Am I on the bipolar spectrum or not?

By Kristina Randle, Ph.D., LCSW

Q. My therapist isn’t sure: I am 47 years old. I suffered terrible episodes of depression — on and off — from the age of 30 through age 43. At the age of 43 (while NOT in a depressive episode) I recalled a trauma that I suffered when I was 8 yrs. old. The trauma I suffered at age 8 was that I was raped by our parish priest. This memory had been completely repressed from the time it happened until I was 43 years old. I don’t know why I remembered this at this particular time in my life, but I did.

After discussing this with my husband and the pastor of my current church, I reported the incident to the archdiocese where it had occurred (in a different state). I found out from the archdiocese that I was not the first person to report abuse by this particular priest, and that he had been under investigation already. (I later found out that my older sister has been abused by the same priest).

Within about a month of this traumatic memory surfacing, I had a raging manic episode. I felt euphoric, I went on uncontrollable spending sprees, I rarely slept, I was delusional to the point of thinking that I could “save the world,” I stole a friend’s checkbook and wrote out 5,000 dollars in checks to myself (forging his name) just so that I could finance my insane spending. After causing A LOT of damage (including getting arrested), I finally came CRASHING down. I became dangerously depressed and suicidal. I was hospitalized twice in the next couple of months.

It has been 4 years since this manic episode. I have still not come out of the hideous depression, am unable to work, and am on social security disability. The difference with this depressive episode is that it has not lifted for 4 years, whereas in the past, the depression would come for a “season,” and then leave. This time, it hasn’t let up. Also, the manic episode I had seems to have been a “one-time deal.” I had never had a manic episode before the memories came back, and I haven’t had one since.

I see a psychologist weekly, but I am not currently on any meds. (In years past I was on many, many, different anti-depressants, and mood stabilizers, but none of them helped me). After the manic episode, I was prescribed Lithium, but my then psychiatrist would not prescribe an anti-depressant for fear that I would have another manic episode (she assured me that Lithium would help my depression as well as prevent another manic episode). After about a year and a half of Lithium (as well as a host of other mood stabilizers), I decided to go off all medication, as I did not think any of them were doing me any good. I don’t think any of the assortment of meds I have been on over the years have done me any good whatsoever. I have not had a manic episode since. But my depression lingers on. I am just barely functional.

I guess my question is (finally): is someone who has had only one manic episode be considered bipolar? Did the trauma of remembering the rape incident cause my brain to go off on a single isolated manic episode? Has the trauma of remembering the rape caused my brain to dive into this hideous depression that will not let up? Are there many people who just stay depressed forever because their depression is “medication resistant”? Although there is some family history of depression and of bipolar disorder, I wonder if my problems have been caused (mainly) by the childhood sexual abuse. If I decide to resume seeing a psychiatrist (as my psychologist hopes), I wonder if I should tell him I suffer from depression, or bipolar disorder? Where do I fall on the spectrum?

A. I am not sure if you are on the bipolar spectrum. It seems that you have a form of chronic depression and a history of a singular incidence of mania, most likely triggered by your traumatic rape memory. Because you only had the one instance of mania, my sense is that you suffer primarily from depression and not bipolar disorder. I do not believe that you can be considered truly “bipolar” if you only had a single mania episode. Please know that I really do not have enough information to know with any certainty what your diagnosis is, but based on your letter, that is my take on your diagnostic situation.

You asked about what caused your current problems. This is a very difficult question to answer and the truth is, even if you had a definitive answer, that information would probably do you little good. Answering the “why” question does little to help you know “how” to go about helping you recover from your depression.

If you do decide to see a psychiatrist, you do not have to come in with your own diagnosis. Just answer his or her questions about your mental health history and see what his or her take is on your diagnosis.

In general, your energy would be better spent trying to find a good, solid therapist who you can partner with to help you overcome your depression rather than trying to pinpoint your exact diagnosis. You already know that you’re suffering, now you need to find someone to help you end your suffering. I hope that the therapist you have now is helping you through this battle but if he or she is not, and you are not seeing significant improvements, then find a therapist who truly can help you make progress. I hope this answers your questions. Take care.

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Last reviewed: By John M. Grohol, Psy.D. on 28 Sep 2007

APA Reference
Randle, K. (2007). Am I on the bipolar spectrum or not?. Psych Central. Retrieved on July 24, 2014, from http://psychcentral.com/ask-the-therapist/2007/09/28/am-i-on-the-bipolar-spectrum-or-not/

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