Hi all, I have suffered with anx and depression for many years, but lately bipolar has been mentioned by my therapist. Could I run through my main symptoms and you kind people can give an opinion? I have bad anxiety most of the time, I don't have a classic high, my high is more about lack of need for sleep, don't seem to need much food, loads of creative work going on and I get really out of sorts if I'm interrupted. My downs happen generally after a high time of a few weeks, then I just crash out - dont want to do anything or talk to anyone
Bearing in mind how difficult these things are to judge at a distance - nevertheless, Id say, yup, sounds pretty Bipolar 2 to me!
The lack of sleep - not needing to sleep or eat - loads of creativity and energy - and irritability at interruption - theyre all pretty textbook. Bipolar is massively underdiagnosed - because who goes to the Doc when they feel great?!
Its only in Bipolar 1 that you get the more widely known and obvious symptoms like heightened sexuality and lack of inhibition, huge overspending, psychosis, drug addiction, etc. The depression, however, can be every bit as severe in Bipolar 2. So your therapist is being responsible by suggesting re-diagnosis. Are they offering to refer you to a psychiatrist? If so, dont be scared to go! I know its a bit intimidating - but it could be very useful for you. Let us know how you get on! x
Thanks, that's very helpful indeed. I don't think I have any type 1 symptoms. My gp has mentioned a psychiatrist ,but I'm so scared of talking meds,it does worry me a little
Are there typical lengths of time of up time vs down? Generally speaking I am anxious and up than I am down, recently though I have made a decision to do less of the creative things, I felt they were taking far too much out of me. As a consequence I'm suffering more extreme bouts of depression. So hard to know what's going on!
That pretty much sums up bipolar - '[so hard to know] Whats going on!' - one of the big myths is that Bipolar means up one minute down the next. That type is actually pretty rare ('rapid cycling'
. There are no 'rules' - some people are mainly depressive, with a few minor highs - yet are still truly, genuinely Bipolar, others (myself for example) have Major highs followed by Major lows clearly alternating.
Also, highs dont necessarily feel nice. Some people have Irritable hypomania, others have angry highs. You can even get something called a Mixed Episode or mixed state (i get these and they are truly horrible) - where you have the energy of a high, but the feelings of a low. Could that be something like what you describe as anxiety? The mixed moods make me feel like a cornered animal - just desperate, climbing the walls.
Dont be scared of psychs and meds. Most psychs these days let you choose which drugs you want to try and wont force you to take anything you dont want to. It wsa a revelation to me - I avoided mental health professionals for 20-odd (very odd!) years cos I had images of Victorian cold-showers routines and forced medication and Bedlam type hospitals! Things genuinely have moved on and the psychs and nurses are all pretty human these days.
PS you dont say what type of creative activity you have scaled down - generally creative activity is therapeutic, but you wont get much out of anything whilst you are actively ill - either depressed or severely manic. You know yourself best. If its a social type of creativity - eg music - it rather depends on the people around you. If it entails lots of drinking and wild behaviour - probably best to stay away for a bit. If its only occasional and calm and surrounded by sympathetic, sensible types, Id say its probably useful. Only you can decide. All the best!
My creative outlet was art, I would spend hours non stop creating a piece, till I was exhausted, then it was all about the next,and the next etc. I was so constantly driven, it felt good at the time buy straight after it just wasn't enough. My anxiety I would describe as feeling really having the need to be creative, to please or excel at everything, and knowing that it isn't possible, so while I'm actually doing whatever it is I know at the same time it's pointless and wont give me what I need. Do hard to put into words. I guess I've got some pretty dark artworks out of it, but I just don't think I can keep doing it anymore, I still have the drive, but just don't have the will or the energy anymore. Work is usually a huge thing for me, I'm a programmer so it's a great canvas to be creative with, but I need to excel- if not then it's not worth it. And now I'm at the stage of my nightmare where I need to be off work- which I hate, but I know I can't keep going as I am
Textbooker and textbooker (to paraphrase Alice!)... that trope of the 'tortured creative genius'aint a myth. Theres lots of evidence to show creative people are much more at risk from Bipolar.
And the perfectionism you desribe is a prominent feature of a type of depression called Dominant Goal type depression. (Fellow sufferer - except my bipolar so bad i never got enough 'normal' to achieve anything. We all have our crosses to bear tho, i guess!)
Are you able to concentrate well enough to read a book? Cos Im gonna recommend two that really, really helped me:
They F@#k You Up - by Oliver James
Touched with Fire - by Kay Redfield Jamieson
James is a child psychologist - his book is about auditing your childhood and has a good chapter on Dominant Goal and perfectionism
Redfield Jamieson is a hugely eminent psychiatrist - who also suffers from Bipolar 1. Its about bipolar and the creative mind. Theres a list about 10 pages long and a very in-depth scientific appraisal of all the major artists, poets, composers etc who were definitely or probably bipolar - its also very humane and interesting and a good read. Both available on Amazon last time i recommended them (im a bit of an evangelist for these books cos i reckon they saved my life).
Know what you mean about a creative outlet becoming an inlet - for pressure intrusive thoughts obsession etc. i try to write as much as i can while i am well - but my writing only really flows when im hypomanic. So i keep getting tempted to stop my lithium. Only the cringey memories of all my nympho-psychotic manic embarassments is enough to make me keep taking the tablets! Its a poisoned chalice, for sure. A double-edged sword.
Thanks Christine, thats all really interesting, and familiar . I do struggle with focusing long enough to read a book, but I'll see if I can get.my hands on those thanks! Its so difficult these days to get any kind of.diagnosis, many therapists say a label isn't important, but sometimes I think it's.needed
too right diagnosis is vital - i only really started accepting my illness once i had the diagnosis. when you say therapist, do you mean a private counsellor that you have arranged yourself, or an NHS practitioner? Cos if its private then yes unfortunately you will have to go through your GP to get a referral to your Community Mental Health Team psychiatrist, and some GPs are more co-operative than others. I would definitely order Touched with fire (Kay Redfield Jamison) as it contains all the diagnostic criteria lists from the Diagnostic Manuals that the psychiatrists use (theyre american but our Royal college of psychiatry guidelines are based on them). So you could check off your symptoms against the actual scales a doctor will use - information is power!
Good luck whatever you decide to do and keep in touch!
My therapists are NHS assigned yes, I would love to be able to go private. I don't always think the NHS have the very best to offer sometimes. My local community psychiatric nurses I must say are fairly useless, they don't seem to help at all. Brilliant thanks, I'll look for that!
know what you mean about nurses - they're not very proactive in my experience. Kind, sympathetic, well-meaning - but i) completely unaware of most research since they qualified ii) unimaginative about treatments, therapies etc. HOWEVER .... in terms of getting a proper diagnosis, emergency/crisis help, meds - I think you're better off with the NHS because its an unequivocally recognised diagnosis. So if you're already 'in the system' I would say - make an appointment with your psych ASAP to explore treatment options - the main reason I say that is because Bipolar is a progressive condition. Every manic or hypomanic actually permanently damages the brain, making another manic/hypomanic more likely. Also because anti-depressants are great and lifesaving in my case (remember, depression and bipolar are conditions with a mortality rate approaching heart disease) - but anti depressants have to be handled with care if youre bipolar because they can trigger manic episodes. And it sounds like your hypomanics arent so much fun, even if you enjoy the creativity? I mean, my full-blown manias are only fun while im in them ..... the aftermath is horrible. The last one cost me forty grand - despite the fact it also saw me join a pain-for-pay website!! work that one out haha.
All the best - I think you'll be very pleasantly surprised at what the NHS offers - it seems to take Bipolar more seriously than 'common or garden' depression (thats not fair, but thems the breaks).
Thanks Christine, who generally would be the one to make a diagnosis? GP, psychotherapist or psychiatrist? I ask because so many don't seem to want to commit themselves! No my up times are dreadful, very creative and productive but God I could live without them! At least with the depression I can sleep!
Diagnosis (in the NHS) can only be made by a psychiatrist - if a GP suspects anything more serious or complex than mild-to-moderate depression or anxiety, they're supposed to refer you to the Community Mental Health Team, which are headed by consultant psychiatrists, who will diagnose you, then give you a care plan - which, realistically, will be meds and monitoring by a psychiatric nurse. If you live in a city, near a research uni/psych hospital, you might be lucky enough to get a referral there, where your care might be a bit more cutting edge, but I dont have first hand expereience of that, so cant advise. Most areas have various projects for therapeutic help - walk'n'talk groups, support groups, art therapy (might want to skip that!), music therapy - thankfully ive never been offered basket weaving, but maybe they hold that joy in reserve for the really interesting cases! I personally dont tend to join in with the therapeutic groups stuff, cos im a bit of a bookish loner. But some people really do find it very helpful indeed - mainly cos you dont have to explain anything, everybody there 'gets' your condition and are sympathetic.
I would talk to your psychotherapist - if theyre in the NHS, they should be able to refer you back to the CMHT or your GP to make that referral. (You may have to hand-hold them through this process, dont get fobbed off or put on the back burner. But if your therapist was the one to raise the suggestion of bipolar in the first place, they should be pretty chuffed to be 'proved right' so will fight your corner to get diagnosis. HOWEVER - psychiatrists tend not to like being 'told' by other (lesser) professionals. So I wouldnt go into the psych appt saying :'my therapist says im bipolar' .....!
I think I'll ask my GP to refer me to a psychiatrist, she actually offered on Monday, so I think I'll take her up on it . Yeah that makes sense, I wouldn't think they would appreciate that! The previous diagnosis of anxiety and depression just doesn't sit any more, there's never a shift in my symptoms, they seem to cycle too regularly
Sounds to me like you actually have some pretty decent people on your side. If your GP has offered referral - rip their hand off!! Lots of people have to battle to get that referral, so I think you're in reasonably good hands. I hope your psychiatrist is equally decent: a good sign is if they give you print-offs of different medications to choose from showing their side effects etc. That way you'll know what your options are rather than just being told what to take. Psychiatrists tend to try and include you in your care plan these days.
Indeed yes, mostly the people around me are good, in all honesty I think it would be great to have a proper diagnosis, rather than a really generic one, maybe they won't see bipolar, but I think they are better placed to decide, rather than a GP who doesn't know, and a psychotherapist who doesn't think it matters
Absolutely. Go back to the GP and say you want that referral after all!
Then when you have your appointment with the psychiatrist be sure to mention the creative bursts, especially how they take over your life. Talk about the lack of sleep, absence of appetite (especially if you lose weight because of it). Mention that your anxiety is chiefly around success and artistic perfection, and that as the energetic phase progresses it becomes increasingly fraught and intense and ends up in a terrible crash. If you overspend and get into debt, tell him that - dont be ashamed - same goes for drinking, drug use, sexual behaviour - they are all symptoms. If you ever have any unusual thoughts or see/hear things that arent real - im thinking when you are in the throes of creative obsession - again, dont be embarrassed, he's heard ten times worse even though all this stuff feels cringey, its very important to get everything out in the open. All the above symptoms are genuinely Bipolar symptoms so will contribute to him correctly identifying this as your problem. Very best of luck! Please let me know how it goes!
thanks so much for the advice, thats really super helpful. overspending has been an issue, i ended up bankrupt just because i didnt think or care about what would happen once i spent. drinking - i dont at all, totally stopped, drug use - no never, sexual behaviour - jeez where to start! unusual thoughts - pretty much all the time, which lead to the anxiety i think, see/hear things- no to that one. after a creative episode the crash was mainly one of total worthlessness and anger at myself for spending so much time on effort for something which has no importance - then either another more intense period of it to try and better it - or totally giving up.
Well today I saw my therapist and my referral to psychiatry is done! I should get an appointment soon! Fingers crossed it's not too long. Many thanks for all your advice