[Rapunzel]

Today my T said he thinks I am likely to be a true bipolar even though I don't get manic. He's suggested before that I might be bipolar but I said I didn't think so. Now he's saying that my depressions are just like the deep depressions that are seen in bipolar disorder, even though my highs only approach normal. What do you think? Oh, and he wants me to get on medication. If what he says is right, how does that affect meds?


<font color=green>"Loneliness does not come from having no people about one, but from being unable to communicate the things that seem important to oneself, or from holding certain views which others find inadmissible" Carl Jung</font color=green>

[darkeyes]

Yes, people with a mild degree or level of bipolar can still be bipolar with no obvious manic like behaviours, and it can even be misdiagnosed as just depression sometimes. Bipolar is not a black and white thing, you'd be surprised of all the variations and intensities.
Meds affect is the attempt for stabilization of moods, preventing mood swings, in cases where there are often pretty dramatic swings that can interfer with daily functioning, relationships, etc. There is so much more I can share with you but wouldn't want to bore you or anything like that.
I do not get "manic highs", I am bipolar-II(mild) and mainly suffer the longest with deep dangerous depression, so being the AD's no longer work I have been on a stabilizer (anti-convulsant) called Lamictal (Lamotrogine) which is used for bipolars who have depressions more than mania and only for mild mania is what it is most effective for, this is what I read in several books, journals by the Psychiatry Assoc., and internet so do not quoate me on it, ha!ha!
Take care,
"darkeyes"

In giving advice seek to help, not please your friend
SOLON

[Rapunzel]

Darkeyes,

Thanks for your response. If you have more to share, it wouldn't bore me at all. I don't know if my T is right about that - he says he can't say for sure anyway, but I suppose it's possible.

<font color=green>"Loneliness does not come from having no people about one, but from being unable to communicate the things that seem important to oneself, or from holding certain views which others find inadmissible" Carl Jung</font color=green>

[lalo53]

Hey Punzee,
My shrink told me it doesn't matter what the diagnosis is, as long as the treatment is working.
Bye,
Ziggy

[FearsomeAnna]

Rapunzel,

People can be truly bipolar without the stereotypical manic behaviors seen in some cases (like mine - bad voices, no no! ).

What you see in bipolars is mood cycling - crushing, horrid depression followed by, something different, and then something closer to "normal" and then back again. What you may have been experiencing is closer to what is called "mixed moods", which is linked to people getting involved in self destructive behaviors like SI, attempted suicide, etc. This is because you have both the symptoms of depression and mild mania at the same time - i.e., you wouldn't be exhibiting manic behavior per se, but you'd have a noticible spike in energy or motivation, but still the despair and sadness and emptiness of depression. Needless to say, this is a highly dangerous period to be in.

I agree with your pdoc that new meds are the way to go - you wouldn't need an antipsychotic like Zyprexa or Risperdal, but more likely than not a mood stabilizer such as Lamictal or Depakote - in addition to your AD.

Sometimes the mood swings are worse than the depression itself - it's so unpredictable and you can be feeling ok one minute and like total crap the next and then very "blah" and so on and so forth. The mood stabilizer would help get rid of all this swinging around and at least get you back on to a continuous spectrum. It's much easier to feel like you're making progress when you're not zipping all over the place but can see clear improvement from one day, week or month to the next.

some of it's magic
some of it's tragic
but i had a good life all the way......
~jimmy buffett

[sunstreamer]

Hi everyone!

Although I'm brand-new here (joined 2 or 3 days ago), I wanted to respond to Anna's saying (paraphrased) BP characteristically is about mood swings. In bipolar disorder - either I or II - (or any of the other designations; for instance, Hagop Akiskal here in San Diego put togeter an extensive BP taxonomy), the manic or hypomanic episode defines the disorder and depression's not necessary at all in order to get a dx of BP, though in any case very often the manias are mixed states or dysphoric manias.

Many persons with BP have a far more stable mood than a "normal" person; many people with a dx of bp live with a near-chronic high or low; I'm a BP II, NOS, "recurrent hypomania with no hx of major depression," though at times I become agitated and highly dysphoric, but always for extremely short times, as in maybe an hour or 2. I spend my days and sometimes my nights mildly manic and often highly productive. Also, though I've flunked all the med trials I've been on, for the most part I'm relatively reasonable and functional, despite living with a near-chronic high.

What I'm partly trying to explain is BP has a plethora of possible presentations and I think it's fair to say it rarely presents exactly identically in even 2 different persons. And, though the version of BP I live with has been quite predictable over the years, there's no reason for me to imagine it'll continue that way.

Hugs, everyone!
Marisol

[bptoo]

Hi Marisol, welcome to the forums! Your post was well thought out and I agree with it whole-heartedly!

I read an article awhile back that more and more Mental Health care professionals are dx'ing Bipolar as a catch-all when thay are having trouble coming up with a diagnosis for their patients. This is because Bipolar has such a broad range of symptoms that can fit into more than one type of depression. For instance, mania, while a staple of Bipolar, is also a symptom of Manic Depression and Borderline Personality Disorder. I wish I had saved this article, it was very interesting to say the least.

I look forward to hearing more from you on this subject, and to getting to know you better. This is a great place with truly wonderful people!

I'm glad you found us!

Greg



"Beauty is truth, truth is beauty - that is all you know on earth, and all you need to know"

[lenjan]

I spent a week in the funny farm in mid-Feb. My pdoc doesn't do inpatient, so I worked with a friend of his who does. After 6 years of being treated for recurrent major depression (plus PTSD and anxiety, but those are irrelevant at the moment :-), Doc Friend looked over my history, noticed that the meds I've responded to best have all been for bipolar, and came up with the idea that I might really be bipolar II.

I've tried to find info on this, but can't seem to find a lot. I'm on 2 AD's, Risperdal, which was originally prescribed to help with the self-injury and which I am now so habituated to that I ended up suicidal quickly after tapering off it, and Lamictal. I was interested to see that someone described the "feeling OK, then horribly crashing" phenomenon, as that's what I was doing daily before the Lamictal kicked in. I've also been on Depakote, which I couldn't tolerate at all, and Trileptal, for about a week, before I started finding bruises in places I didn't bump.

I'd love to hear others' experiences with this sort of thing, as I like to be an educated crazy person :-) so I can educate the non-medical people who have to deal with my badly wired brain on a regular basis (like my boss). If there are any good websites out there explaining bipolar II, could somebody point me toward those too?

Thanks

Candy

There used to be a real me, but I had it surgically removed. -- Peter Sellers

[shakes]

It is funny to see this posted because I have always wondered if I was bipolar. The T that I was seeing up at school told me that there was no way that I was bipolar because I did not have maniac episodes, but I always wondered.... My depression sways so much I am on a constant roller coaster. I can be sooo happy and then BAM for no reason I am so down I feel like I am being crushed by a truck and just feel the need to run and hide under my bed. This is the way I always am. I can never just be happy because then I usually come crashing down. My mood swings are so severe sometimes.
I do not know..it is probably not bipolar but I was just curious what others thought.

Jessica

<font color=blue> You are in this snowglobe. It is encovered in glass and secure. But one day someone comes and shakes the globe and the pieces go flying everywhere. Now they will eventually settle but they won't be the way they were before and they can never be that way again. </font color=blue>

[lenjan]

Jessica, you are describing me to a T. I could split the day in half with my moods. I'd be just fine in the morning, sailing right along, if not happy as a clam, at least neutral ..... and by lunchtime I'd be suicidal. The only thing that stopped it was a therapeutic dose of Lamictal (and before that, Depakote, which I got kept on even though I couldn't stand it).

Bipolar II, according to my pdoc, is "depression plus." You *don't* get the manic episodes like bipolar I -- you just get the severe depression, and the irritability, and the problems sleeping, all of which I had in spades before finding new life on a mood stabilizer.

Your T at school needs some more education, I think. Can you find a community clinic that will let you pay on a sliding scale? That's what I do because my insurance will only authorize 1 visit a MONTH with a T and that's about as useless as it gets. I see my T at this clinic twice a week and only pay $10 a session. I've made more progress in 5 months than I have in the last 5 years. It's worth a try.

Candy

There used to be a real me, but I had it surgically removed. -- Peter Sellers

[shakes]

Candybear,
I have been looking for one. I actually just secrued a part time job and will be getting a steady income so now I can really think about going. My only problem might be the fact that I still live with my parents. That might screw up the whole sliding scale thing.
Ill let you guys now.
It does feel better to know that I am not alone in feeling this way. Our symptoms are very much alike. Plus when my moods tend to get more severe I basically stop sleeping for weeks at a time. I almost feel as though the instability has gotten worse within the past few years. *Big sigh* I am having one of those days.

Jessica

<font color=blue> You are in this snowglobe. It is encovered in glass and secure. But one day someone comes and shakes the globe and the pieces go flying everywhere. Now they will eventually settle but they won't be the way they were before and they can never be that way again. </font color=blue>

[lenjan]

Jessica,

It is only in the last month or two that I have been able to sleep most nights without sleeping pills. My sleep has been a disaster for years. I notice too that when my moods are more intense, I have horrible insomnia.

Since my little excursion to the ha-ha house a few months ago for being actively suicidal, my pdoc refuses to give me Ativan anymore, which is the only thing that has ever helped me sleep. (Helped with the anxiety too.) But I seem to be managing it pretty much on my own now. I don't know what turned the corner.

I did learn one intriguing little tidbit from a psych nurse while I was in the hospital. She's done research on sleep, and told me that they've now discovered that caffeine has a rebound effect after 8 hours. So, if you drink a soda or a cup of coffee at 8 p.m., you're going to be wide awake at 4 a.m. I tested it out and darned if she wasn't right. Maybe stopping caffeine in the early afternoon would help some. I switched to decaf (a big deal for me -- I'm a serious caffeine addict!) in the afternoons and evenings, and now I sleep through the night.

Hope you find something that helps.

Candy

There used to be a real me, but I had it surgically removed. -- Peter Sellers

[shakes]

Grrrrr *laugh*
I love my caffeine...but I am prepared to make the sacrifice. I also believe my problem is that I do not have a steady sleep schedule. Sometimes Ill be in bed by 11 and others by 6 and then I can sleep until 10 in the morning or 3 in the afternoon. I really think it is screwing me up. Unfortunately it is one of those things that I have not been able to kick since college. It also does not help that I do not have a job in the morning that makes me get up early.

Jessica

<font color=blue> You are in this snowglobe. It is encovered in glass and secure. But one day someone comes and shakes the globe and the pieces go flying everywhere. Now they will eventually settle but they won't be the way they were before and they can never be that way again. </font color=blue>

[Leslie]

Dear Rap,

I have been told I am bipolar 2 . I do not get extreme highs but I do get extreme lows. My brother is also bipolar. He gets extreme manic highs which would last for days. I have questioned if i real am BP because I saw my brother with this since I was a child and I don't have the same symptoms. One thing that pointed doctors in this direction of being BP, was when I was on a large amount of paxil for depression and I was getting worse. I went into a deep depression which also had manic features. Couldn't sleep, racing thoughts, very irritable Ususally mood stabliziers help people with BP.

Take Care,
Leslie

[wi_fighter]

Wow! I think I have to look into BP II.

I too can go from being fine to wanting to just go away forever in a matter of hours. Usually it's triggered by something, though. I also wonder if I have adult ADD, and that causes part of my depression. It takes me 12 hours to do 6 hours worth of productive typing for my job. That leaves me no time to get out and socialize, and I'm burned out for the day before I hit my daily income goal. That leaves me with not enough money AND not enough time. All that leaves me tossing and turning in bed at night, wondering how I'm going to handle everything, then I realize I can't handle it and then sends me into a depression. And on and on.

Where do people like me turn? The ones who are too "rich" for reasonable sliding scale fees but too "poor" to cover them?

Nope, I wouldn't be BP II. I've never had a hypomanic episode. Probably more dysthymia. It seems to fit pretty well. Darn, and here I was hoping to fit in with the "cool" people of the forums.

[darkeyes]

Wow, this is similar to me, I have an older bro that is BP-I, but has been in "remission" (my own defination) for about 30 yrs. on Lithium
I was DXed as BP-II 5 years ago, I felt this DX may be way off, when I was thinking of what I saw, as a little girl growing up with a bro who was BP-I, back then just was called "manic-depression". He would get very violent manias, some started out mild, happy go lucky, then escalated to some really bad scenes
When I was DXed, I was going through some family and marital stuff and still feel my behavoiur mimicked BP, I too are more of a depressive, never what I would consider manic, unless when people finally find happiness they are considered manic. I've resolved myself to the fact, being a genetic thing, I will keep in touch with my pdoc/and maintnance meds. once menopause is over or near it, I'd like to be off meds. but stay in touch with pdoc to be sure I'm alright. Can't help it, but I am curious if my former psychologist's DX of me, influenced my former pdoc's final opinion/DX.
Sorry, I just had to talk to you, found it something that someone has or had a similar feeling about their DX and wow, coincedence (sp?), of a bro with BP-I, and their sister(s) like me, get DXed BP-II (mild).
Thanks for letting me, ramble.

Sincerely,
DE

[dogtanian]

</font><blockquote><div id="quote"><font class="small">Quote:</font>
Rapunzel, "mixed moods", which is linked to people getting involved in self destructive behaviors like SI, attempted suicide, etc. This is because you have both the symptoms of depression and mild mania at the same time - i.e., you wouldn't be exhibiting manic behavior per se, but you'd have a noticible spike in energy or motivation, but still the despair and sadness and emptiness of depression. Needless to say, this is a highly dangerous period to be in.

</div></font></blockquote><font class="post">

i get that most often i think. i had to tell my t and pdoc years ago i thought i was bipolar. when i was at school i had major depression including extreme lethargy but i would have periods almost every day of extreme aggression where i would be violent and generally horrible. the gp at the time gave me ad's which made me go totally off on one - i almost killed a teacher (!!) - so they took me off them again, the gp said it may be bipolar but since i was only in my teens she said it was more likely to be "teenage angst" - hmm i've never seen teenage angst like that! anyway i ended up being treated for alcohol and si addiction, and "depression" and it took me to work out what it really was. i told my t and he put me to a p who confirmed it almost immediately. it makes me so angry that no one worked it out before - after all it's their jobs!!!

but in a way i can understand it, because - how often do you go to the gp or doc asking for help because you feel happy or normal? i was having times of mania where i was like a happy bunny gone mad but i thought that was normal! so i never mentioned it to the doc until i started thinking about it more deeply. it's hard to spot manic phase if the person only presents with depression - no one expects to go to the doc for happiness.

they should've got the aggression earlier tho anyway sorry if that was off topic - good luck with your research xx

[BaggageKeeper]

I am 68years old and can remember dealing with depression from the age of 5. However I wasn’t diagnosed with major depressive disorder (Unipolar depression) until I was 25. I have been on close to every AD for Unipolar depression without relief, though some have helped a little for short periods of time.
The last 5 years my depression has significantly worsened so my psychiatrist prescribed Lamictal. I was confused about the RX because it is for Bipolar and I had never been diagnosed with Bipolar nor had any manic episodes. However, the Lamictal has really helped, which confused me even more, until I read this forum about how some have had “manic” episodes of normalcy or some that lasted an hour or less.
Having read this forum I was able to recall that there have been episodes in my life where the depressive episodes ended for an hour or less (sometimes as little as 15 minutes) and where I felt happy and energised and motivated to get up and do positive endeavours. The feeling would quickly pass and I would be dropped right back down into severe depression, wondering what had happened.
I now feel I have been wrongly diagnosed for over 40 years and wish it were more widely known, and published in papers for general population, about the different variances of Bipolar disorder. Perhaps then others wouldn’t have to suffer for so long like I have.

[Gabyunbound]

As someone mentioned, there are many many 'flavors' of BP (I and II). But my feeling has always been that if one's moods flip from one end to the other in a matter of hours, then we should start thinking of the possibility of Borderline Personality Disorder. I don't want to venture a diagnosis for anyone who experiences this, but it's something to consider. You can find the criteria on-line, which requires a lot more than quick mood swings, but you can get a pretty good idea if you fit the criteria and then bring that into an appointment with your T and/or Pdoc and see if they agree. Pdocs and T's can be loathe to diagnose BPD because of all of the stigma, but if you're proactive (and you suspect it), you can have a conversation with them, and as I said, see if they agree. You can, of course, have both BP and BPD at the same time.

[BeyondtheRainbow]

For all of you who are new to this PsychEducation | Treating the Mood Spectrum is a really god place to learn about bipolar. It's written by a psychiatrist who specializes i bipolar and I still go there to check for information on things 15 years after that site helped me realize I had bipolar and the treatment I was getting for MDD was making me worse.

[Cocosurviving]

Hello there....this can all be so confusing. I was misdiagnosed with MDD in 2011. Then put on an AD that sent me into hell for months. I then went for a second opinion. I learned I had bipolar 1. Afterward I read a lot of books and joined this forum. This year I had questions because my pattern changed. I would get manic in spring and summer. Then SAD in fall and winter. Well this year is the first year I had no mania. I learned on here from others that mania sometimes takes a back seat to depression as we age. I’m now 41....I do know I have bipolar 1. I have a lot of the classic symptoms. I’m going to check out the website BeyondtheRainbow listed.

[Fuzzybear]

I came across this old thread and thought it might help someone. I've been reading old posts. (if it doesn't help, please ignore this ''bump'')

[Soupe du jour]

Hi Fuzzybear. This is an interesting topic. I'm only chiming in to emphasize that there is a "Bipolar Spectrum" concept, and within that there can be various presentations and degrees of mood fluctuations and other characteristics. I agree with earlier posters that a person could be on the bipolar spectrum without having had any notable hypomania/mania. The cycling must be considered. There are also situations where a person may have had one hypomania (or mania) in their entire lives that were otherwise solely consisting of depressions. One of the posters also mentioned that if a person responds better to moodstabilizers over antidepressants that perhaps that qualifies as bipolar spectrum. Likely psychiatrists and other experts have differing opinions, though.

It is important, I think, that when a person presents as "atypical" that differential diagnoses be explored. For example, Borderline Personality Disorder can sometimes be mistaken for bipolar disorder. Even some forms of anxiety...and other disorders. When I studied Abnormal Psychology these investigations were emphasized. Does the patient meet the criteria for another mental health disorder? How do they respond to certain medications? The latter, in the end, is among the most significant. We all like labels to explain what we're going through, but sometimes it's hard to put an exact finger on one. Then there are people who have never had a single depression that meets THAT criteria, but only a full-blown mania and only one in their lives. Those, too, can be on the spectrum.

[FluffyDinosaur]

OP mentioned "my depressions are just like the deep depressions that are seen in bipolar disorder." I expect OP isn't around to answer this, but could you or anyone else elaborate on how bipolar depression presents differently from unipolar depression? I would find that extremely interesting. Is it just the possibility of mixed features, or are there actual differences in the symptoms? For example insomnia versus hypersomnia? If bipolar could be distinguished from unipolar depression based solely on how a depressive episode presents, that would be extremely useful for diagnosis. I always thought that was not possible, but it sounds like OP's treatment team thinks that it is?

Like Soupe, I'm also a proponent of the bipolar spectrum model. Research suggests that "bipolar 1" and "bipolar 2" are likely the same illness, just with different labels based on the history of (hypo)mania. Those labels are purely artificial. "Bipolar 2" is something that the people who make the DSM came up with when they realized that some people's mania is less severe than the classic form. Nobody has shown any physical difference or significant difference in effective treatment compared to "bipolar 1." They appear to stem from the same genetic basis. That's why it's far more useful to consider bipolar as a single illness on a spectrum, with some people tending more to the manic side and others to the depressive side, and everything in between. This seems to be the view towards which psychiatry is leaning more and more. I think that's a good thing.

That said, if there's no history at all of (hypo)manic episodes, or if you're "always hypomanic" or "always depressed," I personally don't think it makes sense to call that bipolar. The whole thing about bipolar is that you have distinct episodes that tend to last for a while (at least days), not just mood lability. Sometimes those episodes can perhaps last years, but even then they are clearly different than your baseline personality. Bipolar is an illness that can afflict you regardless of your personality. It's not a personality disorder.

If mood shifts chaotically every day and there's never a period of "normalcy," then in my opinion, that should not qualify as a form of bipolar. At that point the definitions just become way too blurry and it sounds to me more like borderline or something else. Something that is caused, for example, by an adaptation to trauma and has become your personality, for lack of a better word, your way of coping with the world. That's not bipolar, because bipolar episodes by definition are deviations from your "normal" self.

For the same reason, I'm rather skeptical about things like "ultradian" cycling. Whenever I read stories from people that are supposedly bipolar with ultradian cycling, it always sounds to me like borderline, and like someone was hesitant to use that label because of the associated stigma. Sure, sometimes you have mixed episodes where manic symptoms and depressive symptoms are both present, and when the depressive symptoms abate for a moment then the mania gets a chance to shine through and you may go from dysphoric to euphoric for a few hours. But even then, that mood lability is episodic, not chronic.

Long story short, I'm all for considering bipolar to be on a spectrum, but let's not stretch the limits so far as to make the concept meaningless. There's already way too much confusion among the public about what bipolar is and I really don't need people to conflate bipolar with things like borderline any more than they already do. When people hear I'm bipolar I would like them to have an accurate understanding about what that means, and that understanding is already lacking enough as it is.

I often hear people mentioning that borderline can be easy to confuse with bipolar. Personally, I don't really see that. There are plenty of symptoms in borderline that are not characteristic of bipolar. The chronic, non-episodic nature of borderline (being a personality disorder), intense fear of abandonment, the tendency to "split" people into good and bad, rapid mood changes, usually measured in hours and often caused by interpersonal stressors, impulsive personality (not just impulsiveness in the context of a manic episode), and more. There's plenty to go on, in my opinion. In contrast, bipolar people (barring comorbidities) can have a perfectly well-balanced personality and mainly get disregulated due to their episodes.

Apologies for the long post, but I had to get this off my chest.