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Yesterday I had my intake appointment with the new psych’s office. I walked away with my mind practically blown. The big news was that I might have polycystic ovary syndrome (PCOS), which is sometimes misdiagnosed as bipolar disorder. So I’ve had another v58.69 ordered up, but this time for endocrinology: estrogen, progesterone, testosterone, DHEA sulfate, and LH/FSH. With a follow-up appointment in just two more weeks, I should have an answer soon. If my testosterone levels are abnormally high, that seals the deal.

So of course, the first thing I did when I got home was look up PCOS. The big issues that it might be causing for me are mood swings around menstrual cycles, high levels of masculinizing hormones leading to acne and excessive facial hair, and insulin resistance as part of metabolic syndrome.

That would explain why it’s so damn hard for me to lose weight even when I do everything right – and Mom had the same problem. The NP said that PCOS aligns well with a lot of my symptoms, and of course, even things I didn’t realize were symptomatic. Things like very painful cramps, depressive PMS, weight gain, difficulty losing weight, blood sugar problems, past thyroid issues, acne, and a whole bunch of other details. There are often also fertility issues related to PCOS, but I’m unconcerned about that part.

So if I’m diagnosed with PCOS, the main treatment approaches are metformin (a diabetes medicine) to improve insulin resistance, sometimes birth control pills (which cause disastrous mood swings), and weight loss. Yeah, because that has worked out so well for me in the past. This would be a serious incentive to put a lot more effort into getting into better shape. And if I end up on metformin, it might actually make it a lot easier to lose weight. I already get moderate exercise and eat much healthier than the vast majority of the American public, and yet I stay fat. I would be delighted if anything could be done to help remedy it.

The kicker is that sometimes PCOS is misdiagnosed as bipolar disorder. There’s also some evidence that they are often comorbid conditions. I haven’t seen anything (yet) in my quick searches to suggest that manic symptoms are involved with PCOS, but there’s a general link to mood swings and depression. So, what if I’m not actually bipolar? That would take some mental readjustment. I just got used to having “certifiably crazy” status! Given the way I’ve responded to Lamictal, plus the triggering effects of travel, time changes, and weather conditions, it seems unlikely that there is no mood stability issue at all – but it might be exacerbated by endocrinology issues.

Oh, and I’m back on Adderall. Thank goodness. They will be doing urine tests to ensure that I’m taking the amphetamines, but they use far more precise tests and they aren’t going to flip out over positive results for marijuana. I discussed it up front with the NP and she said she didn’t consider it a problem, so long as I’m not self-medicating or using it excessively.