Undergoing diagnostic evaluation for bipolar disorder--advice needed!

Hi everyone,

My therapist has recently been concerned that I might have bipolar disorder. She said I have something called rapid cycling. I've been referred to a local psychiatrist for evaluation, however my appointment is a long way off. I wanted to get some feedback from you about my symptoms. I understand that this is in no way a diagnosis or professional medical advice. I just need people who understand this disorder to give me feedback.

For as long as I can remember I've had these periods I've termed phases. Each phase is centered around a specific interest--more like obsession, really. I become obsessively interested in a specific topic for a period of time and then the phase ends and the interest ends completely or wanes. The phase starts with increased optimism and always a feeling that I've finally found my purpose in life. That optimism wanes as the phase progresses. I also always believe that my current obsession will lead to big things. Becoming a famous blogger, a new career path, psychic abilities. Then the phase ends and I'm back to square one. I become irritable and anxiety-ridden when anyone tries to distract me from my current obsession. I spent an entire vacation on my computer instead of outside enjoying my trip.

While I'm in a "phase" I have horrible insomnia. I will sleep less than 5 hrs per night on average. In the spring, I went 3 weeks sleeping only 2 hrs/night. It was brutal. I don't wake up well-rested though. I'm exhausted and then become wired again mid-day-evening. In the phase I also have racing thoughts and elevated heart rate. I become distracted and can't engage in favorite activities like reading. I can only focus on my current obsession. Basically I feel like I'm on speed. Like I've downed 20 caffeine pills or snorted cocaine. In the phase I end up doing things I wouldn't normally do, stealing, maxing out credit cards, converting religions, etc. It's ruining my life.

When the phase ends, it's like I finally have sobered up after being drunk. I look around and see the devastation I've caused--most often to my finances--and deeply regret my actions. But I can't stop these phases. I've tried. It's like I'm powerless against them. There's a small part of my brain that tries to rationalize my behavior, but it's overshadowed by this monster.

The phase ends and I either feel normal for a 2-week period or alternate to depression. I've been treated for depression since I was 18. I'm 37 now. My "phases" have begun to worsen with age to the point where they're seriously interfering with my work, marriage, family, and friends. I used to like these phases because they were the opposite of my depression. I thought this phases were what other people experience as happiness. After my depression, they're such a relief. But now, these phases are destroying everything.

I've been reading about bipolar disorder but manic episodes (and hypomanic episodes) seem more severe than what I'm experiencing. I have insomnia, but don't feel energized when I wake. I have optimism, but not euphoria. No hallucinations or delusions either. No increased sensory perception. I realize that bipolar is a spectrum and everyone is different. But from what I'm describing, does it sound familiar? Does it sound like bipolar disorder?

Thanks in advance!

Yes it does. I think everyone or almost everyone here feels "We're not that bad" "We hardly fit the Dx" In truth we don't see how "bad" things are for ourselves. I'm glad you're going to see a psychiatrist.

It absolutely does sound like bipolar. I'm 5 years from diagnosis when I'm finally accepting it and 5 years in therapy when I see how much it affects relationships etc. in my life. Take small steps to learn about yourself and continue therapy to learn about ways to help yourself deal with these wawes.

Your phases sound like hypomania, I have been diagnosed for 15 years and i can relate to a lot of what you said. I am glad your going to a pdoc...there is relief but it does take patience. Best of luck to you and hang in there!

Check out PsychEducation | Treating the Mood Spectrum It has a huge amount of information written by a psychiatrist who specializes in bipolar. It discusses mania and hypomania. If you have just hypomania that might be why you feel mania doesn't fit. A therapist and psychiatrist (pdoc on here) are great starts.

You seem to have a lot of insight. I agree that researching bipolar is logical, but try to avoid retrofitting your life experiences to fit a diagnosis; I've done this, and it's very tempting. Bipolar disorder is interesting, really, and psychiatrists find it interesting, too. Reading about it can be compelling.

Also, being knowledgeable about psychiatric and pharmacologic terminology is useful but can also get in the way of meaningful dialogue with your psychiatrist. For instance, s/he may ask, "Do you ever see/smell/hear things that aren't there?", and your response is, "My visual, olfactory and auditory hallucinations only occur in the context of my psychotic episodes while in a manic phase." Or the pdoc wants to talk about meds, and you respond, "Yes, I agree that an SSRI would be a reasonable approach to my bipolar and clearly indicated, but current research suggests that it might precipitate a switch, so I would appreciate your balancing that out with a mood stabilizer and a weight-neutral antipsychotic. I would prefer to utilize a short half-life benzodiazepine for anxiety, recognizing the risks of dependence and withdrawal syndromes."

Obviously, I'm exaggerating. Most of us are pretty bright, so it's hard to appreciate (for me, at least) that my pdoc may be way ahead of me. OTOH, there are bad pdocs, too, so you want to be able to recognize that.

BP is on a continuum and is not the same for everybody. As long as these phases last a minimum of two weeks they would fit with symptoms of BP.

The phases range in time. Never less than 2 weeks. Sometimes they're 1-3 months. Of course, the phase changes during that period. It isn't as intense toward the end. The insomnia calms, heart rate slows, etc. I rejoin society--meaning I stop isolating myself. But then depression sort of starts creeping in. Or I become "normal" for 1-2 weeks before depression or another phase.

I used to like these phases but they're becoming increasingly destructive. I'm taking bigger and bigger risks. Maxing out credit cards, converting religions. That sort of self-destructive behavior has increased over the years.

I talked to my parents about this evaluation. I've had these "phases" as long as they can remember. To them, it's my normal behavior. But I didn't start having the associated insomnia, increased heart rate, wired feeling until after I lived with them. I've done a pretty good job shielding them from my more intense behavior. They don't live in the same state most of the year, so they don't witness my behavior first-hand. I'm on my "best" behavior around them. My husband gets the brunt of it. He sees the full spectrum.

It's the insomnia & elevated mood that are the reasons I question my therapist's belief that I'm somewhere on the bipolar spectrum. Yes, in the beginning-middle of a phase, I become unable to sleep. Sometimes I get no sleep, sometimes 2 hrs a night. Never more than 5. But I'm not exactly well-rested when I get up as literature describes. I'm often exhausted upon awakening then mid-day become wired again. My body is tired though. It's like taking a bunch of caffeine pills. You feel tired underneath but you're so wired your mind won't sit still. Thoughts will race. It's hard to describe. I don't wake up energized though.

And while I'm in a better mood and the beginning of a phase, I wouldn't call in euphoric. More optimistic is probably a better descriptor. No delusions, etc. And I don't pace or anything like that.

Thanks everyone thus far for the feedback. I'm trying to wrap my head around everything. It definitely feels like something is not right with me--in addition to the depression/anxiety--but I'm not certain what it is. There's definitely the feeling of cycles though.

Hello starshinelady. Welcome to PC Bipolar sub-forum.

I have had the same experiences. Even the stealing, lol. since I'm lucky, I've never being caught.
I haven't done it in the lasts few years do to tech changing faster that I can learn. But it's fun.
The item is not important, most, I give away or lose. It's the thrill of the challenge.

I go thru the same cycles with interests. Only now, I know the fever will come back, and I don't get rid of stuff anymore.
Electronics, yes, they become obsolete with time. Now, guns, coins and stamps, don't bother me much. I know one day, I'll wake up wanting them.

If going thru this cycles makes a bipolar, I must be one.

However, deep depression needs distraction too. And that's what they are for me.
Distractions. And if bought at auction, all the better.

Good luck with your appointment. Cheers.

This statement caught my eye. I guess I thought that everyone is at some point on the bipolar continuum...like maybe people who don't suffer with any MI at all would be "not at all bipolar." Perhaps a spectrum would be:

Not at all bipolar-----Kinda bipolar-----A lot bipolar-----Nothing but bipolar

So, while your therapist suggests that you might be on the spectrum, s/he could mean that you're quite high on the spectrum, if not at the highest level. So I don't interpret the spectrum as minimizing your symptoms at all. In my mind, this is kind of interesting because I think that the degrees of bipolarity are overlapping and not exclusive. Maybe people should be diagnosed only as "Bipolar," with a specifier, "Currently a lot." I'm being a little silly now.

But seriously, the spectrum concept is a little confusing. If it's true, then a person shouldn't really have a fixed diagnosis at all because it changes. For instance, right now I consider myself to be quite well recovered. Just kidding (well not really...).

Sorry I am in a hurry and haven't read the previous replies to this post, so I'm sorry if what I say is repetitive. BP is one of those diseases where symptoms vary person to person. I'm not sure I believe it is on a continuum, but I do believe certain BP people get certain symptoms more often or even at all than others, and there are people whe are BP who never experience certain of the BP symptoms. I was diagnosed with major depression over 10 years (no pdoc has told me, but I suspect I'm bipolar II, a type often misdiagnosed as major depression, really need to ask my pdoc). I never really complained or got help when I was hypo unless I was not sleeping. I really don't like not sleeping even if hypomanic or manic. As for if I was manic, spending money left & right or having sex with strange men or masturbing for hours (thank God I don't sleep around since I've been married, I would never cheat on my husband, it's just not how I was raised and my moral compass is so against it), I was so embarrassed about my lack of control over finances, and my sexual behavior, I never mentioned it to pdocs. I mainly went to pdocs to get meds to help for depression (ended up on lots of SSRIs, pretty much if it was out there, I tried it, they often promoted manic symptoms, like extreme overexercise due to my eating disorder). Now, I think being on SSRIs for so many years has rewired my brain permanently. I have no proof of this, but I really feel this it the case.

Getting the right diagnosis sooner is more helpful, in my opinion, helps the meds work better (though meds are by no means a cure-all, often they are not, but sometimes they will at least help some.

Getting evaluated (especially by a good pdoc, many have ratings online, often with patient responses, read them first! Get on a waiting list - often long - for a highly rated pdoc, especially if one of the things he/she treats is bipolar. In the meantime, see a so-so pdoc if you have to. Best of luck to you.

Often a therapist knows good pdocs in the area; ask for recommendations there because bad pdocs are a dime a dozen. Sometimes too, therapists can shorten the line to get you in to see a good pdoc, depending on the therapist.

I feel my bipolar is up one day and down the next... could it be the meds... or do I need a change in meds... I am really trying to figure out this forum... I would love some help

—-you definitely need to be screened for bipolar. I’ve been bp2 mixed for more years than I would like to say. Many people walk around not knowing they have this. So on the upside here is your opportunity to get some help. Take what you have written here. They are using 15 minute sessions now and it will take them too long to know you if you start cold. You wrote a very sophisticated analysis here. It will help them a lot. Maybe you should go into behavioral health! But please don’t avoid going . To me, the rapid cycling is the biggest clue, and it’s so uncomfortable. Hugs!