I've been diagnosed MDD for about 16 months. Took me decades to realize I needed help just for that. Thing is, that's just what I dared to talk with my doctor about. I had a Catch 22: I think (in addition to my ADHD) I have Bipolar 2 alongside anxiety and PTSD and need to address it. I stopped seeing the pDoc because it's $375 each visit, no insurance accepted. I was able to get my antidepressants managed by my PCP, but not my Ritalin, so I've been of that for about six months. But now I needed to go back to get a diagnosis for my whole, actual condition and begin sorting out a treatment plan.
But! My anxiety makes me so reluctant to even talk to my doctor about it. I start to worry like always, that he will think I'm faking it. I always, always have a kind of imposter syndrome. I just had my second hypo-manic episode (at least since I learned what they are) that fortunately only lasted six days. A few days after finally getting some sleep (read: sleeping from Thursday to Saturday), I started getting waves of anxiety so intense I was feeling rollercoaster vibes and going fetal. Its happened twice when I was driving, which is no bueno. I can't identify a cause, most times. Sometimes it's when I think of the state of the world. Most times I have no idea why I feel scared.
So my wife (who has bipolar 1 with psychotic features, anxiety, etc.) Saw me struggling and gave me a tiny dose of alprazolam. I was chill in maybe ten minutes. It felt so nice to finally stop freaking out for a while. So she leveled with me. She told me she's been convinced of my BD2 for about as long as we've known each other, but she could tell I wasn't ready to accept it. That I need to go to our doctor (we share 'cause they're so hard to find nowadays) and just tell him how I feel.
So that brings me to today. I reached out and took the first step in getting back under his care. I plan to talk with my wife in the next day or two so we can make a list for me. If I don't have something to reference when I see him, I'll worry too much about "choking" and that he'll kick me out. I know it's stupid worrying that he'll judge me. But that's where I am. Oh well. A list of my feelings with times and situations where I was overwhelmed or when I was playing my piano for almost three days straight. How it felt, what I was thinking.
I'll bring in my list and maybe I won't even need it. But if I have it, I can handle going into the office. Then maybe I can get something like xanax for my anxiety, and if he agrees about bd2, then maybe look into a mood stabilizer and whatever else evens me out.
Also, is it weird that I'm actually happy in some way if I do have Bipolar? Like it brings me closer to my wife. I'm this way that I am anyway. But if I am diagnosed, then it's kind of like, not only do we share a disorder, but she gets to be right about me all along. She gets to say she saw the signs and waited for me to be ready, then helped me get treatment. That's good, right? She's awesome. She's only ever wanted to take care of me.
I know this is a little all over there place. I just needed to share somehow to make it real to me. Thanks for reading.
PS - I have to sleep, so apologies if you reply and it seems like I'm ignoring you.
Edit: typo
Thank you for your reply! Wall of text incoming!
I can't imagine I would ever even get diagnosed without my wife's insistence. We are really good for each other, and that's simply one of the ways she's really good for me. She is also the one who prodded me to go get my ADHD dx. We had been together about a month, and we were driving to a park with my son. I was telling a story, and I kept getting sidetracked by details. You know, like I would mention something, then think I have to explain it or give back story before moving on. So it took me like... twenty minutes to tell a one minute story. She said something like, "You've just hit the seventh level of inception on your story, honey." Other times, we would be talking and I caught a funny expression on her face, like she was scared or overwhelmed. "What's wrong? Why do you look like that?" ... "Well, I'm sorry, but I'm having trouble keeping up with your pressured speech and racing thoughts. I think you might have ADHD. That is if you don't have bipolar." I got dx'd about a month later.
So back in 2017, she was aware that I exhibited signs of Bipolar. She also pointed out then that my sister likely has it, and my father (who she only met last June) almost certainly has it, based on conversations with my mother, so it could be familial for me. I think I remember stories of my father's grandmother being kind of moody and unpredictable, but I never met her. In my wife's family, her mom has depression, and all the girls in her generation (or family tree branch) have it. Five of them. Their grandmother and her sister had it too, though I think they didn't call it Bipolar then if it was even fully-diagnosed.
The thing is, I just figured she had confirmation bias. Maybe I'm not using that term correctly, but I thought that maybe she just wanted to see these things so we had more in common, as silly as that sounds now. It wasn't until my recent mixed episode that lasted a little over a week that I began to accept that I may have a mood dysregulation disorder and impulse control issues. Especially, the symptoms seem to be worsening not that I am treating my depression with Bupropion for the past year and a half.
I still may not have Bipolar, but after going through my mood journal* that covers the past 19 months, and listening objectively to my wife telling her side of the story, I am starting to believe it -- even accept it. I put together a document that I'll bring with me to the doctor. In it, I document everything I can remember from my recent episode. Things like how long I was awake without sleep, things I was doing with my time, and how I felt about it. I also listed some instances of functional impairment, impulsivity, etc. I sometimes have difficulty verbalizing complex emotions, so I have to focus more on what my body was doing instead. I shared the document with my wife and she thinks the doctor is going to love it. I know that ADHD symptoms are sometimes mistaken for bipolar symptoms, so I'll leave the differential diagnosis to my doctor. The thing I want to hear most from my doctor is something like, "Yes. What you are experiencing is real. It has been studied. We have a framework for it."
As for meds, like you, my wife also takes Lamictal, and she swears by it. She was on lots of others before she got here. She and I (before I considered I may also have bipolar) used to lurk the reddit bpso sub, and almost weekly, there would be a non-SO there talking about not needing meds, all while exhibiting delusions of grandeur, paranoia and psychosis. She was like, "Yeah, when I was young I thought maybe I didn't need the meds, too. But you take them so you can stay out of the hospital, keep money in your bank account and your friends stay friends." She has also mentioned the degenerative nature often. She worries she will leave me caring for her when she "loses it." That is just to say, she doesn't miss a dose, ever. I am a little scared to try lamictal and seroquel or anything like them, just because of fear of the unknown, and worrying that it may "change who I am," but, I think I need a change. I also don't know if my doctor will want to treat many symptoms at once or begin meds one by one. I wonder if I will get something for my anxiety, and also a mood stabilizer possibly with anti-psychotics. I guess I 'll see. One thing is for sure: I won't be doing 90-day intervals of tele-health for the next year or so. I have a feeling my doctor will want me in the office every month.
Ha! I replied to your comment only after skimming it, and now I see that you mentioned how it runs in families. I have seen evidence to support this too. I think three out of four of my immediate family have it (counting me), and nine in my wife's family.
I'll close by saying that I don't want to get too ahead of myself. One doctor somewhat ruled out bipolar when I went in for my ADHD consult in 2017, but now I think I may recognize more signs than before. Even if I don't end up with a "label" of Bipolar Spectrum Disorder, I am confident that my doctor will still treat my symptoms. It's a spectrum, after all.
Thanks for letting me expound.
*I journal my medications, moods, outside influences like news and social media, motivation levels, meditation, sleep hours and restfulness, etc., and I also keep a written "free" journal for my thoughts.
Final disorganized thought on meds: I am worried to have to take multipl medications that I should never miss a dose of when pharmacies can be so adversarial. I know that Lamictal especially is one that you cannot go off cold. That's all. Take care.
If this response it too long, don’t feel pressured to reply
The whole missing bipolar is so real. It looks like so many other things that it’s hard to say where bipolar begins and other things end. Also the book BIPOLAR, NOT SO MUCH was really helpful for me understanding bipolar and how I recognized it for myself. It has some useful tricks as well. One that I use is blackout curtains as having time in the dark really helps with mood episodes(even if you don’t sleep/ it doesn’t cure them), now I sleep in the dark whenever possible and it has really helped
The journaling helped me convince the psychiatrist that I saw. I was like hey, I’ve been having sleep issues and quite a bit of bipolar symptoms, and it’s making my life suck. She made me journal for like 2 weeks while we started lamotrigine but if I hadn’t had my initial log of symptoms it likely would have taken much longer. For me personally I never felt like I was depressed so it would not have made sense to talk about my symptoms. Like when I spent a month going to bed at 5am and waking up at 7am because I was organizing the house all night, I wouldn’t even think to mention it , because that definitely was not depression and just felt like a natural thing to do in the moment. My psychiatrist also tried to get me to explain what I thought was hypomania and because I couldn’t explain it, they gave me the helpful description of a buzz or feeling g like crawling out of your skin, which I related to more than the other possible symptoms like feeling pressured or to some degree risk taking. In hindsight, especially now that meds are working should have been a sign that something was up if I wasn’t so wrapped up in hypomania I might have noticed.
Journaling helped because I would write stuff like that and believe it was perfectly normal and now I’m just like wtf when I read what I thought was a regular day with regular emotions. Now the few moments of break through hypomania (still putting the finishing touches on meds) I get the buzz which I used to think was enjoyable and now I actively dislike along with the euphoria. For me once I experience stability there was no going back. And for me the meds are life or death, so I take them even when I skip other meds. I was pretty scared about it at first because being dependent for life on a med that you can’t miss a dose for (talk to psychiatrist about exact details as there may be more detail or more rules for different meds) is really scary. But for me now having actual control over my mind and being connected to reality is worth taking lamotrigine as one of the most serious thing in my life. Like I have legit been hypomanic and not eating or sleeping and still taking it because it is my lifeline. What surprised me the most was how much I really really don’t want to go back to hypomania (I cannot say this enough) that now after how little I want to take it, it’s non negotiable for me as well.
Also about confirmation bias, I felt the same way that I was just looking for bipolar symptoms, but for me at least, mood episodes lead to such an altered state of mind that you might only get a small piece of it and that it actually might be more intense than you believe in the moment. The aha moment was when I had a hypomania bordering on psychotic when I first suspected bipolar and it was pretty short. So like at the end of the week I looked at my journal and was like oh this is actually really clear, but like other times it just felt like the flow of life with just enough detachment from reality to not realize it was happening.
The more I talk to my wife, the more things she remembers that point to me having bipolar. It's surreal that I am not aware of most of this stuff. Not just like, "Oh, yeah. I remember that. That does seem like a hypo episode." More like, "What? I was just feeling creative and I didn't want to sleep for that week in case I lost that feeling... oh, now that I say it out loud..."
Thing is, for the past decade, I've related to bipolar as the partner of my wife, who has bipolar 1. I look for signs in her, and I collect things that cheer her up or bring her to reality (I have some interesting stories on this topic, but not fitting for this post). In short, I work hard to be her most dependable support system, as a matter of survival. I don't know how to look for the signs in myself yet.