can you bleed like me? / C’mon baby can you bleed like me” ~ Garbage, “Bleed Like Me”

Medication bottlesI went to the psychiatrist Wednesday and received the oddest diagnosis of my life: he told me that I’ve got bipolar disorder and that I’m on the wrong medication.

For most of my life, I’ve been convinced that I’ve had major depressive disorder and nothing else. When I was a teenager, I thought I might have been bipolar (age 15-19) but my manic side gradually faded with puberty and I became much more of a depressive.

This is the first doctor or psychiatrist in the history of my life to ever tell me that I’m bipolar. At first, I thought he got his diagnosis wrong. “I can’t be bipolar, I’m not really manic. I don’t spend a lot of cash – well, not recently anyway – I don’t experience euphoric states quite often and I don’t have feelings of grandiosity. And I don’t engage in risky behaviors, you know. I don’t drink or do drugs. I’m a good girl. I can’t be bipolar.”

Continue reading “Bipolar disorder”

Who I Am

I am a 26-year-old black female who suffers from bipolar disorder. I was diagnosed with the illness in November 2006. I’d been diagnosed as suffering from major depressive disorder (MDD) beginning at the age of 14. I still consider myself to suffer primarily from depression although I do have occasional manic episodes.

This blog has helped me to recognize many of the things that I am. That
I truly am more than my diagnosis and that my diagnosis does not define
me. I am not just a person with manic and depressive episodes. I am a person with a personality. I’m smart, witty, drop-dead gorgeous—okay, I wish, but I’m not ugly—musically inclined, and ambitious. And that’s just scratching the surface.

I can be happy, sad, angry, and joyful. I have so many emotions that could classify me as anything. I have a short attention span, for instance. The docs missed the attention-deficit hyperactivity disorder (ADHD) diagnosis (although I lack the hyperactivity).  I suffer from anxiety as well but not a single medical record lists me as suffering from generalized anxiety disorder (GAD). So I self-diagnose. It helps me to realize that all of my flaws can pigeonhole me into any diagnosis I choose. I accept my flaws – “diagnosable” or not – and my strengths. This is my journey to learn more about myself, my diagnosis, my medical treatment, and anything relating to my personal life and general mental health.

I’m skeptical of pharmaceutical companies. I don’t hate them; however, many of their practices are shady and I—along with some of my favorite medical blogs —hope to shed light on the “unfavorable” news they choose to keep hidden from the public.

I highlight celebrities who admit to mental illnesses. Many of them suffer from depression, which is the fashionable mental illness of the moment, but others truly suffer from problems that are worth talking about.

I also write about my personal life relating to mental illness. I struggle with constant thoughts of suicide. Readers of this blog will note a pronounced emphasis on suicidal thoughts and behaviors.

Feel free to read on to the next entry about my Perfectionistic Tendencies. Chronicling my journey to managing and treating my illness can hopefully aid me. And eventually, someone else.