Trigger warning: Suicidal idealisation, childhood abuse, unempathetic actions

Alright, I'm without a diagnosis - prescribed with two medications (see below). My psychiatrist listened to my summaries (and read the notes of my psychologist) and prescribed me lamotrigine. I was happy to take it, but unfortunately started my bad habit of reading everything I could find.

I saw it was commonly prescribed in the treatment of bipolar disorder(s).

At first I figured, sure it CAN treat that, but that's an off label use for it. Why should I take it for an off-off-label use (like to help with an odd jumble of symptoms and feelings).

With time though, I've started becoming more self aware of several 'states' that I move between (generally over a 2/3 week basis, unfortunately).

The mood states

I have a moderately elated period, where I smile and laugh - stay up late playing computer games, dance to my music when alone, etc. I can't concentrate very well in this mode, but I focus better than when in my depressed stage.

Then I have a... stormy period, where I get highly irritable and confrontational (verbally). Suicidal imagery (generally hanging, or wrist slashing - hanging from a 3rd person perspective, wrist slashing generally me looking down at wrists with vivid dark red contrasting on white tiles).

Something as simple as a fellow students' misinformed comment in class, or my girlfriend humming along to a song, make me snap - get angry - and lash out/correct/force my own opinion (again, verbally - I'm not physically abusive - ever). Sometimes I can grit my teeth or take deep breaths, roll my eyes and clench my body and resist the irritable episode - but mostly I can't. I force a perfection on others that I know I'm nowhere near, myself, but I'd never admit that to anyone else.

Now, these are all similar to what my Dad used to do when I was younger (except he didn't have the good fortune of escaping physical lashing out when he was overwhelmed). He doesn't 'believe' in 'psychology' - meaning that I only started looking into my mental health seriously once I left home (with the exception of a weak tranquilliser in late high school to help with morning nausea and the beginnings of social anxiety).

Then there's full blown depression, which I obviously don't need to describe. Self mutilation is something I managed to stop doing (it remains in my youth). Lethargy and severe agoraphobia come with this, always.

Lethargy and agoraphobia are also present in the other 'mood states' some of the time. I generally avoid going out if I don't have to (sometimes when I do), my girlfriend and a few friends who visit me and talk to me over IM are my only social contacts. I don't go out, or drink, very often (initially drinking conflicted with my lamotrigine, it doesn't any longer - but I still don't have the desire).

(Finally: I have an almost complete lack of empathy for others, including my closest friends/girlfriend - at certain stages, unless it relates to me, or would bring about something that affects me. I 'show' empathy because I recognise what people want from me, but I rarely feel it (also - I don't bother 'showing' empathy to people I'm not close to).

Currently, I should be in a post-grad seminar (but I couldn't 'stomach' the idea). This means I will likely lose my DP (duly performed) certificate (its a non-physical certificate) which basically refers to whether I have attendance that permits graduation/writing of examinations. I can't bring my self to care most of the time, it feels like such a petty facet of life to focus on.

I'm on a full bursary, so I am under a lot of pressure to perform well - which I generally manage tolerably at. I'm lucky to have the cognitive ability I have, because I definitely don't deserve it or take advantage of it.

Anyway, I hope that you, more experienced individuals can help me make sense of it. I was considering bringing these things up in my next therapy session (haven't been for a few months, restarting next friday).

Thanks for reading, interested in hearing your thoughts and experiences even if you don't feel you can help/comment