[OliverB]

I read my medical report from 2 years ago: depressive symptoms without meeting the criteria for a depressive episode. I usually got anxious-agitated depression, I felt really sad, I felt I shouldn't be alive, but I could't sleep, cannot rest, end up studying a lot and becoming extremelly irritable to the point of wanting to kill everyone (I was IP many times for few days while in that mental state, but they didnt diagnose me with anything. I was given depakine which took me out of that state but made me feel like a zombie, so I stopped taking It after a week). A year ago I had a normal depressive episode.

Rigth now and since many weeks, I feel full of energy, thoughts and feelings. I feel I can run forever, but after so many weeks I am starting to feel tired and irritable while I cannot rest. I do not feel depressed, I feel as if I had taken meth. If you looked at me rigth now, you would think I am normal. I am not doing anything crazy. I do not look ill. I have managed to sleep by taking xanax and prazosin and I feel less agitated that a couples of days ago. Still, I feel this highness is not normal, my body is screaming for rest.

I do not know what to think. I am not doing anything crazy or severe. I look normal, I am working, my professors are happy with me , my coworkers too (They have told me I look a bit high and have asked me to speak not so fast, but it was a "dude I want to take the same thing you do lolz").

Possible trigger:

It only gets dangeeous when i sleep too little and I begin to get SUI urges. It is horrible to be so tired and unable to sleep and so full of thoughts

I have an appointment with my therapist in a week and half. I plan to tell him all of these but I am worry he will think I am faking it. I mean, I doubt it is severe enough to be bipolar, I am more likely just cyclothimic or anxiety. I went to a new pdoc at the end of december but it ended up pretty bad. I

[Sometimes psychotic]

From what I recall you also get psychosis...this could easily indicate bipolar...however as you know we aren’t doctors here.

[OliverB]

Originally Posted by Sometimes psychotic

From what I recall you also get psychosis...this could easily indicate bipolar...however as you know we aren’t doctors here.

Yeah, on the medical report there was the same than for depression: psychotic symptoms without meeting the criteria for schizophrenia.

I often feel like it is not bad enough or that MH professionals will think I am lying so I do not tell them a lot of things that could be important.

I am much more worried about them thinking I am lying rather than about the diagnosis...

[OliverB]

Oh, it could be all due to PTSD. I am not lying about it, It is on my records. I have been doing really well with PTSD related problems. Sometimes I think my anxiety has mutated into depression, because I am anxious only about making severe mistakes and MH professionals thinking I am lying, but not about anything else.

Obviously not a doctor here, but if you have been to IP multiple times in this mental state you describe and the doctors did not diagnose you with bipolar during any of those IP stays, then either (A) you don't have bipolar, or (B) you may have intentionally or unintentionally withheld information from doctors that they would need in order to diagnose you with bipolar. But if you have had multiple "evaluations" in an IP setting and doctors STILL don't want to diagnose you with bipolar, I would personally think no to the Dx. I mean, I could be wrong, but if you have felt this way multiple times and each time they've said no to bipolar despite observing you in a controlled setting for days at a time, they must have their reasons? But if you are hiding things from them, then it's certainly possible you have bipolar and it's going unnoticed. So it depends on how open you've been with mental health professionals.

Also, there is such a thing as MDD w/ anxious features and MDD w/ psychotic features. And PTSD, as you say, can definitely mimic bipolar in a lot of ways.

[Sometimes psychotic]

I’m not so sure, it takes a manic episode to be bipolar and this could be the first one you’ve experienced...just thinking....but as you said it could be ptsd.

[*Beth*]

Well...all I can say is that I generally feel the same way you've described. I have expressed doubts about my BP dx many, many times. I've told my pdoc that while I do get "high" (emotionally), the euphoria turns to irritability-to-anger and easily slips into rage - I am not one to do "reckless" things. I have a history of being responsible and reliable, not reckless.

No one would know right off that I'm experiencing mania; depression...maybe, but probably not. I have some beliefs I can't quite keep straight, pdoc says they're paranoia. Whether those beliefs are paranoia or PTSD...?? Who knows.

I constantly question the information I've given to my pdoc. Maybe she misunderstood me, maybe I didn't explain well, maybe this, or maybe it's that.

When all is said and done my dx is BP1, but my pdoc is always quick to remind me that I also have CPTSD from traumas that occurred between ages 5 and 51.

Perhaps it's what I frequently hear - that it isn't so much about the diagnosis, but more about which treatment works.


Oh - something else I'll mention. In your original post, what you've described could be a mixed state. Not fun.

[Nammu]

I agree with bluebicyle if you've been ip multiple times and not diganois BP it's is unlikely.

[bpcyclist]

Every poster has given you outstanding information, in my opinion. That said, hear me loud and clear. I am not judging you. Not judging at all. But, if you have for whatever reasons withheld information from your care teams, then, in my opinion, all your previous diagnoses are suspect and you need to start all over. This is just my take and others may disagree. But that's how I feel about your story. Just listening to what is happening now, I am getting a major bipolar 1 vibe. Irritaility and agitation are textbook bp 1 symptoms, by the way. People just don't talk about it. Again, this is all just me and everyone else's mileage of course can vary.

I think you need to tell you psychiatrist you have held back important information and you want to disclose it now. Tell he everything, even if you think it won't matter. It might be critical to her. Don't worry about her thinking you are lying. She takes care of people with these stories for a living, all day long, every day. Just tell her what is going on. Then, I think you can start to get some traction here.

I hope you can sleep a little tonight.

[*Beth*]

^^^ I agree. Without the proper symptoms and information the dx will be questionable, to say the least.


As far as your provider thinking you're lying, it's like bpcyclist says...that's their job. Plenty of times I've told my pdoc something and she'll say, "Why didn't you tell me this before?! It's important!" I do feel embarrassed, but there are things I forget to tell her...until I remember.

[~Christina]

Have you gone to the same IP each time? I know mine always reviews my previous stays.. If you have been numerous places someone might miss the “ episode” or “ shifts” like Blue mentioned, maybe you didn’t share everything you were feeling by choice or your brain just didn’t let you go there.

You don’t have to be “ manic” like you see on TV ads. Buying stuff or enjoying a glorious shiny world where you “ hear” colors because they are so vivid

My “Mania” is ugly , dark , rage-y , I loath myself, I hate myself

PTSD can mimic BP symptoms in many ways..

You have posted here in what I thought a psychotic state but I’m no Doctor.

[OliverB]

Originally Posted by bluebicycle

Obviously not a doctor here, but if you have been to IP multiple times in this mental state you describe and the doctors did not diagnose you with bipolar during any of those IP stays, then either (A) you don't have bipolar, or (B) you may have intentionally or unintentionally withheld information from doctors that they would need in order to diagnose you with bipolar. But if you have had multiple "evaluations" in an IP setting and doctors STILL don't want to diagnose you with bipolar, I would personally think no to the Dx. I mean, I could be wrong, but if you have felt this way multiple times and each time they've said no to bipolar despite observing you in a controlled setting for days at a time, they must have their reasons? But if you are hiding things from them, then it's certainly possible you have bipolar and it's going unnoticed. So it depends on how open you've been with mental health professionals.

Also, there is such a thing as MDD w/ anxious features and MDD w/ psychotic features. And PTSD, as you say, can definitely mimic bipolar in a lot of ways.

Those IP stays were really unhelpful, I even left one of them without the pdoc consent. They didnt diagnosed me with anything beyond a copy-paste from past issues (psychotic disorder nos, anxiety nos, mood disorder nos, schyzotypal,...). Of course I didnt tell then anything since they were treating me so poorly!

After these IP incidents my now former pdoc decided to try depakine. He was the one that two years ago wrote that I didnt have a depressive episode even if I showed depressive symptoms, but just a year ago he said I was having a depressive episode (???). I was sincere when he told me I was having a depressive episode (and we tried a low dose of a tricyclic antidepressant... SSRI cause me mania, which in the past ment I was given a huge dose of seroquel that made me gain like 80lbs). Yeah, I know I tend to hide a lot of things, for me it is not easily to open Up after so many bad experiences.

My therapist seems to agree to the PTSD but he seems to think there is something else going on. I am afraid of telling these things I have told you in my first post.

[sarahsweets]

I'm not sure any doctor could diagnose you with anything if you withhold information from them. What prompted your IP stays?

[OliverB]

Originally Posted by sarahsweets

I'm not sure any doctor could diagnose you with anything if you withhold information from them. What prompted your IP stays?

I had the most horrible irritability you can imagine, I just wanted everyone from the Earth to dissapear. I couldnt sleep at all, I couldnt rest even taking benzos. I was thinking on ending it just because I couldnt stand anymore that agitation. I was taking a massive dosage of Klonipin (clonazepam) while trying to control it (to the point my pdoc got scared when he found I was taking up to 15-20mg a day). Gabapentin/Pregabalin calmed me a bit but not really much. I was like this for maybe 3 months until my pdoc gave me depakine.

I doubt I told the IP pdocs about how I felt, I guess they just saw me angry and half sedated from klonopil/Gabapentin/Pregabalin. Actually, nowadays for me it is really hard to understand how I could be awake while taking that amount of meds, last nigth I took 0.25mg of xanax and I have slept 7h (I woke up at 4:30 and at 6:00, but I could keep sleeping... Thanks to xanax, of course).

I haven't really thought about it, actually for some reason I thougth they could notice your MI without you saying really much anything. I guess that is why I got many whatever-NOS instead of a more specific diagnosis (beyond PTSD that is the only thing I have told them in details).

[OliverB]

My therapist (I have only see him once) asked me about all those IP stays, I told him I couldnt sleep and I was going out of control mainly from it. I didn't tell him about the irritability.... And I don't remember more about it since I was taking too much benzos...

(It was the same place I was IP)

[OliverB]

I guess I just do not want to be told I am depressed/psychotic/bipolar/whatever and need meds since they cause me really bad side effects that prevent me of having a normal life.

I would like to be normal. Med free...

[FluffyDinosaur]

All I can say is what you're describing sounds very similar to some of my own experiences. What you call agitated depression sounds similar to the symptoms I get during mixed episodes, and the hypomanic symptoms you describe are recognizable to me as well. When I was first learning to recognize my symptoms I found this table to be useful because it contains (to me) very recognizable descriptions: https://www.psychiatrictimes.com/sit...PSY0918_07.jpg .


Even the fear that you're somehow "faking it" or exaggerating is something I've struggled with, and still do sometimes between episodes (the doubt usually quickly disappears when I'm in the middle of an episode). I'm diagnosed bipolar 2. If you've withheld information then your previous diagnoses may well be inaccurate. Based on what you've described I definitely would not rule out bipolar.

[*Beth*]

Wait a minute...it sounds like the turmoil you're feeling comes down to not wanting to take meds. Understandable...who does want to take meds? Probably not a single person on this entire forum. Ultimately, the choice is yours, not your pdoc or anyone else.

[FluffyDinosaur]

Originally Posted by BethRags

Wait a minute...it sounds like the turmoil you're feeling comes down to not wanting to take meds. Understandable...who does want to take meds? Probably not a single person on this entire forum. Ultimately, the choice is yours, not your pdoc or anyone else.

Good point, and that's very understandable. I'm dreading the (especially long-term) side effects as well. For what it's worth, my pdoc is very open to letting me take part in the decisions as to which meds I take, or even to try without meds (while being monitored) if I want and I think my life is stable enough. It's not perfect and I don't think side effects are completely avoidable, but at least for me I'm not forced to take any meds I don't want and (at least while I'm not a danger to anyone) I'm free to partake in the decision as to which is worse, the bipolar or the "cure." I guess what I'm trying to say is that getting an accurate diagnosis doesn't automatically mean you'll be completely at your pdoc's mercy when it comes to meds.

Originally Posted by OliverB

I guess I just do not want to be told I am depressed/psychotic/bipolar/whatever and need meds since they cause me really bad side effects that prevent me of having a normal life.

I would like to be normal. Med free...

Like BethRags said, you get to decide if you want meds or not. If someone tells you that you "need" meds, then that's their opinion and you can do whatever you want with their opinion (unless you've gotten into legal trouble and you are legally required to take meds, as that's a very different situation).

I don't see the harm in being honest and open with someone if it gets you the help you need. Plus, meds aren't the only treatment available. You can do therapy and be med free if that's what you desire. There are people on this forum right now who aren't on meds and they are content. So in that respect, I don't think it would hurt to get a diagnostic opinion. In fact, a proper diagnosis can help you understand yourself better. I'm not saying that a concrete diagnosis is "necessary" to get proper treatment, because the end goal is to treat the symptoms, not the label, but understanding yourself and your brain chemistry can be a powerful coping mechanism on its own. And since you're asking us if you have bipolar, I think you're actually seeking a concrete diagnosis because you feel it's important. So, why not be open and honest so that you can be confident that you do or don't have something? (I know opinions aren't perfect, but you see what I mean.)

[OliverB]

I am afraid it is bipolar because many pdoc would try to force meds if it is the case. I know the theory: if you are not harming yourself or others, they cannot force you to take meds. But there are so many bad pdocs that would force you anyway... Once I was IP I was told if I didnt take abilify, they wouldn't release me
I told that pdoc I had taken it in the past and It made me feel awful but he didn't care and forced me to take it. Thats why I do not want them to think I am bipolar/psychotic.... (Them=pdocs). I am going to try to tell everything to my therapist (a clinical psychologist) so he can understand it and help me (I have had a good experience with him)

[bpcyclist]

Just to be clear, if you live in the United States, it is very likely that your refusal at inpatient to take meds could only be overriden by a court hearing. Med Court. And once there, patients do win those cases. I know two who did. The judge didn't agree with the state and the patients went on about their merry way off meds. So, if you want to refuse, just be up front about it with everyone and say you refuse. Then, you can see where it goes.

[*Beth*]

I do want to point out that being IP is not the same as just being the patient of a pdoc. No outpatient pdoc can actually force a patient to take meds. They can suggest a medication(s), but they cannot make you take it against your will.

Originally Posted by BethRags

I do want to point out that being IP is not the same as just being the patient of a pdoc. No outpatient pdoc can actually force a patient to take meds. They can suggest a medication(s), but they cannot make you take it against your will.

I think it depends on the country you're in, though, and the country's laws. I have a friend on here (U.S.) who was forced to take meds even when they were not in IP. It was a court order -- I think called an involuntary commitment. They do it if you have a history of being involuntarily committed to IP and refuse to take the meds after being discharged. So basically, it's their way of keeping you out of IP because they know you will just end up in IP again and again and again as long as you continue to refuse meds. That's typically when you're forced into getting injections or forced into having someone watch you take your meds. (Yes, they literally do have people come to your house to watch you take your meds. I'm not lying. That's what happened to my friend.)

[*Beth*]

Originally Posted by bluebicycle

I think it depends on the country you're in, though, and the country's laws. I have a friend on here (U.S.) who was forced to take meds even when they were not in IP. It was a court order -- I think called an involuntary commitment. They do it if you have a history of being involuntarily committed to IP and refuse to take the meds after being discharged. So basically, it's their way of keeping you out of IP because they know you will just end up in IP again and again and again as long as you continue to refuse meds. That's typically when you're forced into getting injections or forced into having someone watch you take your meds. (Yes, they literally do have people come to your house to watch you take your meds. I'm not lying. That's what happened to my friend.)

Yes, you are correct, blue. I had forgotten.