Bipolar assessment on Wednesday

[MummyToBoys29]

I hope everyone is well!
So I’m booked in to see a psychologist on Wednesday for a 1 hour appointment to be assessed for bipolar. I was asked to fill out a mood chart or download the app and fill it in daily. For those who have bipolar or are in my situation what are your thoughts on my mood chart? I’m scared for Wednesday 😬 and don’t know what any of this means

If your mood changes that rapidly you may be more Borderline Personality Disorder rather then bipolar. With Bipolar disorder you tend to see moods/episodes of depression or mania that last for several days or weeks. Whereas with BPD, it can vary in just a few short hours/day to day.

Apologies for my username I wrote it when I was down.

Yep that looks like the wild ride that is bipolar. Both myself and one sister are diagnosed with bipolar, I also have ptsd and anxiety. I have never filled out anything that fancy. assume it’s an app but have had to keep a record in the past. One thing that stood out is when you felt manic you had hardly any sleep. That’s a for sure for me.

I find stress triggers me and alcohol. I am practically teetotal now, if it’s a wedding or something I will have one drink but it will induce mania for me. I drank alcohol twice last year.

My sister is more unwell than me. I attribute my better circumstances to having a very stable tolerant DH, not having money worries, being able to rest as I retired early and took my pension, not having to rely on benefits, avoiding alcohol, saying no to situations I won’t like such as very busy and noisy venues. Getting plenty of sleep, not being on social media, eating mainly healthy food.

I was not diagnosed till I was in my early fifties after a very stressful event landed me with extreme depression this was then followed by horrendous mania. In depressive phases I have wanted to die but in manic phases I have put myself at risk and could have died.

I look in the mirror if I feel a bit off, if I think I look dreadful I’m aware I’m sliding in to a depressive state. If I think I look great then I know mania is on the up.

I was offered a huge amount of therapy, in total I had 5 years, I think this doesn’t exist quite like this anymore.

Good luck, top tip is avoid any drama and that may include cutting off people. I cut off two relatives as very triggering for my condition.

I’m bipolar and by comparison my highs and lows last months rather than days, so if it is bipolar, it’s rapid cycling.
its likely you will be prescribed a mood stabiliser
They used to wait for 3 episodes before diagnosing, but now just one manic episode is enough

@Soveryunwell Thank you so much for replying. What you have written feels like I’ve written it if that makes sense ? Like we are the same person however I’m only 31. Yes I find alcohol and stress triggers me. And I suffer horrendously with paranoia.

I’ve had 4 years of talking therapy and none of it has worked and they tried me on some antidepressants that wasn’t working or helping me manage. I had to do a mood chart in January and half of the month and wanted to die and was so angry and agitated with the world and everything in it and then the other half I’ve was spending mine and my partners savings like it was an endless pot of money and then drank wine every single day!

likewise I have a very supportive partner but I always worry what I’m putting him through!

I cut off all my family when my mum passed 6 years ago and that’s because my mum told me to before she past and said they would cause me more stress.

Thank you for sharing with me 💐💐

Oooo that looks very similar to my chart for the past year. My bipolar has ramped up due to bereavement, stress and ptsd. Otherwise I’m was much more stable like @uncomfortablydumb60.
Therapy helps me, antidepressants send me even more off the scale. (Psychiatrist was not surprised and very annoyed I’d been given them from the GP).
Due to start mood stabilisers in June as I just can’t manage ‘normal’ regularly enough anymore and I don’t have a family support system and I’ve had to promise to stay in therapy alongside. So following with interest.
@MummyToBoys29 wishing you all the best.

@Alphabet1spaghetti2 Thank you for replying 💐 The last time I was this up and down was October last year. Yeah I found antidepressants ramped it up and bit. That’s what’s I’m struggling with at the minute I’m unable to manage ‘normal’ and it sets me off 🤦🏼‍♀️ once I go whatever way I can’t stop it or redirect! … I hope you are well 😊💐

It does look like your moods are fluctuating more rapidly than would commonly be associated with bipolar. A hypomanic episode has to persist for at least four days, and a manic episode in excess of 7 to meet clinical criteria. Rapid cycling doesn’t mean constantly fluctuating between up and down, it means four or more cycles of mania/hypomania and or depression within a twelve month period.
Shifts that take place over a few hours or days is much more commonly associated with EUPD (or what was previously known as borderline personality disorder).
I notice that you’ve at least one day designated “10” in terms of mood elevation… was that with or without alcohol? What does that look like to you? As an example, for me, something that I’d be charting as a 10 for “mania” would have me hospitalised. So rapid pressured speech, usually accompanied with delusions by that stage, no sleeping and yet loads of energy. Your “high mood” days don’t seem to correlate with a marked reduction in sleep, which would be expected with a manic or hypomanic episode. So I’m just trying to get a sense of what your idea of a “10” on those days looks like.

Sorry, correction, I see that one of the higher days you’d did get quite a bit less sleep. But it’s hard for it to build a picture in itself over the course of a month… so if for example, you were drinking and sat up late, does that account for getting less sleep. It doesn’t seem to have persisted into the next day and sleep was within normal realms again which wouldn’t by typical (although not impossible) without having been medicated if you were manic.

@MummyToBoys29 If you have a rescue plan, try to stick with it and maybe start using it sooner. I find if I wait too long that’s it for me, and I just have to ride it out (hoping for the best outcomes) until either the depression or mania burn out. Then deal with the fallout. My husband (deceased) used to know exactly how to cope with me, spotting the signs way before I did, and together we managed to deal with things. We were very independent.
I’m having to learn new techniques, build a support network and learn to use a support plan - which for me is very scary as it feels like I’m losing my independence and question myself almost nonstop.

@Alphabet1spaghetti2 Im so sorry regarding your husband. My fiancée is the same he tells me I’m on the turn and he is very good at sometimes helping me so it doesn’t get out of hand. I find I sometimes switch so fast that I don’t know how I got into a certain situation or how I become extremely low so fast. A few months back me and my partner was playing cards which we sometimes do and we was laughing and BAM! I was crying I hated my life and stayed in bed for 5 days not eating … I can imagine that is scary for you 💐 You sound like a really strong willed woman 💐 we can all support each other in here

I didn't do any charts before I got my bipolar diagnosis last year but I can tell you that having a diagnosis was the best thing that could have happened to me.

I take anti psychotics and they have worked wonders, especially in preventing manic episodes. They also lowered my dose of sertraline because that was triggering mania.

I was in a bad way before I got help, I had almost completely destroyed my marriage and my family, not to mention myself.

The consultation process was very interesting because they noticed parts of my behaviour, such as talking very fast, which I had no idea I was doing.

I hope you get your diagnosis and some good meds. Best of luck xx

@MummyToBoys29 oof that’s tough. I tend to have a slow slide into an episode, usually over a week, which gives me time to attempt to follow my agreed rescue plan, (which means giving up my perceived independence, so of course I don’t follow the plan until its too late because I’m too stubborn, plus I really quite like being in a manic phase) but then can drop out of an episode almost like a light switch has been flicked and I can feel it like a visceral sensation.
Totally relate to camping out in bed, my car has also been my safe space of late - much to my neighbours concern. I’m exceedingly fortunate to have a very understanding employer, a genius in the form of a therapist and a key worker who are all there for me even when I’m being a right pompous idiot or a crying mess.

Yes, you’ll find your normal when you’re in therapeutic range of a mood stabiliser( for me, it’s lamotrigine) I’m also on a daily antidepressant Any uptick in my mood( usually caused by changes in circumstances, stress of most kinds, and strangely changes of seasons.. summer for me) are nipped in the bud by adding lorazepam and aripiprizole( antipsychotic)
My DS1 can always tell, even if I think I’m fine. He will then contact my GP( it’s on my record) who then rings me with a prescription.
i can slide rapidly into deep, deep depression with literally no thoughts in my head) like a switched flicked off which is why I remain on the antidepressants.
If you are diagnosed then please don’t think life is over, it’s just changed and can be managed.

The major breaking point in my talking therapy was admitting to myself the part I played in it all and not just blaming others. I also used to be attracted to people who were not so good for me especially making women friends who were similar to my own Mum, she was a hyper critical woman. That’s one thing with therapy seeing the world through fresh eyes.

So I woke up agitated but I think it was because I didn’t want to go out today but had to 🤦🏼‍♀️ I have been prescribed Aripiprazole 5mg. @Alphabet1spaghetti2 @Soveryunwell do you have any experience with this medication ? I’m paranoid to start it 😬

I’m on 30mg of Aripiprazole (Abilify) alongside a couple of other meds. I’ve had very few, if any side effects from it. 5mg is a very low dose so it’s likely you won’t have too many negative side effects with it. It’s not known for being as sedating as many of the others.

@BelfastBard Aw ok thank you so much for replying. I hate trying new medication makes me paranoid 🤦🏼‍♀️ Do they help you ? 💐

I’m on 15mg of Aripiprizole as “ belt and braces” as my consultant put it.
I’ve found I tolerate it well. Less sedation and no effects on my weight, unlike Olanzapine and quetiapine where I rapidly gained 2 stone on each

I have found them helpful. As other pp said, they’re less likely to cause weight gain than some others or make you drowsy and that was crucial for me. I take it with 350mg Lamotrogine and 80mg SR Propranolol and it seems to keep me on the level.

Both those drugs did the same to me. And I was so self conscious about the weight gain I stopped taking the medication which was an absolute disaster.

@uncomfortablydumb60 that was going to be my next question about weight gain as I don’t want that .. I’ve heard bad things about quetiapine regarding weight gain. I have a bit more faith in them now thank you and thank you @BelfastBard for sharing with me. I no longer feel a a fish out of water! I feel I fit in now if that makes sense ?

You’re welcome. Don’t be afraid to try them
Any questions then I’m happy to help.

I was diagnosed as bipolar 25 years ago. I have been in quetialine for the last 10 years and have achieved a healthy weight on this - whereas lithium piled the weight on for me. I would be wary in your position of taking antidepressants unless you are very stable in mood as they can often make those with bipolar tip into mania . I’ve found mania far more dangerous than depression - like you when manic I overspend but also put myself in unsafe situations. Your moods do swing very rapidly so it may be also worth looking at EUPD although I’m sure your psychiatrist would have considered this. My strongest advice to you is to listen to the psychiatrists even if you don’t like what they are saying, and push for any reviews to be done by a psychiatrist and not be discharged to care of GP as they are not experts in their field. As a message of hope - I was hospitalised with mania as a student, but have recovered and enjoyed stable mental health since - obviously with highs and lows - and I believe I also suffer from seasonal affective disorder. When I was in hospital (in the 1990s) bipolar was viewed as chronic and I was expected not to return to my studies but be in and out of hospital for life - that was the usual prognosis. Medications have improved and I’ve never been back in hospital since. I’ve had episodes of hypo mania but they have been treated in time. Listen to your partner when he observes your mood changing -is he able to come to the assessment with you?

What dose of quetiapine were people on who experienced weight gain? I’ve just started on 50mg

I was on around 300mg per day, although the max I was ever on of it was around 400mg I think.
I have at points since then, had 25mg to take once at night which didn’t seem to cause any weight gain.