Newly diagnosed Bipolar 2 w/ Schizoid features, lots of questions

Hi all,

Apologies in advance for the long post. I've talked to my psychologist about most of this stuff, but I'm hoping some of you may have some more personal insights based on your own experience.

I'm newly diagnosed bipolar 2 with schizoid features. There's also a variety of other symptoms, such as some dissociative symptoms, anxiety, etc. According to my psychiatrist I test positive for schizoid PD, but for now that part of the diagnosis is only "schizoid features" until we talk about it some more.

For me the bipolar part of the diagnosis is by far the most important; being schizoid doesn't bother me much, but the mood swings are becoming almost impossible to manage, especially the depressions. What does bother me about the schizoid part is that I find it very difficult to completely grasp how the bipolar and schizoid parts work together. To me they seem almost contradictory in some ways.

For example, I normally prefer to be alone and don't care much for socializing, and I don't have nor do I want any friends. However, aside from the usual symptoms (huge surge of energy, euphoria, feeling like I can do everything, starting lots of new projects, etc.) I also become a lot more outgoing when hypomanic. I become way more talkative and social, have been hypersexual where I really wanted to hook up with strangers (though thankfully I've managed not to go through with it until now--barely), and I sometimes become very sentimental and feel a weird sort of "love" for just about everyone. I've been told it's like I'm drunk or something. I have a lot of trouble reconciling that social aspect of the hypomania with the schizoid part of the diagnosis.

I also can't really identify with what I hear from many schizoid people, that they feel no emotions inside. For me, while I may appear aloof on the surface, I definitely do experience a lot of strong emotions, especially when going through a mood swing. Also, while I find it extremely draining to have a wife + kids, at the same time I can honestly say that I love them, and I usually have no trouble showing them affection even though at the same time I'd prefer to be alone 90+% of the time. They are the only people I can show affection to, though. It's a dilemma I haven't been able to figure out yet. I have a strong desire to isolate myself, but at the same time I really want to be a good husband and father.

On the other hand, I think the schizoid features are also the reason why my hypomanic symptoms tend to be more inwardly directed than is the case for some of the more extroverted bipolar people. This combination of symptoms is making it harder for me to fully accept the diagnosis because I can't always completely identify with other people's stories. I'd like to get more insight into this because I'm already having a very hard time fully accepting that I'm bipolar, even though my mood charts, family history, and my wife tell me it's true. Somehow as soon as I'm euthymic I start thinking it's all in my head, or I subconsciously influenced the tests, or something.

Are there any others out there that have the combination of bipolar + schizoid PD and can shed some more light on how the two combine? I'm beginning to suspect maybe the schizoid part isn't true, and I'm just really introverted.

Also, does anyone have any experience with bipolar 2 turning into type 1? I've been having more psychotic-like symptoms lately, especially when in mixed episodes. For example, I'll feel these terrifying presences, become somewhat paranoid, sometimes have trouble knowing if my dreams/memories are real or not, and I've had very brief visual hallucinations (so fleeting I almost immediately doubt if they happened at all). Maybe I'm just imagining things, but I'm afraid this will only get worse, especially since I've had similar things happen in puberty, where I thought I was psychic and saw special meanings in everything.

Hi Fluffy Dinosaur, welcome to PC. I hope you are able to find this forum helpful. Obviously, we aren't experts, but there are many here with years of helpful experience.

I am admittedly a bit out of my depth, but I was wondering if a diagnosis of Schizoaffextive Disorder Bipolar Type has ever come up with your doctor. Isolation can be a symptom and it would also explain the euphoria and psychosis.

Keep in mind that you're on a spectrum somewhere. Any one diagnosis may not be a perfect fit. I'm floating without a proper diagnosis myself. It feels uncomfortable not to know exactly what is causing your discomfort, but the most important thing is to ensure your symptoms are being addressed. The treatment plans for many of these disorders overlap, so perhaps you can find something effective while you and your doctor are waiting for things to play out.

Good luck to you. It is nice to have you posting and I hope you get the answers you seek soon.

Hi fern, thanks for the welcome! I appreciate the input, and schizoaffective is definitely something I've considered. However, with schizoaffective I would expect the psychotic symptoms to always occur, whereas for me they're definitely tied to mood swings.

I'm more and more starting to think along the lines of a spectrum like you mentioned, at least for the schizoid part of the diagnosis. I'm even starting to think I should just focus the treatment on the bipolar (which is a lot more tangible for me) and just accept the schizoid traits for what they are. For what it's worth, my psychiatrist has also done some tests for autism (which can sometimes appear similar to schizoid PD in some respects), but those came back negative.

That all makes sense. I think it is definitely a good idea to focus on the treatment. Feeling your best is absolutely the most important part. Not only is it a spectrum, but patients can also evolve over time and the presentation of symptoms can change. Finding what works now along with tracking symptoms to try to understand your patterns covers the now and long term needs.

Have you considered journaling or using a symptom tracker? It can help you get a better sense of what triggers your cycles and how you've responded to various treatment options over time.

I'm currently using mood charts that track mania/depression and also anxiety and irritability (which are all major factors for me). I'm open to any other recommendations you might have! I've also tried journaling but I find that I'm too ashamed to write about myself in an "up close and personal" way. Mood charts work for me because they're pretty clinical and detached.


Thankfully I had stumbled upon the idea of mood charts about 6 months before I could start with my psychiatrist, so that really helped with the diagnosis (I had both mixed and depressive episodes during the time). I'm also starting to understand some of my triggers, although the big challenge now is how to deal with the ones I can't avoid (lack of sleep due to kids, stress due to traveling for work, etc.).

I was diagnosed with bipolar 2 disorder for many years. About seven years ago life went haywire...I became severely anxious and had what my then-pdoc referred to as "dysphoric mania." Life became a hell for me. Each year, especially during the darker months, I seemed to acquire new aspects of my disorder. Delusions, agitation/anxiety that made me feel like I would implode. So intense that I felt physically unwell from it. I began to feel and believe that I was dying. Then paranoia. And so on.

My current pdoc, I've been seeing her for about three years. She tells me that while my initial dx was BP2, that I go into the BP1 territory at times. I tend to have a lot of mania; it's just not always a euphoric mania, but is often dysphoric. Or mixed states with some delusional symptoms.

Actually, we haven't discussed my diagnosis in a could of months. I intend to ask her some questions about it when I see her this Thursday.

I think you're doing a great job with tracking then. I'm not a 'dear journal, today I feel....' person either

I track my own set of criteria in a journal, but I think it is similar to mood tracker apps. I track my meds, sleep, activities, diet, depression, anxiety, racing thoughts, any physical symptoms or discomfort, exercise and the weather.

Lack of sleep due to kids is such a tough one. I go through that sometimes and I am grateful my little ones are a little older now and sleep much better. Work stress is also very hard to control. Keep reaching out here as those situational triggers occur. We've had some really fantastic suggestions come up over time. Also, its just nice to know you aren't alone and that you have the support of those who genuinely understand.

Thanks! I'm definitely happy that at least I know what's going on now, and I'm getting treatment with regular check-ups to re-evaluate how it's going and whether any changes are needed medication-wise and so on. It makes it feel just slightly less out of control.

Sorry to hear about that, Beth, and I have to say this hits pretty close to home... It sounds awfully similar to the kind of deterioration I'm seeing as well.

I was relatively stable during most of my twenties, having hypomanic and depressive episodes but also months of euthymia. But for the past three or four years it's been getting worse. Much more and worse depression than before, and I've also been having dysphoric manias like the ones you describe (in my mind I've been calling them mixed episodes). Right now I'm lucky if I'm stable for three or four weeks at a time.


During those dysphoric episodes I can barely sleep at all, maybe just for an hour or so before I wake up in a panic and my mind just starts racing again. Anxiety and irritability are out of control, it feels like I'm going to jump out of my skin. I've even cancelled a work trip because it was so bad. I can't be near anyone because the tiniest thing will just send me off into a rage. I have these angry tirades about whatever minor thing is bugging me, and the tiniest sound from the neighbors or what not will just drive me absolutely crazy and I'll have all these violent thoughts. I've also had paranoia, and really strong feelings of "dark presences" that make me scared of the dark like a little kid.


Then sometimes for a few hours the depression will randomly lift, and it's almost like a regular hypomania where I'll start to feel euphoric, start lots of projects, etc. Until the depression comes back and it turns dark again. I try to keep it inside as much as I can, but sometimes I can't and I yell at my family, and then afterwards I feel so guilty I start having suicidal thoughts. Until now whenever I have those thoughts I immediately think I can't do it because I don't want to abandon my family, but it scares me to know that my grandfather actually did commit suicide, it makes me wonder how many times he didn't do it before he finally did.

I often wonder where this is going to end. The symptoms are already much worse than they were and I sometimes wonder how long it will be before they just become completely unmanageable. I've talked to my therapist about it, but somehow I have this tendency to downplay the symptoms and I can't seem to really get across how it feels to me.

I know that out of control feeling. It was incredibly distressing for me. I went into a mixed psychotic manic state one night and it ended very badly. I've been on a serious mission to take back as much control as I can ever since then. I'd do pretty much anything to protect my family from going through another round of that with me.

There are a lot of angles we can tackle these diagnosis from. Lately I've been focused on making sure that I pay attention to my physical emotional and spiritual health in addition to my mental health. I feel like it helps balance the load and lessens the role the medications have to play in keeping us healthy. Meds are certainly a critical tool, but I found there are tons of tools in the toolkit. There's a lot to learn and the outlook on thriving can be a good one.

You're doing a pretty good job of describing it here. Consider maybe writing it down and taking it with you. Maybe even just print out this post as it has some pretty great detail...

Thanks, maybe I ought to do that. Writing it down is somewhat easier for me than talking about it (especially when anonymous). I think it's mostly a tone of voice thing where my tone is kind of flat and might send the signal that it affects me less than it does. That and I've been hesitant to disclose stuff like those violent thoughts because I don't want my therapist to think I'm violent (which I'm not, I've never hurt a fly except in my mind).

I can appreciate that. I was very hesitant to admit a number of things to my therapist. I soon realized she had pretty much heard it all. I also realized that mostly I was avoiding it because I simply did not want to admit these things and actually say them out loud.

I did learn about myself that my subconscious mind basically spewed out all of my trauma and any strange thoughts I had suppressed when I was psychotic. It all came out druing mania when I had no filter and I was completely exposed. My poor husband! He heard so many completely scary and dark things that I would NEVER act on. It was like the most twisted things from my darkest nightmares were front and center for him to see. I had no filter whatsoever. At any rate, I decided I better start talking and processing this stuff with someone before it happens again. My hope is talking about it helps me to release this energy in a more productive way.

Hi FluffyDinosaur!

I'm bipolar type 1 with rapid cycling so I could try to chime in on the bipolar aspect however I am not really knowledgeable about the spectrum. I definitely agree with fern that a mood journal is a great tool to have to track what moods you feel. I just started using a app called eMoods and its pretty good for tracking bipolar symptoms. I think one of the important things with bipolar is to begin the process of identifying potential triggers. For example, traveling almost always makes me hypomaniac while the changing of the seasons from fall to winter almost always makes me depressed a bit. Also I always believe that knowledge is power so being as educated about whats going on is always good. Lastly, sleep is important because it helps our bodies stabilize.

Yeah, I think you're right. I guess I'm still kind of wanting my therapist to like me as a person and not think I'm too messed up, but maybe I should give up on that idea.

It doesn't help that I was raised by a drama queen who used her kids as a sort of emotional caretakers. I guess I'm afraid of expressing too much emotion now because it makes me feel like I'm becoming the same way. For me expressing any feelings feels as though I'm being manipulative and overdramatic. I'll probably tell my therapist that so at least she has a better idea of how to interpret what I'm saying, maybe that will help.

I can definitely relate to what you're saying about your family. That feeling of failing to shield them from it might be the worst of all.

Yes, please do! I'd appreciate any input there. The schizoid spectrum is of secondary concern for me, the main issue is the bipolar. If it were just the schizoid symptoms I probably wouldn't even have gone to therapy in the first place to be honest.



Thanks, it helps to know this and to see that those triggers are real. For me traveling tends to start with depression or a mixed episode before I leave (due to the stress probably) and then once I'm there I tend to become hypomanic. By the time I get back I'm so exhausted it takes a week or two to recover. It turns a one-week trip into a 6-week endeavor, and it's exhausting having to come up with excuses not to travel. I don't know how to explain that I can't handle another trip without disclosing that I'm bipolar. I'm also the same when it comes to seasons, except for me the summer is worse. I tend to be a lot more agitated, I think it's because of the light.

I think that would be the perfect thing to tell your therapist. It explains a lot.

It is the worst of all. I will never forget the look in my children's eyes when I was manic. I traumatized them. I'd give anything to take it back. I cannot, so all I can do is use this fear as the best motivator of all to do all I can to stay well. Whatever it takes.

For what it's worth, I think it means a lot to kids that their parents at least acknowledge what's wrong and are working to do something about it. My parents both had issues, but I don't blame my dad nearly as much because at least he acknowledges it. Other than that, I think we just have to hope that the 99% of the time when we're good parents is what will stick, rather than the 1% when we're not.

That is so very true. My mom got ill in the same way I am when I was 22 or so. She refused to acknowledge it or seek any kind of treatmemt. It made me feel completely helpless. I was very upset with her for not trying to shield herself and my family from further trauma.

I put my treatment out in the open for my kids. They know when I'm going to the doctor or the therapist and why I go. When I was on meds they knew why I took them. I've explained to them why it is so important for me to eat right and exercise. I think it helps them to process everything to know I'm working hard to make sure it doesn't get out of control again. I had never experienced any kind of mental issue before and it came on fast. Neither my husband or I saw it coming. At least now we know what to look for and we have a bunch of tools to use to lessen the blow.

I think you're definitely doing the right thing! Not only because understanding what's going on is helpful to kids, but also so that if worse comes to worst and they inherit some component of the illness, at least they'll know what it is and know how to cope with it to some extent, without having to figure it all out from scratch.