So my doctor thinks I am bi-polar

[Eats_Crayons]

@jsgoddess

Can anyone give me kind of a basic idea of how bipolar disorder would manifest differently from depression with anxiety?

Depends on the person. But when I have a mixed episode and describe it as “despairing anxiety” it’s not the same as “depression with anxiety”. It’s much, much more… energetic and strangely internalized. Really, when I say “depression and anxiety on 17 cups of espresso”, I’m not kidding. I have literally begged to get knocked unconcious to get relief from the incredible energy.

In a mixed episode, in my experience, there is incredible distress about the amount of energy you have coursing through you. I often feel like I have an impossibly vast hurricane somehow condensed into my cranium – and that just can’t be! It’s also difficult for me to talk because I talk so fast that people can’t understand my words, and often my thoughts are coming SO FAST that my mouth can’t keep up. So my sentences cut each other off mid-stream and my words come out in the wrong order.

“I went to the store. I bought some cat food. Then I did laundry.” will come out as “I went dry-laun dry-laun cat food.”

It’s like taking too much speed while riding on a rollercoaster after your best friend has died. A remarkable free-fall that is so BIG words fail to describe it.

He can play a computer game for days straight, gets a bug in his ear about buying or doing or accomplishing something and he won’t let it go until it’s done.

As Q.N. said that’s sounds more obsessive.

Hypomanic or manic, it can be hard to sit still long enough to settle down for one task, even if I’m fixated on it. When I’m hypomanic, you practically have to tie me to my chair. I will probably do a minimum of three different tasks all at the same time (oh, I get a helluva lot done, I tell ya), and I will stand up, sit down, stand up, sit down as I do it. I used to wander around a lot. Work really fast and intently for 10 minutes, wander the building for five. Sing to myself as I’m working or talk in cartoon voices making up complex narratives like I’m scripting an episode of the Muppets. It’s really hard to get me to shut up.

Oh, I can work for days straight too with no food or sleep, but I don’t think I could focus on one thing for more than five minutes.

Also, as Q.N. pointed out. A lot of disorders are comorbid. Particularly those that affect the same part of the brain. For example OCD and Tourettes often show up together in the same individual.

[Eats_Crayons]

@Q.N. Jones

Manic symptoms are:

1. inflated self-esteem and/or grandiosity
2. decreased need for sleep
3. more talkative, or feels pressure to keep talking
4. “flight of ideas” or racing thoughts
5. distractibility
6. increase in goal-directed activity
7. psychomotor agitation
8. excessive involvement in pleasureable activities, esp. those that are risky

snort!

Compare this to my last post!

[Q.N.Jones]

@Eats_Crayons

Hypomanic or manic, it can be hard to sit still long enough to settle down for one task, even if I’m fixated on it. When I’m hypomanic, you practically have to tie me to my chair. I will probably do a minimum of three different tasks all at the same time (oh, I get a helluva lot done, I tell ya), and I will stand up, sit down, stand up, sit down as I do it. I used to wander around a lot. Work really fast and intently for 10 minutes, wander the building for five.

Such an excellent point. I may want to play a computer game all night long, but I sit down and try and I’m bored in five minutes. I get up and wander around, all the while dying to get back to the game.

And repeat.

I start lots of projects that I can’t finish, and come up with ideas for at least as many that I’ll never start.

If he’s focusing that hard on something, and getting things done, that’s why I say it sounds more obsessive than manic. Couldn’t quite articulate it before. Thanks, Eats_Crayons.

[Q.N.Jones]

@Eats_Crayons

snort!

Compare this to my last post!

Mna, I know. When I first got manic (really manic), I wasn’t sure I was, so I whipped out my DSM-IV and read that list.

And busted out laughing. Seemed like such a good joke!

[Q.N.Jones]

DSM-IV criteria for Obsessive Compulsive Disorder:

A. Either obsessions or compulsions:

Obsessions as defined by (1), (2), (3), and (4):

(1) recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress
(2) the thoughts, impulses, or images are not simply excessive worries about real-life problems
(3) the person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action
(4) the person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind (not imposed from without as in thought insertion)

Compulsions as defined by (1) and (2):

(1) repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly
(2) the behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive

B. At some point during the course of the disorder, the person has recognized that the obsessions or compulsions are excessive or unreasonable. Note: This does not apply to children.

C. The obsessions or compulsions cause marked distress, are time consuming (take more than 1 hour a day), or significantly interfere with the person’s normal routine, occupational (or academic) functioning, or usual social activities or relationships.

D. If another Axis I disorder is present, the content of the obsessions or compulsions is not restricted to it (e.g., preoccupation with food in the presence of an Eating Disorders; hair pulling in the presence of Trichotillomania; concern with appearance in the presence of Body Dysmorphic Disorder; preoccupation with drugs in the presence of a Substance Use Disorder; preoccupation with having a serious illness in the presence of Hypochondriasis; preoccupation with sexual urges or fantasies in the presence of a Paraphilia; or guilty ruminations in the presence of Major Depressive Disorder).

E. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Specify if:
With Poor Insight: if, for most of the time during the current episode the person does not recognize that the obsessions and compulsions are excessive or unreasonable

OR

DSM-IV criteria for Obsessive Compulsive Personality Disorder:

Diagnostic criteria for 301.4 Obsessive-Compulsive Personality Disorder
(cautionary statement)
A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

(1) is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost

(2) shows perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her own overly strict standards are not met)

(3) is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity)

(4) is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification)

(5) is unable to discard worn-out or worthless objects even when they have no sentimental value

(6) is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things

(7) adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes

(8) shows rigidity and stubbornness

[wonky]

@Q.N. Jones

As you can see, a lot of mania is experienced internally and isn’t necessarily obvious to others. You’d really have to show this list to your husband and have a serious talk with him.

We’ve discussed it but he tends to assume that if he’s got other things going on the doctors would already know. If they haven’t mentioned it, it’s because he hasn’t got it.

But from your description I think obsessive does sound much more apt. Can anyone point me to a good reference for learning about diagnosis and treatment of obsessive disorders? Would you think it likely that if he’s obsessive as well as depressed that the treatments or medications for depression simply wouldn’t work all that well? I guess what I mean is, is treatment for obsession basically the same thing (anti-depressants plus therapy) as treatments for depression, in which case the lack of a diagnosis (if he’s obsessive) hasn’t been hampering the treatment?

[Eats_Crayons]

@jsgoddess

Can anyone point me to a good reference for learning about diagnosis and treatment of obsessive disorders? Would you think it likely that if he’s obsessive as well as depressed that the treatments or medications for depression simply wouldn’t work all that well? I guess what I mean is, is treatment for obsession basically the same thing (anti-depressants plus therapy) as treatments for depression, in which case the lack of a diagnosis (if he’s obsessive) hasn’t been hampering the treatment?

www.mentalhealth.com is a really handy resource in general. You can surf various diagnostic criteria from both the U.S. and European descriptions of the different diseases and disorders. It often talks about different medications (or has links to it) as well as conflicts and contraindications of various kinds.

It’s also easy enough to follow that you don’t have to be and M.D. to follow along.

[Q.N.Jones]

@jsgoddess

We’ve discussed it but he tends to assume that if he’s got other things going on the doctors would already know. If they haven’t mentioned it, it’s because he hasn’t got it.

WRONG. Doctors only know what you tell them. Ain’t like they can shine a light in your ear or take an X-ray of your head and diagnose you with mental illness. If he’s not talking about things that are pertinent, they’re not gonna know.

But you surely are aware of that.

But from your description I think obsessive does sound much more apt. Can anyone point me to a good reference for learning about diagnosis and treatment of obsessive disorders?

See above. Be aware that he may not be a textbook case of OCD or OCPD. Nevertheless, if he has some obsessive-compulsive symptoms, and they’re affecting his life, treatment is still a good idea.

Would you think it likely that if he’s obsessive as well as depressed that the treatments or medications for depression simply wouldn’t work all that well?

Here’s the thing about anti-depressants: they’re not going to cure your depression all on their own.

Most people will need to put some kind of effort into recovering from depression, in addition to taking meds. This means therapy and/or lifestyle change.

This could be the reason his depression isn’t getting any better. He does not sound like a very cooperative patient.

I guess what I mean is, is treatment for obsession basically the same thing (anti-depressants plus therapy) as treatments for depression, in which case the lack of a diagnosis (if he’s obsessive) hasn’t been hampering the treatment?

Well, therapy for obsessive-compulsives is going to be a lot more behavior-oriented than that for depressives (usually). If he’s not getting help for his obsessive tendencies, and those tendencies are causing situations that make him miserable, then it’s possible that’s what’s hampering the recovery.

Has he tried Luvox? It’s an SSRI anti-depressant, but it’s mostly used as an anti-obsessive/compulsive. If he’s taking anti-depressants, this would probably be a really, really good one to try.

It is not much used in the U.S., so his doctor may not know much about it. He should really ask. Also, you could both do some research/reading about it.

A start: Luvox

[Eats_Crayons]

@Q.N. Jones

Ain’t like they can shine a light in your ear or take an X-ray of your head and diagnose you with mental illness.

But if they drill a hole in your head…

What?

[wonky]

@Q.N. Jones

Here’s the thing about anti-depressants: they’re not going to cure your depression all on their own.

Most people will need to put some kind of effort into recovering from depression, in addition to taking meds. This means therapy and/or lifestyle change.

This could be the reason his depression isn’t getting any better. He does not sound like a very cooperative patient.

It’s weird. He’s cooperative with doctors. I’d argue that he’s sometimes too cooperative. He doesn’t question things as much as I do.

But he won’t take responsibility for his treatment. I guess it’s all part and parcel of the same thing. He’s got serious phone avoidance and won’t call for an appointment. If I’m not willing to take on the responsibility, and sometimes I’m not, and sometimes I can’t, he will absolutely refuse. His doctors ignore that aspect and basically expect him to do things that they refuse to acknowledge that he will not do. He claims that he can’t do them (call and make an appointment, etc.). I’ve tried to make it very clear to doctors what’s going on, but they will still create a situation where he has to take charge and he won’t do it.

So, guess who gets to shoulder all the responsibility and all the blame? You guessed it.

Oh dear. I didn’t mean to go all ranty. Sorry about that.

[Eats_Crayons]

@jsgoddess

So, guess who gets to shoulder all the responsibility and all the blame? You guessed it.

Oh dear. I didn’t mean to go all ranty. Sorry about that.

No worries. Any disability from physical to mental, debilitating or not-so-bad, can require a huge amount of patience. Whether your grandma has Alzheimers, or your aunt has cancer and needs assistance, or your borther broks his foot and is whining on the couch a bit. It’s not easy.

I’m quite aware that I can be downright infuriating. My ex could be infuriating too and her moods swing were “normal”!

It can be frustrating. It’s human nature. My freinds borther has Tourettes. Most of the time the family just ignores it, but once in awhile someone will snap and just go “Gah! Would you shut the hell up, already???” then immediately feel guilty for it.

It’s just a matter of remembering that the circumstance may drive you batshit, but the person is still the good-guy.

[Q.N.Jones]

@jsgoddess

So, guess who gets to shoulder all the responsibility and all the blame? You guessed it.

Oh dear. I didn’t mean to go all ranty. Sorry about that.

Friggin’ hamsters ate my post.

I had a long post in reply to this, but here’s the short version. I’m too wordy anyway.

Anyone who is married to a person struggling with mental illness is under a lot of stress. It’s enough stress that you should not try to shoulder it alone.

My mom was under a ton of stress over my illness for a long time. She ignored it until she had a TIA (mini-stroke) and lost her hair. All because she was so freaked out about what was happening to me.

She ended up doing what she should have done long before that: she got her own therapist. Someone to be a sounding board for frustrations. Someone to help her figure out how to best help me. Someone to help her figure out when to intervene and when to back off.

It’s made her feel a lot better.

I’d strongly recommend that you find a therapist yourself. My mom only goes about 6 times a year, but it really helps. She got hers through EAP at work.

You deserve some help and some relief. Don’t wait until your hair falls out.

[Q.N.Jones]

@Eats_Crayons

But if they drill a hole in your head…

What?

Huh? Sounds reasonable to me.

Then again, I’m crazy.

[Eats_Crayons]

Snicker

[Q.N.Jones]

I knew the SDMB was a neat place, but I never realized I’d end up using it to bond with cool bipolar people.

You crack me up, Eats_Crayons.

[Eats_Crayons]

Hey Q.N., ever take an IQ test? While reading about all this BPD stuff, I found a tidbit that said that “biploar people tend to have high IQs”.

“Really?”, I said to myself. Went to the psychology department at my university where the students are forever trying to do experiments. “One ticket for an IQ test, please!”

<Bart> Coo-oo-ool! </Bart>

Of course then I had this kind of existential crisis. “You mean, if I wasn’t sick I’d be stupid??? :mad: Hmph!”

[Q.N.Jones]

@Eats_Crayons

Hey Q.N., ever take an IQ test? While reading about all this BPD stuff, I found a tidbit that said that “biploar people tend to have high IQs”.

Yeah, this is one reason I didn’t suffer even longer before getting diagnosed. My resume screams “smart” and the first thought it brought to the minds of my docs always was, “Hey, maybe you’re bipolar!”

Of course then I had this kind of existential crisis. “You mean, if I wasn’t sick I’d be stupid??? :mad: Hmph!”

No. If we weren’t smart, we wouldn’t be sick.

Oh, wait, that isn’t any better, is it? :smack:

[Eats_Crayons]

I kind of prefer the “driven to insanity be genuis” angle.

Although my car is in storage, so I don’t drive much anymore.

[Q.N.Jones]

@Eats_Crayons

I kind of prefer the “driven to insanity be genuis” angle.

This is what I’m going to start telling people.

“You know…just like Van Gogh.”

I’m sure people will be impressed with my modesty.

[MaggietheCat]

I am sorry to get to this thread so late. I am bipolar. I have attempted suicide three times in the last 15 years, before I was properly diagnosed. I went through the failed medication and incorrect diagnosis syndrome before a very good therapist figured out what was wrong with me.

My major problem is that I do not fit the classic pattern for bipolar, so the doctors diagnosed me with major depression. I was on Prozac, Paxil, Wellbutrin, Trazadone and a host of other drugs, and nothing worked. Until a new therapist decided that just because I didn’t fit the pattern it didn’t mean that I wasn’t bipolar. She put me on lithium and it changed my life. I literally think differently than I did before. I used to wander around in this little thought circles, dwelling obsessively on one little thing or another and unable to think about regular life activities. Now I don’t do that any more. I swear, the lithium won’t let me. I think better and more clearly than I ever did before. I haven’t had a big-time crash in almost ten years. I am out of therapy and as long as I take my meds I’ll be fine.

One thing that I have noticed about the bipolar people I have known - they are often resistant to taking their meds because the highs feel so good. It’s like they can’t remember the depressions and the suicidal impulses; they only remember the “I Am God” feeling that comes with the mania. Well, I remember both. And I am hear to tell you that it is not worth it to suffer the downs for the sake of the highs. I don’t have either any more; I just have normal emotions. That’s enough for me and I’m not ever going back.