Not sure why I have bipolar diagnosis

A couple doctors have diagnosed me with bipolar mixed states but I don't get manic. I have agitation and horrible racing thoughts instead. My recent hospital stay was from racing thoughts where I couldn't relax for 3 days so I went to the ER and my discharge papers said "Bipolar, anxiety disorder, autistic disorder". Same Dr. who diagnosed me as bipolar diagnosed my mother as bipolar, too. I've always had major depressive episodes since 13 yrs old, I'm 58 now and have been hospitalized 27 times since 1990 (with little relief). I've taken every SSRI, MAO, Mood stabilizer and anti-psychotic since 1986.

@cool09 sorry you have been hospitalized so many times and not got relief. That must be rough on you.

As a peer support person I cannot speak about your diagnosis, but my partner has a bipolar diagnosis and can spend lots of time in depression stabilized with meds. If the docs are not careful they get a racing mind and irritability, trouble sleeping and insomnia, a sense of infallibility. Mania is not what I thought it was. It is much more difficult for me to deal with them in the manic side. They usually need to do ECT in order to get stable again although staying on meds helps.

Maybe you could google and find out more about it. There are also different types of Bipolar, I and II and others.

@CANDC

Hello @cool09. I'm sorry to read that you've been hospitalized so many times. I also fully know what mixed states bipolar disorder is all about, and mixed states are indeed part of bipolar disorder for a large number of people. And they suck!

One should not expect that manic or hypomanic elation must be present for a bipolar diagnosis. Though mixed states don't usually feel like an "elated" state, they do have some of the symptoms in the hypomania/mania list. I suppose it is definitely possible to have never felt elated with bipolar mixed states, or maybe if elation was felt briefly or early in the episode, there could be lack of insight to it. Believe me on this. I know at least in my case.

I hope you will talk to your psychiatrist about any doubts or confusion about your diagnosis. It's a learning process and often an acceptance one, too.

I have "agitated depression" which is in the bipolar spectrum, I guess that's why I have it. (But not many doctors have picked up on it.)

''Agitated depression'' - sounds very familiar to me. I have horrible racing thoughts.
A couple of the better professionals have mentioned ''mixed'' to me.

I'm sorry you've been hospitalized so many times.

I have dysphoric mania. Not haha happy mania (generally) but the everything is bugging the crap out of me usually mania. Coupled with the depression. Sucks.

I hate that.

Yeah there is such thing as dysphoric mania/mixed episodes/agitated depression (they're all practically the same thing and can lead to a bp dx).

I've been on an SSRI (zoloft) for 1 yr. and they're not to be given to bipolar patients because they can cause mania. I had one Dr. who wouldn't give me anti-depressants 20 yrs ago. I was on paxil for 5 yrs and I managed with little problem. I'm in a quandary it seems...

Check out Psych Education and see what you think. Look especially at mixed episodes. I'm not sure how much of that there will be but he's pretty comprehensive.

The site is written by a pdoc who specializes in bipolar. He's pretty amazing; tons of information and it's all presented clearly. His page was the way I finally accepted that I was bipolar.

cool09, as you see, there are all sorts of versions of bipolar, not just the classic mania, then depression When I'm manic, I can't stop talking and can't stay still, but I don't do the other things like overspending.

I take antidepressants along with a mood stabilitzer and don't have any problems with that. I did have one doc who wanted me to just stop taking all of my antidepressants cold turkey. I told him "good-bye" for that and how he acted when I questioned his judgment.

He says that you might want to try an anti-depressant if you have GAD (generalized anxiety disorder). I have GAD really bad. Most anti-depressants haven't helped my anxiety except for paxil (which I've tried 4-5 times).

Are racing thoughts a symptom of bipolar disorder? Mine stopped in 2014 when I started Geodon but they've come back with a vengeance. They were horrible in college. I don't know what to do. Afraid of going to the hospital.

Racing thoughts are often a symptom of bipolar disorder when the person is having a hypomanic episode, mixed episode, or manic episode.

Have you ever been on Gabapentin for anxiety (GAD)? I find it very helpful (many people do).

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Originally Posted by MuddyBoots Yeah there is such thing as dysphoric mania/mixed episodes/agitated depression (they're all practically the same thing and can lead to a bp dx).

^^^ Exactly. When I was first diagnosed around 1987 the pdoc called it an "agitated depression." I remember that the name scared me. On through the years I've been labeled with all of those above and a few other words, but really, they all mean basically the same thing.

I can relate to your experience in a way. Here is my long reply. I hope it helps.

I had two periods of psychiatric illness in my life that doesn’t fit neatly in any diagnosis. The only diagnoses (ASD and GAD) that fit don’t come close to describing those two periods of my life. I heard three different labels: bipolar spectrum, first episode psychosis, and agitated depression.

My first experience was hell. I think it started out as generic depression that eventually mutated into something more serious. I started hallucinating and experienced ideas of reference that gradually became more developed. About six months after that started I began to struggle with reality testing. My world started to get really bizarre. Eventually it began to feel “normal” or logical even though my thinking was odd and implausible to an outsider.

I remember feeling very restless during that time. At times it was severe. Sometimes I would feel like hurting myself (which I never did) or letting the tension out violently by breaking things and punching walls which I did. When it got really bad I would go on very long walks to nowhere, just to walk the energy off. It was nasty and very hard to contain myself. Walking seemed to help the most. Sometimes I would scream.

The restlessness I felt was deep. It did not resemble my typical anxious restlessness or an over consumption of caffeine. It was a combination of mental anxiety and extremely restless muscles. I could not sit still. It affected my ability to focus and sleep. It was brutal and felt like the unpleasant side effects of a Haldol injection. There were no feelings of elation or euphoria, although I did believe I held special knowledge that everyone was oblivious to. I was also paranoid.

When this illness crept up I wasn’t on any medication and using any substances. I wasn’t looking after myself very well. E.g., eating well. I wonder if that had anything to do with it.

My present psychiatrist told me I had psychosis. The consult she had me go to at the hospital stated it was probably “bipolar spectrum”. That psychiatrist backed it up with my reaction to Cipralex. When I started taking it I got “high” for about 4 weeks. It was mostly pleasant. I didn’t require much sleep. I was motivated to do things, but was restless and struggled to focus.

Could the psychiatrist be misinterpreting medication side effects for mental illness?

The second time I got ill, it wasn't as severe. I wish I knew exactly what I had or that it fit neatly in a diagnosis.

You've been through so much, I'm so sorry to hear that. When I first started having an absolutely horrible time with my illness, I was diagnosed with issues I didn't understand- honestly, I thought they were ridiculous. I decided that if I was going to be labeled, my docs were obligated to explain why each label applied. I took a piece of paper and wrote down each diagnosis. I then made a list of the things I was feeling. I had the doctor explain what factors lead him to make each diagnosis. I then had him explain to me how the symptoms I was feeling fit into the diagnoses that were made. It's really important you write down your questions and the answers you received so you don't forget to ask a question or the answer to it. I've used this process in the past and it helped me to understand why I was give a diagnosis. Also, it has been interesting because it seems the docs are more willing to give me the time I need when I have list of questions prepared. I use one of those 6"x9" steno pads and it works perfectly.

I want to welcome you to the forum @Apogee

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Originally Posted by *Beth* I want to welcome you to the forum @Apogee

Thank you for the kind welcome @*Beth*. I look forward to the discussions here. (I'm still trying to master the tech stuff on how to post but new learning is good for my brain. )

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Originally Posted by Apogee Thank you for the kind welcome @*Beth*. I look forward to the discussions here. (I'm still trying to master the tech stuff on how to post but new learning is good for my brain. )

It's a large forum, but be patient with yourself and ask for help when you need it. You'll figure it out By the way, feel free to jump in on the Bipolar Check-In Thread. It seems to move really fast, but once you post, you'll catch the drift of the thread.

Oh, and you're in the same time zone as I am! There are only a few of us here, most are further east, UK, Europe, Australia. I'm waiting for someone from Hawaii to show up.