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What Goes Up Must Come Down

The first time I truly got depressed was when I was 20 years old and the guy I was involved with told me that although he really liked me, he was still in love (with his ex-girlfriend). It was downhill from there. Failed relationship after failed relationship. More and more severe depression. Suicidal tendencies followed by a suicide attempt. 

In all this chaos, there was something very important to my recovery. My diagnosis in 1999 was depression, but no one had ever addressed my hypomania. It wasn't until I attended a NAMI (National Alliance on Mental Illness) workshop that I even learned that there was a type 2 of bipolar disorder which included not only severe depression, but hypomania as well. 

After this workshop I was determined to get a more accurate diagnosis. I went to a new psychiatrist and told her that I thought I had bipolar type 2. She assessed me and confirmed what I already knew. I did indeed have bipolar disorder type 2. 

It is so easy to misdiagnose someone as just depressed who actually suffers from bipolar disorder type 2. The hypomania is never as apparent as the depression. And since the hypomania is much more subtle than mania, sometimes people just think, “Oh, she's just in a good mood.” 

No, my highs were not just good moods. I experienced racing thoughts, rapid speech, inflated self-esteem, grandiose ideas, hyper sexuality, and overspending -- all of the classic symptoms of hypomania. But for years and years, even after I was diagnosed with bipolar type 2, I was still only treated for the depression because it was the depression that was causing the suicidal thoughts, not the hypomania. 

After being on SSRI's that induced hypomanic states, I finally started seeing a psychiatrist that was educated enough about bipolar disorder type 2 to know not to prescribe an anti-depressant to someone with this type of bipolar. Instead, she prescribed mood stabilizers only. My moods stabilized after that. (Editor’s note: Some people with bipolar disorder do take anti-depressants, but not by themselves. They are often combined with a mood stabilizer.) 

Knowing my triggers to my hypomania helps tremendously. When I am depressed, I don’t want to spend any money, but when I am hypomanic I want to buy out the store. I don’t have the hyper sexuality anymore because I joined a 12-step program in 2008 to address this. The other symptoms are not as severe either but they are still there. 

Another big trigger to my hypomania is insomnia. During these periods of my mood cycle I get up super early or don’t sleep all night. I get very excited and want to do everything under the sun. I clean like a fiend, I make lots of commitments, etc. So to manage this mood symptom I take an anti-anxiety which also helps with sleep. 

What I have learned over the years is that what goes up must come down and the higher my hypomanic state, the worse my depression will be. I realized that not only is it important to manage the depression, but it is equally important to take care of myself when I am in a hypomanic state.

Comments

The above article is so my story.... first diagnosed with depression. Put on antidepressants that gave me hypomania/mania. Finally went to a decent GP and Psychiatrist and was properly diagnosed and put on mood stabilisers. A much better outcome. Love the high but its controlled.... not looking forward to the low. Hopefully it won't hit too hard this time now I'm on meds.

is article was spot on for me and how my disease cycles, with its various symptoms.

For me, a sentence in the last paragraph posed my dilemma perfectly. "What I have learned over the years is that what goes up must come down and the higher my hypomanic state, the worse my depression will be."

It is thus so for me, everytime. It is good to know that there are others who share the same experiences. Most importantly, it is encouraging to see how others handle it. For then one may try to use the same techniques.

I was being treated for depression for over 10 years.It wasn't until a new Dr started at my surgery,that my diagnosis was looked into a little more deeply. Also with the help of my ex partner between the three of us we established that I was not suffering with just depression. I've been diagnosed for 6 years now & it still doesn't get any better.I will be taking medication for the rest of my life. It is managed with the medication most of the times but I still have blips. It may sound strange but I still miss my manic episodes....

Seriously, I think those of us with bipolar II are not very well understood. My mom's psychiatrist recently convinced her that I was misdiagnosed as a teen (mind you this psychiatrist has NEVER met me). This is likely because I do not have episodes of mania. People tend to ignore the hypomania. The don't think twice about the fact that I sometimes don't sleep for weeks, that I am suddenly talking very fast and nonstop, that I am constantly move move moving. My brain won't shut off, but they choose not to see it and then shityy ass psychiatrist try to convince you mother that she "did you wrong" by getting you the help you needed. Sure, my first physiatrist didn't get the meds right, but he definitely got the diagnosis right.

I was dx with bipolar 2 in 1989.After that, my antidepressant and mood stabilizer worked well for ten years. I was a radio disc jockey in alternative (Nirvana, Stone Temple Pilots, Sonic Youth) and my mile-a-minute thinking worked well for quips between records. I was cutting corners, getting my psych meds from a GP (whoops) one day they stopped working. She didn't recommend I see a specialist, she just said she didn't know what to do. Next. I went downhill rapidly after that and had to go inpatient again for two months and into a half way house. I still had trouble. I have also become aware that my dad is bipolar/gambler/borderline and that he offers generous things, and then he screams about me asking for them. The most recent was about my book. He said, "find out what it will cost to self publish A-Z and I'll write the check. Then he told me I was 'stupid' 'an easy mark' an 'idiot,' and that I had asked for money. I went down into a two day suicidal depression and slept the whole time or tried to. See you mentioned hypomania making it hard to sleep, for me, it's the reverse. I um, have a hard time sleeping when I'm depressed. I guess it's anxiety. I also have had a hard time with Antidepressants pooping out after a few good years and then I'm stuck holding the bag. Thanks for your share.

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