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Ptsd


bigjim

Question

In fed 1997 i was denied service connection for ptsd.

the last statement in the letter says: VA examiners diagnosis of the veterans

condition in bipolar effective disorder. what in the world does this mean?jim

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Guest fla_viking

Dear Veteran

That means they feel you have mood swings of high and low. They have medicatons for that. If you can prove you had that in service, you can get service connecton for it.

Terry Higgins

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  • HadIt.com Elder

They apparently diagnosed you as having Bi-polar Disorder.

Bi-Polar Disorder is what used to be called "Manic-Depressive".

"Manic-depression distorts moods and thoughts, incites dreadful behaviors, destroys the basis of rational thought, and too often erodes the desire and will to live. It is an illness that is biological in its origins, yet one that feels psychological in the experience of it; an illness that is unique in conferring advantage and pleasure, yet one that brings in its wake almost unendurable suffering and, not infrequently, suicide."

Signs and symptoms of mania (or a manic episode) include:

Increased energy, activity, and restlessness

Excessively "high," overly good, euphoric mood

Extreme irritability

Racing thoughts and talking very fast, jumping from one idea to another

Distractibility, can't concentrate well

Little sleep needed

Unrealistic beliefs in one's abilities and powers

Poor judgment

Spending sprees

A lasting period of behavior that is different from usual

Increased sexual drive

Abuse of drugs, particularly cocaine, alcohol, and sleeping medications

Provocative, intrusive, or aggressive behavior

Denial that anything is wrong

A manic episode is diagnosed if elevated mood occurs with three or more of the other symptoms most of the day, nearly every day, for 1 week or longer. If the mood is irritable, four additional symptoms must be present.

Signs and symptoms of depression (or a depressive episode) include:

Lasting sad, anxious, or empty mood

Feelings of hopelessness or pessimism

Feelings of guilt, worthlessness, or helplessness

Loss of interest or pleasure in activities once enjoyed, including sex

Decreased energy, a feeling of fatigue or of being "slowed down"

Difficulty concentrating, remembering, making decisions

Restlessness or irritability

Sleeping too much, or can't sleep

Change in appetite and/or unintended weight loss or gain

Chronic pain or other persistent bodily symptoms that are not caused by physical illness or injury

Thoughts of death or suicide, or suicide attempts

A depressive episode is diagnosed if five or more of these symptoms last most of the day, nearly every day, for a period of 2 weeks or longer.

Do Other Illnesses Co-occur with Bipolar Disorder?

Alcohol and drug abuse are very common among people with bipolar disorder. Research findings suggest that many factors may contribute to these substance abuse problems, including self-medication of symptoms, mood symptoms either brought on or perpetuated by substance abuse, and risk factors that may influence the occurrence of both bipolar disorder and substance use disorders.23 Treatment for co-occurring substance abuse, when present, is an important part of the overall treatment plan.

Anxiety disorders, such as post-traumatic stress disorder and obsessive-compulsive disorder, also may be common in people with bipolar disorder.24,25 Co-occurring anxiety disorders may respond to the treatments used for bipolar disorder, or they may require separate treatment. For more information on anxiety disorders, contact NIMH (see below).

All the above information is taken directly from the NIMH ( National Institute for Mental Health ) website and is all the connection ( nexus ) that you should need to cause the VA to reconsider your claim.

You need to file for the re-opening of your claim based on new and material evidence.

You need to go back and tackle this again.

BTW, I have been suffering from Bi-polar Disorder for 40 years, and it's a bitch, and I don't care how much I've been told that such-and-such a drug will do WONDERS, it always seems that the person telling me about the WONDERFUL drugs............doesn't happen to have Bi-polar Disorder. Funny that.

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  • HadIt.com Elder

You can have both PTSD and Bipolar! ~Wings

Bipolar Disorder/Comobidity

http://www.brainexplorer.org/bipolar_disor...morbidity.shtml

-snip-

The Stanley Foundation Bipolar Network reports a high percentage of concomitant psychiatric conditions [occuring with, at the same time] with bipolar disorder. One of the most common comorbid conditions is anxiety disorder, including panic disorder and social phobia. Symptoms of anxiety and panic followed by hypomaina may complicate the course of bipolar disorder (Suppes et al, 2000).

Other psychiatric conditions that can occur with bipolar disorder include post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD) and impulse control disorders (e.g. pathologic gambling, kleptomania) (NIMH, 2000; Suppes et al, 2000). The NIMH recently reported a high incidence of PTSD and OCD in patients with bipolar disorder, with 43% of patients exhibiting symptoms for PTSD. However, only 2% had the symptoms of PTSD listed on their charts, suggesting that improved diagnosis of this concomitant condition may lead to better treatment of bipolar disorder (NIMH, 2000). This may be especially relevant in the case of OCD as the course of the OCD and mood disorders often alter in line with each other.

1: Int J Geriatr Psychiatry. 2006 Jun;21(6):582-7.

Psychiatric comorbidity in older adults with bipolar disorder.

Sajatovic M, Blow FC, Ignacio RV.

Department of Psychiatry Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA. martha.sajatovic@uhhs.com

INTRODUCTION: Comorbidity patterns and correlates among older adults with bipolar disorder (BPD) are not well understood. The aim of this analysis was to examine the prevalence of comorbid PTSD and other anxiety disorders, substance abuse and dementia in a population of 16,330 geriatric patients with BPD in a Veterans Health Administration administrative database.

METHODS: Patients were identified from case registry files during Federal Fiscal Year 2001 (FY01). Comorbidity groups were compared on selected clinical characteristics, inpatient and outpatient health resource use, and costs of care.

RESULTS: Four thousand six hundred and sixty-eight geriatric veterans with BPD were comorbid for either substance abuse, PTSD and other anxiety disorder, or dementia (28.6% of all veterans with BPD age 60 or older). Mean age of all veterans in the four comorbidity groups was 70.0 years (+/-SD 7.2 years). Substance abuse was seen in 1,460 (8.9%) of elderly veterans with BPD, while PTSD was seen in 875 (5.4%), other anxiety disorders in 1592 (9.7%), and dementia in 741 (4.5%) of elderly veterans. Individuals with substance abuse in this elderly bipolar population are more likely to be younger, minority, unmarried and homeless compared to elderly bipolar populations with anxiety disorders or dementia. Inpatient use was greatest among geriatric veterans with BPD and dementia compared to veterans with BPD and other comorbid conditions.

CONCLUSION: Clinical characteristics, health resource use and healthcare costs differ among geriatric patients with BPD and comorbid anxiety, substance abuse or dementia. Additional research is needed to better understand presentation of illness and modifiable factors that may influence outcomes.

PMID: 16783798 [PubMed - in process]

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There are also different types of Bipolar if you will, Bipolar I, and Bipolar II Disorder.

They are learning more and more about Bipolar Disorder everyday, but that doesn't help those of us who are having great difficulty in the here and now!

I have SSDI for Bipolar Disorder, along with Fibromyalgia, but have yet to prove the nexus in-service...had the symptoms, but what the vets says means zero to the VA.

I have the PTSD diagnosis now, and have something more to work with combining the PTSD & Bipolar, as well as chronic vascular headaches.

I would continue to research how PTSD and Bipolar are connected and work on the NOD...watch the time limits for the appeal process.

Are you getting SSD now? If not the Bipolar Disorder diagnosis, along with any other disabilities can get you SSD while you are working on SC VA for PTSD, etc.

Keep on working on your claim, don't let this get you down, and quit like I did in the past...you have the same information that the VA has in 38 CFR, M2-1, and any other VA decisions/memos, etc., just figure out how to use it to prove your claim.

Your post was a blessing for me, since everyone offered bits of info. to help you, they helped all of us who have PTSD, and Bipolar, etc. and are working on present claims.

Boondoc

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I helped a manic bi polar vet. We had a heck of a time. When he was in the Navy decades ago no one really understood bi -polar at all.

We were able to get his SMRs and more importantly his personnel file which showed periods of unusual behavior and one episode which was very bizarre.Yet ,most of the time he did his Navy job very well and had no unusual symptoms at all.

After twelve long years of fighting the VA he was awarded 100% for Manic Bi Polar-service connected.His unusual behaviors were highly consistent with manic bi polar and when he thought he was an Admiral one day and started given orders to everyone on the ship- this was all documented (he was thrown into the brig) it also proved decades later that he had bipolar of a manic type while in service.

Fortunately (the vet agrees with this) his disorder would have caused him to spend well over over $140,000 in retro in a week but the VA declared him incompetent and the wife handles the money.

Not all bi polar vets are found incompetent and this really means little at all-but this vet was glad VA declared him incompetent because another symptom he has is erratic spending sprees.

If you have a nexus to your service that shows bi polar episodes more than anything that would support PTSD, the bi polar should be claimed as service connected.

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  • HadIt.com Elder

Shrinks say that if you have co-morbidity of having more than one emotional disorder you are less likely to get better and more likely to get worse. Drug and alcohol abuse are very common for those with bipolar, PTSD, panic and all axiety disorders as well as schizophrenia. People who feel anxious and depressed tend to self medicate. The military of old tended to wink at drinking problems as long as the soldier could do their jobs. Drug abuse they treated as a criminal problem even if the soldier was crazy or PTSD typed. Even today if you tell the VA that you do any illegal drugs you are dead meat. You tell the shrink that and you will probably be labeled a personality disorder.

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In fed 1997 i was denied service connection for ptsd.

the last statement in the letter says: VA examiners diagnosis of the veterans

condition in bipolar effective disorder. what in the world does this mean?jim

tks ya'all, yes i have reapplied for ptsd and bipolar, currently drawing ssd

for open heart, lungs and kidney failure,, but thanks to all,,,jim

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  • HadIt.com Elder

My daughter has Biopolar diorder and believe me, it is horrible.

I watched her take an overdose of 27 Klopin be admitted to a mental hositpal and have electric shock treatments.

I have gone to her home to retrieve a butcher knife from her, as she was ready to slice her wrist.

It has been Hell for her.

She receives 100% SSA.

She is doing much better now and her meds seems to be working for her.

Her Psychiatrist states she is the closest thing to having multiple personalities.

Keep fighting.

You can have Biopolar and PTSD with Anxiety, Depression and all in between!!

Josephine

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Dear Veteran

That means they feel you have mood swings of high and low. They have medicatons for that. If you can prove you had that in service, you can get service connecton for it.

Terry Higgins

I remember now of being treated for somehting , in pearl harbor, hi

it had to do with highs and lows in hospital for abut 10 days , i think

they thought i was sort of crazy,, put me on a lot of medicine, quit

the medicine when shipped out, it too is in my health record if not lost ?

thank you all for the help.. smooth sailing//jim

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Shrinks say that if you have co-morbidity of having more than one emotional disorder you are less likely to get better and more likely to get worse. Drug and alcohol abuse are very common for those with bipolar, PTSD, panic and all axiety disorders as well as schizophrenia. People who feel anxious and depressed tend to self medicate. The military of old tended to wink at drinking problems as long as the soldier could do their jobs. Drug abuse they treated as a criminal problem even if the soldier was crazy or PTSD typed. Even today if you tell the VA that you do any illegal drugs you are dead meat. You tell the shrink that and you will probably be labeled a personality disorder.

I'm probally dead meat...I admitted to using a common weed for self medicating constant chronic pain years ago, but since I had signed a pain contract I had not used it since.

she told me that I was just self medicating and that with severe nausia and chronic pain from migraines and PTSD, etc. I should tell the pschyatrist on my next appointment since our body chemistry's are different and it would help him know what medications to give me. After I could, and plan to, move to one of the states that have passed State bills protecting patients from being prosecuted for using MJ in the treatment of many diseases. I have a physcian who will prescribe it to me, so if the VA says anything I will pay the $ and get his prescription.

I was caught by one of my Corps School instructors wearing his "Trident" I don't remember doing it, but I sure found out the next day!!! He was a really nice man, and accepted my appoligy, and didn't beat me senseless...he figured I was already that way :rolleyes:

Boondoc

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  • HadIt.com Elder

VA will prescribe Synthetic THC (Marinol/Dronabinol) under limited circumstances: typically for cancer/chemo patients. It's in the VA Formulary - but it's very expensive!

see http://www.hiv.va.gov/vahiv?page=cm-411_nausea

"Dronabinol (Marinol) may relieve nausea, especially when nausea is accompanied by a loss of appetite. This remedy is best tolerated by patients who have tolerated inhaled marijuana. The starting dosage is 5 mg 2 or 3 times daily."

Edited by Wings (see edit history)
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  • HadIt.com Elder

Boondoc

Were you ever seen by a shrink while in the military? I believe that the VA is trying to get out of paying you by saying bi-polar instead of PTSD when you can easily have both and the symptoms can be similar. The stressor would be the thing if you have it. Some bi-polar types are mostly depressed and others are mostly manic. Bi-polar people don't usually have flashbacks and hypervigilence and nightmares about their stressful events, but they do drink and self medicate to try to cheer up or calm down. All the bi-polars I know do self medicate to some extent and many used pot and alcohol. I have been in a group therapy for years and many bipolars have come and gone. The guy who had PTSD could not stand the sound of choppers and had fits of rage.

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Boondoc

Were you ever seen by a shrink while in the military? I believe that the VA is trying to get out of paying you by saying bi-polar instead of PTSD when you can easily have both and the symptoms can be similar. The stressor would be the thing if you have it. Some bi-polar types are mostly depressed and others are mostly manic. Bi-polar people don't usually have flashbacks and hypervigilence and nightmares about their stressful events, but they do drink and self medicate to try to cheer up or calm down. All the bi-polars I know do self medicate to some extent and many used pot and alcohol. I have been in a group therapy for years and many bipolars have come and gone. The guy who had PTSD could not stand the sound of choppers and had fits of rage.

yea i did , saw one in pearls harbor in 1977, it is in my military health record. didnt tell him

about stressers, didnt know at the time, never heard this work till lately. but if i was

turned down for ptsd why didnt they give me comp for bipolar???//jim

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"yea i did , saw one in pearls harbor in 1977, it is in my military health record. didnt tell him

about stressers, didnt know at the time, never heard this work till lately. but if i was

turned down for ptsd why didnt they give me comp for bipolar???//jim"

You claimed PTSD-and apparently they did not look for any other documentation in your SMRs for bi polar.

What diagnosis has your current doctor given you?

Do you have your SMRs?

If you are diagnosed with bi polar- you would have to prove it was diagnosed or manifested in service- in your SMRs.

For PTSD-as John said-you have to have proven stressor in service that caused the PTSD.

If you have both- you might need a good psychiatric assessment to show the extent of each disability.

Also -you have to show that the bi polar or PTSD has an affect on you now, with current medical documents-treatment records and meds, etc.

What disability are you being treated for?

Edited by Berta (see edit history)
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yea i did , saw one in pearls harbor in 1977, it is in my military health record. didnt tell him

about stressers, didnt know at the time, never heard this work till lately. but if i was

turned down for ptsd why didnt they give me comp for bipolar???//jim

Jim,

Like Berta said, do you have your SMR's and C-file, or have you seen your C-file at the RO?

You need to be able to see what the C&P doc. wrote on the exam results.

You really need to look through your SMR's for what exactly you were hospitalised for at Pear Harbour, and look for symptome at medlink, or another good medical site that covers the DSM-IV so you know what symptome of Bipolar, and PTSD to look for in your records.

This will help you to file your NOD and then you can show the VA where they are wrong and you are right.

Like me, I have a stressor in my medical record, a current diagnosis and the shrink made the connection so there;'s the nexus need to prove PTSD. The Bipolar is a different story, I have nodiagnosis in my SMR's and didn't go to sick call, since I was the LPO of sick for the last part of my hitch. Without something proving the Bipolar, or symptoms in ones medical records in-service I don't see SC for it.

You may very well have diagnosed in-service...only your records will tell, and if you didn't file a claim for Bipolar they wouldn't be looking that direction even if they saw the diagnosis in your SMR's.

Keep on working on it.

Boondoc

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"yea i did , saw one in pearls harbor in 1977, it is in my military health record. didnt tell him

about stressers, didnt know at the time, never heard this work till lately. but if i was

turned down for ptsd why didnt they give me comp for bipolar???//jim"

You claimed PTSD-and apparently they did not look for any other documentation in your SMRs for bi polar.

What diagnosis has your current doctor given you?

Do you have your SMRs?

If you are diagnosed with bi polar- you would have to prove it was diagnosed or manifested in service- in your SMRs.

For PTSD-as John said-you have to have proven stressor in service that caused the PTSD.

If you have both- you might need a good psychiatric assessment to show the extent of each disability.

Also -you have to show that the bi polar or PTSD has an affect on you now, with current medical documents-treatment records and meds, etc.

What disability are you being treated for?

bertha: at this time i do not have a psychiatice dr. after coming back from the third tour in nam,to pearl harbor, i sort of went off,7-10 psyc ward pearl harbor, 4-5 weeks in house alcohol treament, tried to burn a

girl friends house down, seen a psyc for a month or two. stressors, got a head full,now they bother be

more as i get older. only thing being treated for in had open heart, 4bypass, dr said due to hypertension

lung filled up (ards) and kidneys are in truble, 8 pills in the morning and 8 at nite, draw 100% ssd,

thanks berta for the help//jim

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Bigjim- it seems to me that they might have denied also due to your not having a current disability- in their way of thinking-

Service connection requires not only the nexus to service but a current documented disability with a clear cut diagnosis and current treatment records.

The VA loves paper- they need to see a paper trail of treatment records and medication records -as well as the disability's diagnosis.

I read a BVA claim the other day that was handled by my POA. It had been denied as when the vet first filed for PTSD, he had no diagnosis nor any medical treatment for PTSD.He never went to the VA or a private doctor for any PTSD treatment at all. He had no Vet center records or nothing else they could award on.

No private shrink sessions and no medications.

In all the time it took for the claim to be decided by the BVA he provided no other evidence and he never got any medical care or actual medical diagnosis at all.

I heard he made quite a stink with my POA when the BVA denied him.He lives in this area.

He probably assumed that all Vietnam veterans have PTSD and he did not have to prove it.

In your case- it does seem that the VA did not have any current record of any specific disability.

They need medical proof of PTSD and treatment for it.

Do you have a service officer helping you with your claim?

It is odd that they came up with bi polar. They must have based this on maybe the C & P you got?

Your service medical and personnel records should be obtained to see what is in them as to what the hospitalization was for.

Edited by Berta (see edit history)
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Bigjim- it seems to me that they might have denied also due to your not having a current disability- in their way of thinking-

Service connection requires not only the nexus to service but a current documented disability with a clear cut diagnosis and current treatment records.

The VA loves paper- they need to see a paper trail of treatment records and medication records -as well as the disability's diagnosis.

I read a BVA claim the other day that was handled by my POA. It had been denied as when the vet first filed for PTSD, he had no diagnosis nor any medical treatment for PTSD.He never went to the VA or a private doctor for any PTSD treatment at all. He had no Vet center records or nothing else they could award on.

No private shrink sessions and no medications.

In all the time it took for the claim to be decided by the BVA he provided no other evidence and he never got any medical care or actual medical diagnosis at all.

I heard he made quite a stink with my POA when the BVA denied him.He lives in this area.

He probably assumed that all Vietnam veterans have PTSD and he did not have to prove it.

In your case- it does seem that the VA did not have any current record of any specific disability.

They need medical proof of PTSD and treatment for it.

Do you have a service officer helping you with your claim?

It is odd that they came up with bi polar. They must have based this on maybe the C & P you got?

Your service medical and personnel records should be obtained to see what is in them as to what the hospitalization was for.

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bertha, my claim is approx 3 months old now, went to lexington ky, last week and checked

with va, my medical records have not been requested, still on the shelf, in the normal????

yes, i have service officer commonwealth of ky helping with my claim, should i rattle his cage

since my primary claim was or is for prostat cancer, thank you for your wonderful support

bigjim///

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