Wondering if I am bipolar instead of just depressed/socially anxious?

I am currently in my 13th severe month-long depressive episode in the last 20 years with little hope to recovery. I have done a fair share of psychotherapy and adopted different medications yet it seems as stressors line up as they do in life I have not really developed any coping mechanisms and the downward spiral starts very quickly to a state where hospitalization seems to be adquate. Needless to say it has impacted my life in every possible dimension to the point of solopreneurship being my only. professional option and adopting a nomad lifestyle becuase of the negative memories in many of the places I stayed for longer times.

One thing I am noticing this time that prior to this depressive episode I was highly functional. Very disciplined in my routine and habits, highly productive, and quite outgoing for someone with social anxiety.

So with that the difference between the non-depressed and depressed phases could not be more accentuated.

As I seek to restart medication once again I wonder if I need to consider effective treatments for Bi Polar Type II. It hasn't come up in the past with any psychiatrists or psychologists but then the focus has always been on the ongoing depressive episodes and less on the non-depressed states in which family usually tells me to slow down and not overburden myself. I read that not diagnosing the maniac phases is quite common.

Outside of sharing my thinking/concern with my psychiatrist and psychologist, are there any recommended diagnostic tests to take that allow for classifying potential maniac episodes? If anything I would consider them of soft nature which may put me in Type II?

Thanks in advance for any guidance or pointers.

Hi globalcitizen80 - welcome to MSF. I am sorry you are having depressive episodes. I hear you that you also have periods of great productivity in between episodes. That does sound familiar with the way my friend behaves who is diagnosed with bipolar, but in no way does that imply that is your diagnosis.

Here is a quiz that does not really diagnose but may be of interest https://psychcentral.com/quizzes/bipolar-quiz

Here is an article by the Mayo Clinic that may be of interest. https://www.mayoclinic.org/diseases-...t/drc-20355961

Hope you get the support you are looking for. @CANDC

Yes, it is common. It is important that you be seen by mental health professionals during the times when your family tells you to slow down and not to overburden yourself.

One way of homing in on a diagnosis, whether for bodily or mental ailments, is an approach called "the empirical method."

Here's how it works: they try different drugs on you. If you respond positively to a particular medication, then it suggests that you have whatever disorder that medication is known to treat effectively.

Most pdocs will start off treating depression with antidepressants. If those meds aren't helping much, then they start giving you "mood stabilizers," which are usually anti-psychotics. Another mood stabilizing drug is lithium. If you show improvement while taking a mood stabilizer, then that suggests you may be on the bipolar spectrum.

I attended a lecture, sponsored by the Depressive Bipolar Support Alliance, where the speaker was a former research biologist who became a psychiatrist. He said that a psychiatric diagnosis is basically a more-or-less wild guess. He said people are inclined to take a diagnosis as a literal "truth," when it's really just a provisional hunch on the part of a doctor. He said a psychiatrist needs to know a patient for about 5 years before a truly insightful diagnosis can be settled upon.

Psychiatrists know very well that, much of the time, they are guessing. That's why, over the long course of treating a patient with persistent symptoms, they tend to throw all kinds of drugs up against the wall to see what sticks. Then, when a favorable response occurs, they reverse-engineer a diagnosis.

Rose, this is why we must be our own best advocates. There is no substitute for reading as much about these related disorders as possible. When I was about 25 years old, I knew I had inherited anxiety and depression. I found those easy to recognize, bipolar not so easy to pin down. Especially bipolar 2 which is SO SO sneaky. I could easily remain undiagnosed as bipolar still today, now that I am in my 70's. At about 25, from my reading, I diagnosed myself, then had the diagnosis confirmed by a really excellent psychiatrist. Respectful of all the hard work the professionals put in, I am not at all surprised to read your post about how they are mostly guessing. Meanwhile we suffer on the wrong meds for decades. The worst thing for misdiagnosed bipolars is that antidepressants, used at all or incorrectly, can push us into hypomania or mania. I always got in more trouble with my highs because when I am down I keep to myself. To make things even more challenging, I often experience mixed states and can rapid cycle within the same day. Woo-hoo! But hang in there people! I obtained 3 degrees and co-parented a wonderful son who is very successful. I am keeping an eye on the grandson who is showing some of my symptoms. In Phoenix it is now extremely hard to even find a psychiatrist who takes my insurance. Nurse practitioners are taking over and if the MD psychiatrists are just guessing, phew. Since covid has ravaged the ranks of health professionals, it is all the more vital to research, research, research your own medical, dental, and pet conditions. Read, read, read!!!!! This forum is an invaluable source of info. Sincere thanks to DocJohn!!!!!

Nothing can trump being seen when you are feeling really well; but that begs the question of why one would make an appointment about feeling really well! catch-22. That's what you need to do though, next time your feeling really up, or as someone else noted if a family member is telling you to slow down, THAT's when to go get checked out; they'll ask or know about your depression as well of course; but its that seeing the elevated mood that creates confidence that there's something there that isn't solely depression.

Surprisingly to me, when I called for help about feeling *really well*, they had me in the office within a couple days; they generally want to see it, and will often take extra efforts to make it happen.

Hello globalcitizen. The next move would be to share the above experiences with a psychiatrist and ask for a thorough evaluation for possible bipolar illness. An online questionnaire can be a tool to help provide a start to such a conversation, but as you wrote, it's not a diagnostic tool.

Questionnaires don't ask nearly enough questions. Plus sometimes it's very hard to gauge through them where your "ups" fall in a spectrum. Also, how various levels of stress affect one.

I'm not a doctor or therapist, but from personal experience, a couple additional things to mention to them include:

* The medications you've taken, how they've affected you, including your moods, and how fast they caused a switch.

* A full description of what it felt like during your depressed days, more normal ones, and far "better" or energetic ones.

* How your moods affected your school and/or job performance and relationships with others (in terms of social anxiety and other aspects) and what the feedback was during your most energetic (or "up") periods. Did you ever suffer any form of consequences during the latter, small/medium/large?

* The effects, good and bad" of behavior during your more "up" days and weeks.

* How long the depressions, more normal mood times, and assumed "up" times lasted, individually and in relation to each other, plus the patterns.

I took an assessment at a new psychologists office long after I was diagnosed. It did include questions about the manic or hypomanic phase. It was years ago, but I would guess it was at the very least about 10 pages long. They charged me $300 which irritated me because I knew I was bipolar.