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Is it hypomania... or is it my personality?

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Hiya all.

So I've been dealing with some pretty unambiguous periods of depression since I was 14 (I'm 20 now) but never sought out ~professional help for my symptoms until now b/c I was afraid of meds and convinced that I could deal with it on my own. At least that was the case until I ended up in an emergency room on the 11th with suicidal thoughts. I didn't get admitted but the doctors there referred me to an outpatient psychiatrist and I decided to accept the appointment because I figured it couldn't make things any worse.

Anyway, I came out of the initial evaluation with a dx of "recurrent major depressive disorder" but the pdoc suspects I may actually have BPII. She said however that she wouldn't make the diagnosis right away because she wasn't sure if my "up" periods were true hypomania or just my normal, non-depressed personality. While I've had episodes of hypersexuality, impulsive spending, etc I didn't have any sleep disruption during these episodes, or depression/regret about my actions after they ended. Basically the pdoc says the lack of physical symptoms combined with lack of regret suggests that impulsiveness and risk-taking are natural features of my personality, not symptoms of hypomania. She decided she wants to see how I respond to a trial of zoloft before investigating BPII any further.

Agree? Disagree? Tbh I've spent so much of my adult life depressed I'm not sure what my "natural and non-depressed" personality is, so I can't dispute her speculation about what I'm like under the depression. I'm new to this so if some of y'all could give me a primer on what hypomania looks/feels like it would be very appreciated.

Edited by moderncorinna
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You'll find out pretty soon if you're taking anti-depressants! 

Prozac, and most SSRI's, made me feel pretty good for a month or so, then things would switch into high gear, but mostly mixed -- extremely irritable, quick to get into a rage, physically destructive, etc. 

Bipolar II's primary symptom is a chronic, low grade depression that often starts at a young age. The hypomania of BPII is also devilishly difficult to identify, and I don't know that regret (or not needing sleep) is necessarily a symptom of a hypomanic episode. For me, I tend to get really hyper-involved in projects, or I start making elaborate plans for the future (count my degrees, degree attempts, colleges, moves, and career changes), aka an excess of optimism.

You're making a great start by identifying what may be symptoms for you personally. As you tune into what a mood is, what it feels like, what the markers are, it'll become more clear. 

This book might be a little dated, but it's the best book I've read on BPII: https://www.amazon.com/Depressed-Recognizing-Managing-Bipolar-Disorder/dp/0071462376

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Just seems a bit odd to me. Zoloft is not really the most efficacious choice for MDD or BP2, and it can trigger hypomania in bipolar individuals.

I went through prozac, buspar, and then mirtazapine (all titrated to max dosages) before they each quit working and my symptoms got worse. I was seeing a gdoc at the time, and he eventually referred me to a pdoc.

Hypomania is mania's boring younger cousin. For me, I get 4-5h of sleep instead of 7-10, and still feel refreshed, pressured speech, rapid flurry of ideas, and I feel like I'm on top of the world. I don't really have spending problems, delusions, or hypersexuality, but I'm also so wired up that I just can't sleep and I feel like I need to keep moving and talking. My SO says I'm the life of the party, and I feel like it too. However, I'm also pretty medicated, so I'm not sure how much further it would go if I wasn't on meds. It's different for everybody.

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Well, I don't know if "regret" describes how I feel about my hyperspending/hypersexuality. I regret having to pay the bills and am hoping I don't take such huge risks again but regrets?  Not sure I'd describe it that way. 

I was depressed for many young years and refused treatment. Then I took a whole string of unhelpful meds. In retrospect I had hypo and manic, or maybe mixed times that were missed until finally I was so manic on Cymbalta it was obvious to my pdoc. Why was the dx missed for so long?  I was depressed for many years. Your story reminds me of mine although no one ever mentioned bipolar, just blew off what were actually bipolar symptoms. It will probably be a wait and see thing for you. It's only recently I've learned what my nondepressed personality is like and I hope you find yours sooner. I'm doubtful that hypersexual and hyper spending is "just you" but maybe it's a matter of degree. In the end, it's all about whether the meds work, and for me they didn't work until the dx was right. Keep track of how you feel and in time it may be easier to sort out. 

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