[DaveinJapan]

Hi all. I’m writing to get some opinions on a confusing situation that has come up. I’ve suffered from depression off and on for practically my whole adult life, but my mental health situation has changed in the past couple of years. As for the depression, I’ve taken all kinds of anti-depressants over the years, but they never worked very well (indication of bipolar disorder maybe?). But to my knowledge I’ve never had a manic episode. That all changed 18 months ago.

I suffered the symptoms of a full-blown hypomanic episode that ticked all the boxes. Awake for up to 72 hours at a stretch, couldn’t stop talking, delusions of grandeur, all of it. This went on for at least a couple weeks, maybe more. I wound up in the hospital for 6 days where they brought me down.

I informed them at the time that I had been drinking large quantities of alcohol. I also suffered symptoms of withdrawal unrelated to the manic thing, which they also addressed. What the doctors DIDN’T know, or at least weren’t fully aware of, was that I was also taking xanax along with the alcohol. I’d been hoarding it for some time, and had started taking large amounts.

That would seem to account for my severe withdrawal symptoms, but what a psychologist recently suggested was that that xanax/alcohol mix could also have caused the mania (rather than bipolar disorder itself).

Since that time, I had one more what I would call minor hypomanic episode. Awake for a couple days at a stretch, and some hints of that ramping up feeling of boundless energy, but nothing so severe as the last time. That, too, was accompanied by alcohol/xanax withdrawal (I’ve also sought help for the addiction problem and it’s under control now). Other than that, no hypomania in my life that I know of. I also don’t engage in inappropriate shopping, never really have. I HAVE engaged in a lot of reckless sex and, of course, substance abuse. Just no shopping.

So, the question is, could that set of circumstances lead to a misdiagnosis of Bipolar II that I now have?

Thanks in advance for your thoughts. I’m very curious about this.

For the record, I’m currently on a mood stabilizer that seems to work well, so bipolar or not, I seem to have found medicine that works better for me than anti-depressants.

[sarahsweets]

Do you mind me asking how old you are?

[Skeezyks]

Hello DaveinJapan: I'm sorry but I'm not qualified to opine with regard to the situation you described. Perhaps there will be other members who will feel able to do so. I noticed this is your first post here on PC, though. So... welcome to Psych Central. One thing you might do, here on PC, would be to take some of the quizzes & tests that are on offer. Here's a link to the listing of quizzes & tests that are available:

Psychological Quizzes and Tests

I hope you find PC to be of benefit.

[DaveinJapan]

Sarah, I'm 48, so I was 47 when the manic episode happened. I realize that's unusually old for a first instance.

Thing about it is this was very powerful, weeks long, and didn't feel like anything substance related if that makes sense. The lack of sleep was ridiculously strong, I would lay there all night and try to relax but sleep would never come. Having to talk all the time was close to uncontrollable, I was calling everyone I knew and talking for hours (international rates lol). And when I wasn't talking, I was typing up 8-10 page emails. The physical sensations were powerful as well, tense muscles and jaw, that sort of thing. It was impossible to relax. But I felt pretty good at the same time, if that makes sense.

To me, that's totally manic, though I never felt that before (or since, except for one mild case 7 months or so ago). I just don't think that's something that drug withdrawal might cause, though I'm curious if anyone has any experience with that.

FWIW, my doctor said she suspected I had Bipolar II, and that was *before* the hospitalization so I might've been "upgraded". I could ask, my current psychiatrist is the same guy who was my primary in the hospital a year and a half ago.

Thanks for the welcome Skeezyks!

[Nola0250]

Hi, I am also 48 and was diagnosed at 47 with BP II. According to my pdoc, it’s not all that uncommon and the stress of hormones starting to change at this age may be what tips the scales. What you described is very close to what I’ve experienced, for what it’s worth. Except that I managed to avoid hospitalization but that was more luck than anything else.

[sarahsweets]

I asked how old you were only because BP diagnosis's usually pop up in your teens/early 20's but it can be overlooked or misdiagnosed enough to where you do not find out about it until later in life. I cant help but wonder about the withdrawl from the benzos/alcohol though. That totally screws up your nervous system for a long time and affects your sleep. Having your sleep screwed up makes your mental health take a dive. So personally I believe its possible that its related to that and not necessarily BPII. With that said though if you had BP symptoms that were masked by drugs or overlooked by doctors it could just be something that you are connecting the dots about now. I guess I am not that much help..

[DaveinJapan]

No you're very helpful Sarah. Thank you.

It's true, I was abusing alcohol and other drugs for a very long time, so it was a lot of self-medication that may have been going on, and may have masked my condition somewhat.

I also have a strong history of mental illness on my mom's side (mom died of depression, aunt bipolar and schizophrenic, great grandmother as well), so when I was diagnosed it wasn't terribly surprising. And the medication I'm on DOES seem to work well for me (no depression of late, nor any manic symptoms that I'm aware of), whereas traditional anti-depressants did nothing.

So it's pretty confusing. I'd love to get to the bottom of it, just for my own mind's sake, but I suppose it's a lot of conjecture.

I'd appreciate any thoughts you guys might have! Thanks.

Nola, thank you for your input as well.

Hi DaveinJapan. It's really important that you stop the drinking, or at least limit it greatly. When people abuse substances, it's not always easy for doctors to make accurate diagnoses.

We can't diagnose you here. You must talk to your doctor (psychiatrist ?) about that. However, if a moodstabilizer is helping you that is good.

There is what they call the "bipolar spectrum". Many psychiatrists now believe that a fairly large number of people with mood issues may fall in this spectrum. Some of those who do, may or may not meet sufficient criteria for bipolar diagnoses listed in diagnostic manuals.