Posted by Elizabeth on August 11, 2001, at 23:32:02
In reply to My Diagnosis is in and It's Still Foggy, posted by Simcha on August 10, 2001, at 7:33:10
> My pdoc said that I definately have Major Depressive Disorder. I've had several MDEs in my short 31 year long life. Therefore I need ADs to remain in remission. OK, I get that...
Major depression is a pretty general diagnosis -- it includes a lot of people with a lot of different types of problems, IMO.
> He said that when I came in initially he thought that I could be bipolar. He says he has not ruled it out completely but he says he has found no real evidence of bipolar in my case so he can't diagnose it...
Well, it's a possibility, and he wants to be on the lookout, since antidepressants can be destabilising for bipolar patients.
> He also says that I have mild sexual OCD possibly. I guess the fact that I have made so much progress in my 12-step programs around this issue makes my case mild or barely noticeable. That I find amazing!!!
This should demonstrate to you (and anyone reading this thread) that these diagnoses aren't as clear-cut as they might appear on the surface. For example, it's possible to have some minor obsessive-compulsive behaviours that don't really constitute OCD.
> Well, he is treating me as follows. I'm on 40mg of Celexa and 150mg of Wellbutrin SR. I'm feeling better since he has upped my Celexa from 20mg to 40mg. Perhaps this simple diagnosis of MDD is all I have? It would be nice.
Like many people with recurrent depression, you have other complications. I think this is common.
> How could he end up diagnosing me as bipolar later?
If you suffer a manic or mixed episode in the future. Perhaps he has a hunch, based on the presentation of your depression, that you might be susceptible to mania or hypomania.
> I've read some things about bipolar. I read that at some point in your life you need to have exhibited manic symptoms. I don't ever remember a manic phase. I remember a lot of depression. I remember a lot of obsession and compulsive behavior.
Some manias and hypomanias are not as obvious as the classic euphoric mania. There may be mixed features -- symptoms of depression and mania occurring simultaneously. Mixed episodes are characterised by anger, agitation, etc. -- unpleasant feelings, rather than a "high" -- combined with behavioural inhibition and impulsivity.
> I have been super busy before in my life.... Is this what manic is like?
That's a common feature -- a period of intense goal-directed activity and feeling like you're accomplishing a lot -- although that by itself doesn't constitute mania or hypomania.
> Maybe some of the people who have a diagnosis of bipolar could tell me what the illness is like and what the treatment options are...
Bipolar disorder is as broad a category as major depression is. You will find that you get a lot of different answers to this question.
> Ok now I'm rambling... I posted this in the social board too because I did not think I was going to mention my meds after all..
Rambling's fine...although it could be a sign of hypomania. :-)
I can give you one bit of advise: if you're not sure if you're unipolar or bipolar, you should take special care to monitor your behaviour and moods when taking antidepressants. If you start seeing signs of impulsivity (spending excessive amounts of money, abusing drugs, hypersexuality, risk taking or self-destructiveness), anger or irritability, racing thoughts, excessive energy (like, you stop feeling a need to eat or sleep), grandiosity (making "big plans" that aren't realistic, for example), etc. If you do feel uncertain about your mood state, ask someone who you spend a lot of time with if you've been acting unusually in any of these ways.
I hope this is helpful to you.