Mood Disorder, Bipolar, Depression or Cyberchondriasis?

Reader’s Question

I’m 20 and am in my second year of university in the UK, though I’m American. The fact that I go to university might be relevant because I have hated it with a passion since the start. Over the past year or so I’ve been wondering if I have some sort of bipolar disorder or some other mood disorder. I’ve always been an all or nothing kind of person. At any given time I’m either feeling full of energy, ready to spontaneously give in to urges, self confident and full of ideas that I’m ready to act on or I’m in my room and feeling completely worthless. Frankly, the only thing that keeps me from labeling myself bipolar are two things: how my moods rarely keep consistent more than two or three days and how the strength of any episode I’ve encountered never quite reaches the level the DSM IV says it should for it to be Bipolar Disorder II. My average episode lasts a day and a half, or somewhere around there.

And most of the time when I’m feeling depressed, I can, with some effort, force myself to leave my room and do something slightly productive. I’ve never had a day where I couldn’t leave my bed (though I’ve had plenty of days where if it weren’t for my friends I live with, who I’ve never discussed my suspicions of this illness with, and not wanting them to think there’s anything wrong, can usually force myself to be social enough to hang out with them like a zombie, completely miserable) and I’ve never gone on some sort of manic spending spree or had any experience that could be diagnosed anything more than being hypomania (most likely at the lower end of hypomania).

There’s some background info that you might be interested in. I have an aunt that has suffered from schizophrenia since she was in her late teens. I have another aunt, on the other side of the family, that hasn’t been diagnosed with anything as far as my parents know, but clearly is suffering with some sort of mental disorder. She is completely dysfunctional and can just barely hold a job and her house is pretty much a biohazard. My Dad’s side of the family is full of alcoholism and according to an aunt on that side of the family, who studied psychology (I’m not sure to what extent), my Grandfather suffered from some sort of psychosis. I have experimented with illicit drugs a fair amount (if I were to count each substance with my fingers, I would run out of fingers to count with). The only substance I’ve ever felt I lost control with was cocaine (which was about 2 years ago and just around the time I think the mood patterns were beginning). I dealt with that myself and haven’t used it in well over a year. I got to the point where it was all I could think about and was prepared to steal from my parents to pick up another gram.
The only illicit substance I still use daily is weed…though I make sure I don’t spend the entire day high…like some people I know. I have spent days without smoking and never noticed any change in my moods…for better or for worse.

Basically, I feel like I’m being thrown from a euphoric state, related to the feeling I grew to be so familiar with from coke, into a deep, empty, sinking feeling once every 48-72 hrs. I’ve never held a consistent feeling for more than 3 days or so. I’m also usually (but not 100% of the time) able to function when suffering from depression. There are times where I will be feeling completely depressed and can force myself to act ‘normal’ in order to avoid a weird situation.

I’m sorry this is so long…I’ve done as much research as I possibly can and am trying to paint a picture as accurately as possible…I haven’t seen any therapists, though I know I probably should. You can abbreviate this as much as you want if you decide to put it on the website. I haven’t been able to get this out of my mind for over a year and this is the first time I’ve sought any kind of help outside of my closest circle of friends (most of them are 3000 miles away)…and as you can imagine, they haven’t been a huge amount of help despite their good intentions. I’ve been wondering if this is entirely in my head and I’m just being a hypochondriac. If you have any further questions about my background or symptoms I would of course be happy to answer them.

Our Consulting Clinical Psychologist’s Reply

My first impression would be a chronic moderate depression. Hating school, best friends 3000 miles away, family very far away, living independently, history of substance abuse, etc. From a clinical standpoint, the telltale indicators are the depressive episodes, chronic dissatisfaction with life, lots of rumination (excessive thinking about the subject), probably a sleep/energy/appetite problem, and fatigue. Those bursts of energy should be happening at your age and as you have described, they don’t reach manic or hypomanic range. If the bottom line is “life is miserable” — then depression is your likely culprit. Add to the situation that you don’t discuss it with your available friends — you’re becoming “bottled up” emotionally.

I’d recommend seeing a mental health professional…a psychiatrist if available. The history of substance abuse and the family history may be important. You might also want to look at articles on depression on this website or on my website at www.drjoecarver.com. By the way, I’d be careful of too much research on the Internet. We now recognize that some folks are becoming cyberchondriacs — researching too many illnesses on the net, then worrying about the multiple symptoms.