Anxiety as an Expression of the "Ups," or a More Blended Experience of the Poles.

The basis of my diagnosis of Bipolar II is that I shifted from periods of torpid depression to periods of high anxiety and restlessness. I have been following a period of excessive somnolence during the winter months only to lose my ability to sleep once daylight increases. During my restless, anxious periods I used to believe that it was just more depression. I was miserable all the same. I was wired enough to be unable to sleep, but found this an extremely unpleasant experience where I still craved rest. This made the bipolar diagnosis more difficult to detect. My psychiatrist explains to me that Bipolar is better defined as extreme shifts in energy, explaining why I always feel 'depressed' when I am, in fact, "Up."

I would like to know if anyone else understands their Bipolar disorder in this light. I know that most of us have experience dysphoric feelings during their manias but I am not sure how many people match me. Please tell me if you relate!

Lately I have been shifting into this state, having difficulty sleeping, extreme destractibility and much anxiety that escalates into panic attacks. (Just Thursday night I panicked for hours first at the thought of pain existing in death, and secondly found scratches on my arm that I couldn't remember receiving, causing me to panic about The Lamictal Rash or that I was hallucinating them) My heart palpitates often and I can feel my breath picking up but this can happen often outside of mental anxiety or panic.The thing that has been weirding me out lately is spending days with this feeling of something swirling inside me. Think of butterflies in your stomach or the strange waves you may receive when anxiety beings ... but this turning is not unpleasant. It almost feels like I have contained emotions that roll about my belly and chest but are never completely released.

I am not doubtful of my diagnosis, I am very convinced that I am Bipolar II especially since I started paying attention much more to my mood swings after the suggestion and diagnosis.

Here are some questions: Does anyone else experience a swirling sensation inside of them whether it is pleasant, unpleasant, or neither? Does anyone else experience panic and symptoms of anxiety as an expression of mania or hypomania?

One thing that I really want to talk about: I am never sure in saying that I am 'hypomanic' during these times of anxiety. I have simply never identified with that word although it is obvious that I have dramatic shifts. It's like I can't fully relate to others here because my moods are a cr@pshoot that run in all sorts of places but can't be placed on a spectrum. I just feel like I am experiencing more of the same thing but in a different way, and not a flip into something different. Does anyone think that I am not experience pure "ups" but rather a mixed state?

I especially want to know if people find their two poles to be a more blended experience rather than distinct episodes or switches? Do you have difficulties identifying an 'up?'

Give me your opinions guys, but, more importantly, your experiences!! Thankyou.

Ill post something longer later.

My mood swings are ties to the season. Hypo during spring and mild depressions during winter. (I've only ever had terrible situational depressions) I typically increase medicine in the spring. I know I am going up if I start doing/saying certain things.

Honestly, I spent 2 weeks crying about death. I had terrible anxiety that wouldn't go away. Anxiety is the physiological response to mental worries. I have problems with my stomach when Im anxious. I also developed acid reflux from worrying too much. I am neurotic though. Not as bad as it used to be, but I worry a lot. Its a sign of something for me, too.

These are such good questions... I suffer from a lot of anxiety. There are specific things/situations that trigger it pretty badly.

For the last about 3 years or so I have experienced my anxiety (and other mood states) as very distinct (i.e. anxiety distinct from hypomania/mania, etc.) I recognize what has triggered my anxiety and I experience mania as something very different, a pretty radical switch.

But I have to say that I've only been able to make such clear distinctions since therapy. Before I was no good at all at identifying my emotions in general -recognize what I was feeling, why... I did recognize extremes in a general way, but everything was mostly swirled together into a huge mess, I didn't know which way was up. I think better medications have helped me somewhat to step back enough to be able to recognize what I'm feeling, but it's therapy that has really helped.

I know you're tracking your moods yourself, but are you in therapy? It might help you parse out your feelings, your moods.

That said, I don't think there's such a thing as some sort of 'pure' mood state and we'll all be feeling different things at the same time. I certainly don't feel just 'happy' when manic, although I wish that were the case. And maybe when feeling different things at once it's not necessarily a 'mixed episode' maybe it's just that it's normal to experience different emotions together within a given 'pole.'

Hugs to you,
ultramar

Yes, this fits for me. My anxiety and hypomania can be hard to tell apart, which is one reason why my BP was missed for years. In retrospect, one way that I can tell them apart is that when I am truly just anxious there is lots of ruminating and going over thoughts in my mind. It is more paralyzing. When I am more hypomanic, there is more action about the anxiety--writing things, organizing things, talking too much, etc. I'd say my hypomania is 50-50 anxious vs euphoric.

EJ

Yes yes and yes! Wow put into words things I thought I could never explain. I can't tell where it's anxiety disorder or elevated energy level, your pdocs description is finally one that I feel like that makes the bpII dx finally make sense to me. I seriously can't leave bed for days or who knows how long, not even enough energy to shower or get my son to school and other times I'm having crying spells and irritable and anxious and sometimes it's mixed like much needed extra energy, insomnia, chattiness, mind racing bright ideas which at any moment could turn into torment wanting to pull my hair out even trying to pull it out. And I get that anxiety swirling pit of stomach feeling so too much... I've heard they've found cells like brain cells in the stomach area, leytons cells I recall, I wonder if that has anything to do with it? It's a mind-stomach confounding wrenching trip! Time for another half klonopin and Bach sleep remedy and lavendar lotion for me, I need to sleep! The rapid cycling is ultra confusing too... Ughh! Up down left right and how about all at the same time... Damn I don't like rollercoasters.

BlueInanna: So awesome that you can relate to this so closely! Especially with the swirling stomach feeling. I am happy that you've found a better way to understand yourself.

I have actually heard that my experience is not that uncommon, but seems unbelievable as a diagnosis because it often expressed itself as depression with anxiety, treatment resistant depression, cycling depression, etc, so it is looked over. A lot of times people with unipolar depression are giving mood stabilizers like Lamotrigine and lithium, even anti-psychotics like Abilify, so these people could really have experiences like us.

Eliza Jane: Admittedly, I was only meeting with my Psychiatrist for a little over a year before she changed my diagnosis, which is pretty quick. However, during this time I had been on so many varieties of medications for depression and anxiety that never succeeding in helping. She's a keen doctor, I think that she knows all about different expressions of Bipolar 2

Ultramar:
This! Thanks for this idea. I like it a lot.

Confused: One of my worst symptoms in anxiety is nausea and tummy troubles. I have lost 20 pounds in 5 weeks from a period of mental anguish where I could not even get food in my mouth without gagging. If I managed to get food inside of me it felt like a hard, sickening lump and I vomited a few times from this feeling. This week this feeling has begun again, ironic considering that I was dieting to lose weight for two months (14 pounds! yay!) but I am ashamed with the weight loss I experience through anxiety. When I initially had panic attacks that I could not identify, I always thought that I was having a strong reaction to something bad I had eaten, as I always ended up being nauseous.

Pretty much to anyone: I am convinced that my anxiety is tied to the bipolar and not that I have a separate anxiety disorder, which may be the case for others. I have the same concept as when I have a difficult time focusing. I don't think that I have ADHD or Panic Disorder...I can't distinguish it from anything else.

It took a long time for me to even realize that I was having panic attacks, so maybe it's possible I have a comorbid condition and I just don't harve the self awareness to recognize it. When I started becoming really depressed, I spent a lot of time hiding in bathrooms crying, always wishing to flee class, and persistent intense worry. I was crying, so I thought that was depression, and I thought the fears (failure, abandonment, death) were a reasonable reaction to how I felt. (But I guess there was nothing "reasonable" about it.)

I can identify with your post but I haven't been dx'd. I have been wondering about bp2 as it came up when I was searching for agitated depression. Have you read 'why am I still depressed?' from what you say, if you haven't, I think you would find it interesting.

Whatever it is with me, it cycles all over the place and it's not good energy lately. I want to crawl out of my skin. Does that sound familiar?

I have not read "Why am I Still Depressed?" but most of my understanding of Bipolar 2 originated from this site: Bipolar II, Mood Swings without Mania; Brain Tours; Stress and Depression; Hormones and Mood; and more...

And yes, "crawling out of my skin" is something I have experienced a lot.

My 'ups' are anxious, agitated, irritated and obnoxious. They are not the happy good feeling ups that most people feel. I often start getting angry and cleaning things that I can never finish and then I start getting angry at people (basically my husband) and I am very tired and want to sleep but can't. My hypomania is very uncomfortable for me and I will do ANYTHING to avoid it so I take my meds religiously.

In all the years I have only had one happy hypomania where I was the life of the party and everything was great but since I am rapid cycling it didn't last long.

I think that a lot of these weird hypomanias could be considered 'mixed states' where you are actually in a hypomania and depressed at the same time.

OP, you've described very well what I feel from time to time.....like now. Most of my manic episodes are euphoric, grandiose, soaring; but then there are times that I'm restless, agitated, angry, upset, irritable, and wired. Like now. It doesn't feel like mania, though my test scores on the Mood Tracker and Mania tests are very definite about it, and yet I'm certainly not depressed, for I don't have this kind of energy when I'm in that state.

Thank you for defining this phenomenon so well. Maybe I'll copy and paste this description for my next e-mail to my pdoc, if you don't mind, because I can't articulate it as well as you have.

Although probably necessary in some cases, I have a bit of an aversion to multiple diagnoses -because some different symptoms/experiences may well just be part and parcel of 1 diagnosis instead of separate ones. Plus I'm afraid of the idea of being medicated for each diagnosis separately which could lead to a boatload of medications, which may or may not be necessary.

For example, ADHD-type symptoms could be part of your anxiety (i.e. lack of focus), depression part of bipolar, etc. Although I think the DSM doesn't always take everything into account, maybe it would be useful to look over the criteria of just bipolar and anxiety and see if other experiences you're having that seem separate might be part of these two.

My personal belief is that anxiety is a different phenomenon, although that it can definitely affect other issues you're having. As far as anxiety vs hypo or mania, can you think of what you may be reacting to when you get anxious? Try to keep an open mind, there are tons of different things that might make you anxious (i.e. your own thoughts and fears as well as anticipated anxiety-provoking experiences). Anxiety can definitely make you very very energetic (not in a good way), frenetic, sleeplessness, etc., but there is something making you feel anxious.

There are things that can trigger anxiety as well as bipolar episodes, I think figuring out these triggers can be very helpful

I also recommend "Why am I still depressed?" It was very informative and I definitely had numerous "That's ME!" type moments.

EJ

I am so glad that I have managed to express myself to articulately and that it is helping you! There is a possibility that I will be switching psychiatrists, so I guess I should keep this on hand as a way to express myself to anyone new.

Honestly, as I was typing this I was thinking to myself that there were so many people that I wish that I could just find an excuse to show this off to them.

I definitely believe that ADHD/ADD type symptoms are tied both to bipolar activated and inactivated states. As in, when I am anxious my mind can't grab unto a single thing, and this can make me very anxious or frustrated to the point of depression because there is nothing I can focus on, work on, or distract myself with. When I am depressed, I am simply too mentally exhausted and there is no pleasure in participating in anything, anyway.

However, as I have been studying my own triggers of late, I can say that I probably do have a sort of Psychological-Panic-Disorder type of separation from the bipolar. I believe that the panic attacks may have originally sprung up from the bipolar disorder, especially the intense periods of paranoia that hit me like a bulldozer out of no where and especially when the panic just initially happened, without triggers.

Yet, as time went on, I began to experience anticipatory anxiety in relation to panic attacks and certain situations....and that is how a psychologically fueled panic disorder begins. So, in that sense, that response may have developed from the bipolar disorder and although the bipolar disorder may be of biochemical origin there is no doubt that the panic is worsened psychologically. So it's like I have a base bipolar panic intensified from a developed panic disorder.

I was just thinking about that, so maybe I just learned something very new about myself!