Hey guys, long time lurker here, and I'd really like your input on something. I'm a bit stuck when it comes to treatment, and I'd like to hear some peoples' opinions, as I wont be able to see my doctor to talk about it for a little while.
I’m currently diagnosed as having GAD and MDD, but I’m starting to think I have a bipolar spectrum disorder. Here are some points:
Failed multiple antidepressants (Zoloft, Lexapro, Prozac, Viibryd, Pristiq). Failed and/or had too many side effects Had side effects on every serotogenic antidepressant, even while augmenting (Wellbutrin, Buspar) like sexual dysfunction and extreme fatigue Atypical depression — BP Depression has excessive sleeping with a lot of daytime fatigue and an increased appetite, opposite of MDD Very anxious — BP much more likely to be accompanied by stronger anxiety symptoms The fact that “If all the treatments don’t work, maybe you’re treating the wrong thing” Excessive nighttime eating (seen in BP Depression vs unipolar) Racing thoughts Earliness of first depressive episode (age 19 at the LATEST), and research shows it’s very likely to be bipolar disorder if before the age of 18/20/25 (experts disagree on the age) My anxiety symptoms could actually equate to mixed state Losing and regaining interest in hobbies (I’ll enjoy my “typical” hobbies one day and then later, zero interest / motivation) Cousin has BPII (I know immediate relatives are the key, but still, a data point) Online shopping addiction (computer, iPad, something new in the mail every day)
The fact that Bipolar Spectrum Disorder doesn’t require mania/hypomania, just multiple non-manic markers of bipolar (see links below for source) The odds that I have treatment-resistant depression coupled with very prominent anxiety, and considering my episodes of depression aren’t THAT bad that they would be so hard to treat So, what do you guys think? For me, it would be a big relief to get a diagnosis as somewhere on the bipolar spectrum, as I've tried so many meds already, and I just wanna feel better If anyone is curious as to my regiment and past meds, I'd be happy to post that as well.
Thank you all so much for taking the time to read and respond! It means a lot!
Spoke with pdoc today as I was in a really bad way. He talked with the nurses from the home based treatment team and between them they felt I should be admitted to the Acute Psychiatric Unit.
I really don't want to be so he had another meeting with the home base treatment team and it was agreed that the support for me would be increased and i would get more visits and phone calls from the nurses over the next few days and could see the on call pdoc and be admitted if it comes to that. My pdoc also increased my sodium valproate to 1500 mg and I can have an extra 1 mg clonazepam PRN. I have access to the on call pdoc over the weekend if my meds need to be changed again.
Hope I don't totally crack up over the weekend. I really don't want to go inpatient despite suicidal thoughts. They are only thoughts. Right now the blackness and agitation and racing thoughts are really difficult to deal with but I need to keep going. Feel scared
Thanks for listening/reading my rant
Well I seem to be in a never ending mixed state. Making some progress, the mood changes are softer, if that makes sense. But, my moods even confuse me, let alone the people in my life.
My biggest struggle is recognizing when the depression comes that it is not permanent. It seems for ever, I do damage to myself when I get like that, mentally and physically.
So, was wondering if anyone has, I don't know, tips maybe.
I seem to float untethered from mood to mood. My lack of control is starting to make me restrict and vomit my food up. All for a sense of control. I have not had an eating disorder ever in my life, unless you count amphetamine abuse. I will talk to Tdoc and pdoc about this. But want to hear from others.
I try to stay present, I try distraction, I even hide in sleep.
Just can't seem to stay stable for any period of time.
When I'm hypomanic I've done things I found embarrassing (especially when I was delusional), but nothing I would describe as dangerous. Unlike my mixed states which would definitely be under the dangerous category (self harm, suicidal, ect). That doesn't seem to be unusual, but when I'm falling into depression it's a completely different experience.
Sometimes it's like I can feel a depressed episode coming on. It feels like this hole in my chest that keeps growing and every part of me is falling inside, piece by piece. I feel the most reckless and impulsive during this time. I haven't completely got into the laying in bed, staring into space depression state yet, but I know it's coming. Mostly I just feel numb and when given the chance I end up doing all kinds of things to not feel that way. From getting a tattoo (which I love) to coloring my hair pink (which looked awful) to spending too much money on anything that could bring me even a little happiness. Then I've done other things like drinking a lot while on medication which I would never do normally.
I don't feel hyper and focused the way I do with hypomania or restless and angry like a mixed state. I just feel like I'm sinking slowly and all I want is to feel like someone else for a while. I don't know if this counts as depression or some other state. Has anyone else had a similar situation?
I'm relatively new here and had a recent tentative diagnosis of Bipolar II after months of being MDD only. The tl;dr of this is that I'm not sure I understand the difference between "agitated depression" and "mixed states," and how those related to a dx of MDD versus Bipolar. Read more below.
I've struggled with depression for years, and finally saw a pdoc and started an SSRI in October '12. Still having breakthrough episodes in Jan so upped dose to 15 mgs and promptly went into my first real manic episode -- hypersexuality, spendy, restless, considered divorce, flying high for days, etc. I found it both thrilling and troubling and knew something was "wrong" but wasn't sure what. Googling revealed that antidepressants can trigger mania in people who are bipolar. Further reading on bipolar helped me realize that I've probably been experiencing hypomania for years, primarily in the spring: restlessness, agitation, super bitchy/angry, unable to feel settled or content, taking on lots of new projects/hobbies, spending money, wanting to move (or moving!), wanting to have a baby (and getting pregnant!), wishing for major life changes, etc etc. But I wasn't ever flying, happy, or euphoric, and had a lot of bad, grumpy, unhappy days.
When I described this to my pdoc at our last appt, when I finally 'fessed up about the manic behavior and we were discussing mood stabilizer options, she mentioned "agitated depression" as another possibility. I'm confused as to what the difference is. Is there a difference? Is it just a matter of terminology? Does the fact that I was triggered into mania by my antidepressant mean I'm not "really" bipolar? Could it just be atypical depression? She was less interested in nailing down a dx than understanding and treating the symptoms (for now, I am continuing the Lexapro and titrating Lamictal, with plans to lower the Lexapro dosage after I'm stable on Lamictal). Which is the right thing to do, I'm sure. But in trying to wrap my head around all of this stuff, I'm finding myself wanting to be able to say "I have MDD" or "I have Bipolar Affective Disorder" or whatever. Can y'all help?
Thanks for any insights you might have.