Posted by SLS on October 24, 2005, at 18:24:18
In reply to just for the record... what would my diagnosis be?, posted by spriggy on October 24, 2005, at 15:57:11
Hi Spriggy.
How old were you when you first became ill?
My first impression is that you have major depressive disorder (MDD) with racing and crowded thoughts. This is considered by some researchers as being a bipolar-spectrum illness. That you have a family history of bipolar disorder would certainly argue in favor of this categorization. If this is true, then I think it makes sense to add some focus on mood stabilizers and atypical neuroleptic antipsychotics in addition to an antidepressant like Wellbutrin or Remeron. There are alternatives among these, but I think you need to take things one step at a time. Perhaps taking Klonopin in the meantime might help with the anxiety until the MDD is adequately treated. It would also help prevent panic attacks and perhaps act as a minor mood-stabilizer.
"MDD with racing/crowded thoughts, versus MDD without racing/crowded thoughts, had significantly lower age at onset, more [major depressive episode] MDE severity, more psychotic, melancholic, atypical, and mixed depressions, and more bipolar family history. Of the intra-MDE hypomanic symptoms, irritability, psychomotor agitation and distractibility were significantly more common in MDD with racing/crowded thoughts." - Unipolar depression with racing thoughts: A bipolar spectrum disorder? FRANCO BENAZZI, md, phd - Psychiatry and Clinical Neurosciences Volume 59 Issue 5 Page 570 - October 2005
Your anxiety and agitated MDD with racing thoughts might lie along a continuum of transition between MDD and mixed-state bipolar II disorder. I would treat it that way.
- Scott
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> I know none of you can't actually "diagnose" me, don't worry. But you are all very intelligent and no quite a bit about psychiatric disorders so I figured it wouldn't hurt to get some opinions on what I *sound* like.
>
> Here are my symptoms:
>
> I will list them ranging from severity to less severe:
>
> * Anxiety- I know this could mean ANYTHING but my anxiety tends to make me feel very uncomfortable.
> I don't want to sit still or have time to be quiet. I try to stay super busy so that I can avoid thinking too long and then getting obsessed over this feeling. If I sit and think about it, I feel as if I could go crazy. It's hard to describe. Bare with me.
>
> * racing thoughts- my thoughts feel mumbbled together- once again, hard to describe. It's almost as if my brain/thoughts were a ferris wheel and instead of spinning nice and slow, it goes faster and faster and faster and faster.
>
> I find myself telling myself " slllooooow down your thoughts."
>
> * Derealization: This is occasional but when it comes, it is most severe. I feel as if I'm not really "here" or like this is all a dream. It's as if I am disappearing and even things around look different. I can only describe this as what I imagine an acid trip to feel like.
>
> *Shame/guilt- this hits me like a ton of bricks. I find myself feeling SO unworthy of everything. I feel like I'm a failure, especially as a mother. I think of all the things I should do/be and find myself crying out of despair.
>
> * Constant thoughts of death; not really "suicide" but death in general. When I'm in this state, I become nearly obsessed with dying/death, etc.. I sometimes pray for it; long for it, etc.. but do not consider actually doing it myself. I've only been suicidal when on SSRI's.
>
> * Depression possibly? I don't know if this is depression or not- I had such a severe, crippling depression that maybe because I'm comparing it to THAT, I don't realize that's what THIS is.
>
> I find myself looking forward to sleep. I stay just as busy (but only to preoccupy my mind) but on the inside, I'd rather just sleep all the time. Sometimes, I find that I take a cap full of Nyquil just to "escape" and sleep. (at bedtime). I have a fear of laying there, in the dark, wide awake with just my thoughts racing so I'd rather knock myself on Nyquil.
>
>
> My family history is a father with bipolar (and his mother was also bp). My mother has GAD and is neurotic (is that a mental condition?ROFL).
>
> I've had panic attacks sporadically, general anxiety for nearly a year, off and on mild depression (but I honestly think my depression is coming from the constant anxiety).
>
> I had a regular gp who thought I was possibly bipolar becuase of my reaction to Lexapro but when I was seen by a psychiatrist, the psych said it was merely akathasia and said, " You have no mental condition."
>
> I honestly feel like I'm not normal. I can't imagine that "normal" people struggle CONSTANTLY with their thoughts and trying to feel/be normal like this.
>
> But I hesitate to think I'm bipolar because I see no similarities between me and my dad/grandmother. I don't have high high's and low low's. Mine is pretty consistent. Occasionally, I feel "normal" but for the most part, this has been my general state for almost a year.
>
> I won't bring up my health conditions because that complicates things but I wanted to share my mental state and see if anyone has a clue what this is.
>
>
poster:SLS
thread:571455
URL: http://www.dr-bob.org/babble/20051024/msgs/571501.html