[blackwhitered]

My best friend has been diagnosed with depression, but lately has been showing signs of bipolar. The last few days she's been really hyper, talking quickly, staying up late, feeling irritable or really happy, having racing thoughts, etc. She was having thoughts of harming herself during this elevated period. This alternates (within the same day) with numb, depressed moods. To me and from my experience it sounds like she is rapid cycling... She does not want to see a doctor because when they diagnosed her depression, they ruled out bipolar. They put her on antidepressants, which I've heard can cause rapid cycling in bipolar people. She thinks the doctors will think she's faking it or hospitalize her again.

What do you guys think? This sounds like bipolar, right? Is there anything I can do to help her? I'm really concerned about her, especially since she had thoughts of hurting herself when she was ''up".

[~Christina]

Of course noone here can diagnose her. She could very well be bipolar with rapid cycling. Hopefully she will agree to see her doctor. She can be baker acted if she is a threat to herself or others. That would involve the police and the ER and a Pdoc evaluating her. I hope she calms down and can see that she needs some help and goes to her doctor willingly .

I know its hard to watch someone you care for have these kind of problems and feel helpless .

Good Luck and take care

[blackwhitered]

Oh, I wasn't asking for a diagnosis. I'm just making sure that it's not an unreasonable guess. The doctors ruled out bipolar when she was very depressed, and I just feel like that's all they saw... Now it seems like the elevated mood is coming out and I feel like the doctors missed something.

[~Christina]

Bipolar can go undiagnosed for years and years. Hopefully she will reach out for help.

She could also potentially have Borderline Personality Disorder. The biggest difference between the two is that BPD is always caused by something...it's a learned reaction to things, and it cycles much, much faster than rapid cycling could ever do. A person with BPD can go through 3-4 strong emotions in just a few minutes if the triggers are right.

They treated me for depression for years and years, but it wasn't until I was in long term therapy that a T finally put everything together, and that was when they diagnosed me w/ bipolar 1 w/ rapid cycling and mixed episodes. Just be there for your friend, and remember to try not to take anything they say or do personally.

[ultramar]

Bipolar seems to be so difficult to diagnose for various reasons. I read somewhere that when someone is mostly depressed and they have some positive emotions, are happy, excited, whatever, it can seem like hypomania because they're so used to being depressed, it appears to them to be extreme. Though this is something you're noticing and not her.

I think it can also be hard to tell the difference between a lot of anxiety and hypomania, I know when I'm very anxious I get really revved up, distracted, can speak rapidly, trouble sleeping, etc. For me it just *feels* very different than a sort of mania and I can figure out a reason why I'm anxious, but it can appear very similar. There's also the issue of BPD where moods change several to many times in a given day. Of course this can happen with ultra-rapid-cycling, it exists, but from what I've read, I don't think it's very common, though who really knows.

Does she see a psychiatrist regularly? Maybe she can get re-evaluated. Of course it would be ideal if she were to see a pdoc while she is the way she is now. Otherwise, maybe you could help her write down what's been going on lately to show her pdoc.

She's lucky to have a friend like you who's so concerned about her!

Does she have an extreme fear of being abandoned, whether the fear be real or imaginary, and is willing to do almost anything to avoid it? Does she have relationship problems where she puts someone on a pedestal one minute and is telling them where to go the next? Does she think in black and white.....everything is either all good or all bad? Those are ways that BPD is different from bipolar. I hope that may have helped some.

Another possibility is that she is in a mixed state and cycling between predominantly depressive and predominantly hypomanic/manic symptoms. I did that after AD's triggered my first manicky episode and I thought that meant I was a very speedy rapid-cycler, but I recently had a three week long hypomanic episode which goes against that assumption. I think I was just in a mixed state.

[blackwhitered]

Hi guys, I just wanted to update some info:

She's feeling better for now. The hyper and depressed moods she was having mostly lasted several hours, not just minutes. Not sure if that makes a difference.

There didn't seem to be a single trigger... I know she's under a lot of stress... Could that be it?

I told her about how it could be BPD, bipolar, or ADHD and she's seeing her psychiatrist next week. She says her antidepressants aren't working, which is part of why I thought it might be bipolar...

[blackwhitered]

Ok, another update:

She's having a setback. She's having racing thoughts and experiencing derealization. She said things that sounded like she might be a little delusional. She's really scared and I don't know what to do. Any advice? Does this sound like bipolar (maybe a mixed episode)? How can I help her?

If you think it warrants it, take her to the emergency room. Better safe than sorry. If this is strictly recent stuff, it could be a side effect of meds or meds mixed with other things she eats....grapefruit among other things often don't mix well with meds.