Nurse with Cyclothymia?

wish_me_luck, BSN, RN · Jan 1, 2013

Jack, I am not in TX, but I am in a very similar situation in VA. I have BPD (with alcohol abuse). I am a new nurse and I am in HPMP (the VA equivalent of TPAPN). I do drug screens, but it's because I have alcohol abuse issues. It may be that you won't have to do drug screens. I do have to get forms filled out by my health care providers and will have to by employers. I don't want to give you false hope, but many people are okay with it, especially if it is for mental illness.

I have been very honest and forthcoming about it and people appreciate it. Actually, many people feel for me.

The consequences of not disclosing can be far worse. I don't know if people realize this, but health care providers (i.e. psychiatrists/phyisicians, etc.) are required to report when a health care professional enters in-patient tx or anything like that. It may vary by state. I don't know the severity of yours, but it would be awful to get so bad off and need in-patient help and not be able to get it because you told the Board that you didn't have a mental illness. The consequences could include doing the monitoring program anyway plus discipline, suspension, etc. It's not punishment for mental illness, it's punishment for lying.

I should be getting the okay for work soon. To help me get experience, I want to volunteer (plus volunteering is something I have done for a while.) I would have something to offer then. I started HPMP thread to help other people navigate/know what to expect. It got a little off track in the beginning (with the costs of everything), but it should be good now. I will probably update next when I get any sort of approval for looking for work and what kind of paper work goes with that. Then, I will update on the difficulties of getting work while in it.

I know it doesn't help because I am in VA, not TX...but know that you aren't alone. ((_jackburton))

Long Term Care Columnist / Guide · Jan 2, 2013

I have bipolar disorder and am a relatively successful nurse-administrator. From what I understand, cyclothymia is something like "bipolar lite"---the highs aren't as high, the lows not as low---but it is listed on the so-called bipolar spectrum. It may not even pose a huge issue for you. Even if it does, however, you can still do well in nursing; it's a matter of proper medications/therapy and making your health your number one priority.

Until you have a definitive diagnosis, however, you shouldn't disclose anything. No sense borrowing trouble. You are not being untruthful when you tell the BON that you don't have a mental illness, because you haven't been diagnosed with anything yet. There are probably a million nurses out there who have some kind of mood disorder (depression is VERY common), yet don't declare it to their state boards because they haven't received a formal diagnosis. And why should they? For that matter, why should any nurse have to declare---and be subjected to unnecessary, embarrassing, and expensive monitoring---if their illness doesn't interfere with their ability to practice nursing?

But that's an argument for another thread. In the meantime, DON'T disclose to the BON until/unless you are officially diagnosed. Good luck to you.

rockstar11 · Jan 2, 2013

There are states that do not require disclosure of mental illness. I do know that there are several of us that are very good nurses. I would hate to see a diagnoses hault your pursuit of nursing!

wish_me_luck, BSN, RN · Jan 2, 2013

I think TX is one that you must disclose. They actually ask directly if you have been dx'd or received tx for a mental illness in the past 5 years. If you haven't been formally diagnosed, then don't report. But, if you have, then you need to.

I just have the mentality that if the public must know my personal health information, then I am going to take the time to educate people and spread awareness.

NurseDirtyBird · Jan 2, 2013

This is really up to your personal discretion, in any state. Do you want the BON to know your personal health history? Do you want any potential employers to know your personal health history? I agree with other sentiments that you don't have to disclose diddly squat without a definitive dx. You can't disclose what you don't know.

I got my BPD dx after I was already licensed. My psychiatrist told me he has no reason to report my dx to the BON unless I pose a threat to my patients. I've done nothing to make anyone feel I was a threat, therefore, none of anyone's business.

hiddencatRN, BSN, RN · Jan 2, 2013

There are states that do not require disclosure of mental illness. I do know that there are several of us that are very good nurses. I would hate to see a diagnoses hault your pursuit of nursing!

Yeah, I had to disclose nothing about my health. Just answer criminal background check questions and pay my fee.

_jackburton · Jan 3, 2013

Thank you all so much for the input. I suppose not getting a definitive answer from the BON would suggest not disclosing bipolar when i in fact i dont (or at least the full blown version), or a definite diagnosis. Insurance companies make a distinction between the two and i heard some people can be diagnosed as both bipolar and cyclo.I suppose i am just freaking out for no reason. It just seems ridiculous that that a junkie not in treatment can get through without a problem and honest people may get screwed and worry senselessly.

Doing some research it seems like texas is the exception to the norm along with Ohio and as one mentioned Virginia. I wasnt concerned with going through the program so much but i certainly didnt plan on sticking around texas for another two years because of it. So it seems best to get the education here and apply for my license in a friendlier state. Or just go straight for the BSN back home in Wisconsin. Im fortunate to not have any thing to tie me down here.

It is pretty funny that i could get licensed in wisconsin and come back here to work since they are both compact states. Texas is crazy they ask the same question when trying to get your drivers license.

Again, thank you all for the input. Sorry for any typos im typing on a tiny phone.

Long Term Care Columnist / Guide · Jan 3, 2013

Just out of curiosity---are you seeing a mental health professional for this as-yet undiagnosed condition, and how long have they been trying to figure out whether or not it's cyclothymia?

For what it's worth, I really hope you don't wind up with a bipolar-spectrum diagnosis, because it's a huge PITA to deal with both personally and professionally, and I wouldn't wish that on anyone. Looking at things from an optimistic view, it's possible that the reason they're taking time coming up with a definitive dx is because your symptoms are mild enough that they really don't add up to illness (by contrast, I got my BP diagnosis at my very first appointment). In which case you can go on your happy way and not have to disclose anything to the BON. :)

Wishing you the best of luck.

_jackburton · Jan 3, 2013

Viva,

Yes I am seeing a psychiatrist for a few months and am currently doing a trial of lamotrigine 100mg monotherapy. I am a little weird with meds. Just about all of them mess up my head. I suppose how i described my reaction to SSRIs prompted her to try a mood stabilizer. The funny thing is I have had similar reactions to every drug I have been on lamotrigine, SSRIs, SNRIs, Adderall (this doc was waaaay off base), lamotrigine even Buspar. So I'm not sure about anything except that I am EXTREMELY sensitive to all meds.

I have read SSRIs can throw bipolars into mania. Still my reaction was weird, felt funny after about two hours of taking the med and it lasted about 6 hours, then I felt normal again until the next dose. This prompted me to take the med before bedtime which worked, I would simply sleep through all of the side-effects and feel fine the next day. The lamotrigine seems to work, it has brought me to the same "apathetic like" place as the SSRIs. Maybe that is where all these drugs end up not depressed but not full of life. I suppose the latter is for me to accomplish.

Either way if I am somewhere on the mood spectrum I would imagine I am just at the cusp. I have been able to accomplish more in my short time on this planet while having symptoms than most will in their lives. I have seen the med cocktails many are on and sympathize with those needing so many drugs to stay stable. My MD seems more concerned with treating the symptoms than a label. I asked her what she thought once and got a lot of "maybe" "I'm leaning towards," but no "you have..." I guess I will just wait to see.

There is an excellent nursing school in my hometown. Ultimately I would like to end up back there with my friends. Moving to Texas was a failed experiment. Introvert in a new town makes it hard to make friends. My whole situation makes me think its more a situational depression in a chemically sensitive individual, it all got worse when I came down here. I trust my MD....i think. So we will see what happens at the next meeting.

Thank you All!!