Manic Depression?

October 28, 2008 6:01 AM

Do I have "Manic Depression"? I know you are not my Dr., but since I'm not dying and my Doc usually changes the subject on me, I'd love to hear your general knowledge and experience before I go force the issue.

I have brief periods of extreme confidence and empowerment followed by periods of debilitating depression. I've NEVER been OK, but somehow, I have a life now, with a wife and kids and I feel like I'm holding everyone back.

FTR, I am an artist and a writer, so I've always taken being "different" as a given. But now, the more I pay attention, the more I realize that something isn't right.

Also, I take paxil for anxiety and it works for that but is a nasty drug that makes me sick sometimes.

I'd like to hear what you have to say before I try to mess with my Docs, who seem to be more concerned with my weight and BP than anything else. (I'm not even really overweight.) Thanks in advance! Also, this isn't a goof. I'm really tired of being tired.

posted by anonymous to health & fitness (16 comments total)

Yeah, maybe you do. Even if you don't, you have debilitating depression (ouch).

So it seems like you have a mental health problem that needs, needs, NEEDS to be addressed.

Anything that debilitates you is a big deal.

We can't diagnose you over the internet, you have to go see a psychiatrist for that.

Good luck.
posted by sondrialiac at 6:15 AM on October 28, 2008

See a different doctor. You feel like you're holding everyone back, and you very well might be. With the right treatment, that doesn't have to be the case.
posted by TurkishGolds at 6:21 AM on October 28, 2008

Do you have periods where you stay up all night and are very hyper and giddy only to crash a day later? Do you have any inkling about what usually triggers a crash?

If you have bi-polar or not - it might be helpful to read A Brilliant Madness. There is consensus from those with BP that it's a very good read and guide.
posted by watercarrier at 6:26 AM on October 28, 2008

Obviously a diagnosis is out of the question from a paragraph of information. I'm not sure why you seem to wish to have a label attached, as being diagnosed with a label shall assist in your recovery. The fact is clearly your emotions seem to be quite volatile from what you are saying. If you don't feel like your Dr is understanding you, try something different. Try a different doctor, try a pyschotherapist, try CBT, try different meds. There is not one 'fix' but in trying a range of different things the chances are that you shall get to a positon you are more comfortable in or at least be able to understand your reactions to things better. Pyschotherapy with a therapise you trust and have a good repour with can be incredibly useful. Good luck.

PS I understand the whole bored of being bored, tired of being tired, sick of being sick thing.
posted by numberstation at 6:35 AM on October 28, 2008

"the more I pay attention, the more I realize that something isn't right."

This is actually something that most people don't realize, but the more you pay attention, paradoxically, the more pronounced your symptoms will seem to be (and become). Part of the solution lies in the fact that you need to stop thinking about it so much.
posted by tybeet at 6:41 AM on October 28, 2008

brief periods of extreme confidence and empowerment followed by periods of debilitating depression

Yep. That was me. And I got a bipolar diagnosis at the end of last year. Obviously this doesn't mean that you do, but it's definitely worth getting a professional opinion about. Bipolar disorder comes in two main flavours. There's classic manic depression, or Bipolar Disorder I, which includes full-blown mania with psychosis and delusions. You don't have this. I have Bipolar Disorder II, in which the ups don't go as far, but result in hypomania, which is the sometimes-destructive not-always-fun ultra-confidence you might have experienced.

I always knew there was something wrong with me. I always thought I could cope with it and I was mostly right. Then a couple of years ago when, with the stress of other health stuff, I reached the end of my coping resources. I'm just about to get back into work now. This is mostly thanks to finding a drug that worked for me. It's like all the things that got in the way of being myself have vanished. It was quite a surprise to find myself in the middle of all these layers of anxiety, worry and depression. Not everyone responds this well to treatment (I didn't with the first few drugs we tried). The therapy helped a lot too.

There's lots of great information about bipolar disorder online these days, and plenty of people write blogs about their experiences, which I've found really helpful. Seeking treatment isn't easy and being on the wrong medication can really suck very quickly but it was definitely worth it for me.
posted by xchmp at 6:54 AM on October 28, 2008

Go to a psychiatrist. Bipolar is difficult to treat (if in fact you have it, and I'm not saying you do). A general practitioner is not equipped to deal with this.

I grew up with someone who had (diagnosed, but untreated) bipolar. Please, I beg you, do this for your family.
posted by desjardins at 7:03 AM on October 28, 2008

Speak to another doctor.

A couple of years ago my family doctor had me fill out the Goldberg Depression Quiz during a period when I was feeling particularly bleak. A couple of weeks later I filled it out again and when asked about why my moods had shifted my doctor was able to identify my depression as triggered by work-related anxiety.

Recording how you answer this on a) a really bad day b) a more normal day c) an energetic day might provide a more tangible measure of how you're feeling, and could be something your doctor will pay more attention to.

Good luck.
posted by pipstar at 7:14 AM on October 28, 2008

The key phrase in your question was "debilitating depression." I don't know if you are bi-polar, but if you are having depression that interfers with your ability to function, you should definitely see a mental health professional. Don't leave this to your primary care doctor.
posted by hworth at 7:30 AM on October 28, 2008

There's classic manic depression, or Bipolar Disorder I, which includes full-blown mania with psychosis and delusions. You don't have this. I have Bipolar Disorder II, in which the ups don't go as far, but result in hypomania, which is the sometimes-destructive not-always-fun ultra-confidence you might have experienced.

Correction: You *probably* don't have Bipolar I. I have a close family member who was as you describe for a long time -- Bipolar II (and untreated); then had a major manic episode with psychosis and requiring hospitalization.

You should have psychiatrist evaluate you. Bipolar is very treatable, but if not treated it can get worse. If it gets really bad your life can be completely wrecked.
posted by jockc at 8:03 AM on October 28, 2008

my Doc usually changes the subject on me

A second opinion from another doctor is several tiers above any advice you will get here.
posted by [NOT HERMITOSIS-IST] at 8:08 AM on October 28, 2008 [1 favorite has favorites]

Of course impossible to say here, but what you've said would certainly raise enough interest in me to find out more.

It's hard enough to elicit such a crucial history as a doctor. If you're brave enough and concerned enough to try to bring it up on your own and your doctor changes the subject, he or she is doing you a big disservice.

I'd agree with trying to get a referral to a specialist (psychiatrist) to handle any potential mental health issues. In my experience, there are some general practitioners who though they seem to be great at what they do (not sure if that's the case with yours or not), when it comes to mental health they've failed to develop the appropriate communication tools/skills to help their patients.
posted by drpynchon at 8:59 AM on October 28, 2008

Nthing that you need a mental health professional's opinion and help. Make an appointment today. Today, really. You don't have to live like this. Reading up can helpful, and you've got some good suggestions upthread. But those can wait a few days. Getting started with diagnosis and treatment is priority #1.

It may actually have been good that your GP didn't make some casual diagnosis (though it's unacceptable that s/he has been dismissive -- ditch that doc). Too few GPs know how to detect bipolar symptoms, esp bipolar II and cyclothymia which aren't nearly as obvious as bipolar I. It's important to get a correct diagnosis, because the latest research is showing that antidepressant medications do not work for bipolars. Bipolars respond to mood stabilizers, but not antidepressants.

By the way, there are other potential explanations for what you're experiencing. A thyroid disorder, for instance, could be covering up a genuinely confident personality with symptoms of depression. A psychiatriast will usually order blood testing to rule out stuff like this before making a firm diagnosis.
posted by nakedcodemonkey at 9:58 AM on October 28, 2008 [1 favorite has favorites]

A Bipolar I diagnosis requires at least one manic episode. Whether you're Bipolar II, or have another mood disorder, we could only speculate. Get another doctor.
posted by Zed_Lopez at 10:09 AM on October 28, 2008

Oh, and one comment about your feeling that you're holding everyone back--everyone has different strengths and problems to deal with. You will feel guilty about having this problem, but keep in mind that it's like having a bad knee. It's not your fault and it will probably always be a concern, but it's treatable and you can have a great quality of life if you keep working on it. Your family might have to work around it from time to time, but overall they'll be fine and they love to have you around.

If you start having thoughts like "they would be better off without me" seek mental health treatment IMMEDIATELY.
posted by sondrialiac at 11:43 AM on October 28, 2008

No one on AskMeFi can tell you whether you have bipolar disorder. I know this is said for most medical conditions, but it's especially true in this case. Even if one has a manic episode, bipolar disorder is only suspected. My aunt and my brother in law are suspected to have bipolar disorder, but psychiatrists and the books I've read are quick to say years of observation is necessary to make that diagnosis more concrete.

Anyway, nthing you need to make an appointment to see someone who specializes in mental health issues.
posted by Nattie at 4:10 PM on October 28, 2008