Q: I’ve been on anti-depressant medication on and off since I was
16 (I’m 24), and am currently on the waiting list for psychotherapy for my depression (I live in the UK so am on the NHS, waiting list is about 1 year). I previously paid to see a private psychotherapist who suggested that I may be suffering from manic depression, however I couldn’t afford to pay for more than a few sessions so I feel that issue was left somewhat unresolved. I have taken some online tests, which I know can be unreliable, but seem to indicate that I could be bipolar. I have felt in the past that I may be having a manic episode but I don’t really know how people feel when they’re not depressed, so I just assumed that ‘normal’ people felt like that. I have never had a period of my life when I have not felt depressed, so I’m not really sure how I’m supposed to feel when I’m medicated. I don’t want my doctor to think I’m being a hypochondriac, but at the same time if I am bipolar then I presumably need to change my medication (I currently take fluoxetine). Any suggestions?

A: Sounds like you are in a difficult situation. Bipolar Disorder can take on many forms so it can be difficult to diagnose accurately. Some people mainly experience depression with only having occasional manic like symptoms while others frequently cycle between both. However, a true manic episode does not feel “normal.” If it does not interfere in your functioning but is still an elevated experience, this is called hypomania. Many of my clients prefer the manic symptoms to the depression so sometimes don’t see them as troublesome. It may be a good idea to ask those who are close to you to give you feedback on what you seem like to them during these times. It is also imperative to continue talking to your doctor about your experiences so that he can provide the best medication options. You are correct in that if you really have Bipolar Disorder antidepressants alone can cause more problems. Trying to get an accurate diagnosis and treatment is not being a hypochondriac. If you do not feel comfortable with your doctor I hope you could change and get a second opinion. I hope you are able to get a therapist soon but in the meantime it sounds like you are doing all you can. You may also find some self-help books that would give you some suggestions on managing your moods through your own efforts. Hang in there and good luck.