Bipolar Diagnosis as a Teenager. Is That a Proper Diagnosis Now?

Reader’s Question

Do you think I have been diagnosed properly? I’m from Brisbane, Australia. I was diagnosed with bipolar when I was 16, although I was suspected to have had it from approximately the age of 12. I am too scared to try medication again because I tried Effexor XR and it kind of made me go crazy.

I would get into screaming fits with everyone around me, turn into a walking zombie, experienced hypomania like you wouldn’t believe, etc. My highs and lows are up and down like a yo-yo and always have been. There is no real pattern that I can pick up on, and I often experience both at the same time or switch from one to the other in a matter of hours. I go from suicidal feelings like the world has nothing to offer me, I’ve been here and done it all before, tired of the repetitiveness but could never go through with it, but I do think about it a lot. The hypomania makes me bite peoples’ heads off; I get really snappy, spend a lot of money, take bad risks with gambling and alcohol and can’t get motivated to work or — as embarrassing as it is to say — keep up with personal hygiene. I get bored with life easily and have done some pretty stupid things like steal money just for the thrill even though I feel really guilty after. Sometimes I get goose bumps for no reason and a huge feeling of euphoria sweeps over me and I feel like I can conquer anything I put my mind to. When I’m frustrated I can’t think properly. My memory is really bad. I can’t learn unless I’m really interested in a topic, which is a struggle with compulsory university lectures. I can’t sit still for very long, and sometimes I wonder if other people can notice it. I will fidget with a pen, twitch my toes, tap my foot, crack my knuckles, arch my back, rub my neck, swing my chair…and my attention span is minimal. I can’t multitask. Most of my day is filled with daydreaming. I’m anti-social but I don’t mean to be: I want to make friends and approach people but I feel awkward starting conversations and panic if I’m stuck with an awkward silence. I can’t help but label people ‘bad’ or ‘good’ and either can feel comfortable with someone or can’t, on first impression. I have been worried about schizophrenia but the thing is, I don’t hear things or see things. I do have a big ego and think of myself as being more intelligent than what I am.

I am my favourite subject, as egotistical as it sounds. I have a lot of ‘word salad’ where I go to talk, but I say the wrong word or mix words up without realising it and sometimes it can be really embarrassing. Some days I can’t stop cleaning and I can’t focus unless everything around me is spotless. I can’t leave the house without everything in place unless I’m depressed. I’m sure people think I’m the biggest weirdo because sometimes I talk a lot and am really happy and bubbly and other days I don’t want to talk and I mope around. I don’t really contribute much to conversations other than a bit of a giggle. I just finished my first year of psychology, and I am too embarrassed to talk to anyone about it. Can you help me? Also how can I manage my ups and downs?

Our Consulting Clinical Psychologist’s Reply

You are accurately describing cycling through depression and hypomania. A significant number of your symptoms are directly related to brain neurochemistry and for that reason, consultation with a psychiatrist is strongly recommended. I don’t doubt that Effexor gave you a lot of difficulty. Rather than an antidepressant alone, you would need a mood stabilizer and antidepressant medication. You’ve also identified one of the difficult aspects of Bipolar Disorder. While we often think of Bipolar Disorder as producing “highs” and it does, the majority of Bipolar patients spend their time in the depressed phase.

Again, a psychiatrist is your best mental health professional for this situation. Keep in mind that you may need to change medications a few times to obtain the right combination for your body system. That’s not unusual.