Archives for;

Dysthymic Disorder

Dysthymic Disorder – Dysthymia – neurotic depression, or chronic depression, is a mood disorder consisting of the same cognitive and physical problems as in depression.

Bipolar Through the Years – Getting Your Diagnosis Right

Difficult to diagnose Bipolar Disorder?

I am not bipolar!  I am (insert other diagnosis here)

I received my first bipolar diagnosis when I was about 30… ish minus a few years.  I am 40… ish plus a few years, so for most of All About Bipolar Disorder20 years (yes I know the math doesn’t work out but this is a true story), I have known that I have Bipolar Disorder.

If you are bipolar yourself you will know that when I say “I have known” it really means “I was told”.  I didn’t believe it at first.  I thought of every other thing it might be and tried really hard to convince the therapist “that isn’t me… not really”.

As an untreated, newly diagnosed bipolar, I felt compelled to express clear objections to specific parts of the diagnosis that did not fit.  I was trapped by the details… a problem which I have often suffered – or more like, caused others to suffer because of.

Over the years and through several different diagnoses and many periods of “those” risky behaviors, going on and off various meds, wrecking certain parts of my life – and recovering once again, I find that those details don’t matter anymore.

I used to have a vitriolic reaction to the suggestion that I should want to be “normal”.  NORMAL, I said… I don’t want to be Bipolar TherapyNORMAL.  Normal is boring.  I was many things but boring was not one of them.

I no longer have that reaction.  My life would have been easier if it were normal.  I would have missed all the bright, scribbly colors.  I would have missed all the scary but fun stuff… but then maybe I wouldn’t have gotten so tired.  Maybe I wouldn’t have had to shut the curtains and hibernate.  Maybe I would have missed all the scary and dark stuff.

Anyway – as usual, I veer off of my topic.  Today, I am 99 percent sure that I am bipolar but I do reserve that remaining 1 percent – just in case.

Over those years – starting before (way before) I was diagnosed as bipolar – I sought treatment.  At 14, I asked my parents to take me to a psychiatrist because there was “something wrong with my brain.” They said “no, there isn’t” effectively telling me that I was just a mouthy, disgruntled, histrionic teenager – which I was, but I was also bipolar.

I often wonder what might have been if I had been treated then and do watch my kids for the same occurrence.  Unfortunately at that time, a proper diagnosis was highly unlikely and probably wouldn’t have changed much.  Except I would have felt heard – and I didn’t.  I do try to hear my kids.

Once I was able to seek treatment for myself, I was diagnosed with several other things long before they hit the jackpot.  The first was “dysthymia” – oddly, this diagnosis came in the middle of a severe depression.

Dysthymia for a bipolar

I was in college, just a hair short of being suicidal, and had to sit down one day and decide if I was going to kill myself – or study.  Serious DoctorLacking concrete plans and lacking a sincere wish to die, I decided to study – but I did go to the student health center the next day where a kindly graduate student decided I was dysthymic and would benefit from group therapy.  Being the mixed-manic that I am, I was in a temporary state of “not so bad” and failed to mention the depth of my despair.

I went to group therapy with a bunch of whining college kids and two well-meaning graduate student supervisors for almost a year.  To be fair, some of these people may have had real problems.  A homosexual boy who was still “in the closet”, a secret cross-dresser, a bulimic, a giant athlete with a sever anger issue and mommy problems… and a couple of other whiners.

I never once mentioned that I was hallucinating at night… or that I couldn’t keep my thoughts going in a straight line….or that I was living in a dark grey fog… or that despite all this, I still wasn’t sleeping.  My dysthymic self simply whined away with the others about parents, childhood, professors…it may have kept me from killing myself but mostly it was just entertainment.  It also kept me from failing out of college, as the dean of my college was informed that I was “in counseling”.

Major Depression for a bipolar

When I finally admitted the hallucinations – that got some real attention.  It also got the notice of a physician – and her medical Medical Doctorstudent who proceeded to ask me stupid questions like “how much LSD have you done?”  I also got a very “fun” visit to a sleep clinic — where the results were inconsequential even though my case was examined by a neuropsychiatrist – or a psychiatric neurologist – whatever that is.

Still, I got the diagnosis of Major Depressive Disorder… I still wasn’t sleeping – and people were literally terrified of me.  Describing me as agitated would be like saying the Niagra River is a stream.  Major Depressive Disorder.  They did give me meds though, stopped the hallucinations and got rid of all that grey fog and I managed to finish college.

Codependent for a bipolar

Moving on a few years on and off antidepressants and anxiety medicines – never feeling right….risky this, risky that….institutionalization (not jail or at least not this time, but still…).  After a particular disturbance, one “therapist” told me I was “codependent”… little did he know how dependent I was…or on what.  I ignored him.

The “intensive treatment” did get me the diagnosis for bipolar disorder which I denied, and did so for many years.  On and off meds, risky this, risky that…back on meds…off…on.

ADHD for a bipolar

A few years later I was pregnant (married too, woo hoo) and had to go off the meds.  After I had my kids – the doctor that I saw said that I was ADHD – not bipolar.  Still not wanting to be bipolar, I took the prescription he gave me….which was of course an amphetamine.  Well that worked well – nuf said.  To be sure, my kids are fine.

Bipolar HeartbeatEventually, I came to reality and the bipolar diagnosis and back to the right meds.   This has required honesty.  Honesty with health professionals and honesty with myself and it requires taking my meds.  I am tired from all the bright squiggles and the darkness.  I do want to be normal.

Now, as a bipolar, I get to watch my kids and see if they have “it” or something else.  Either is scary, both are scary but I hope I will be more help than my parents were.  I still take my meds but I also still retain the right to act on the 1 percent in case something better than bipolar disorder comes up.

Getting Out of Depression

Some tips to get you out of depression

Major depression is the third most common mental disorder in the US.  Nearly 7 percent of the US population is affected in any one year.  Incidentally, if you are keeping track, the two most common mental disorders are Anxiety disorders and Phobia disorders, including Obsessive-Compulsive Disorder and Post-Traumatic Stress Disorder.

Major Depression, also called Major Depressive Disorder (MDD) has an average onset of 32 years of age and is more common in women than in men.  It is also called “unipolar depression” by those who are familiar with Bipolar disorder.  It may include a subset of depressive disorders such as Seasonal Affective Disorder (SAD), which affects people yearly – usually in the winter and Dysthymic Disorder, which is a less severe form of depression.

In order to be diagnosed with Major Depression, a person must meet the DSM criteria including at least five of the following for at least two weeks:
•    Depressed mood most of the day
•    Diminished interest in all or most activities
•    Significant, unintentional weight loss or gain
•    Insomnia or sleeping too much
•    Agitation or psychomotor retardation (slow movement) noticeable by others
•    Fatigue
•    Feelings of worthlessness or guilt
•    Diminished ability to think or indecisiveness
•    Suicidal thoughts

In some cases, depression can be relieved by changes in lifestyle or with psychotherapy, but in severe cases – medication may be warranted.  We are fortunate today in that there are a number of effective medications that have fewer side effects than previous treatments, and the category continues to evolve.

Even with medication – that may not begin working for at least several weeks – some lifestyle changes, and habits may help a person “emerge” from their depression and manage symptoms in the future.

Major DepressionLifestyle changes are difficult, particularly when depressed, but the effort it takes to “soldier through” is worth it in the end.  These tips for helping with depression are not easy – especially when you do not have any energy and don’t feel like getting up, but even though they may not provide a cure – they almost always provide some help.

  1. Get up and move – this is the hardest for most people to do.  It may take a tremendous amount of efforts but even simply getting off the couch or out of bed and walking around the house will help.  Getting up and moving around will increase your blood flow and heart rate will help increase blood flow to your brain and may convince your body that “hibernation” is over.
  2. Get dressed – you may have been wearing the same clothes for many days.  Changing into a “daytime” outfit can help regulate your time clock and may help you feel like you can accomplish something.  If you wear makeup or fix your hair, do so – and by all means, take a shower.
  3. Get out in the sun – don’t stay long enough to get a sunburn but studies have shown that bright light helps your brain wake up.  It resets your internal clock by adjusting your melatonin levels (a hormone responsible for inducing sleep).  It also triggers a “springtime” effect – that again tells your brain and body that winter is over, and it is time to come out of hibernation.
  4. Talk to a friend – making a phone call may not be tops on your mind, but even a wordless chat can help you feel like someone else is aware of your existence.
  5. Watch something enjoyable – even if you don’t want to enjoy anything, do something that would normally make you happy.  Just a little bit of happiness peeking through can go a long way.
  6. Go to bed and get out of bed at normal hours – sleep patterns are often destroyed by depression.  Reestablishing those normal patterns will help reset your internal clock to a natural level.
  7. Don’t take naps – again with both the normal sleeping hours and with the “getting up.”  Reinforcing physiologic habits will help establish normal brain functioning.
  8. Eat healthily – you may want to eat everything, nothing, or only certain foods.  Likely, no matter how much or how little you are eating, you are deficient in some of the necessary vitamins and nutrients – so eating a healthy diet and taking a multivitamin mineral supplement is a good idea.  B vitamins are especially helpful to restore nerve cell functioning, C and E are useful for combating inflammation that can cause sluggishness, D vitamins are useful to aid in the “sunlight” phenomenon discussed before, Calcium and Magnesium are good for the brain cells which are malfunctioning.

Most people who are depressed will find a lot of these activities difficult – and you may only be able to do one or two a day.  None of this is meant to be insulting, but there is science behind all of it – and others have been through it before.
With the help from the medication and the lifestyle adjustments – you will feel like you are coming out of the fog – and be able to do all of them – or sometimes, choose not to.  Choosing not to do something is different than feeling like you are unable to do something – and you want to have control of your life.

– Melissa Lind