[Theresa1991]

I'm coming down from a hypo and am stressed out for various realistic reasons. This makes me feel totally anxious.

The reasons: Just started a new work and have to move out of my flat by April coz my ex-boyfriend will keep it. Anyway I am subletting without permission and last week my flatmate had a fight with a neighbor who then called the landlord. The landlord called me and asked how many people were living in the flat and I said me and my boyfriend and we had people visiting, so I think she believed me and all will be fine. Anyway, if she finds out that I am subletting without her permission she can cancel our contract from one day to the other (German law). I don't think I would have to move out anyway, because to make me move out she'd have to file a lawsuit and it takes a while to get a title. As I will be gone by April anyway I don't care.

But this insecurity and the cold I am having cause huge anxiety. I am afraid to die, to become uncurably ill, to fail at life and so on. On the other hand I have a lot of racing thoughts - where will my life go, what do I want, why am I feeling like this etc. and I am constantly worrying. I basically make it through the day, get home and break into tears of stress and exhaustion.

I could never really handle my anxiety, it just takes over me and I try to hold on for the ride. How do you guys handle your anxiety? The worst part of mine is that a small voice in my head keeps saying "this could really happen" and I can't shut it up, so it keeps repeating the same **** over and over again. Any ideas what I could do?

[bioChE]

You need to talk to your doctor and therapist. It shouldn't take as long as you have to get a diagnosis and start the right meds. Maybe find another doc.

[Theresa1991]

How long did it take you?

I think it is pretty probable I am bipolar with hypo phases because I have shown all the symptoms for years. I think they hesit to diagnose me because I can function pretty well still and can control what I show to the outside world.

[bioChE]

Originally Posted by Theresa1991

How long did it take you?

I think it is pretty probable I am bipolar with hypo phases because I have shown all the symptoms for years. I think they hesit to diagnose me because I can function pretty well still and can control what I show to the outside world.

Mine took ten years to diagnose correctly. I was first diagnosed with GAD, then MDD, and after years of ADs and associated kindling, bipolar. As a fellow "high-functioning" individual, I know the difficulty it is at times to see the reality of the troubles.

That being said, you've pretty well documented here some of the highs and lows in your experiences. I would think if you're able to communicate those with your docs, they'd be able to reach some conclusion one way or the other, especially if they think meds could help you. I would emphasize the highs, as those are the times most likely to get you in trouble. The racing thoughts, hypersexuality, alcohol and drugs, lack of need for sleep, and and whatever else seems a bit abnormal in your life when compared to the "norm." If you can also express the cycling into lows, that's helpful. The key is to be honest and up-front about the troubles.

At times when I'm with my doctors, I tend to downplay my symptoms or pass them off as no big deal. It's always to my detriment. I'm sure it comes out of a desire to present as normal as possible, for whatever reason. You're intelligent and articulate, and I suspect you may be able to do the same thing if you're not actively in an episode.

I really wish the best for you, and that you're able to get your symptoms resolved promptly. Whether that is meds, therapy, or whatever else you need - I can't say which. It is clear, however, that you're struggling with something, and the real route that has worked for me is to go through the medical system. There are people out there who are ready and willing to help, and it's incumbent on us to ask for the help.

[Theresa1991]

Thank you so much for that very helpful answer!

I would like to try meds but still they won't give me any. They say that there is something not quite typical about bipolar in me. I am not sure what they mean, I think it is about the length of my episodes. I have been hypo for two months before getting this cold and I think it can be a usual length for an episode but my t said I was changing so "fast". Anyway, they won't give me any other dx, so we stick to - a little bipolar but not completely.

You may be right about me downplaying my symptoms, especially drugs, alcohol and hypersexuality. On the one hand, I want them to know, so they can help me. On the other hand I feel very ashamed of some things that I came to do when I was feeling hypo. I do show all the major signs of hypomania and I was underlining strongly the racing thoughts because they are what makes me suffer most. They have not seen me depressed yet, though, and honestly I don't hope they will very soon. When I got there the first time I'd say I was probably mixed though and my t also confirmed I appeared very different now. Let's see what she says next week when I appear anxious instead of "oh my god all the plans I made for my perfect life". Anyway, it is like an automatism that I seem to hold down all the strange things I experience as soon as I am in front of a therapist. Like something in me was shutting down and saying: No, you are not gonna show this part of you.

[bioChE]

I know exactly how you feel. In those times in front of a therapist or doc, it's natural to want to put on the best face you can - just like you would for anyone else you respect and/or feel is in a position of authority.

I'm not sure when it happened, but at some point over the last 20 years of dealing with MH issues, I was able to open up to my docs. It might have been me just not giving a crap about what they thought of me, but I became totally transparent with them. Today I have no trouble expressing the reality of my experiences. They know all the dirt, my history of addiction, hypersexuality, depression, and psychotic mania. They also realize that I'm a high-functioning father, husband, and engineer. There's a lot of my life that looks good from the outside in, but from the inside out at times it's rotten to the core. Working with my docs today is a very efficient thing. We've established that there are mood, ADHD, and addiction issues. Knowing that, we can work on a path forward rather than skirting around issues.

One thing to realize about doctors and therapists is that they've heard it all before. They're trained to have experience in most all areas, and you're not going to shock them with anything you've done. They're just waiting for you to open up and show the real you. Put it this way - if you were really able to handle life on your own, you wouldn't be in their offices in the first place.

Regarding the length of your episodes, it's not uncommon to be in a hypomania state for months. My diagnosis is rapid-cycling, as defined by four or more episodes in a year. It's certainly possible to be ultra-rapid cycling and switch moods faster than that.

I have no clue if you're bipolar, cyclothymic, or anything else. It's not clear if your episodes are caused or related to alcohol or substance use, either. I know when I'm not completely sober that my moods are incredibly more complicated and almost impossible to separate from the substances. I seek highs, and seek ways to get myself out of lows. In the past I've self-medicated all over the spectrum, including abusing meds I've been prescribed. At present I think I have a handle on that since I've not done it for almost two years, but it's always a danger and if I slip back into it then it's guaranteed to cause more problems than it solves.

Good luck with your therapist next week. My suggestion would be to be brutally honest, even disclosing the things that you're not comfortable with. That's the quickest route to getting help.

[Theresa1991]

How do you open up to your docs? My t said she had a strange feeling with me, like I was telling all the things that happened to me, but in a very calm way, like it was a third person they were happening to. I don't know how to open up. I think I am mostly telling the facts, but I am just saying and not showing how I feel.

I say: Well, yes, I was hypersexual and been with x people in that week, and yes I had a strong crave for taking drugs, and yes, I slept only x hours and I have racing thoughts that I cannot control.

But she says I seem so calm while saying that that it does not quite fit bipolar. Well, maybe I seem calm, but I am definitely not. I feel like I am hiding from each and every person. I wish they could see into my head.

I just don't know what opening up means: Shall I break into tears? And if I get drained completely the second that I say hi to my doc, how do I do that?

I want to open up and to be helped. Totally. I just don't want to start faking feelings to get meds and I don't know HOW to open up and really show what's going on within me. It feels impossile. Never learned it, I guess.

[Theresa1991]

Concerning the self-medicating - definitely been there. Now trying to get a grip on it. Not easy. I drink less and quit any kinds of drugs, but I keep smoking which I strongly want to quit too. Right now anyways it feels impossible with all the pressure I am under.

I know that my moods get more complicated when drinking, so I try to stick to my rules - like having a drink on weekends is fine, but not during the week. I get by so so. Sometimes the noise in my head is just unbearable and I don't make it through, moreover when I cannot sleep. Anyway, I think I am slowly climbing the ladder here. I tend to go from hypomanic to mixed when drinking and from depressed to more depressed. For a few hours though it seems to relieve the pressure and that's why I have ended up there time and time again in the first place.

[bioChE]

If you want to open up to your docs, I'd suggest you find some of your relevant posts from here and print them. Take them to your appointments and let the docs read them for themselves. I think you've done a really good job of opening up to us on here, and it might be more stuff than you've been able to remember while talking in your appointments - or maybe it's said in a different way while you have been "in the moment." It provides perspectives they may not otherwise see when you're in their office.

It's not a big deal to cry in front of your therapist or psychiatrist. I've done it. I seldom cry, but there have been times I've been overcome by emotion while discussing things that were difficult for me to say.

Nobody is going to think you're faking emotions to get meds. The determination of whether or not to medicate you is 100% up to the doctor's discretion. Besides, psych meds aren't fun....they're merely better than the alternative most times.

Again, if you're not getting the help you need then it could be worthwhile to seek a second opinion from another doctor. Different docs have different approaches to treatment and medication, and there's a chance someone else could shed more light on your situation or be a better fit for you personally. It's good that they're being careful about not jumping to a diagnosis, but there is also a felt need for something different than you're getting now.

Your explanation of the self-medication is very familiar, it coincides with a lot of my personal experience. It's not necessarily out of a desire to just get blasted, but out of a desire to feel _somehow_ different than you do normally. Besides meds, that's the only way I know how to relieve the pain and emotional suffering I go through almost all of the time. You're right that it's not easy to control drinking when you're doing it for an emotional release.

I never learned how to express emotions rationally either. At least when I was around your age. Maybe at 41 I've just been through so much psych treatment that I know how to talk about things more openly than I used to. Your docs won't judge you for however you act in their sessions - they've already formed opinions by meeting with you thus far.

One thing I find helpful when meeting with my doc is to take a notebook to my sessions. When I'm sitting in the waiting room, I take a few minutes to review in my head how I've been feeling since the last time we met. I jot down a few notes about the thoughts that come to mind; nothing extensive, but something to refer to and anchor the conversations we have when sitting face to face. If I don't write things down, I have no direction for the conversation and often forget things until after we meet - then I have to wait another month to talk about them, if at all. I'm not good at journaling, I never have been. But taking a couple quiet minutes before a meeting pays off in a huge way.