Recent Bipolar Type II Diagnosis

Final_Out

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Registered Member
BLUF: Command directed BH eval gave diagnosis of Bipolar Type II couple days ago, looking for some assistance on way ahead and what to expect. I have browsed the forums which have helped answer some questions but am anxious about what the future is going to be like.

I had been having a lot of mental health issues since I joined in 2005. For context I am a SSG in the Army, and been both reserve and active duty throughout the last 19 years. I am currently active duty and since roughly the end of 2022, I have been in the lowest of lows I have had in a long time and my behavior when getting pushed over the line has either been acting out violently by trying to break items, or a full breakdown of crying which has happened in front of the Junior enlisted, of course the response was "you can't do that in front of joes" which would make me more upset since I really felt I couldn't control it. I started therapy through an off post referral and after a few sessions and descriptions of past BH issues, she said that she suspected BPII, but knew that a diagnosis could cause issues with the Army. A couple weeks later we attended JRTC, where I had made a comment in frustration caused them to pull me out of the box, and was told to attend a mandated BH appointment. So after a roughly 4 hour session, the doc said he was going to diagnose BPII, and that he would send the information to my commander and I will have my medication intake on the 1st. I skipped a lot of my BH past, but it is something that makes sense however, I had really planned on trying to stay in to pay off more debt and try to go to retirement. Unfortunately my time in the Reserve means I only have roughly 9 years of Federal Active time. Of course my leadership are all like they are wrong you were just having a hard time adjusting, and saying that its not a big deal. With all the research I've done in the past week I have assessed that it is 100% a MED board to be found fit for duty, with the outcome being almost 95% an unfit for duty due to the condition, I say that because I have read about those with 18> 20< years of active service, which I do not fit into. Honestly I'm anxious, and scared. I came back on active to get my finances back in order get promoted finally despite completing SLC 3 years ago, and then either get experience for a good career outside the Army or go to retirement. Feels like that dream is going to get pulled away. I know its something I can't really plan for know but I'm afraid of how much this will impact me financially, and how much it feels like I am letting down my team mates. Asking around with my leadership for what to expect is coming up empty too so any help on planning on what I have to do and what my expected timeline may be would be very helpful. Thank you.
 
Staying in is an unlikely outcome. Have a plan that involves medical retirement. If you minimize your symptoms in the BH exam you will be out with a small payment. Be honest about your struggles with the VA examiner.

Do your best to stay out of trouble. The manic half of bipolar often leads to legal issues. Avoid that complication.

You didn’t mention much about your treatment plan. Hope you are working the plan. Pills alone will not work. It will take maximum effort.
 
Staying in is an unlikely outcome. Have a plan that involves medical retirement. If you minimize your symptoms in the BH exam you will be out with a small payment. Be honest about your struggles with the VA examiner.

Do your best to stay out of trouble. The manic half of bipolar often leads to legal issues. Avoid that complication.

You didn’t mention much about your treatment plan. Hope you are working the plan. Pills alone will not work. It will take maximum effort.
Thank you that does help. My appointment for my treatment plan is on the 1st of May but was informed that it would likely be a mood stabilizer of some type and maybe and anti depressant. I’ll keep updating my process so it can be helpful to others
 
Glad you’re getting some help. It sounds like it’s been a struggle for a while. I’m diagnosed with bipolar 2 and just finished my BH DBQ yesterday. I read through the DBQ beforehand and I tried to be honest with the assessor but I ended up minimizing some of my symptoms. I just couldn’t help it! So my DBQ came back looking pretty low. It’s hard because I’m doing so much better on medications, but I was in a terrible place before medications. Should I have described how I was before medicated!? I don’t know the answer, the system incentivizes being sick.

I wish I would have had notes with me during the encounter to help me remember to talk about suicidal ideation and paranoia.

I hope it all works out for you!
 
Glad you’re getting some help. It sounds like it’s been a struggle for a while. I’m diagnosed with bipolar 2 and just finished my BH DBQ yesterday. I read through the DBQ beforehand and I tried to be honest with the assessor but I ended up minimizing some of my symptoms. I just couldn’t help it! So my DBQ came back looking pretty low. It’s hard because I’m doing so much better on medications, but I was in a terrible place before medications. Should I have described how I was before medicated!? I don’t know the answer, the system incentivizes being sick.

I wish I would have had notes with me during the encounter to help me remember to talk about suicidal ideation and paranoia.

I hope it all works out for you!
You can file a VARR if your MH condition is found unfitting.
 
Thank you that does help. My appointment for my treatment plan is on the 1st of May but was informed that it would likely be a mood stabilizer of some type and maybe and anti depressant. I’ll keep updating my process so it can be helpful to others
In the meantime, do your best to stay the middle road. Also, don’t expect the pills to help immediately. It often takes 2 months to fully kick in. These meds often have a long half life, so it takes a while to get to a therapeutic serum level. Talk to your provider about medication expectations.
 
So was told last Thursday by the psychologist who did the evaluation that he would have the information to my commander in one or two days. My understanding is that a BPII diagnosis at minimum would be a temporary profile. However checking MEDPROs I’m seeing nothing. Went to ask in person for an update but they closed at 1530. Like I should have received a profile by now right? Hard to start planning for things without a good starting point.
 
Get use to waiting. Nothing in this process goes fast.
 
Update: had medication intake with psychiatric nurse practitioner. Prescribed Lamotrigine and confirmed BPII diagnosis. Have follow up in 2 weeks for medication check. Issued a 90 day non deployable profile. She said she needs to check medical history and have follow on interviews before she can determine decision point for med board and depending on how I take treatment and history I could stay in but I’d essentially be on continuous non deployable status for remainder of career if she believes I am fit for duty.
 
First off, it's a good thing you were diagnosed now instead of later. Typically BPII symptoms worsen the longer they go untreated. I was medboarded for BPII as well. Bipolar, as well as a prescription for mood stabilizers, are not compatible with military service. Unless you heavily advocate for yourself, expect a recommendation for separation. If it gets rated at 30% or more, you'll be a medical retiree. Mine came back at 70%, although I don't feel like it's 70% disabling (then again... that's exactly what someone who's stable with bipolar would say). I hired Mr. Perry to help me through the process. Look at my thread history to find my timeline and other info. Just so you know, my life SIGNIFICANTLY improved after I became a civilian. I don't know enough about medical versus normal retirements, but in any case, getting out seems to be good for most people's mental health.
 
Well the reason I think it still be a MEB is this is the latest diagnosis in a long series of them which I didn’t state in the first post. First was major depression in 2011 and then major depression w/ anxiety and the conversation of Borderline Personality Disorder came up but not official. Another bit of depression and anxiety in 2017 and i actually think i had a hypomanic episode because I had sought out a same sex anon hookup which also happened on the other SRIs I have taken. 2020 went on Wellbutrin and helped with smoking but was more irritated all the time and had more risk seeking sexual behavior. 2022 diagnosed ADHD and off Wellbutrin till 2023 which again was great for smoking but again feel it put me in a hypmanic state again because I was feeling great for a couple months and then just nose dived again along with the aggressive and irritability which leads into the incident at JRTC where the ordered a command directed evaluation. Looking back I am trying to figure out if I had any behavior that was actual manic episodes. Trying to recall from the last 19 years it’s hard to remember details but there have been som moments that I can clearly label as not typical or appropriate actions and behaviors but I guess I just be honest and let the doc decide.
 
Update. Met with Psychiatrist yesterday. After our conversation she said she was going to submit for a MEB but needs to wait until September 3rd to allow the full medication evaluation. She mentioned she wanted to make sure she could put into IDES that I a mentally fit to go through a board. From here what should I expect? Will I get contacted by a PEBLO in a couple weeks or is that done once I am deemed fit to start the board process?
 
Update. Met with Psychiatrist yesterday. After our conversation she said she was going to submit for a MEB but needs to wait until September 3rd to allow the full medication evaluation. She mentioned she wanted to make sure she could put into IDES that I a mentally fit to go through a board. From here what should I expect? Will I get contacted by a PEBLO in a couple weeks or is that done once I am deemed fit to start the board process?
I am also going through an MEB for Bipolar Disorder II. Shortly after my diagnosis, I got an email notification about being Code 37/IRILO and introduced to the PEBLO. The months following my diagnosis was just gathering information for my narrative summary (NARSUM) for my MEB package. Once your NARSUM/MEB package is complete, your PEBLO will route it to AFPC where they will determine if you should proceed with a full medical board or if you are fit for duty. I will attach a full timeline of how the process has been going for me:

06/01/22First visit to PCM regarding MH concerns
10/12/22Diagnosed with Bipolar Disorder Type II
01/13/23Code 37/IRILO notification
05/10/23NARSUM completed
06/15/23MEB/IRILO package submitted to AFPC
06/28/23AFPC determination for a full MEB
10/08/23First VA C&P exam
11/30/23Approved for medical hold (New DOS: Feb 2024)
01/17/24Final VA C&P exam
02/02/24DAF 618 and IMR sent
02/09/241st medical hold extension (New DOS: Sept. 2024)
03/28/24MEB package submitted to IPEB
03/29/24MEB package accepted by IPEB
04/11/24Received PEB findings (DoD: 30% / VA: 0%)
04/30/24Appealed the findings, contacted ODC for legal assistance
05/22/24Agreed to new PEB findings (DoD: 50% / VA: 90%)
07/29/242nd medical hold extension (New DOS: Mar 2025)

At this point I am just waiting on orders, which is taking a significant amount of time.

Hope this helps!
 
Can you give me an idea of what the timeframe is between diagnosis (/ when the provider officially initates the process) and the email notification/ PEBLO intro?
I had my formal diagnosis appointment today, and told this would serve as the medical decision point. Doc estimated I wouldn't receive an email for ~4 weeks. I know this is a 'hurry up and wait' process, but I was expecting to have more references/resources immediately following this appointment.
 
Can you give me an idea of what the timeframe is between diagnosis (/ when the provider officially initates the process) and the email notification/ PEBLO intro?
I had my formal diagnosis appointment today, and told this would serve as the medical decision point. Doc estimated I wouldn't receive an email for ~4 weeks. I know this is a 'hurry up and wait' process, but I was expecting to have more references/resources immediately following this appointment.
From diagnosis to PEBLO introduction, it took about 3 months for me
 
Can you give me an idea of what the timeframe is between diagnosis (/ when the provider officially initates the process) and the email notification/ PEBLO intro?
I had my formal diagnosis appointment today, and told this would serve as the medical decision point. Doc estimated I wouldn't receive an email for ~4 weeks. I know this is a 'hurry up and wait' process, but I was expecting to have more references/resources immediately following this appointment.
If the doctor is saying that appointment was the medical decision point then it should be about four weeks for PEBLO. My delay was my psychiatrist wanted to give me 90 days on the medication to stabilize first. Then in the middle of the evaluation period she moved position so I had to work with new one. My actual decision point is looking like September 3rd. I called Fort Libertys PEBLO office and they are saying there are currently on a 4-8 week timeline for contact.
 
This is incredibly helpful, thank you. I was under the impression this was the “referral point” but the timeframes weren’t matching with the other timelines I’ve seen here.
 
My real concern now is pay. What is unfortunate in my situation is I’ve done both active and reserve time since 2005. I’ve had no breaks in service but my Active Service years only total around 9yrs 5 months as of today and am a SSG. Unfortunately the past 3 years they have never reach my OML number. So I have to hope that this condition can qualify to get some % of the concurrent pay. The incident did happen at JRTC and I know I’ve had a similar breakdown in Afghanistan. Wish I had a better idea so I can plan for working full time or part time when I get out while I attend school.
 
Finally an update. BH submitted referral approximately Nov 22nd, 2024. IDES Representative contacted me to schedule initial PEBLO/Legal brief today, Dec. 17th, 2024, for Dec 31st. Taking some leave so couldn't make the earlier appointment.
 
So finally have an update on everything adding time line here and in signature. If possible any advice or tips for what is next would be appreciated.
2024
April 8-Command Directed Mental Health Assessment
May 1-Confirmed BPII Disorder start treatment
Nov 22nd-Referral to IDES
Dec 17th-contacted by IDES for initial brief
Dec 31st-initial brief

2025
Jan 7- Intake appointment
Jan 16- VA C&P Exams
Jan 31- MEB Packet Received
Feb 5- Legal review
Feb 12- MEB submitted for ratings
Mar 27- Proposed ratings received DoD: 50% PDRL VA: 90%

In the enclosure section of the proposed ratings document it stated that a records review had conditions that qualifies for additional benefits which is lumbar strain and degenerative disc disease. My PEBLO said I was at 150 points and need 300 (actual numbers are fuzzy everything speed up) to bump up to 100% I have a meeting with my PEBLO on Monday and then the legal review. 90% is way higher than I expected. With the added conditions would it be enough to push me over the threshold to receive 100%? If at all possible it would make up for not being able to receive normal retirement. While I have hit 20 total years of service as of today, 10 of those years were AD and the other 10 Reserve. I was informed the appeal process is roughly 2-3 months, so while that would help out with pay and give a couple more days of terminal leave, I am ready to move on and start the next chapter.
 
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