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Does Bipolar always start as a Depression?


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I suffered from Depression, years before being diagnosed as Bipolar. I would say 15 years before. Then I had a psychotic break and went from depressed to psychotically depressed.

Years later when I had my second psychotic break, I was diagnosed as bipolar.

 

Did your Bipolar start as a Depression????? Does Bipolar always start as a Depression and then turns into mood swings?

 

What came first (in your case)? Mania or depression

 

Is every depressed person fate, being bipolar in the long run?

 

 

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Hi Cookie, my situation sounds similar to yours.  I was diagnosed with depression at age 10, and then my diagnosis was amended in my early 30s.  The pdoc who diagnosed me with bipolar disorder told me that a diagnosis is a snapshot of where we are at any given point in time, and that diagnoses can change over time.  I believe that my depression transitioned to bipolar disorder when I was in my 20s, but I did not know that's what it was.  I recognized depression, but not mania.  My understanding is that my situation is not uncommon.

 

My understanding is that bipolar disorder does not begin with depression for everyone: some with bipolar disorder do not have many depressive episodes, while others spend most of their symptomatic time being depressed.

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I had psychotic symptoms (thought broadcasting) as a fairly young child (coming home from the school I went to grades 1-3).  But I don't remember being depressed until high school.  Of my mood symptoms, depression was the first. 

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I probably had depressive episodes before I had my real first mania, but I was first diagnosed as psychotic/schizophrenic because I had clear psychotic symptoms and got hospitalized because of these.

 

The BP diagnosis was definitely an aha moment.

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I have no idea how it started for me, nor if there is a trend. I've never come across any research suggesting that there is a dominant pattern of depressive onset. Nor is it put to people suffering depression that it is likely going to become bipolar.  Rates of depression without bipolar are high enough that I think we can say that depression is not just -pre bipolar.

 

I totally get the urge to compare yourself, CookieN, but really, we're in the infancy of what science knows and can prove about mental illness. In the 1960's, someone gave a guinea pig Lithium and that using Lithium as a med was created. Our research into mental health is at that new stage. So my advice is don't get too hung up on identifying if you own experience of bipolar is like anyone elses or if it matches some canon of what we know about bipolar.

 

What we know is that we can see a trend of mood disturbance common enough and distinct enough to cal it bipolar. We have tested meds (many only in the last 30 years) that appear to manage it, thought the meds and how well they work is usually very individual to the person who has bipolar. We know that some people function in society better than others with bipolar, it comes with a suicide rate of about 20% and different meds and therapy approaches help. We know it doesn't have any definite origins, it does run in families and we can start to see what conditions bipolar develops in. But in terms of how people get it,. or curing it, no one actually has an answer applicable to everyone at this point.

 

It's still a very recent thing to get a brain scan of someone we already knew had bipolar and be able to point to brain activity that is unusual, let alone be able to diagnose it in people.

Edited by Titania
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Titania has some very insightful advice above about the scientific validity of being able to diagnose Bipolar accurately, let alone to add in the depression as a first symptom. However, I can certainly say for me personally, my symptoms started as depression, being first diagnosed with depression as a child, and was diagnosed with Bipolar by age 16 when I had a manic slightly psychotic episode. 

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Thank you all for your responses.

I´ll tell you why I made this question.

One day I asked my pdoc why I was being diagnosed as Bipolar if I had never had mania? (I´ve had psychotic symptoms though). He answered that I was not experiencing mania but it would come in the future.

So that made me think there was a trend or pattern among people with MI. And thought my future was to experience mania. It has been 2 years since my pdoc said that and I haven´t experienced mania.

 

Another thing was that I was always seen and diagnosed as a depressed person. But by reading CB and looking back I noticed there was some kind of pattern. Like I would spend a year perfectly fine, and then a year in which I was depressed, then normal again and so on.

 

Part of why I asked my question, was to know what happens next. If my illness will worsen. (like I would get another dx). But as Titania said. I shouldn´t compare myself.

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I imagine everyone is different. I unquestionably had depression starting at age 10. I did not have a severe manic episode until age 27. In-between? I don't really know. I definitely had some episodes of depression in there, and possibly some hypomania or mild manic states here or there.

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I did, too. But doesn't catnapper have "something cyclical going on" instead of hypo and manias? I might have the wrong member. But I believe s/he is being treated as if bipolar. But maybe that is the same thing my dad called "soft bipolar."

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I was diagnosed during a hypomanic episode.  And only because I kept a referral appointment.  The pattern was feel good, depression, call md to get AD, start to feel better, cancel follow up appointment, feel great, stop AD, feel good, repeat.  After a few of those my md referred me to a pdoc, and that appointment happened during the feel great - stop the AD phase.  Despite coming off Zoloft and a clear pattern of AD use and feeling great, pdoc gave me a BP2 dx.  He does not believe in SSRI-induced BP2.  In his words, "I can give 99 people an AD, and they will not become hypomanic.  If you're hypomanic because of it, you're BP2"

 

So I don't know if I was depressed first or hypomanic first.  Hypomania is productive and pleasant for me.  It's not something I would see a dr. about.  Depression sucks everything out of me.  It is something I would see a dr. about and demand FIX IT RIGHT NOW!!  I've had a couple of minor episodes since getting my dx.  They've all started from stability ramping up to hypomania that I don't see, but others can, followed by a crash into depression.  If I listen to them, it's a gentle crash.  If I don't it's a hard crash. 

 

Since being on a mood stabilizer, I've also had depressive episodes by themselves (as in no hypomania either directly before or after), but nowhere near as bad as before when I was on an AD.  As far as I know, I have not had any episodes of only hypomania.  They've all ended with a crash into depression.

 

If my pdoc is correct, then you can have depression without becoming bipolar.  Because those 99 people will respond to AD treatment without becoming hypo/manic.

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