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Dysphoric mania or just plain psychosis?

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Okay, so about four months ago, after being hospitalizaed for an overdose I was labelled depressed and got put on Prozac. Now, I've experienced deep, dark depression before, but I don't really think that was the reason I took the overdose. I didn't even know what the hell I was doing. I've always been extremely moody, going from bouncing off the walls/singing at the top of my lungs/talking to God/trying to walk through walls/cleaning the kitchen at 11pm to curling up in the corner crying and moaning about how much life sucks and how sweet death is. I have also had a tendency to become very, very angry/destructive on occasion.

Anyway, that's not really what I'm asking about. When I was on Prozac, it lifted the depression a bit but after a while I stopped getting those episodes of euphoria and went through what has now been labelled by my psychiatrist as a psychotic episode. I heard voices telling me to kill myself, I was extremely irritable, I thought everyone was out to get me, thought people were reading my mind and thought the TV was sending messages to me to kill my family. Because my psychiatrist does not pay much attention to my previous episodes of major hypperactivity/bouncing off the walls/euphoria, and because I also get depressive episodes, she has suggested schizoaffective disorder (depressive type). I'm just wondering if this "psychotic episode" I went through could have actually been a dysphoric mania triggered by the Prozac, and that I am not schizoaffective, but bipolar. I have periods of normal functioning and I get panic attacks. I also have several symptoms of Asperger's and I know mood disorders are common in aspies.

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I have to go teach my first class, but....

Yes to the psychosis, no to the Prozac induced dysphoric mania.

Here is an old posting from AirMarshall:


After rummaging around I remembered Kassi's description:

Dysphoric Mania: Primarily a mania with depressive features.

Agitated Depression:  Primarily a depression with manic features.

Mixed State:  Non-specific includes both of the above terms. Mania + Depression.

I haven't found textbook quotes for you. In practice it can be impossible at times to discern the difference between dsyphoric mania and agitated depression.


Click on "Diagnosis" in the left frame

Has a good text and graphic that shows the Bipolar Spectrum and how the latest thinking is that  Bipolar really isn't bipolar.


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A.M. knows about this stuff.  I'll only add that your psychosis sounds an awful lot like the psychosic mania that got me my BP diagnosis in the fist place.  That was induced by another AD, wellbutrin.  It was sorta similar to mixed states I'd had before, but the voices and distortion were out of this world, literally.

I haven't had even a whisper of this kind of thing since being on an AC mood stabilizer.  I only needed zyprexa for a few weeks until the AC kicked in.

The BP spectrum is fascinating, but I'd suggest you just read up and not fixate on the exact diagnosis yet.  The question is what med will work for you.  The diagnosis is just a tool your pdoc will use to figure that out.

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