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

@needsnewartsyinsta Thank you for replying. I understand you saying look into EUPD but I haven’t a clue what is going on and it’s been going on for years .. Would they prescribe that medication for someone with EUPD 🤦🏼‍♀️ they have told me today that I am 99% bipolar … Thank you @uncomfortablydumb60 xx

Re Quetiapine I was on a big dose to try to stabilise mania/ psychosis Off the top of my head 4-600mg.
Aripiprizole is the only one I haven’t gained weight on

@MummyToBoys29 - I’m glad you got a firm 98% answer - my understanding is mood stabilisers aren’t prescribed for EUPD .
Did they say what you will be prescribed?

Aripiprazole is primarily an antipsychotic. So it’s possible that’s why they’d consider its use in EUPD?

Hope your appointment went well yesterday. I don't have bipolar but in my life I have had one psychotic episode and one manic period as well as depression but lots of my life my mood is quite stable and CBT, as well as guided journalling has worked for me. So I likely don't have bipolar. Although recently I'm under stress and wandering if I do...

So sorry to jump on this thread for myself...the thing that makes me think I may be bipolar is I was prescribed setrline for depression and it did not agree with me all, I could sleep had hallocinations and very strange thoughts. I had it less than a week. I came off it and was reluctant to try another medication, fso was referred to a specialist and only after consultant discussion tried qutiapine. Just a low dose stabilised my mood and it was good for me. I came off it slowly after I felt better.

Mood stabilisers are sometimes prescribed for EUPD - in our case quetiapine was prescribed for emerging EUPD

You need to be wary of mood trackers - self reported states do not necessarily meet clinical definitions. When you say manic, what does that look like? How does it feel? Mania tends to go on for weeks/months without intervention. And it is definitely noticed by other people. Many people are diagnosed with bipolar via hospital admission. Rapid cycling is defined as 4 or more episodes within a year - not daily or weekly fluctuations in mood. Was this assessment NHS or private?

‘99% bipolar’? I’d be wary of your diagnosis. Your symptoms don’t fit bipolar, the mood changes are much too frequent and fast. I also doubt you’ve actually been manic 10 on the mood scale. Mania at that level means you’re acting completely of character, you’re thinking so quickly that your speech is garbled, you have absurd ideas etc. Most will end up being either arrested or sectioned at that level.

It took me 3 years to go from probably bipolar to bipolar. When they did my history there were aspects that were consistent with bipolar and aspects that were consistent with EUPD and they wanted to observe how much moods changed over a longer period of time, what my high moods looked like and whether i had them in the absence of antidepressants.

The first 18 months I was rapid cycling and only had 3-6 week periods of stability in between episodes. I was found to be very sensitive to antidepressants but mostly susceptible to depressions so it took some time to find the right medication. I ended up on quetiapine as a mono therapy. I then settled roughly on two episodes a year, depressed from august to September. Hypomanic /mild mania from April - June. My moods have since stabilised further and my mood is lower in winter still but not to the extent of depression and chirpier but not hypomanic in the spring/summer

I've been on quetiapine for the last 12 years at doses between 300 and 800mg and i would say it's been weight neutral for me. I gained about half a stone after turning 30 and another half a stone after stopping breastfeeding, although I was also on lithium at this point which I think contributed. I've gone up one dress size in the 12 years although there are still clothes I've had since being 16 that I still fit in and I'm 37!
Since getting the probable bipolar diagnosis I have been treated as if having bipolar waiting to see how my moods would be with treatment. Before treatment I would find in the run up to an episode I would have days and weeks where my mood would bounce from low to high every few days and then would settle either high or low. My moods were more susceptible to outside pressures which would make them seem more erratic
Something else to consider is neurodiversity as there has been some studies showing that some women with bipolar diagnosis actually should have an autism diagnosis instead particularly those that experience hypomania and not mania. It's not something I've explored myself as my manic episodes are very obviously mania and nothing else

Yep. At a “10” rating of manic, I’d totally lack the insight to even recognise it as such. I’d be massively, seriously unwell. And it wouldn’t have passed the next day. Everyone around me would spot it a mile off and I’d be in complete denial that anything was wrong.

I have schizoaffective/bipolar 1 & had periods of rapid cycling.

That pattern doesn't look like bipolar at all as the changes are too rapid. Periods of untreated hypomania tend to escalate over several days to a couple of weeks. Depression is usually weeks to months untreated. That's still rapid cycling.

True mania would never last for just a day

That pattern on your chart looks more like mood swings or emotional dysregulation eg EUPD.

Therapeutic dose for bipolar starts from 600mg.

I don't think it's necessarily the dose that causes weight gain but it changes your metabolism long term resulting in weight gain.

I haven't noticed a difference when I've increased /decreased dose but definitely has long term effects causing weight gain.

My husband has bipolar 2, and autism (they can both be true)

I hope the medication helps you. They have not only changed his life but our whole family’s. It took a while to find the right meds, and amount, but he’s doing great now.

I have bipolar and EUPD and I have mood stabilisers as well as antidepressants.
If you have a significant other in your life, try to get them to learn about it and how to recognise if you’re about to go up or down.
DP is quite good at spotting when I’m on the way to hypomania but sadly not when I’m spiralling downwards.