Looking for help, advice, insight, etc.

[michaelb]

Good afternoon everyone - my name is Mike. I have come to this forum to hopefully find answers to several of my questions, and seek the help of others in this time of need.

This morning, for what must be the millionth time, I spent money excessively on absolutely nothing of value (baseball cards, lottery tickets, etc.). Given my current financial state, these are things I do not have the luxury to afford, yet continue to purchase almost as if in spite of myself. My relationship is at the breaking point with a woman I love dearly, yet I cannot come to grips with why I constantly act on my impulses without any thought to the consequenes of my actions.

My moods come and go. I have spent the better part of the last year dealing with suicidal thoughts, being depressed and happy, going around in circles so to speak. Currently, I am on medication to treat a panic disorder (20 mg Paxil once daily and .5 Xanax once daily). The panic disorder is under control, but there seem to be other underlying issues here that I need to come to terms with in order to make progress in life. I am 33 years old, and many times I act like I am 7. I also tend to seem to screw things up (almost subconsciously on opurpose) when they are going well.

This is the jist of everything. I really do no know what else to write. I hope I can begin to find answers so I may begin to take steps to deal with my issues, as I cannot continue going on like this.

[paula]

Hi michaelb & welcome to our community!

To me, this sounds like you suffer from what I suffer from. "Bipolar Disorder".

I am posting some info on Bipolar, but you could also look on the info pages on this site. It has all about Bipolar.
Signs and symptoms
[QUOTE]
Bipolar disorder is a condition in which people experience abnormally elevated (manic or hypomanic) and abnormally depressed states for a period of time in a way that interferes with functioning. Bipolar disorder has been estimated to affect more than 5 million Americans—about 3 out of every 100 adults.[3] It is equally prevalent in men and women, and is found across all cultures and ethnic groups.[4] Not everyone's symptoms are the same, and there is no blood test to confirm the disorder. Scientists believe that bipolar disorder may be caused by chemical imbalances in the brain. Bipolar disorder can appear to be unipolar depression. Diagnosing bipolar disorder is difficult, even for mental health professionals. What distinguishes bipolar disorder from unipolar depression is that the affected person also experiences the "highs" of a manic phase.

[edit] Major depressive episode
Main article: Major depressive episode

Signs and symptoms of the depressive phase of bipolar disorder include persistent feelings of sadness, anxiety, guilt, anger, isolation, or hopelessness; disturbances in sleep and appetite; fatigue and loss of interest in usually enjoyable activities; problems concentrating; loneliness, self-loathing, apathy or indifference; depersonalization; loss of interest in sexual activity; shyness or social anxiety; irritability, chronic pain (with or without a known cause); lack of motivation; and morbid suicidal ideation.[5] In severe cases, the individual may become psychotic, a condition also known as severe bipolar depression with psychotic features.

[edit] Manic episode
Main article: Mania

Mania is generally characterized by a distinct period of an elevated, expansive, or irritable mood state. People commonly experience an increase in energy and a decreased need for sleep. A person's speech may be pressured, with thoughts experienced as racing. Attention span is low and a person in a manic state may be easily distracted. Judgment may become impaired; sufferers may go on spending sprees or engage in behavior that is quite abnormal for them. They may indulge in substance abuse, particularly alcohol or other depressants, cocaine or other stimulants, or sleeping pills. Their behavior may become aggressive, intolerant or intrusive. People may feel out of control or unstoppable. People may feel they have been "chosen", are "on a special mission", or other grandiose or delusional ideas. Sexual drive may increase. At more extreme phases of bipolar I, a person in a manic state can begin to experience psychosis, or a break with reality, where thinking is affected along with mood.[6] Many people in a manic state experience severe anxiety and are very irritable (to the point of rage), while others are euphoric and grandiose.

[edit] Hypomanic episode
Main article: Hypomanic episode

Hypomania is generally a mild to moderate level of mania, characterized by optimism, pressure of speech and activity, and decreased need for sleep. Some people have increased creativity while others demonstrate poor judgment and irritability. These persons generally have increased energy and tend to become more active than usual. They do not, however, have delusions or hallucinations. Hypomania can be difficult to diagnose because it may masquerade as mere happiness, though it carries the same risks as mania.

Hypomania may feel good to the person who experiences it. Thus, even when family and friends learn to recognize the mood swings, the individual often will deny that anything is wrong.[8]

Diagnosis is based on the self-reported experiences of an individual as well as abnormalities in behavior reported by family members, friends or co-workers, followed by secondary signs observed by a psychiatrist, nurse, social worker, clinical psychologist or other clinician in a clinical assessment. There are lists of criteria for someone to be so diagnosed. These depend on both the presence and duration of certain signs and symptoms. Assessment is usually done on an outpatient basis; admission to an inpatient facility is considered if there is a risk to oneself or others. The most widely used criteria for diagnosing bipolar disorder are from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, the current version being DSM-IV-TR, and the World Health Organization's International Statistical Classification of Diseases and Related Health Problems, currently the ICD-10. The latter criteria are typically used in Europe and other regions while the DSM criteria are used in the USA and other regions, as well as prevailing in research studies.

[edit] Criteria and subtypes
Main article: Current diagnostic criteria for bipolar disorder

[edit] Bipolar I

In Bipolar I disorder, an individual has experienced one or more manic episodes with or without major depressive episodes. For a diagnosis of Bipolar I disorder according to the DSM-IV-TR, one or more manic or mixed episodes are required. A depressive episode is not required for the diagnosis of Bipolar I disorder but it frequently occurs.

[edit] Bipolar II

Bipolar II disorder is characterized by hypomanic episodes rather than actual manic episodes, as well as at least one major depressive episode. There has never been a manic episode or a mixed episode. Hypomanic episodes do not go to the full extremes of mania (i.e. do not usually cause severe social or occupational impairment, and without psychosis), and this can make Bipolar II more difficult to diagnose, since the hypomanic episodes may simply appear as a period of successful high productivity and is reported less frequently than a distressing depression. For both Bipolar I and II, there are a number of specifiers that indicate the presentation and course of the disorder, including "chronic", "rapid cycling", "catatonic" and "melancholic".

[edit] Cyclothymia

Cyclothymia involves a presence or history of hypomanic episodes with periods of depression that do not meet criteria for major depressive episodes. A diagnosis of Cyclothymic Disorder requires the presence of numerous hypomanic episodes, intermingled with depressive episodes that do not meet full criteria for major depressive episodes. The main idea here is that there is a low-grade cycling of mood which appears to the observer as a personality trait, but interferes with functioning.

[edit] Rapid cycling

Most people who meet criteria for bipolar disorder experience a number of episodes, on average 0.4 to 0.7 per year, lasting three to six months.[20][21]

Rapid cycling, however, is a course specifier that may be applied to any of the above subtypes. It is defined as having four or more episodes per year and is found in a significant fraction of individuals with bipolar disorder. The definition of rapid cycling most frequently cited in the literature (including the DSM) is that of Dunner and Fieve: at least four major depressive, manic, hypomanic or mixed episodes are required to have occurred during a 12-month period.[22] There are references that describe very rapid (ultra-rapid) or extremely rapid[23] (ultra-ultra or ultradian) cycling. One definition of ultra-ultra rapid cycling is defining distinct shifts in mood within a 24–48-hour period.

[edit] Challenges

The experiences and behaviors involved in bipolar disorder are often not understood by individuals or recognized by mental health professionals, so diagnosis may sometimes be delayed for 10 years or more.[24] That treatment lag is apparently not decreasing, even though there is now increased public awareness of this mental health condition in popular magazines and health websites. Despite this increased focus, individuals are still commonly misdiagnosed.[25] An individual may appear simply depressed when they are seen by a health professional. This can result in misdiagnosis of Major Depressive Disorder and harmful treatments. Recent screening tools such as the Hypomanic Check List Questionnaire (HCL-32)[26] have been developed to assist the quite often difficult detection of Bipolar II disorders.

It has been noted that the bipolar disorder diagnosis is officially characterised in historical terms such that, technically, anyone with a history of (hypo)mania and depression has bipolar disorder whatever their current or future functioning and vulnerability. This has been described as "an ethical and methodological issue", as it means no one can be considered as being recovered from bipolar disorder according to the official criteria. This is considered especially problematic given that brief hypomanic episodes are widespread among people generally and not necessarily associated with dysfunction.[27]

Flux is the fundamental nature of bipolar disorder.[28] Individuals with the illness have continual changes in energy, mood, thought, sleep, and activity. The diagnostic subtypes of bipolar disorder are thus static descriptions — snapshots, perhaps — of an illness in continual flux, with a great diversity of symptoms and varying degrees of severity. Individuals may stay in one subtype, or change into another, over the course of their illness.[29] The DSM V, to be published in 2012, will likely include further and more accurate sub-typing (Akiskal and Ghaemi, 2006[which?]).


I hope this helps

[mscat]

Hi Mike Welcome to our Community,
To me some of what you have described is a compulsion to spend money. Much like a Cumpulsive gambler has , they feel a need to full fill this desire. There are so many compulsions .Anther one, is Compulsive eating, Compulsive swearing, your not alone either. Those are very hard issues to break.
Since you have mentioned that you are taking medications , then I am amsumming your talking to a MD, Psychatrist? How about a therapist ? It helps to seek out professional counseling , so they can give you the support you need and treat you propperly with the right psychotherapy, and a combo, of medications.
In this community we can offer you plenty of support and feedback, but can't diagnose .Only to encourage you to make good choices for yourself that can help you on your road to recovery.
There are many of us on here who can relate to where you are coming from. Anxiety, Depression, relationship issues are all very real and difficult problems to have to try and sort out on one's own.
Hope you will write more on here and tell us more about yourself.

[kaudio]

Have you shared these problems with a doctor or counselor? Perhaps they can help you begin some sort of therapy with you to address your impulsive behaviour. Also, have you made your doctor aware that you are experiencing cycles between depression and happiness alongside your panic issues?

Your thoughts are very welcome, and I am sure you will find that the members here are very supportive.