So, is this hypomania?

[antikamnia]

I know I could just read the lists of symptoms, but they never really seem to capture what weird brain stuff is like when it actually happens, so I thought maybe if I described what happens to me someone out there could go "yes, that's it!" or "meh, no, you're on the wrong path here."  This seems to have gotten long, but I don't have anyone in meatspace to ask other than my p-doc, so I figured I'd be detailed.

I'm 43, and I have long term (30+ years, starting at least in early teens) major chronic depression with looong depressive episodes, especially the last 5 years or so.  Also GAD, same duration, with mildly agoraphobic episodes, panic, etc.  For years I answered the question "have you experienced any manic episodes" on screenings with "no", although the last 5 years or so I've been hedging with "I don't know what feeling normally good is, so IDK," and I don't have anything I would classify as the full-blown mania I see in friends--sudden moods with grandiose plans, expansive gestures, intense hyperactivity, crazy spending sprees, etc.  

But I get these periods maybe 2-3 times a year where I kinda start feeling better and then there is this sort of whoomph and it's like I'm on a low dose of the best, smoothest speed in the world.  I feel good, I don't hate the way I look, I actually gather up bills and pay them, I can call and find people to fix things in my house, I actively set up things to do with my friends multiple times in one week, being dead doesn't seem so much like an alluring option, I go to the gym, I resolve to start cooking means with multiple food groups again and actually do it, all these things sound pretty normal, I guess?  

Do normal people feel like this?  Crystal clear.  Fierce.  I do the sort of kinda crazy things I've fantasized about for months but always seemed prudent not to do--usually because they seemed like they'd go bad pretty quickly, and sometimes they do, but never--well, since I left my teens--really anything that would be actively dangerous or professionally or financially really risky, and never "out of character" except I would otherwise be too anxious to do them, and, hey, having some adventure sometimes is good, right?  I mean, I could just be super-anxious the rest of the time and this is normal.  I have trouble sleeping more than 5 hours a night, which I just started noticing coincides with this other stuff--usually the depression+meds makes me sleepy a lot--that's the only thing that doesn't seem like it probably isn't necessarily normal.   This part usually lasts ~ 4-5 days, but the more or less not depressed part lasts longer--maybe 10 days, maybe a month, occasionally longer if I'm lucky.  

I also have these spurts every couple of months for 2-3 days where I feel like breaking things and everything drives me crazy and I snap at people.  I mean, not badly, but it's not what I'm like the rest of the time.  And occasionally, with that, I get these periods of a few hours where I can't stand to have anything touch me and everything is wrong and I can't move because I don't know what I'd do and I rock back and forth.  Also, I scratch and cut myself (infrequently), although I do that when I'm depressed or anxious, sometimes, too.  

Like I said, I've never really thought this could possibly be mania, but I'm in one of these periods right now and happened to be reading some info on BP-II and hypomania sort of randomly and it felt like maybe that was what happens to me. With a kind of dramatic dip of a couple of years when everything in life ganged up on me--life threatening illness, accidental deaths of loved ones, divorce, natural disaster, all in a row--I'm comparatively very successful in the career niche I managed to carve out to suit my mood/anxiety parameters, advanced degrees, introverted but like people.  Lots of friends who are okay with me avoiding them for months sometimes when things are really down.  Always go to work, take care of my daughter, bathe, eat, groom at least reasonably well even when really depressed, etc.  Just push through.

The meds I'm on right now--Wellbutrin, Lamictal, Zoloft--seem to work pretty well to make that much less of a struggle. Did talk therapy for years and years but, other than a long push of rather eclectic CBT when I was going through some really awful mostly relationship-related crap, it never really helped. I mean, I could articulate my neuroses and the shrinks helped clarify that, but I never felt better about anything.  

I don't know that changing my diagnosis would make any of that different, but I'm wondering if this is worth bringing up with my p-doc, or if this just doesn't look like hypomania and I shouldn't even bother.  Does this resonate with anyone?  Or maybe someone can tell me if this is what normal feels like? I just feel like I have no real frame of reference.

 

 

 

 

 

 

Edited November 27, 2015 by antikamnia
(ed. to break up blocks of text)

[crtclms]

We really aren't in a position to judge. We can't diagnose. You could be hypo, you could be mixed, you could be depressed. Do you know what a mixed episode is? If you don't, you should look that up. Sorry if you do, and I am sounding condescending.

I think it would be a really good idea to print out your post, and make a pdoc appt. for sooner rather than later. Tell them you aren't feeling well (assuming that is true), they often can get you in faster than for a med check. You can read the post aloud, or hand the post to your pdoc to read.

I will say the fact that you are listing so many symptoms, and are still unsure of what to do, makes me think you don't trust what your psychiatrist says. That may be warranted, but if it is true, you need to look for a pdoc you trust.

Just a tip: On Crazyboards, people have illnesses and are on medications that make long paragraphs difficult to read. If you could break your second paragraph into two or three, that will likely get you more responses, because a lot of people just skip "walls-o-text."

And a head's up: If hypo is what you are experiencing it can feel fabulous. But it can turn on a dime, and become dysphoric hypo-mania. Dysphoric = all the energy of Hypo, and all the bad feelings and thoughts of depression. It is the worst. That's also a rough description of mixed episodes. So you can also become mixed, or escalate into mania.

You have to treat hypo as seriously as depressive, mixed and manic episodes. Every time you have an episode, your chances of having another episode become higher. That's called kindling, which is a model for epilepsy that the majority of psychiatrists think may apply to BP as well. So I know it is tempting to leave a nice hypo alone, but it is risky and bad for your brain.

I realize I've been giving a lot of info as if you are bipolar, and I can't make that diagnosis. I am just trying to give you some information.

I also think you might want to try CBT again; you seem super anxious. How are you controlling your GAD?

Sorry this is so long, it looks like I vomited a dictionary.

 

[sugarsugar]

Your history sounds very similar to mine. Finally, I had some behavior I told my new pdoc about, and it was quickly diagnosed as manic. In retrospect, I had been having hypomanic times, and mixed, but never mentioned symptoms I didn't consider part of depression. So, finally, a new diagnosis and new meds. What did it matter? Well, I haven't had an episode of depression since the med change, which seems like a miracle. So, I can't say if you are hypomanic, but I'd say, tell your pdoc your suspicions. If it leads to better meds, it's worth it. And now that I'm not depressed, I have a better idea of what is "normal" vs hypomanic. What a waste of time all those years before, but now I know.

[aura]

Your post made me think of this website: http://psycheducation.org/. It's a very particular viewpoint on mood disorders and, not being a doctor, I don't have an informed opinion... but you might find it interesting to read through anyway.

[dancesintherain]

I'd agree with the people above me.  Both that the website that aura mentions is very good and a helpful look at the issue and something you might want to consider. Secondly, that it's worth telling to a pdoc, and if you don't have a pdoc you trust, to consider finding a new pdoc so you can work with someone you trust.

The main significance of a new diagnosis is that sometimes it leads to different meds. Not always, as the main goal is to treat the symptoms.  But if you have symptoms that you're not reporting (for understandable reasons, I don't mean that in a judging way), your pdoc isn't going to know that they need to be treated.