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Doctor Kevin
Doctor Kevin, Ph.D.
Category: Mental Health
Satisfied Customers: 1482
Experience:  25 years in private practice
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So I have been diagnosed with cyclothymia, but I dont think

Customer Question

So I have been diagnosed with cyclothymia, but I don't think it's the case. I am 21 going on 22, female. I have a family history of mental problems. So to lay it out briefly - I get depressive, manic/hypomanic and mixed episodes. Usually, I sense when an episode is approaching, but I do not know how long it would last. With depression it might last from 2 hours to 2 months. Manic/hypomanic - 1 hour to 2 weeks. Mixed is usually a day or a week.
Depressive episodes include loss of interest in anything, loss of motivation (I just couldn't care less about my lectures and other duties), I don't feel like eating, sometimes I can't sleep either, just feel really deep in dispair and hopelessness. I can usually distinguish an episode from feeling just a bit low because when I feel blue I feel things like love and I care about other, when it's an episode - everything can burn and I would not care. When I'm manic/hypomanic - I feel I'm the best at everything, that everyone loves me, I don't care how much money I spend, and I become quite sexually promiscuous. When it goes too far I become paranoid about others talking about me, or plotting against me. Sometimes I have delusions like feeling that gravity is way to strong for me. And with mixed I guess that would be the fits of rage. They usually come towards the nightfall. And I tend to be very hysterical, I would hurt myself, like cutting or throwing myself at things, but it has got worse because I started beating up my boyfriend who is much bigger than me, and he couldn't stop me.
I become suicidal and sometimes I get into this sort of trance and I cut myself more, being totally oblivious to everything, not feeling pain at all.
I must say, I cannot really say what I am as a person, but apparently it is quite normal for me to be impulsive, but rational at the same time. And I have noticed that over the past 5 years this got worse. What I want to know is what it might or is it just a cyclothymia thing, should I go see another doctor and what should I expect.

thank you in advance,
Maria
Submitted: 2 years ago.
Category: Mental Health
Expert:  Doctor Kevin replied 2 years ago.

Dr.Kappler :

thank you for choosing just answer Maria. To begin with the diagnosis of cyclothymia is given when the diagnosis of bipolar disorder does not fit. From your description of your symptoms however I would wonder why you would not be diagnosed with a bipolar disorder. For your information here are some self tests on the web to explain in detail what I'm talking about:

Dr.Kappler :

http://www.thehealthcenter.info/selftest.php?id=6

http://www.blackdoginstitute.org.au/public/bipolardisorder/self-test.cfm

http://counsellingresource.com/lib/quizzes/bipolar-testing/goldberg-bipolar/

Dr.Kappler :

My second concern is that a diagnosis is only as good as the treatment plan it develops. Has your psychiatrist put you on any mood stabilizers and have they worked reducing your mania? has a put you on an a antidepressants to help you with your depressive episodes?

Customer :

Thank you, I have done some tests, they do say it looks like bipolar. The reason I was not officially diagnosed with it is because I'm too young and my character is not stable yet. The psychiatrist insisted on me being really unstable but normal.

Dr.Kappler :

you mentioned that you can at times become hysterical. I have found that were to be overused and psychological nomenclature. The fact that it is almost never applied to men means to me that it's almost useless in helping me figure out what to do to help you. Is usually used to denote a personality disorder but your psychological awareness of your situation would not be typical of someone with that disorder.

Customer :

They said that they don't feel the need to give me any medication due to the symptoms not being severe enough, and antidepressants would increase the chance of manic episodes appearing

Dr.Kappler :

You mentioned that you are too young to have a bipolar disorder. Perhaps your physician is not aware of the controversy over applying this diagnosis to children. There's nowhere in the criteria for bipolar disorder that mentions an age.

Dr.Kappler :

The older antidepressants had a tendency to spark mania however the newer antidepressants do not come such warnings. It is typical for psychiatrist to put some in who is suffering is much as you do on a mood stabilizer such as lithium which has very little side effects and a newer SSRI antidepressant.

Customer :

Well, I have been battling with this for 5 years now, and since I possess an analytic mindset - I thought it over many times, trying to figure out what is going on. I recorded moods, things I have done, I did some tests on myself.

Dr.Kappler :

If your psychiatrist is reluctant to offer you medication he must not understand that at times you resort to cutting yourself to deal with the intensity of your emotions. Have you been honest and telling him how that your symptoms have become?

Dr.Kappler :

is very important for people with mood disorders to spend a lot of time introspective and recording your moods. It is also very helpful to have a partner who is willing to help you understand what triggers your moods and how to gain more control of them. At times this may be even more important than being prescribed the correct medication.

Customer :

good to know. the psychiatrist, however, says that I am way too self aware and way too rational to be suffering seriously. but there are moments when it is really hard to get a grip of myself, obviously. I tried to teach myself how to control it to any extent, but it's going out of control now

Dr.Kappler :

It is important for you to feel that you are in control of your actions and your emotions. Your ability to maintain this may have help you avoid the extremes of emotions that characterize a manic-depressive.

Customer :

yes, I told him everything that was going on with me

Dr.Kappler :

That is very important. Did you know that the number of political leaders, successful entrepreneurs, and notorious lawyers who are also manic-depressive are extremely high.

Customer :

and I am lucky enough to have people who support me and try to help me, but it is hard for them. I have had a history of verbal abuse (came out of nowhere) as well as physical

Dr.Kappler :

It is not a diagnosis of the dullards. The creativity that people reach in a manic state is truly unbelievable. Many of these people are hard driven, charming and powerful leaders when their and control of the extremes of their emotions.

Customer :

he told me that psychologically I fall into the pattern of artistic kind of behaviour - with a lot of ups and downs

Dr.Kappler :

Your history of verbal abuse simply means that you now have a challenge of understanding the triggers for this behavior. Aggression we now know is learned. The only and eight response that a baby has is a fear of falling. Most people with bad tempers have learned from someone near to them

Customer :

I am aware of it, yes. I am a very straightforward person, and quite persistent, so some aggression is only natural.

Dr.Kappler :

I didn't realize artistic kind of behavior was a diagnosis. The so-called attitude of an artist is usually a euphemism for the kind of stuff the people around them have to tolerate just to get a few masterpieces

Customer :

But that kind of outbursts scare me and people around me. Mainly because they seem to be unfounded, nothing would trigger them and they would be too violent

Dr.Kappler :

they have had some very good results in a prison population which is where worked as a forensic psychologist for many years teaching people with anger management deficits assertiveness training.

Dr.Kappler :

You mentioned that the outbursts of verbal violence have little prodromal signs. In my experience of running anger management groups for over 30 years that is the hardest type of anger to deal with

Dr.Kappler :

.Is only

Dr.Kappler :

It is only someone who knows themselves extremely well that can learn how to avoid such volcanic eruptions

Customer :

true, there are signs, but that would help me see that there is an onset of an episode.

Dr.Kappler :

.Have you thought about seeing a therapist who may be skilled in your problems a regular basis? I found it helpful

Customer :

Yes, I looked into that. However, British system is quite complicated in that sense

Dr.Kappler :

I was in psychoanalysis four times a week for a year and found it immensely helpful in determining my emotional states. Even seeing someone on weekly basis may be very helpful for you

Customer :

It took them a year to refer me to a council psychologist, who told me they can't help after two sessions, and then I had two sessions with a psychiatrist, who claims there is nothing really wrong

Dr.Kappler :

you might consider checking with the near psychoanalytic Institute. They provide low-cost therapy to young people.

Customer :

I would like that, I thought about it myself - maybe that would help

Dr.Kappler :

I only paid a small fee for my analysis and it was extremely helpful. You will find that the Jung Instyitute has training analysis as well.

Customer :

That is what I am doing now, searching for some sort of alternative practice

Customer :

good to know, thanks

Dr.Kappler :

this would take you outside of the Byzantine British health system

Dr.Kappler :

if you are near a major city you also may look into other major psychological treatments to see if the institutes that are providing credentialing would offer low fee therapy. I believe the cognitive behavioral approach is currently the most popular and you may find an offer for more intensive therapy at a reduced rate through one of those institutes. The trainees are top-notch and already have licenses to practice therapy. There well supervised and very earnest in their efforts

Customer :

I will look into that

Dr.Kappler :

.Anything else I can help you with?

Customer :

there was something I wanted to ask, but it slipped my mind for now. Thank you for your advice, though

Dr.Kappler :

I see that you're currently off-line. I will be available this evening till midnight Pacific standard Time and be online again tomorrow morning at 9 AM. If you have found my answer to be sufficient please click the green accept button so that I can be paid. Getting this company a deposit does not mean that I will be paid for my work. You can continue to ask questions after you have accepted my answer

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  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
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  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
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