[Juliana]

Hi there. I would love to get some insight from people who have BD.

I had agoraphobia for 3 years (from 2001-2004). It started after I had had Benign Paroxysmal Positional Vertigo for nearly 2 years. I was too sick to work or do much of anything. My balance was severely affected, I was dizzy, I bumped into things, fell down, the room spun when I turned my head, I got bedspins, my vision was blurred and I was nauseous and vomited a lot. It was like being extremely seasick all the time. I just stayed at home and tried to keep still and took antinauseants. Once the physical symptoms cleared up, I was afraid to leave my flat. I started having panic attacks when I tried to go out. (I had never experienced panic attacks before.) When I finally acknowledged that I had agoraphobia, treatment with Celexa, Clonazepam and CBT helped me get over it.

I went back to full-time work, but still had occasional panic attacks. They didn't interfere with my ability to do my job, though.
They weren't severe; they were just a minor annoyance (nausea, trouble swallowing).

I went off Celexa about a year ago and my anxiety didn't rebound. I found that I was mildly depressed, though, and felt very lethargic all the time. I was feeling stressed about my financial situation. It was difficult making ends meet. I had so much catching up to do after being too sick to work for 4 years and I was feeling overwhelmed.

I went back to my psychiatrist whom I hadn't seen in over a year. She had treated me for 2 years while I had agoraphobia and when I was going through the early recovery phase. At this appointment, I told her about my depression and my constant tiredness. She gave me a quiz to fill out and then told me I was bipolar. She wanted me to take Seroquel so she could see if she "was right" about her diagnosis. I read about the side effects. I was feeling lethargic and sad. Seroquel did not seem like the solution for that and I was sure I wasn't bipolar. I decided I didn't want to be her guinea pig, so I didn't take the medication. The depression started to lift a bit and I was getting some of my energy back, so I went back to her a few weeks later and told her that I hadn't taken the Seroquel. She told me that the fact that I was feeling marginally better was a "red flag" that I was bipolar. I told her I wouldn't be making any more appointments with her.

So, what I'm wondering is why she would tell me I'm bipolar. I've dealt with depression off and on since I was in my 20s (it runs in my family). The anxiety problem lasted for 3 years and then got better. I have never had a manic episode. I've never had an episode of pressured speech. I'm a very predictable person. I'm always very careful with money. I'm very careful in general. I have never done anything remotely "risky." I don't do things impulsively. I'm the opposite of impulsive. I'm a worrier and I'm very CAUTIOUS. I'm more calm and even-keeled and safety-conscious than most people I know.

Some of the things on the quiz I checked YES for were:

feeling more self-confident sometimes
having more energy sometimes
not needing much sleep sometimes
feeling happier than usual for no reason sometimes

Wouldn't most people answer YES to those? I would be a zombie if I was exactly the same every day. I feel happier and more self-confident and more energetic when I'm not depressed... and sometimes I'm just in a good mood. It doesn't happen very often, but sometimes I'm downright cheerful.

I talked to my friends and family and my GP and they all agreed that they have never seen any signs of mania OR hypomania in my behaviour. My GP has known me for 14 years and she told me she thought it was irresponsible for my psychiatrist to give me that diagnosis. She was as confused as I was. I had seen the psychiatrist for 2 years and not once did she suggest BD. As soon as I got mildy depressed, though, that's the diagnosis she came out with -- within 10 minutes of talking to me that day.

I am now taking 20mg/day of Lexapro (started taking it for depression after the suicide of my uncle). The depression has lifted and the panic attacks have completely disappeared. I have a very busy, demanding career and I'm handling it very well. Anxiety doesn't control any aspect of my life anymore.

I'm just wondering why my psychiatrist would give me a BD diagnosis. Am I missing something? I try not to think about it, but I'm a natural worrier. Are there other symptoms of BD that I don't know about?

Thanks in advance for any insight you can offer. Sorry for the UBER long post.

I've heard of people (like myself) who have bipolar, but have been misdiagnosed with unipolar depression. I don't think I've heard of a pdoc giving the dx of bp without any signs of mania or hypo mania. Since you are doing well on the Lexapro, I doubt you have bp. Usually anti-depressants will throw someone with bp into a mania. Glad to hear you are doing so well. Have you changed psychiatrists? I probably would.--Suzy

[polarbear206]

Hi.

I am new to this board, so you are my first post to reply to. I am a psychiatric nurse and I have bipolar disorder. There are many red flags that came up in your history that should be considered for an underlying bipolar diagnosis. There is a broad spectrum to bipolar disorders. You don't have to have full blown mania or hypomania to have a diagnosis of bipolar disorder. Time will tell since you are only taking an antidepressant for now. I would stronly suggest starting a daily mood chart. Esp. track your hours of sleep. I also reccomend educating yourself on this disorder, so you know what to look for as far a cycling goes. There are many subtypes of bipolar disorder that overlap with unipolar depression. I hope this helps and good luck

Polarbear

[Juliana]

Thanks for the responses.

Suzy, I don't go to that psychiatrist anymore. I haven't been to a psychiatrist since my last appointment with her in the summer. I just go to my GP. She's the one who prescribed Lexapro for my depression. In addition to doing well on Lexapro, I did well on Celexa for 16 months too. It lessened my anxiety and made me feel calmer. The only unpleasant side effect was that I felt very lethargic and wasn't very productive while I was taking it. My flat was always a mess. I called it my "inertia" pill. ;-)

Polarbear. Thanks for the information (and thanks for making your first post a response to mine). My sister thought she was bipolar at one point (because of her mood swings) so she talked to her psychiatrist about it. He told her she wasn't bipolar, though. His diagnosis for her is social anxiety and depression. She has always been the "moody, temperamental, sensitive" one in our family and she goes through phases of going on shopping sprees and overspending and then getting depressed about it afterwards. I'm her opposite in that department. I don't like to spend money. I'm the one people come to for support and advice, because I've always been the "rational, logical, calm" one. So, I'm just very confused about red flags. I would love to know more.

[Meta]

Hi Juliana,

I hear ya. I think Bipolar is a tricky diagnosis. I wouldn't of course be able to say whether you are or aren't,. I'll just give you a few thoughts starting with I was given the diagnosis of bipolar over 20 years ago--I had difficulty accepting it. My diagnosis primarily came about after taking one of the older tricyclic antidepressants Imipramine, for a severe depression in my early 20's. I started cycling back and forth between mainly depression and hypomania for about 6 mos.

Then I got the bipolar disorder diagnosis. As you probably know one of the key ways bipolar II or III is diagnosed is if you have a hypomanic or manic episode following administration of an antidepressant. Despite knowing this, I pretty much rejected the diagnosis because I think I felt since I didn't really go out of control like the classic Bipolar I people--and my episodes were really short, and I have a brother and sister who are that classic type and I didn't see myself as being like them. I also thought deep down too it might not be so bad to be a little bipolar if I was more productive--well, it never really was all that productive, but I did tend to say things I wouldn't say if I wasn't hypomanic and have angry outbursts--not extreme ones--but I just wasn't me.
I agree that the things you answered yes on would probably apply to most people and alone are not indicative of BD except the sleep issue is key for me. For me, needing less than 6 hours sleep is a prime indicator I am in a hypomanic episode OR it can trip off a hypomanic episode.
Since I didn't really accept my diagnosis, I went off my medications several times ove the years primarily because I think my deep down belief was that my depression was a sign of character weakness and the hypomania was sort of a fluke. The depressions always returned and the hypomania.

I think it is believed that repeated depression in your 20's often may be "soft" bipolar disorder. That unipolar depression is more likely for people over 40--although not exclusively. If I am mistaken on this, I hope someone would answer in this thread because I am not as up on the science of these disorders as I once was.
Anyway, Juliana, I would express your concerns to your pdoc, ask what it is that makes her give the diagnosis, talk about your feeling that it doesn't apply, and that family and friends state they do no see such signs.
When you say you are a worrier and cautious , calm and even keeled, I relate because I think that is my more "normal" self. These sort of disappear when I am hypomanic. There was a time when I wanted to just think the hypomanic episodes where these characteristics receded greatly were as I said, a fluke, but now I accept that i am bipolar II or III. For me acceptance was a long time in coming.

Take care,

Meta

[Juliana]

Thanks so much for the info and for sharing your experience, Meta.

I don't want to go back to the same psychiatrist. She was so cavalier with me when she gave me the BD diagnosis. Her attitude bothered me. I didn't like the fact that she wanted me to take Seroquel just so she could see if she was right about her diagnosis. I didn't like being treated like a guinea pig. I had gone to her because I was feeling sad and lethargic. I told her that my job was very busy and feeling so lethargic was frustrating me. I wasn't sleepy during the day; I just had no energy. I've read about Seroquel and it seems like it helps a lot of people, but I wasn't willing to risk some of the dangerous side effects to treat a condition I don't believe I have. It's also sedating and the last thing I wanted was to feel MORE lethargic. Being sedated would have affected my job performance. I was a graphic designer and a copy editor at the time. I needed to be on the ball so I could multi-task effectively and not make mistakes.

I did well on Celexa (calmed my anxiety) and Lexapro has been working for me since I started taking it (no more panic attacks and my depression has lifted). Clonazepam also worked well for calming anxiety and lessening the panic attacks when I was getting over agoraphobia. I've had bad reactions to some ADs -- Wellbutrin made me feel very depressed, Paxil made me very physically ill and I ended up in hospital for dehydration, and Effexor made me feel very drowsy but fidgety and I had trouble falling asleep. So, I'm glad I've found something that works for me.

The only time my mental health interfered with my ability to live a full life was when I had agoraphobia. My life ground to a complete halt for 3 years when I was agoraphobic. When I go through periods of depression, it doesn't interfere with my job. I tend to welcome the distraction of work. I get more depressed when I have time on my hands -- like weekends when I don't have anything planned or when I'm lying in bed at night before I fall asleep.

My sleep habits have always been pretty much the same. I'm a night owl. I take a nap for an hour or two after dinner and then I stay up late. It's the quietest time of the day and that's when I feel like I have some time to myself -- and I really need that relaxing time -- to read a book or watch a movie. If I'm trying to come up with a creative idea for a project at work, my ideas usually come to me late at night -- when I'm away from the ringing phones and interruptions. Most of my best design work has been done late at night. That's very common amongst my colleagues too and when I was in art school, the studios were always busiest late at night. I work in that art school now, and I often see students just leaving their studios when I'm arriving at work. It's a place full of night owls. It's when it's dark and the world is quiet that most creative people are able to clear their minds and get some creative work done. I do a lot of writing at my current job and I tend to do my best writing after 10PM. I sometimes have a hard time getting out of bed when the alarm goes off at 7 and I wish I could sleep for 2 more hours (but who doesn't?). I usually have a long sleep-in every Saturday morning.

I think I'll talk to my doctor about this and tell her I'm still concerned about why the psychiatrist gave me the BD diagnosis. It does bother me. I'm a logical person and I like to understand things. I don't understand the logic or reasoning behind that diagnosis. Even when I went back to see the psychiatrist after I decided not to take Seroquel, she gave me no explanation of her diagnosis. My GP told me at the time not to worry about it because the diagnosis seemed wrong to her, but I might ask her to refer me to another psychiatrist. I'm not concerned about it on a regular basis because I'm doing well. I'm not in a fabulous mood (I rarely am unless something WONDERFUL happens), but I've been feeling less depressed and less anxious lately and I'm pleased about that. I would like to understand more about BD and get another psychiatrist's perspective, though.

I took the advice of one of the earlier posters in this thread and I've been keeping a log of my sleep patterns and moods.

Thanks again for responding.

[DaveyJones]

Hi, Juliana,

We would like it if our diagnoses could be as cut and dried as, say, cancer or some other disease that has a visible basis. Mental health diagnosis, for the most part, and bipolar in particular is simply not that way. Many doctors won't even tell you a diagnosis because it is a working theory, not a medical fact. The truth is that the way we present can change radically over time. With bipolar in particular, sometimes the only way to make a firm diagnosis is to see how the patient reacts to the various drugs that are used for treatment.

It can be frustrating, but that's just the way many docs do it. For you, you should find one that does thigs on a more cut and dried basis. Just don't be frustrated if they get it wrong the first time.

Good luck in your treatment...I hope that you get better soon!

DJ

[Juliana]

Thanks for the response Davey. When I got the diagnosis of agoraphobia and GAD it made sense to me. I have overcome it and am doing much, much better now. I was also diagnosed with depression on a number of occasions in my early 20s -- and I know when I'm depressed, so that makes sense to me too. My doctor eventually decided to put me on a low-estrogen birth control pill because she thought that was contributing to my depression. That seemed to do the trick and I didn't get depressed again for about 10 years. It came back for the first time after I weaned myself off Celexa last spring. I felt mildly depressed and tired all the time. My doctor put me on a low dose of Wellbutrin, but that threw me into a severe depression. My doc told me to stop taking it, and the depression lifted about a week after I stopped. I decided to just do more yoga and walking to deal with the mild depression and I started feeling better. Then my uncle committed suicide in the July, and I fell into a depression that just wouldn't go away.

I'm taking Lexapro now. It has lifted me out of my depression. I don't feel fabulous, but I'm not constantly miserable like I was before. I'm able to feel happy when good things happy and I have a relatively positive outlook on things now, so that's a major improvement. I also haven't had a panic attack since I've been on it. So, for now, it seems to be the solution for me.

My family and my closest friends all know about the psychiatrist who told me I was bipolar. Although they and my doctor all disagree with that diagnosis I have asked them to tell me if they EVER see any changes in my mood -- anything that seems like a red flag to them. I want their input. I don't want anything sneaking up on me. So far, so good, though.

Thanks again for your insight.

[polarbear206]

Hi,

I'm going to direct you to some informative sites to help you sort things out.

Keep in mind that many bipolars are very creative, level headed, grounded and very successful in life. Many with type A personalities. Many famous people have this.

http://www.psycheducation.org/depres...chor-Can-27506

http://www.psycom.net/depression.central.lieber.html

http://www.mcmanweb.com/index.html

[Juliana]

Thanks so much Polarbear. I'm going to read everything you linked to. I appreciate your help. Cheers!