Expert: Ivan Goldberg, M.D. - 3/17/2010

Question
Dear Doc. I have been misdiagnosed so many times for having either bipolar or ADHD. I also have OCD and GAD. I was even diagnosed as having schizophrenia. My final diagnoses was ADHD/OCD/GAD. However I often get that symptom of bipolar called "racing thoughts" It feels like too many things going through your mind at the same time. I was told at first to not take Ritalin but now my new doc has kept me on ritalin because he says I have no symptoms of bipolar. I heard racing thoughts can be aggravated by amphetamines. This is disturbing news for me as I am doing so well on Ritalin. It looks to me as if my life is over and will never be able to take ritalin again. I have been on Ritalin for many years and this only started now.

Answer
Hi John . . .

Your situation sounds complex and it would seem that a firm diagnosis would be a important thing for you to have. The most common misdiagnosis in psychiatry is misdiagnosing some form of bipolar disorder as ADD/ADHD. As you may know, both GAD and OCD are common comorbidities in people with bipolar disorder. There certainly are people who have comorbid ADD/ADHD and bipolar disorder. I have seldom run into any trouble prescribing Ritalin or amphetamines for them, so long as they were taking lithium or another major mood stabilizer.

I am not sure how you should go about doing it, but getting to an expert psychiatrist, or major university department of psychiatry, for a proper diagnostic evaluation is the thing you should do ASAP.

Best regards . . .

Ivan
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