UPDATE October 2020: I’m just putting a little update here as people keep finding this post, I conclusively found out I have ADHD and PMDD, not rapid-cycling bipolar disorder, and since starting treatment for PMDD, my moods have been completely stable, after years of misdiagnosis and taking mood stabilizers. Don’t give up looking for your answers and if the meds don’t work, question your diagnosis.
So this question of bipolar disorder has reared it’s head again and I *still* don’t know if I actually have it or not. It’s very frustrating to not know what’s wrong with you except that you know you don’t function properly. I had post-natal depression 100% but when I look at the mood scale from Bipolar UK I literally only fluctuate between a 7 and a 3 most of the time.
Which I don’t think is necessarily clinically significant to necessitate a BD diagnosis. I also don’t have underlying “phases” (usually… that PND really brought this home to me). There’s some evidence that ADHD’s hyperactive side can look a lot like hypomania and there’s little to separate them.
As a side-note, I feel like that mood scale linked above ought to be mandatory for everyone who is trying to mood chart because without it you’re trying to draw a map without a key. I now know why I failed at mood charting back in 2015.
While I’m waiting to get hold of a psychiatrist (again… RIP salary), I looked online and basically all the “test yourself for bipolar” quizzes go like this:
- Have you had mania? (well, duh, if I knew the answer to this I’d surely know if I had bipolar)
- Have you had hypomania? (gosh golly, if I knew the answer to this surely I’d already have a diagnosis… the nuances of hypomania and the difference between hypomanic symptoms and a hypomanic episode are utterly lost on some people)
- Have you had depression? (again, what counts as clinical depression and if it’s very obviously Post Natal Depression or Complex Grief, do those count or not?)
- Insert a bunch more questions to make it look like we didn’t half-ass this quiz
- Give us your email address so we can
harass you forevermoresend you your results.
The cyclothymia tests are actually nonexistent. Indeed, it seems no two clinicians can agree upon what cyclothymia actually is. I did read a really good chapter on it in “The treatment of bipolar disorder” published by Oxford University Press. That chapter is basically the only thing I’ve seen that actually makes sense of cyclothymia as a clinical entity.
The best part is, cyclothymia is milder than bipolar disorder (but still comes with suicide impulsivity) yet despite the fact that it’s generally agreed these days that people with bipolar don’t always need lifelong meds, the NHS guidelines say people with cyclothymia need to be on meds (that aren’t even approved for use for cyclothymia because literally nothing is) for the rest of their life.
“In case it develops into full-blown bipolar.”
So they’re proposing I take very serious meds that will take years off my life when I don’t actually need them, despite the fact that the latest research says people with cyclothymia have a distinctly different set of debilitating symptoms than people with bipolar, it’s not just “soft bipolar” as some idiot clinicians call it, and never mind that people with cyclothymia are very sensitive to meds in general.
Frustratingly, the NHS can say whatever they want about cyclothymia because there are no NICE guidelines for it. That’s right. NICE recognizes cyclothymia but couldn’t be bothered to actually write any guidelines for how to define, diagnose or treat it, and they clearly state multiple times in their bipolar guidelines that they are not dealing with cyclothymia.
My current therapist is adamant I have bipolar, she doesn’t seem to know what cyclothymia is, she has dismissed ADHD as “not relevant” to my problems, and she seems to think I have no insight which makes no sense because everyone else I’ve ever seen always tells me I have lots of insight into my condition.
This whole thing is such a mess. And my husband, the biggest voice of doubt, keeps saying “I don’t think you have bipolar” like, do I need to borrow an elephant with “she has bipolar” written on the side of… of… those rug things elephants wear?! And does anyone know what those rug things are called?
Arrrgh how did I end up here again with the bipolar stuff? Should I be on meds? Who knows! I wish Blahpolar was still here because I know she would have talked this through with me and helped me work out where to go from here.
Or maybe she would have just made an appropriately-timed bipolar vegetable joke.
That would also help.
To be fair, I wish she was still here even if she never liked or commented on anything I ever wrote again.