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-   -   How does one know? (https://www.neurotalk.org/bipolar-disorder/108118-how-does-one-know.html)

RhiannonsMoon 11-15-2009 05:11 PM

How does one know?
 
Hi All,

How does one know if they are depressed as opposed to bipolar? I've been more than chronically depressed for over 3 years.

I have bouts lasting for months tapering to weeks with only days or upto 9 days at the very most of happiness inbetween.

I don't know that I am bipolar. I don't think I am. I don't have swings from one feeling to the other.

I can feel it when the depression is descending again and I start to retreat. It comes on over the period of a few days.

But how do you tell? I'm not just asking for my personal reasons. I really want to know and understand,

Thanks,
Rhiannon

Mari 11-15-2009 05:24 PM

HI,

Do your sleep patterns change?

M.

RhiannonsMoon 11-15-2009 05:34 PM

Hmmm...I couldn't say yes to that. I wake every morning at the same time, my eyes flying open after the racing thoughts start. And I have to get out of bed there and then to try to distract myself by doing things (as I am now, using the internet to keep me occupied), with the feeling of anxiety & agitation in the background snapping at my heels

Mari 11-15-2009 06:30 PM

Soft Bipolar
 
HI,

Well that is good that you are sleeping.
Sorry about the racing thoughts. Those are awful.

Here is a great web site about soft bipolar:
http://www.psycheducation.org/depres...osis.html#soft


also
http://www.psycheducation.org/depression/Anxiety.htm

Agitation and anxiety can (not necessarily) be symptoms of bipolar.

Quote:

When this kind of anxiety is present with depression, this may be the worst combination of all. Anxiety is a very strong risk factor for suicide when people are depressed. The future looks hopeless and pointless because of the depression; and the present feels unbearable. Again, it's important to know that this combination is very treatable. If you find yourself feeling and thinking like this, and you don't have a doctor or therapist to help you manage it in the short and long term, you should take specific steps to keep yourself safe, including going to an emergency room if necessary.


M.

bizi 11-15-2009 10:53 PM

A good psychiatrist can diagnose you, do you have one or is a gp managing your antidepressants?
do you have access to a therapist?
I am sorry that you suffer with depression so much that must be exhausting.
((((HUGS))))
bizi

waves 11-16-2009 08:40 AM

Hi Rhiannon
 
The difference between a person with recurrent major depression - Major Depressive Disorder - and Bipolar Disorder, is that a bipolar person must have had at least one "high" episode which would include any one of:
- mania
- hypomania
- mixed mania

The episode must not have been induced by drugs, licit or illicit, and must not have an organic basis such as thyroid dysregulation.

For a doc to diagnose you, they will want to take a history of your experiences as well as know about family history of illness. However it is best for them to diagnose your symptoms when unmedicated.

I am wondering if you know that Cymbalta is a type of antidepressant and in some people, even not necessarily bipolar, can cause activating symptoms including racing thoughts. This and other antidepressants can actually cause a manic reaction, even if you are not bipolar.

I am also wondering if you are on any meds besides Cymbalta... If you are taking certain of the AED's, the med could cover manic or hypomanic symptoms. Many of these medications (not all) are used as "mood stabilizers" but with the exception of Lamictal, which works below baseline - i.e. on depression not mania, they work to treat mania and prevent manic episodes. Bipolars may still have breakthrough symptoms. But my point was, if you did have bipolar but were taking AED's they could certainly cover it up... at least most of the symptoms. The racing thoughts could be a breakthrough symptom...

OR

a reaction to the Cymbalta. When did the racing thoughts start? Did you have this going on before starting Cymbalta... were you taking another antidepressant then, also? Ever had them when NOT medicated?

Do you have family that is bipolar? (feel free not to answer)

Generally those with Major Depressive Disorder who have episodes of "atypical" or mixed depression (or agitated depression) are not considered bipolar... but this will vary based on the clinician, and the gravity of the symptoms. Major Depression is common in relatives of bipolars, however, they are more likely to have atypical features including activation (agitated depression). This is more and more being considered to be a "bipolar spectrum" disorder... or soft bipolar as Mari was saying.

Unfortunately psychiatry is an inexact science. The labels are just that. There are some individuals which have a fairly clear illness pattern that matches diagnostic guidelines well. Others do not have such a clear match. The purpose of guidelines and diagnostic labels is really to provide treatment and improve quality of life. So we must use the labels with parsimony and focus rather on the symptoms and corresponding treatments.

i hope this helps you some. :)

:hug::hug::hug:

~ waves ~

Mari 11-17-2009 01:31 AM

Quote:

Originally Posted by waves (Post 590152)
Do you have family that is bipolar? (feel free not to answer)

Generally those with Major Depressive Disorder who have episodes of "atypical" or mixed depression (or agitated depression) are not considered bipolar... but this will vary based on the clinician, and the gravity of the symptoms. Major Depression is common in relatives of bipolars, however, they are more likely to have atypical features including activation (agitated depression). This is more and more being considered to be a "bipolar spectrum" disorder... or soft bipolar as Mari was saying.

Hi,
My mother's family tree has alcoholics and depressives. . . . Also folks with eating disorders, anxieties, ocd, . . .
Some of these people were diagnosed. Most were not.

Also, in a family like this, one might see sudden job / career shifts, moves across country / unwise financial moves. Actually, I think except for my brother, maybe most of my mom's family is conservative with money -- more depressed than anything else.

If you start looking at patterns you can find some answers for yourself.

M.


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