As my therapist and I were going over what medication to try next and I suggested geodon she said “oh good that’s supposed to be good for mania too” and I was confused and told her I didn’t think I got mania. And she told me she thinks I get hypomania, but not the kind where you have a lot of energy and feel on top of the world, I get the kind where you become extremely irritable and angry all the time. So that’s lovely.
Now I’m wondering if she changed my diagnosis to bipolar because of that. I don’t know. I wish she could be more straightforward with me about what she thinks the issues I’m dealing with are because otherwise I just end up confused. I always thought the rage was because of my ptsd not hypomania. Does anyone have a similar experience?
If she states that she believes you have mania, that would indicate a mood disorder, which would mean your diagnosis is either schizoaffective or bipolar.
Just to clarify, a pure manic episode usually includes symptoms such as severe delusions of grandeur, hallucinations, euphoria and inability to sleep for days. Due to the inability to sleep, severe delusions and hallucinations, a person with full blown mania cannot function in society and is a danger to him/herself and others.
Hypomania is a lesser form of mania which often results in and elevated mood, lots of energy and less need for sleep. People in a hypomanic episode are fully functional and can often thrive in society. For some people, this increased energy is euphoric and they’re always in a great mood. For others, it’s unpleasant and is experienced more as “agitation”. The difference is the person that experiences hypomania as agitation instead of euphoria typically has an underlying anxiety problem.
If you can successfully fix the anxiety problem and learn to control your mood enough so that you don’t slip into full blown mania, then being in a hypomanic state can be a major advantage. This is part of the reason people on bipolar are so bad about being compliant with taking their medications. They WANT to be in the hypomanic state. Ideally, you want to be on enough medication that you still experience some of the advantages of the hypomanic state but without the risk associated with slipping into full blown mania. Bipolar people who learn to control their moods enough that they can stay in a hypomanic state can be overachievers that can accomplish much more than a regular person ever could. Beethoven, Van Gogh, Isaac Newton, Winston Churchill, Abraham Lincoln and many other major historical figures are believed to have bipolar disorder.
But I specifically told her I don’t get that phase where you feel energetic and on top of the world, I am very low energy pretty much always. She said it can also present as irritability and anger which I have struggled with.
I would think that would indicate an underlying anxiety issue that’s causing you to perceive the hypomania as irritability and anger instead of high energy. I usually call be angry and irritable being “agitated”.
I admit that I can get impatient sometimes, but if your therapist keeps changing your diagnosis and isn’t explaining things to you then maybe she doesn’t know what she’s doing? You have a tremendous self-awareness, from what I’ve seen on here, @Anna, so I think you can trust your sense that mania of any kind doesn’t fit you.
I hope you’ll speak up and ask all the questions and get clear answers, etc.
Yeah. I was told at my last place I exhibited behaviors of a lot of different disorders so it was hard to diagnose me so she may have the same issues. Not sure. Anyways unless she officially tells me anything different I’m sticking with my old diagnosis.
@Anna You are describing what I go through.
I have the mixed type bipolar variant.
Lots of irritability and anger.
The medication Depakote is a Godsend, it works best for those nasty mixed states.
My doctor also says I get hypomanic, but she hasn’t changed my diagnosis from schizophrenia. Apparently, my hypomanic/manic states don’t last long enough to qualify for a diagnosis of a mood disorder. Geodon does a great job of keeping my moods more stable, though. Mr. Star says he thinks Geodon works more as a mood stabilizer than an antipsychotic for me.
I found this explanation to be accurate and intelligent. Thank you. I get hypomanic frequently, either euphoric or agitated. Luckily the agitation last only short periods, I do wish I could be happy hypomanic more because I’m very fun and creative when I get like that. My friends and family love it when I’m happy hypomanic because they get lots of positive attention and homemade gifts and lots of baked goods. But we bipolars don’t get to choose, do we?
Often times not. But a person’s behaviors can make a huge difference in how they feel.
Trying to stay on a reasonable sleep schedule, eating a healthy diet, exercising, destressing methods, staying away from overly negative people and taking medications can make a world of difference on how stable or unstable a person is, especially someone with bipolar.
Sometimes life events can trigger a manic or depressive episode, which we obviously have no control over, but during the “in between times” our behavior can make a world of difference on our moods. And obviously staying med compliant can greatly reduce the chance of having a full blown manic episode and reduce the severity of a depressive episode.
well said! I try so hard but my sleep hygiene needs work. I’m doing better with diet and exercise, although there is room for improvement. But for me it pretty much comes down to sleep. 8 to 10 hours is good, less means hypomania (followed by depression) more means depression. Either way there is a chance I’m going to be depressed - I mean clinically depressed. For those of you who have had clinical depression you know why I made the differential.
I get hypomanic states and depressive so I got diagnosed with schizoaffective disorder and I don’t think they are going to change that anytime soon. I hope if they do change it they tell you.
I don’t like or approve of the current categories for many mental illnesses. You may have something completely new we have never seen before, and it can’t be categorized neatly into one disease or whatever. Everyone’s brain is different, so you are an individual even among those who share your “diagnosis”.
Yeah that’s what it feels like, like EVERYTHING agitates me. I will experience inordinate amounts of rage over something very small, like people being in front of me in a line (even if it’s like two people!) or someone standing too close to me, stuff like that. I end up getting VIOLENT intrusive thoughts about brutally torturing these people to death for mildly inconveniencing me, which then horrifies me afterwards when the rage passes.
Now that I think of it I have maybe also experienced the other side of things but I more connected it with my delusions. Basically I’d get a strong feeling like something HUGE was happening in the world, I’d be FILLED with energy but not productive energy just like…overwhelming…and the world would seem almost too bright and I have described it before as a thousand symphonies going off in my head or being filled with electricity. I first experienced that at 15 and experienced it a NUMBER of times after that but I always just thought it was because I was really delusional at the time and very excited/overstimulated by the delusions. The rage thing I didn’t develop until 17 which was the same time I developed ptsd so I assumed it was that. It changed my depression and made it much more violent and painful.
She also pointed out my mood is all over the place but that’s because I can very easily be set off and put into an awful mood because something will remind me of my past.
I know how horrible your nightmares are =(