BP dx - unsure if it's accurate or not

Good morning! I have a long story (I'll try to only add the imp't. info), and would love some input into the issue of whether or not I may have BP. The shortest version I can come up with is this:

Originally I was dx with Dysthymic Disorder, DD, as I have been depressed for as long as I can remember (back to kindergarten and I am now in my early 40s). I can only remember a six month period in '96, and then a 12 mo. period in '11 where I didn't feel down 99% time.

I believe that I suffer from MDD (double depression?) and SAD - and can elaborate on the SAD if anyone needs clarification.

I have tried the following ADs - some several times: Prozac, Effexor, Zoloft, Wellbutrin, Lexapro - and combinations of some. None have worked past 6 mos., and several have made me very agitated/irritable within the first week or two of taking them.

I was Dx with ADHD in '06 or '07 and have a Rx for Adderall - which I am not currently taking b/c of unrelated heart palpitations. I believe that it originally helped my focus, but eventually I didn't feel that it helped nearly as much.

Here's the imp't. part: in the fall of '10, I became highly agitated/irritated. Even sounds such as chewing made me want to crawl out of my skin. I believe that the entire "episode" started b/c of my issues with SAD. The year prior, we moved from a lat. of 37 deg. N. to a lat. of 49 deg. N., and daylight during the winter is so much shorter here. I was a wreck by the time I saw the p-doc in early Oct., and ended up on Lamictal and Klonopin (PRN). For the first time in my life I felt normal. No mood swings - just peaceful and calm. Sadly, that "normal feeling only lasted about a year - I feel that the Lamictal has "pooped out" just like the ADs did before. In the fall of '12 - and now '13 - I felt/feel the intense agitation and irritability again. I am still on Lamictal and now take .75 Klonopin each day. Throughout the past two years especially I also feel the agitation and irritability in waves. It's most of the time, but there are small pockets where I feel a bit better (but certainly not normal).

I have never been manic. I have never felt euphoric. But I have felt what I call agitated depression, which some call dysphoric mania. But is it possible that I am BP when my "cycles" simply seem to be cycles of depression, and depression with agitation??? TY so much if you read all of this and also if you have any suggestions.

I'm not sure, actually. It doesn't sound like it could be bipolar because I'm pretty sure the depression has to go away to be hypomanic. It could've been a mixed episode, maybe. Sorry I can't be more help.

I'd suggest talking about it with your pdoc, as they're really the only person qualified to tell you.

Welcome to PC though!!

[QUOTE=crazytired;3243134]

Originally I was dx with Dysthymic Disorder, DD, as I have been depressed for as long as I can remember (back to kindergarten and I am now in my early 40s). I can only remember a six month period in '96, and then a 12 mo. period in '11 where I didn't feel down 99% time.

....

I have never been manic. I have never felt euphoric. But I have felt what I call agitated depression, which some call dysphoric mania. But is it possible that I am BP when my "cycles" simply seem to be cycles of depression, and depression with agitation??? TY so much if you read all of this and also if you have any suggestions.[/QU

I'm sorry you're having so many problems with your dx. I had the same problems. I was depressed when I was 9 due to being bullied at school. Since I was 15 I only slept 3 hours a night and felt just fine. In 1969 no one in my family knew about or heard of BP. I thought it was just me. In 1987, after a bad summer of physical illnesses (torn cartilage in my knee, and a new dx of asthma), losing my job, and having marital problems, I had a dx of clinical depression with GAD. In 2000 I moved and saw a new pdoc and he said dysthymic with GAD. I also have mild OCD, and have since I was very small. In 2011 I was diagnosed BP with GAD and mild OCD. I've been on every AD drug known to man except for the old MAO inhibitors. None of them seems to help my depression. In 2011-12 I took lithium for 10 months with no change in my moods at all. I've never tried the mood stabilizers, but am on imipramine, clonazepam, zoplicone, and respirdal now.

Unfortunately sometimes it takes years to get the proper dx. I don't know why it's so hard for pdocs to figure out. Maybe for me, I just didn't know what BP was, so I didn't tell my pdoc everything I was doing. I knew nothing about BP, and I did those BP things all my life, I thought they were normal. I only saw him when I was depressed.

I'm 59 and I was just diagnosed 2 years ago.

Thanks for the reply - my issue right now is that I don't have the same p-doc for very long. We live overseas (husband works for the DoD), and although I do have access to the bases for psy. care, I am on my 3rd provider in 4 years. First it was on a base 20 min. from me. Then one that was 1.5 hours away, and this Wed. I start at a base 2.5 hours away And all this for 15 min. med-checks. I am not trying to knock military doctors, but they have so little time that I don't feel like my care is adequate at all. For the past four years I have basically dx myself, briefly discussed it with them, and asked for a particular med. I hate it.

Well, here's a bit of a study: Agitated "unipolar" depression re-conceptual... [J Affect Disord. 2005] - PubMed - NCBI It seems like pdocs aren't really sure if agitated depression is ALWAYS part of bipolar or if it can be present in MDD.

The inconsistency in your care is definitely frustrating

I can only tell you about my husband:

He was originally Dx'd with depression. Each medication change seemed to make him more and more agitated. It got to the point that if he was upstairs yelling at my son I would not go up there for fear that I would just make things worse and it would turn physical. I kept telling pdoc (we shared one) this is the worst I've ever seen him and he's scaring me but she didn't listen and told him he needed anger management. Then didn't give him a referral. She then told me that it was me and my issues not him. He eventually ditched the meds and things got better.

Until he got a job, he did well for the first couple of months. Then he fell apart, he needed a dr's letter to go back to work but no GP would give him one. So he entered the mental health care system. Immediately he was preliminary Dx. bipolar from his history. Since BP meds he's done tons better but still can't hold a job.

It is possible to have SAD and bipolar.

It sounds like you're not getting very good care --not consistent or very comprehensive anyway, and I'm really sorry about that

But I think it would be a good idea to try to convince your pdoc to have at least one longer appointment where he/she can do a more thorough evaluation.

I do think that depression itself can manifest itself in different ways for different people at different times, and that agitation can be an aspect of that.

Maybe you could take a look at the Depression forum and see if anyone diagnosed with depression or major depression has experienced the kind of agitation you have.

But of course your best bet is a pdoc, really pushing him/her to do an evaluation. Do you have a therapist? This might help with your depression, if you have access to it. Best of luck.