Mental health rabbit hole

My post on rejection-sensitive dysphoria sent me to Wikipedia. You know what happened next.

I’ve been letting this post marinate since then. It’s a lot of new information to take into account, and there’s a significant amount of overlap among the symptoms of several brain activity disorders. It’s like everywhere I turn there’s a new, better way to describe my experiences.

But I’m also being mindful of how easy it is for research to turn into self-diagnosis. Wikipedia is not a doctor.

Atypical Depression

There wasn’t a Wikipedia article on rejection-sensitive dysphoria, but the original post mentioned atypical depression so I looked that up instead:

Atypical depression. . .shares many of the typical symptoms of the psychiatric syndromes major depression or dysthymia but is characterized by improved mood in response to positive events.

Hmm, this kind of sounds like me. When good things happen I’m happier than I should be with my depression. It’s really like a high.

Atypical depression also features (edited for readability)

Woah, I literally have all of those. This describes me a lot more accurately than regular old depression does.

In general, atypical depression tends to cause greater functional impairment than other forms of depression.

Weird. You think it’d be less.

Atypical depression is a chronic syndrome that tends to begin earlier in life than other forms of depression—usually beginning in the teenage years.

Sounds right actually. I was always sensitive but my highs and lows started to affect my ability to function sometime between 8th grade and 10th grade.

I start clicking through the Wikipedia rabbit hole.

Cyclothymia and Hypomania

Cyclothymia (I just learned) is like bipolar-lite. You have moderate depressed symptoms along with periods of hypomania, which are high-functioning episodes of near-manic behavior.

Why did I continue reading about these? I was mostly just curious. I had just found a new way to think about my illness: atypical depression.

But also, my therapist has described my behavior last summer as “almost manic.” Hypomania basically means “just below manic.” Could this describe me too?

About halfway down the hypomania article I read this:

When a patient presents with a history of at least one episode of both hypomania and major depression, each of which meet the diagnostic criteria, bipolar II disorder is diagnosed.

I’ve had several recurrent episodes of major depression. So if what I experienced last year was hypomania… then it sounds like what I have is bipolar II…

Hmm. Trying to balance skepticism with open-mindedness.

In some cases, depressive episodes routinely occur during the fall or winter and hypomanic ones in the spring or early summer and, in such cases, one speaks of a “seasonal pattern”.

Woah, this describes me so accurately. It’s more than Seasonal Affectedness. I’m like two different people in April-May vs. October-November.

Bipolar II Disorder

So I went to read about bipolar II’s description of hypomania (and see how much of it applied to my near-manic period last summer).

Hypomania is characterized by euphoria and/or an irritable mood. In order for an episode to qualify as hypomanic, the individual must also present three or more of the below symptoms, and last at least four consecutive days and be present most of the day, nearly every day

  • Inflated self-esteem or grandiosity. (Check) 
  • Decreased need for sleep (e.g., feels rested after only 3 hours of sleep). (Occasionally) 
  • More talkative than usual or pressure to keep talking. (Oh yes) 
  • Flight of ideas or subjective experience that thoughts are racing. (Check)
  • Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed. (Wow yes) 
  • Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation. (Yup)
  • Excessive involvement in activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments). (Very much so)

This definitely describes summer 2016, but was I only like that because of the ADHD medication I started taking that May? Was it the high of being able to function on medication? Maybe combined with great weather?

Or is there a different illness that better describes my combination of symptoms? My seasonal highs and lows have been noticeable since high school. Maybe it’s been Bipolar II all along?

I guess I’ll ask my doctors.

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