Tuesday Questions

24 01 2012

It’s Tuesday. There’s not a lot I can say about today other than it is what it is. *sigh* It’s depressing and of course I’m questioning my own diagnosis. Again. Yeah, not a fun day.

So I accept, as you do, that my personality disorder can change my mood from day to day and even from hour to hour which makes sense. It’s something akin to having childlike moods within an adult cage, sort of like an overly exuberent puppy with an attitude problem on a leash. In check but with a lot of turmoil, and with me it’s all inside. However, there are too many factors ongoing which make me loathe to discount the presence of Bipolar disorder.

What factors are these you may, or may not (something I’ve never worked out, if you’re not part of the group who may then it goes without saying you ‘may not’ so why say it?), be wondering. First off is a family history of Bipolar which, looking objectively, comes from my mothers side. There is alledged Bipolar on my fathers side but I’m tempted to question this, especially as I think it’s a personality disorder misdiagnosed. The manic depression is confirmed on my mothers side thanks to my late grandmother who received ongoing treatment (which she kept not adhering to so don’t worry it’s an age old problem). Yes, I know that Bipolar can skip generations, I’m fairly sure it skipped my mother, but the genetic component makes it ever more likely as you can be a carrier (in theory).

Next factor is my interactions with SSRIs. As surprising as it is for doctors to hear, I did manage to go from depressed and not thinking of suicide to a suicide attempt within three days of taking SSRIs which goes to show that there’s something pretty damn wrong going on. There was no precursor to events either, it just happened. If it had been the case where I’d been ideating beforehand then I would discount the SSRIs and we’d be on shakey ground with Bipolar.

Now, there was a case of me rapidly discontinuing SSRIs (I stopped taking them full stop in hospital). This led to episodes of crying for hours for no reason, plus other stuff, then an escape from the ward (can it be deemed an escape if they let you off the ward?), lots of laughing, weird decision making, and all in attempt to kill myself. We know how this ended (for those who don’t, it ended badly) and so it could, in theory, be a case of discontinuation syndrome. The only problem I have with that is that I can’t find evidence of mania as a symptom of DS without any possible lead back to Bipolar. I’m not suggesting my research is exhaustive but it’s certainly a stumbling block.

Next factor is the pattern associated with mood swings. Although I struggle with isolating my up moods (I’m beginning to believe this is because it occurs slower than the down, sort of like a build up), my downs I can map out easily. I struggle to figure out I’m in a down till I’m in about my second week, but then people who know me well can spot my down before I can so I can state what I have done about mapping my downs. Ok, some of my timings may be off but the pattern is there. As far as I can tell, personality disorders don’t actually follow a pattern like this, they are constantly variable. Yes, I may be wrong on the pattern not applying personality disorders but I’m yet to see evidence to suggest otherwise.

So, with these factors in place, I cannot discount Bipolar disorder being applicable. I may be wrong but I’ve yet to receive any data to explain away these factors. There is a conjecture which may help but I’ve got to admit that it’s pretty wild and there’s very limited evidence to back it up. What is it? That I’m surpressing another personality and the SSRIs overrode the surpression and hey presto things were off and away. Personally I think this is crap because whilst I have had times where I’ve had memory blanks yet later found out I’ve interacted with people fully, I remember vividly my issues with SSRIs. So I’m having to discount DID (Dissociative Personality Disorder) because whilst it theoretically could provide solutions, it’s a stretch too far at this time.

Ah well, as Johnny 5 used to say ‘Need input’ because, at this time, I have insufficient data to rule out what I think it is.

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3 responses

24 01 2012
Pandora

One of my big issues after I was diagnosed with BPD (although I accepted it to a point) was that the mood variability required for diagnosis just wasn’t me. My lows are long and anything else, whilst short relative to depression, does not mimic the daily up-down-up-down patterns seen in personality disorders (and even if it did, of course one could have ultradian cycling). And I responded well to my Quetiapine/Venlafaxine combination; as you know, medication isn’t considered a great deal of use in PDs.

So basically I concur entirely with you. Admittedly, I don’t fully understand the NPD diagnosis, but regardless of whether or not you have it, I’m really not sure how the quacks are so ready to dismiss other or co-morbid conditions.

Anyway, as usual I have no advice, but just wanted to voice my agreement šŸ™‚

24 01 2012
NullFuture

I kinda wish you’d quiz me about the NPD because I can’t explain it without direct questions.

Beyond that it’s hard to explain that things feel different between NPD and Bipolar moods, tried to show it on that film I made for YT but think I might need to do another one to expand on it.

Tbh, I’m not surprised at doctors opinions, they’re a very intractable bunch. Therapy is what I’m after more than anything so they can keep thinking it, the only reason I question is for my own benefit, not theirs. If it becomes advantageous to fully realise the Bipolar then I want to be in a position to do it quickly

24 01 2012
theurbanworrier

There was an analysis in the British Journal of Psychiatry (I think last month, poss the month before, but I can’t find it now) on the efficacy of SSRIs, where the researcher said that onset/increase of suicidality once the meds take hold is because unmedicated, the patient can simply be too despondent to even bother killing themselves, whereas once mood gets elevated a bit the patient can get out of bed and their shit together enough to put in an attempt.
It makes complete sense, put like that (to me anyway) but of course, whilst the leaflets say “side effect; suicidal feelings”, they won’t say why lest it give you ideas or a routemap.

Can’t comment on bipolar- my grandad had it and had shock treatment for it so I’m very much in denial that I might have anything remotely like him, to the point of not being able to take in anything about it.

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