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I believe that I can help you.
I am going to ask you a few questions.
Do you have "reckless" behavior, such as in driving or shopping or gambling, etc. ?
Do you find that you have a tremendous amount of energy, often feeling way on top of the world?
No, but there was an incident recently which took the online sex thing to a new and dangerous level and this is what eventually led to facing up to a problem. I contacted two gay escorts and arranged to meet them at a hotel where my industry was holding a works function. I have no interest in men, am appalled by the idea, had no intention of going but it was the first time I contacted anyone directly and I risked ruining my career and professional reputation. It was way beyond stupid and I can't explain it at all.
That is considered reckless behaviour.
What about the feelings of being on top of the world?
No. Not at all. I turn to this behaviour when I am dealing with pressure from work. I run my own business and never discuss with anyone when it's tough. But I can't turn my mind off and deal with the pressure my withdrawing. And I have moments of self doubt, guilt and worthlessness
Do you suffer from depression?
This is part of what I'm asking. I have dreadful lonely lows, am known for violent mood swings because I'll try and be happy and then I'll just fall back in to the hole. I have a great job, wife and children but at times I can't help but get swallowed. And I stay in a hotel, drink, take recreational drugs and watch porn not for sex but for comfort. And I've done it for years - then I come out of it and carry on. I have never spoken about any of this
Actually, the feelings of self-doubt, guilt, and worthlessness ARE signs of depression.
Do you hurt yourself physically in any way?
I am going to send you the official criteria for mania from the psychiatric diagnostic manual, the DSM-IV.
That sounds scary
I want you to look these criteria over.
Mania is one of the two elements of Bipolar Disorder (used to be called Manic Depressive Disorder).
It is very controllable (as you have been controlling yours, in a certain manner).
In my internships, one of my two supervisors, a psychiatrist, had bipolar disorder and was the chief resident of a major teaching hospital and a beloved healer with a normal life.
A) A distinct period of abnormally and persistently elevated, expansive or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary)
B) During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:
1) inflated self-esteem or grandiosity
2) decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
3) more talkative than usual or pressure to keep talking
4) flight of ideas or subjective experience that thoughts are racing
5) distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
6) increase in goal-directed activity (at work, at school, or sexually) or psychomotor agitation
7) excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)
C) The symptoms do not meet criteria for a Mixed Episode
D) The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.
E) The symptoms are not due to the direct physiological effects of a substance or a general medical condition.
What are your thoughts?
Ok. What should I do now? Read it online now?
Absolutely. I am looking for your feedback.
I think there are things there that I recognise. I become obsessed with work and get up very early to work, will do 18 hour days, require little sleep (though that adds to guilt) and I indulge in while nights of seeking a comfort blanket - not really sexual. And it is all self contained and never involves anyone else
Oddly though I get through it and my work is often creative and good. My mind is very flighty but it gives me new ideas
So, as I suspected from your response and what you previously told me, you do have some of these symptoms as well as symptoms of depression.
The term "flight of ideas" is often associated with mania, and can be a POSITIVE occurrence, as it is with you.
However when it goes "over the top", you can get reckless and endanger yourself, as you have done.
You need to find an intelligent and aware psychiatrist to help you.
Not all of them are, unfortunately.
National Health Service has its share of hacks, unfortunately.
This is a big help and makes a lot of sense to me. I scared myself in that last incident and I'm not sure whether I did that subconsciously to accept I needed help. Can you point me in the direction of someone?
If you can find a psychologist or therapist treats BD, then you can do so without medications, but this is not usually the case.
I can recommend some websites in UK where you can search for therapists, and I can recommend a good book to start you off in increasing your knowledge about the subject.
Ok - I think you have been an enormous help. If you could do that that would be great. Is this a specialist area fro you and if I come back here for general advice, can I ask to speak to you?
You can always ask for ELLIOTT at the top of the page and I shall gladly respond.
Here is the information. You can also try an NHS psychiatrist.
Here is a place to look: http://www.psychfinder.co.uk/ Here is another: http://members.psychotherapy.org.uk/find-a-therapist/ Here is a third place: http://www.itsgoodtotalk.org.uk/therapists/
And a fourth place:
And a book:
Thank you. And thank you for your advice.