Depression or Bipolar?

By Kristina Randle, Ph.D., LCSW

I have recently started seeing a psychologist after having to demand to do so with my GP.For the last year or so I have been having rather vicious mood swings, mostly with anger and annoyance. I would scream out in literally a matter of seconds and be back to normal less than 5 minutes later. There was no coming down or building up, more along the lines of calling it a flash in the pan. But while it was happening it was as if I was a bystander, knowing what I was doing was wrong and even thought I felt the anger and often hatred and hated myself for it, I couldn’t control it for those few minutes. It wasn’t as if this was a different person, more along the lines of knowing that this was me, yet I couldn’t control it.

I have recently gotten these under control. However, during the last 8 months I have also being deal with swings of depression, for lack of a better word. Sometimes it would last for hours, or others just for 20 minutes. I would fall into this deep pit that sometimes led to self loathing and internal rage at myself with thoughts that I couldn’t seem to control.

But within the last three or so months things have started to feel numb. Like there is a blanket being thrown over everything, dulling it. Events that I had been sanely excited about before hand, I was hit with one of my swings of depression right before it. Things like Christmas and even my upcoming birthday haven’t excited me at all, a complete different attitude compared with most of my life.

I recently met a friend who has come to be like an older sister to me, and even through spending time with her I was subdued and withdrawn and hating myself for every minute of it.

When these bouts hit it’s with feelings and taunts of utter worthlessness and just wanting everything to go blank whether it be for a little or long time, depends. Worst was recently on a car trip to something that normally would have had me bouncing off the walls, but I seemed to hit rock bottom and had no excitement towards anything at all. I was quiet, numb, blank and hated myself for being that way.

I know it’s a lot, and my psychiatrist has told me that my mood swings work too fast to be bipolar. It’s just that even though it’s only a short time, it’s too strong and too intense sometimes for me to want to handle at all.

I do have a sleeping disorder that is being diagnosed (Delayed Sleep Phase Syndrome) but have suffered with this for most of my life and actually don’t mind having it and never had a problem with it before. But I use to sleep brilliantly when i finally did, but now my sleep is broken, too long or too short. Is this affecting it too?

I use to be a happy go lucky kinda girl, who was loud with her friends and loved being out and about. It seems like I am the complete opposite now. Just after a little more help. Thanks, alexi.

A. Dear Alexi, the emotional roller coaster you’re on must be distressing. As you have described it, you’re up and happy one moment, down and depressed the next. More recently you’ve begun to experience the drastic mood swings more intensely, feeling as though a “blanket” drapes your mind and spirit. This experience has to be very difficult.

If I were able to speak with you directly there would be several medical and personal areas I would explore. I’d want to know what if any medications you are taking. I’d need to know this information because sometimes medications have adverse side effects that affect your day-to-day temperament. Birth control pills, for example, can have a negative effect on one’s mood. Prednisone, for instance, is a steroid drug used to treat common ailments. It’s an important and effective drug for many conditions but it does have, for some people, intolerable side effects such as mood instability. Knowing whether you’re taking either of these drugs would be very useful information.

I’d also ask you whether you’ve explored the possibility of thyroid problems. If the thyroid is operating too fast or too slow (known as hyperthyroidism and hypothyroidism, respectively) it can sometimes cause an individual to feel emotionally unstable and moody. This would also be an important area to explore.

In addition, I’d inquire whether you are using illegal drugs or alcohol now or in the past. This information would be helpful to know because illegal substances can negatively and significantly impact an individual’s mood.

Another area worthy of exploring would be head trauma. I’d ask whether you’ve ever experienced a head injury, slight or otherwise. I might also recommend that you consult with a neurologist or undergo a magnetic resonance image test (MRI) to rule out any possible neurological explanations for your rapid mood swings.

The aforementioned ideas are avenues worth exploring. If you have not ruled out a medical cause to your mood swings then you should consider doing so. If medical causes are ruled out then counseling should be considered. A good therapist can teach you healthy ways to manage and stabilize your moods. Psychoactive medications might also be helpful.

Your ultimate goal should be emotional stability. That is, you should strive to be consistently emotionally measured, not becoming too excited or too upset or saddened. Ideally, both extremes should be avoided.

Thanks, Alexi for writing and I hope that you will consider the information presented in the previous paragraphs. Good luck.

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Last reviewed: By John M. Grohol, Psy.D. on 2 Feb 2009

APA Reference
Randle, K. (2009). Depression or Bipolar?. Psych Central. Retrieved on August 22, 2014, from http://psychcentral.com/ask-the-therapist/2009/02/02/depression-or-bipolar-2/

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