I think I am bipolar after all

Hello

I suspect that I am bipolar (mixed).
22 years old male here. I started having depression-like symptoms and excessive anxiety with obsessive compulsions back when I was 18. I refused to take medication and eventually was convinced to it at age of 20, after a particularly bad panic attack which resulted in worsening my depression.
I was taking Escitalopram, 20 mg daily for almost a year. When I went off it, something happened with me.
I had classic manic symptoms (didn't know at the time) for a period of 3 months. I guess, I think they were.
I became very extroverted. I had states of euphoria which lasted hours with no reason for them.
Worse, I developed false beliefs about my capabilities, I firmly believed myself to be the most talented individual in my college, I started several projects none of which played out.
Through this time I was very irritable and unusally reckless; at time I would get in trouble just for the fun of it which is not my normal behaviour.
At the peak of this state I "lost contact with reality", believing in having supernatural powers and a huge conspiracy taking place in my life - obviously it ended up with incredible embarassment for me as there is no conspiracy, even though I gathered what I thought "evidence", it really did seem like evidence at the time, but from where I stand now I know it was a case of very selective thinking and a few coincidences.
Now I am back to depression...I am taking 10 mg Escitolapram again for a few months. It is not helping; it lowers my anxiety greatly but does not boost my mood or motivation (which is non-existant at the moment).

I did not know it's mania, as I had so little energy most of the time, but now I learned my low energy likely comes from hypoactive thyroid...

If it's mania, should I be getting treatment for bipolar disorder?
I need help, my depression is very bad at this point, I don't enjoy anything and I have no motivation at all, even to do fun things.

I am not currently consulting with any doctor other than my endocrynologist (thyroid problem).

Here is a coherent list of what I am experiencing:

- Anhedonia - I don't enjoy my usual hobbies, I can't think of anything that I would like to do, nothing at all
- Low energy - I feel tired through the day, likely linked to my hypoactive thyroid (started treatment, too early for results though)
- No motivation - I can't bother myself to study or learn new skills, I don't even work even though I'm really in debt, partially due to low energy but a lot of it comes from "why bother" attitude which I just can't get through (may also be linked to thyroid)
- Mood swings/Rage fits - They're pretty bad, used to be a daily thing but I do not get them AT ALL if I am on Escitalopram
- Emotional coldness - I find it very hard to find empathy in me, even bad things which happen to me just don't seem to affect my mood in a meaningful way, it is scary to me and I worry that other may perceive me as cold
- Difficulty concentrating - Any mentally strenous task is too difficult for me, it takes a great effort for me to even write this post, I feel as if my brain does not have the energy to think things through
- Anxiety - Especially at night, I feel unreasonable fear; during the day I am at a constant state of unpleasant alertness, I feel restless. Escitalopram removes this symptom completely.

During the 3 months period after I tapered off Escitalopram most of these symptoms were non-existent and my state was vastly different (as described in a post above).
I had
- Delusions of grandeur - The most talented one, with great destiny, invincible and protected by supernatural powers (what I belied in...I know how it sounds)
- (Partial) Loss of contact with reality - I belied in a supernatural conspiracy in my life, put a lot of effort in proving it, ended up embarassing myself
- Irritability - Anything could spark an argument and I had trouble controlling my anger
- Random states of euphoria - It was not a constant state of euphoria, my mood was not elevated non-stop, but almost every day I was flooded with endorphines, I never took cocaine but I behaved exactly like a person on it, invincible, endless energy, motivation, just felt great albeit it was not a good state due to overconfidence that always came with it

Do you think it might be a bipolar disorder?
I should get myself to a doctor, shouldn't I?
Every time I feel better I just ditch my doctor, I know it's silly. I felt better so I stopped seeing my old doctor, then I felt worse so I got onto escitalopram again but it's not helping (I have a lot of leftovers).

I just really want to feel better...just normal...I hardly remember how NORMAL feels like. I think last time I felt completely normal was in junior year of high school, I miss it. My life is getting more f-up each year as I am having a hard time with, well, basically everything. My manic episode or what I think was one did not help with getting my life in order, altough, I admit, I got really good grades during that semester - that's something...

We are not doctors, hence the lack of ability to diagnose.

It is my uneducated opinion that you have a few more goodies than BP. Which, of course, you have too.
If I was in your shoes, I wouldn't walk, I would run to see a doctor. Good luck.

Welcome to the bipolar forums.

I couldn't day if your bipolar or not for that you'd need to talk to a doctor preferably a psychiatrist. Don't know how it works in Poland but you could start with your general doc and bring up your concerns. You certainly have valid concerns and should get them checked out.

Could you go to the school psychiatrist?

He's a good guy but he's pretty useless since he has no authority to prescribe any medications I might need. Already was seeing him.

I guess I'll have to speak with my GP again, but that is 2 weeks of waiting to see him and no idea how many more for psychiatrist.

Upping the dose of escitalopram to 20 mg as previously. I am already on 10 mg but it's only helping with anxiety.

I'll contact my GP see what he says.

Psychatrists can prescribe meds psychologists can't.

If it is bipolar, and the medication you are taking is an SSRI, you run the risk of the med causing a manic episode. You would be best to consult a doctor before increasing your medication. Please take care of yourself.

At this point I'd welcome a manic episode, I think, as long as no delusions are involved.

I'll try keeping myself on 10 mg daily as this doesn't trigger an episode in me (it already would I think, taking it for a month or so). I don't know if I can keep myself this low though if it's get dark for me again.

Thanks everyone for answers, I'm calling my GP today. I don't want BP medication if it can be avoided...but I should be monitored. Definitely. I know that.

BTW I thought I'd mention something interesting.
I had OCD all my life, but during my manic episode I decided I absolutely have to get rid of it, so I forced myself, step by step like in therapy, to stop doing the rituals. It was not easy, it's probably the hardest thing I've done in my life even with the euphoric power that accompanied me.
Surprisingly it was succesful. I have very little urge to do compulsive stuff since then, it shows up sometimes but all I have to do is ignore it for a bit and it goes away - very much like people after succesful therapy describe it.
Anyone had that happen to them?

The med your on could be making you have a mixed episode.

So I visited my GP today.
He told me what you have said, pretty much, that it might have been an effect of stopping the medicine.
I am supposed to stay on Escitalopram for 4 weeks then come back to him and tell him how I feel. I guess I'm fine with that, at least someone is monitoring my mental health.

UPDATE

I think you guys might have been right about hypomanic state.
The past few days I've been noticing my mood improving, while also becoming more irritable and energetic. My anxiety has increased, even though Escitalopram normally reduces it for me, I have more OCDish thoughts. Ok - energy level is difficult in my case - I have hypothyroidism and maybe the medications are finally kicking in, they are suppsoed to incrase my energy levels but shouldn't touch anything else.

Today I woke up with racing thoughts, after spending half the night thinking about a scientific problem.

What worries me is that my self-outlook is improving at a dramatic pace. I catch myself having these specific thoughts which appear delusional; my head was full of these thoughts last time of what-I-think-was hypomania. Examples include "I know I'll become a brilliant scientist one day" and "hey, maybe I could patent something". They startle me. But I don't want to stop. I feel so good. What do you think guys ? My doc told me to stay on meds for 4 weeks (Escitalopram, SSRI, yes he insisted). If it stays like that it's great, but what if it escalates?

Could use advice. Maybe it's not hypomania, maybe just SSRIs taking effect? It is very difficult to tell for me, as I'm mostly depressed and I am not 100 % positive I'm bipolar. How would I know if it is?

I agree. Get to a pdoc now. Get a therapist. Reduce your stress as much as possible. Hang out with us here in the bipolar forum. We support each other and chances are 99.9999% we can relate to the mood episodes, the manic behavior, we bought the tshirt. Sorry, my friend. I think you'll likely be told by a pdoc you're in the right club. Oh, we do psychosis, too. Some of us. Add in depression and mixed. It's a lot.

But only a pdoc or other medical professional can diagnose you. Make that a priority...see a pdoc and tell them your symptoms and what's been going on. They make the big bucks to explain what's up. I think you will likely need meds to get you stabilized. Hang in there.

Welcome, xo

Thanks for the warm welcome

I saw my GP 2 days ago, but he said I can't see a pdoc yet, told me I need to stay on SSRIs for at least 4 more weeks. I voiced my concern, because all of you here told me not to, but he was adamant about it.

I had the GP SSRI thing happen to me. Horrible.

Can you go somewhere else? What are your options? Can you pay out of pocket to get to a psychiatrist now? It would be worth it. Your GP doesn't appear qualified and making you wait is nonsensical. Bypass him to get to a psychiatrist. I hope that works ok in your country? I know it varies by country.

If you're stuck and things spiral out of control - go to the hospital emergency room.

I sent you a friend request. Keep us posted. xo

I am in the UK, actually. Seeing a doctor privately is very expensive here. I know it's wrong but I want to stay on that for those 4 weeks, I feel much better and maybe it's not hypomania, maybe it will stay like it is right now. I really, really don't want to be back in the gloom.

I feel that someone should monitor me so I don't spiral out of control. I'll keep you posted, feels good to have someone who has been through that and understands.

My boyfriend and I monitor each other. Both have bipolar 1.

Patents and stuff...yes it does sound like mania. But who knows? Not me. I haven't slept in three days. Mixed episode still. Not sure what's next. Fortunately I have a pdoc appt Monday. My AP isn't getting me to sleep. Sorry, I hijacked your post.

Haha it's okay, not sure what you're sorry for.

I think what I experienced last year might have been a mixed episode - I didn't know much about it before but your post got me to read about it. Maybe that's why my mood was not coherent, at times it was euphoric and at times it was depressive but I still had a lot of energy. I used to pace in my room for hours without stopping, constantly, well, talking to myself, discussing stuff. Sometimes 4 or 5 hours would pass that way without me noticing the time. Sometimes I had so much energy I would go out and walk aimlessly (fortunately, just thinking to myself when outside, although I had to force myself not to talk), even at night.
It was an emotional rollercoaster - euphoria, feeling amazing, talking to absolutely everyone, starting ambitious projects that I woudln't finish.
And then overwhelming sadness, but still racing mind, can't stop pondering my problems (real and imaginary), can't sit still, crying myself to sleep.
I'd say it was about 30 % euphoria, 70 % depression, with more euphoria initially and more depression as time went on, for 4 months until finally I came back to mild depression.

I lost a friend because of it, as he was convined I was taking drugs and he doesn't tolerate that. I didn't know I was ill and I stupidly kept telling him how amazing I feel every time I was euphoric, and he just wouldn't buy "I don't know why it happens".
Lost 2 more friends who weren't that close to me, one because of my delusions that I couldn't stop telling him about and the other one because of my erratic, reckless behaviour.
Was really glad to be back to "normal" even if that meant depressed. But you know what - friends that stayed I value far more now, because of the fact they were able to put up with me at my worst, and it means a lot to me.

UPDATE

In the evening I had a massive surge of energy, I started exercising vigurously, I couldn't help myself, but I really can't do that because of hypothyroidism so I exhausted myself very quickly, but it felt so good, euphoric in fact.

I still feel like that, it comes and goes in waves, it went back to normal for a while now it's back at this state. Don't think I will be able to fall asleep. I feel more talkative, energetic, confident and have an urge to exercise.

A bit of speedy thinking here and there. Irritable, during an argument I had an urge to just yell at the other person to have her shut the f.... up. It was very mild and no problem resisting it, but it's not my usual form of thinking.

But the afternoon was as usual, exhausted and anhedonic.

Hypomania, maybe. I won't lie, feels amazing. I'm still keeping an eye on how I feel, can't let it get too far.

It has stabilised over the past few days, my mood is "so-so" but I would not say depressed. My anxiety depends if I drink coffee or not, if I do then it's high and I get some OCD symptoms, if I stay clear of coffee it's very manageable. My motivation is ****, but it is always like that due to hypothyroidism (hopefully will change in the future).

It seems whenever I am getting on it or gettig off it (even just forgetting for a day or two) I am experiencing hypomania-like symptoms but not a full episode. Knowing that I'll definitely not be getting off it any time soon or taking it irregularly, hopefully should keep me stable. I had some problems with it making me totally lose interest in sex, but it seems to have passed

Huge thanks to everyone who replied in my thread.

I am so, so hypomanic. Well I just woke up. I know I have a bus in an hour and I should be rushing to shower, shave and go, not write a post here.

Yesterday felt more off than usual, today I woke up...well, fast. Fast, irritiable, happy. Seems like a typical hypomanic morning, doesn't it?

I had the wildest dreams that night. I mean, I never had dreams like that. They were more real than reality. They felt so "there", they're still in my head, so tangible. Anyone had that on mania/hypomania?

Escitalopram probably does cause mania. I don't know maybe just sleep deprivation - had 4.5 hours of sleep. Anyway, I have to go, just felt a bit compulsed to add a quick update. I'll see how it goes the rest of the day with my probably hypomanic state.

It looks like you are doing a great job of monitoring yourself.

If you need some more "tangible" type of evidence for your GP, you might try a mood chart and since the episodes come on rather sporadically, maybe use a chart which encourages you to rate/note your mood more than twice a day?
Just one option for presenting info to your GP and to have for a psychiatrist once you are able to see one.

Are you sleeping okay?

When do you take your medication?

Are you being treated for hypothyroidism?

Keep up the good work!


WC

Good idea, WildCoyote. I pick up all kinds of stuff looking back over my mood chart.

PS0, a mood chart would help your doc see exactly what you go through and would give them something to really work with.