Is bipolar really the cause of your mood swings?

I just came across this article and thought it may help a few of you with your symptoms - especially "rapid cyclers". It stresses that the correct diagnosis is very important to receive the correct treatment.


Is Bipolar Disorder Really the Cause of Your Mood Swings? | Dr. Matt Goldenberg D.O.

My PTSD did cause dramatic mood shifts but after years of treatment for the PTSD the longer duration of highs and lows were there and my secondary Dx of MDD was changed to BP.
It's easier to see thevBP shifts now that the PTSD is under control but I wasnt Dx BP first and I think that's the question you are asking. If those with rapid mood shifts were Dx BP but the shifts might be caused by something else?

I used to be diagnosed with Borderline PD and PTSD but once the PTSD was treated it became clear that I had BP as my mood shift were more episodic even though I am also a rapid cycler. BPD and BP can be difficult to distinguish and many have both. Perhaps I did have Borderline PD and the treatment dealt with that too? Who knows, but I show no signs of it now. However the PTSD rears its ugly head at times causing me a lot of grief.

I've always wondered what the difference between agitated depression and dysphoric mania was.

Last winter I had a major depression. I was irritable, delusional, suffering from hallucinations and at times severe agitation that interfered with sleep. Someone mentioned that I probably had bipolar disorder. I didn't agree. I ended up doing some research and concluded the dysphoric mania and agitated depression are identical.

My psychiatrist told me I had psychotic depression, which I agree with since the delusions were mood congruent. I've experienced psychosis in the past and still struggle with residual symptoms that are not related to my mood. It can be hard to determine what is going on. I don't have a concrete diagnosis.

Understanding your illness and having the proper diagnosis can make a big difference so it is worth exploring all the possibilities. I've read so many posts written by people looking only for the external fix: medication. Therapy helps even for people with psychotic disorders. Coping with stress and improving one's interpersonal skills and relationships helps even in those without a PD diagnosis.

Medical conditions can explain abrupt emotional changes which are not mood swings. E.g. PCOS. Other psychiatric disorders such as ADHD, and autism spectrum disorder can as well. Definitely PTSD.

I ultra rapid cycle, but it's almost like a clock, 3 days change, 3 days change, etc. I don't get triggered into a mood change. I only get triggered into anger if the mood allows it. So it's safe to say, I might be bipolar. Oh, I forgot about the delusions and hallucinations. That kinds of makes it a ringer.

Dosent everybody get triggered into a mood change
I was sad this am but won the lottery in the pm now im not sad im happy

BPD and BP, especially the rapid-cycling variety, are well-known to have such a significant overlap that distinguishing the two has confounded the medical community for quite sometime.

Often, something of the sort--"Well Borderline is more triggered--not so in Bipolar."

While I don't have a PhD or an MD, I'd say--anecdotally--that this is not the case. A depressive episode can indeed start as irritability, as can a manic episode.
In these stages, given irritability, a person may seem more responsive in a "BPD" fashion.

What I think distinguishes the two is that the Bipolar episodes will continue along their trajectory--i.e. an irritability due to depression will devolve into sluggishness and potential suicidal ideation.

I've been diagnosed with both, although most have said I just have "borderline traits." I notice these are very reactive and don't have the "steady" trajectory that I mentioned above. It's far more haphazard.

So it's not reactivity as much as it is a far more random trajectory over time.

Yeeeeeeeeeesssss... Mood swings does not equal bipolar disorder! Episodes of mania and depression equals bipolar. Just cause you were sad and happy in the same day doesn't mean you have bipolar disorder.

As mentioned before BPD can be brought under control and even cured with the right therapy (I suspect that is why you no longer have BPD traits Wander - you have worked through it and come out on top - well done to you). As I have mentioned many times before, I know personally at least 20 people who now live med and mood swing free after committing to DBT and therapy specific for BPD.

PTSD is a hard one too as it can mimic bipolar and can be comorbid. I suffered from PTSD but have that under control now and my moods became more stable through time and therapy. I was only triggered by certain smells, memories, nightmares and anniversaries of the occasion which triggered anxiety and depression for short amounts of time (ie 3 - 4 weeks). So I could differentiate between that and a BP swing as my BP swings last for much longer. In saying that, in the time close to the event my moods would last much longer but with therapy they quickly shortened and I was able to distinguish between a BP mood shift and PTSD triggered mood shift. I no longer have mood episodes caused by PTSD.

You can certainly have triggers for moods in BP also, but the difference is how long the mood lasts and what the trigger is. For example stress, any stress, good or bad, sets of my BP. But something like someone cutting me off in traffic or ignoring me or "abandoning" (for lack of a better word) me or interpersonal problems does not set off a mood episode as it could for BPD.

As mentioned in the article the correct diagnosis will help you get the correct treatment. It makes me sad to see people struggling so much but have been labeled wrong and are getting the incorrect treatment (not referring just to those on this site, also my experiences as an inpatient and working with the mentally ill).

Jacky your question about winning the lotto - this is a question I always got on admission in my younger days, if you won the lottery what would you do? My answer was always donate it to charity and kill myself. That is how they tested to see if my mood was reactive to external stimuli.

Also remember not every mood is a BP mood and you may have just been feeling a little low but not completely depressed and the lotto win was enough to lift you out of it. Unless of course you are now exhibiting hypo/manic behaviour - that is a telltail sign that it is not a BP mood, but one triggered by an external event and not likely to last.

[QUOTE=jacky8807;4313876]Dosent everybody get triggered into a mood change
I was sad this am but won the lottery in the pm now im not sad

I can laugh at funerals and cry on beautiful days. To win a lottery will feel great, but just feel so hollow. Faked happiness. I couldn't really enjoy it till I had a real mood change.

I just met with my pdoc today and asked him about this. When I was diagnosed I had went into a psychosis so it was pretty clear. Anyway, I was curious on his take. For me he said that bc I respond to mood stabilizers so well, that that is a sure sign its bp and not bpd. But I also have ptsd and sometimes I get triggered, but it's usually over some specific trauma I've experienced.

I think it's good you're trying to educate ppl, but I've found some ppl just want to be bp or sz even if they have very clear symptoms of bpd or histrionic personality disorder. I've given up trying to understand it, lol. I honestly don't understand why anyone would WANT to be bp or sz. I don't get it....

Thanks for the info though.

I meant in more general terms...healthy ppls moods are reactive to situational stressors
Thats what confuses me about the description of bpd
Bp is a horse of a different color
If im feel good manic the world could be crumbling and i would be playing my fiddle

I also wonder if the tendency to quickly Dx for insurance reasons leads to wrong Dx? I was Dx a long time ago and given many tests, MMPI others I can't recall the names of plus a series of tests by a couple of Drs who only test for personality disorders plus observation over time in a hospital. Back then they Dx by ruling out possible Dx then eliminating those that didn't fit. For myself they were checking mostly for BPD and 2 other personality disorders all of which were ruled out. Once I was in an ER and a ER Pdoc Dx BPD but when I questioned my reg docs and T they said it wasn't possible to Dx a personality disorder in that short amount of time. Perhaps this is why they err on the side of BP over BPD, they really need more time but the insuranc companies doesn't allow time?

BPD triggers are more extreme than someone without a personality disorder. For example, if someone with BPD had a disagreement with another person, their response could be sudden onset of depression, threats of SH or suicide, plans for revenge or bouts of intense anger.

Yes this is an issue I have brought up before and it has been discussed in an older thread "Why is BP overdiagnosed in the US". Many get the BP diagnosis to get the insurance and meds, then are later rediagnosed BPD but never drop the BP label. Of course there is comorbility but it is less common than "we" think.

I dont understand it either and I really hope some people are helped by this article as there are so many suffering with BPD when there are brilliant treatments available for it which can in many cases lead to a stable med free life.

Psychosis can also be present in BPD and many with BPD are given similar meds to that of bipolar with varying levels of success. Medication working or not is not an indication of diagnosis.

I am manic/mixed. Meaning ALL of my emotions are raw. Not just happy or sad, like normal moods. It is like PMS Xs a 1000. I have been like this for weeks now. I can't handle any stress at all at the moment without bursting in to tears or yelling maniacally. I can not function. My thoughts are confused. I forget things. I space out. I slapped my eldest son, for which I have apologized profusely.

It is not a specific incident that triggers me. It is all incidents that give you strong emotions.

Otherwise, they are just the moods of everyday life. The ups and downs of being human or a personality disorder are very different from the ups and downs of having bipolar 1. At least to me.

Also, I have a very consistent sense of self and personality. a But, as my therapist says, when manic, i am like an overgrown teen in an adult body.

The fact that my cycles have no trigger, for example I can wake up suicidal and stay that way for days, is what made it so easy for pdocs to dx me with BP.


And yes I have to agree that while BPD consists of reactive moods, like in the case of neurotypical people, the emotional reaction is far from typical, it's bloody extreme. Which is what makes having this damn disorder so horrid, you KNOW you're over reacting, but until you aquire the necessary skill set, all you can do is hate yourself for behaving like a dangerous 2 year old.


I'm always baffled by people posting about how something triggered the depression or mania... I mean I get the stress factor, I think we can all agree a BP person is allergic to stress, but specific triggers?


Ps. If I won the lottery while severely depressed I wouldn't give a damn. I would have to wait for the depression to lift before I even realize I have a shitload of money.

Thanks for mentioning the psychosis. It seems to rarely come up. There are times that happens with BF. There have been some very scary times.
Yes, some are puzzling. Another for sure one that comes to mind though is lack of sleep. Weeeeeee!
Yes. I've dealt with having BP for decades, so am well-aquainted with mood swings, right?. It was not until living with my BF (BPD) these last 5 years that I've seen what you describe. His responses confused the heck out of me for quite some time(!) I'd be like What the hell just happened there?!

You can see the switch flip. It's like BOOM! Everything was just fine, then suddenly everything's shyte (and always has been(!!!)) It's like 5 seconds earlier never existed. (This absolutely blew my mind to see.)

I think that a lot of people confuse emotions with moods. And emotions can be situationally triggered (of course). I might have a strong reaction (or not) to something, but it doesn't last. It doesn't lead into anything more. I think it's important to discern when possible.

Another thing comes to mind. For me (BP), everyone knows where they stand with me. Day in, day out, it does not change. If I love them, I love them whether I'm up or down. They are the same person, so why should that change?
Not so with BPD. You can't be sure one minute to the next where you stand. To him, I am not the same person regardless of his mood. I am good or I am bad. And it totally correlates to his mood. (Yanno, even though I actually continue to be the same person, lol.)

Wow how do you guys with both bp and bpd manage
That sounds rough
Bp alone is wearing on the soul

Well yes, this is indeed a very interesting article.

I don't think I can fault much on what the author wrote in the article.

It's a pity that in my case I fell into the category of "Undiagnosed" - only received a diagnosis at age 31 - when CLEARLY the symptoms, for me, personally, had been present since a late teen.

I was originally diagnosed just depressed.

I mean it's easy to go to your doctor when you're feeling down? Get some tablets?

I never saw my doctor when I felt "happy haha" what for? I didn't think I was "sick"

As I have regular pdoc appointments they can tell my mood state just by looking at me ( how I dress and respond to questions etc). As mentioned I can wake up depressed one day with no trigger and that can be more frustrating than having something obvious trigger it. Stress really is my only trigger and it doesn't matter if it is excite able good stress or tough distressing stress, either way sends me into an episode ( usually depression, occasionally mixed and less commonly hypo). Most of the time I deal with it but when it gets to the point I'm Sui it's time for inpatient because I am dangerous and impulsive during episodes.

What confuses me about this is that I definitely have mood swings within mood states.

For instance, I'll use depression as an example since I'm currently depressed and I'm certain that I get depressed. I'm also pretty certain I get mixed. I am not certain if I get hypo or manic.

This week I've had a baseline of moderate depression, but at times my mood has swung up or further down due to external triggers being present or removed, some that I am more sensitive to due to being depressed.

Does that happen to people with BP? Mood swings within mood states?

Also: The "yo-yo" thing. Can that not happen in mixed states, if there is switching back and forth from one state to the other? I understand mixed states involve both happening at the same time, but have also read that switching from depressed to hypo/manic can take place in mixed states as well.

Its common for most ppl with bp to have "atypical depressions " eating more especially carbs sleeping more and ability for mood to be temporarily lifted from external factors
But its still a major depressive
Switching can happen. In my last bad mania i was manic for a long while would shoot down for days into black come back up to mania
I shot waay back down and was in mixed.landed in hospital
When i first got there i was a wreck that wanted to moan in hell in bed begging themvto drug me to sleep to escape the internal torture
As i was medicated i started switching one day euphoric manic awesome..mysteries of earth...next bed misery pain. Was on seroquel and started lithium. The day i went home i was hypo. Came right home went for a jog (i dont run lol) but in the next coming days lithium took over and stabilized me.

And the pdoc at hospital said it can and does happen ...and he had been working in hospitals for like a 1000 yrs lol. He was awesome