Does this sound like hypomania to you?

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

Which part was supposed to be hypomania? Didn't see it.

Why don't you just ask your doctor why you were precribed lamotrigine? And bring up your idea about bipolar being possible.

Sounds as if it might be a little of both to me, in other words, a mixed episode.

Apathy can be an indication of strong depression and it can be, also, disinterest in criticism---but then, that's indifference which is the withdrawal of emotion. I wonder how your psychiatrist would view that.

If it's hypomanic when you went shopping at that time of night, it was short-lived for an attack of hypomania.

I think you may still have some depression (maybe it's unconscious, but I think it
might be there). I'm not a doctor, though, so I'd talk to my psychiatrist about this one, maybe.

I've been told by a psychiatrist that mania (in your case hypomania) is a reaction to depression. Whether that's relevant in this instance is debatable, but the shopping was very short and uplifting for you.

Take care of yourself, please.

@cocoabeans I can't actually afford to see the psychiatrist again, but I can bring it up with psychologist (and will do) although she's made remarks in the past discarding possibilities of anything beyond Major Depressive Disorder (however, from my side, there's definitely more there than that).

The bit I was asking about was primarily the irritable spell - seems to last the longest out of the three (or is the most noticeable, when considering my symptoms), and definitely comes with increased energy and restlessness, coupled with the above short-fuse. Its the mood where (before lamotrigine) I would find myself going out and drinking heavily/engaging in unsafe activities in - almost as if it wasn't me. With the absence of alcohol I don't do unsafe things, but I still get restless.

My girlfriend went away for a couple of weeks and, after viewing my messages/checking my newsfeed on Facebook, asked if I was ok because I was acting completely different (I was in that strange mixed transition phase - and without her here to cement me and remind me what I normally do I went a bit odd).

I do want to just ask both of them, and bring it up, but I worry that they'll think I'm fishing for some serious problem, or looking for something to cling to. I guess I have a bit of apprehension when it comes to psychologists/psychiatrists.

@genetic, there is a feeling of emotional confusion and way too much going on, so mixed episode sounds likely. Not sure what you mean by shopping though. :P

Thanks for replies guys. I know you must get a lot of 'am I bipolar' posts here. So, sorry for adding to that tally.

One book that a lot of us like is "Why am I still depressed?" by an MD named Phelps. It does a really good job explaining the mood spectrum and all of its nuances other than just complete depression and full-out mania. There is also a website by the author: psycheducation.org. It really gave me a better grasp on why a BP II diagnosis is appropriate for me.

Best,
EJ

Thanks - will check that out right now.

_________________________________________

My mistake; sorry about that; had an unusual early morning today.
Genetic

No problem, you made me reread my own post to check - so I'm obviously not much better off than you in the rested department.

How fast can a rapid cycler be? I've often felt I can't possibly have BPD because I vary from weekly, to a few days - I've even had a few within one day before (only happy/sad, no irritation).

I just shifted from irritable to full on depressed today (irritable lasted 4 days).

Hence why I'm sitting in the dark occasionally tearing up for no conceivable reason, whilst trying to force myself to play some form of computer game.