Not ‘just’ depression, not bi polar. What?

[WildOnce]

I’ve been up and down my whole life but it’s always just been called ‘I get a bit low now and then’. I’ve been on sertraline for 2 years and have been on citalopram a few times in the past.

but the mood swings are getting really bad. I woke up ok but a few challenging moments with the kids and I was rock bottom, exhausted, feeling suicidal, fantasising about running away or driving into a wall and genuinely feeling like that would be the best option. I feel low now but not as bad but this has been happening a lot recently. And then another day I am full of energy, laughs and top of the world.

I’ve always been like this. What is it? Depression doesn’t feel like it covers it adequately but bipolar seems too extreme?

Is there any link to your cycle?

It's unlikely to be bipolar if you've been on antidepressants and not had a hypomanic/manic episode. Bipolar disorder isn't just mood swings... it's things like decreased need for sleep (not the same as insomnia, grandiose ideas etc.
keep a track of what's going on and speak to a medical professional

I do recognise what you are saying and agree as above, that it doesn’t sound like bipolar. I too would speak to a medical professional, especially if you are having suicidal thoughts.
Would it be possible to look at some CBT type intervention to help you manage your response to stress? This is not meant to be critical, I say it with kindness as I have a friend who is similar.

@PermanentTemporary its hard to judge at the moment as I’m breast feeding so don’t have one but historically yes it did so I imagine hormones are still playing a part.

@BodyKeepingScore yes it’s not the same thing

i get scared when I get this low. My brother took his life as a young man and sometimes I feel there is no escape
for me. Sounds so fucking self pitying I loathe myself.

Dysthymia?

Do you have any other traits which may suggest something like borderline personality disorder?

Not true. Hypomania caused by antidepressants only affects about 10% of people with bipolar. In fact it's so rare one psychiatrist told me it's impossible when it happened to me.

OP have you considered borderline personality disorder, ultradian rapid cycling bipolar, or cyclothymia? Cyclothymia is a milder form of bipolar disorder.

Also, even if antidepressants don't trigger hypomania in you, you can get VERY disregulated by taking antidepressants if you have bipolar disorder, but in a way that doesn't fit the pattern of standard bipolar episodes. The effects of this can last for months or years if you don't get treatment (for example antipsychotics; there are ones that are safe for BF).

If you're breastfeeding, are you in the postnatal year? If so you can get better help from the postnatal mental health team, your GP or health visitor should be able to refer you. They might be able to figure out what's going on and start treatment.

Other options to consider are PMDD and ADHD, these are less likely than the ones I outlined above but also worth looking into. You could also have a dual diagnosis like I do (bipolar type II and ADHD) which means the two riff off each other and confuse the snot out of psychiatrists during diagnostic work.

I find that after having kids and my cycle mood is amplified and I'm better able to notice pattern. I feel absolutely low, really really dark pre menstrual then I'm skipping around feeling amazing.

Autism? Many women hold it together and mask until they can't anymore. This often happens in 30s/ 40s with increasing demands of life, children etc.

Also perimenopause if you are in 40s.

Op I would say undiagnosed autism with a strong pms.

I’d agree that it could be a mixture.

For example, I have (severe, combined) ADHD, dysthmia and PMS. I think the ADHD occasionally overrides the dysthmia when I get excited or hyper focused or am just in a fun, stimulating situation (to an extent anyway). The PMS sends me to more extreme lows for a good few days before my period (presumably because the dysthmia means my baseline is lower).

Sorry you’re having a shit time, OP. Life’s hard sometimes even sometimes when, technically, it’s not.

How old is your baby?
Do you have a health visitor you could speak with?

Underlying mental health issues can be amplified by giving birth:

www.nhs.uk/mental-health/conditions/post-partum-psychosis/

Hi OP, I have bipolar and really you need to speak to a psychiatrist.

Rather than focusing on depressive symptoms, when exploring the possibility of bipolar, it’s useful to focus on the periods where you are not depressed. People often don’t do this because they feel much better and so the psychiatrists don’t get the full picture and can misdiagnose. Start tracking your mood from 1-10.

Hypomania can be fairly subtle, so think about the times when you don’t feel down. During those times, do you sleep? Do you sometimes think you’re amazing and take on projects? When you’re feeling better, do you have a very high sex drive? How does your spending change? Are you impulsive? Do your confidence levels go through the roof? I tend to get very irritable and angry too.

I’m going to get slaughtered for this but if you can avoid the NHS do so. This is just my experience, but they can be very dismissive if you’re not very obviously unwell. It’s expensive initially to go private by eventually you have appointments very infrequently. If you then get diagnosed, eventually you can get an agreement put in place which allows the GP to prescribe your drugs on the NHS. Doing this saved my life.

Regarding sertraline, prior to my diagnosis I tried it twice. The first time it didn’t do much but on the second I had scary hypnogogic hallucinations, got very anxious eventually stopped sleeping and went into hypomania.

Read this article in the Times

https://www.thetimes.co.uk/article/sydney-lima-how-i-was-diagnosed-with-borderline-personality-disorder-at-30-5878jr56w

Silvert says: “A lot of BPD patients can be misdiagnosed as bipolar, which means months of feeling high followed by months of feeling low. While with BPD you can receive a text saying someone’s coming home late and all hell breaks loose.” The diagnosis was slowly making me feel as though I was a bratty teenager and it wasn’t sitting well.

Also OP, while a diagnosis and drugs are invaluable all the suggestions above are also managed with psychotherapy. If an hour or you can do is get yourself a good therapist (not counsellor) then that will help.

Wow thank you so much for your responses there is a lot to think about here. I have often felt dismissed by people (friends/family) and the NHS because I ‘mask’ my symptoms very well, appear together and articulate, happy sociable etc. Inside it’s often a different matter!

I do think I may be neurodiverse. Autism runs in the family and I think there is also undiagnosed ADHD. I get sensory overload, social anxiety etc but then in so many ways I don’t fit the bill so to speak.

@NCforThis3 so much of what you have written resonates with me. The hypomania - yes, except sleep. I can cope with less during these times but I still need it. Spending and impulsiveness has always been an issue and I’ve got into massive debt in the pay and have to work extremely hard not to again. I’ll suddenly decide to redecorate an entire room and I HAVE to do it and it’s going to be amazing etc etc despite the fact I don’t have the equipment and time etc. sex drive (before kids) can be distracting and I feel like I’m goddess etc. then the total opposite.

I think I need to reengage with a therapist, I am desperate to understand now. I just want to know what’s going on and not impact the kids.

Baby is more a toddler now, 2 in a few months. This has very much been a feature of my whole though.

Cyclothymia

I have a lot off he ‘symptoms’ of ADHD and having looked up Cyclothymia this also strikes a chord.

A family member has recently been diagnosed with cyclothymia (previously anxiety/depression) & possible ADHD. Sounds similar.

I can spend money like water, it’s horrendous. I think people with BPD and Cyclothymia can have that issue too. So many of these conditions have overlapping symptoms, so if you can track your mood for at least two weeks and then go and see a psychiatrist. Try and recall impulsiveness in the time period when you’re tracking but be aware sometimes you might not have insight.

People, were so dismissive of me. I have friends, have a job and am not stupid so any red flags were waved off as dramatics. I was getting dismissed despite the fact bipolar I & II run in my family. I know it’s really hard but don’t take it to heart and keep trying to get help. Anything can be managed better with therapy, drugs and good medical support.

Incidentally, my psychiatrist includes cyclothymia as part of the bipolar spectrum.