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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10547
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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I fear I may have bipolar disorder. I have been diagnosed with

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I fear I may have bipolar disorder. I have been diagnosed with sleep apnea, am on CPAP therapy, and use it. But, I never feel any better. I have trouble falling asleep at night, and trouble waking up no matter what time it is or how long I have slept. I recently lost one of my jobs because of this. My moods change a lot and are quite extreme. There is so much more and I need help. I have no insurance and not much money now that I got fired. What do I do next? Please help!

DoctorZ :

Hello I believe I can help you with your concern

DoctorZ :

I am sorry that you have been experiencing these symptoms, I can imagine how distressing this is for you

DoctorZ :

I would like to ask you a few questions to evaluate you better, and give you the best possible information if that is okay for you.

DoctorZ :

When did you fist start to notice these symptoms of extreme mood changes and insomnia?

Customer: I guess I really started noticing when I was a teenager, which is why it was dismissed. My mother was ways telling me I needed help, and I didn't want to hear it.
DoctorZ :

Okay, and can you describe the mood swings in more detail for me please?

Customer: Well, sometimes I feel like I can entertain an entire room full of people simply by talking and I feel like everything in the world is going the way I need it to. Other times, I feel cursed with the most awful luck, nothing goes right, I can feel angry or extremely nervous and anything said to me sets off an explosive arguement. I never really physically act out the anger, but I feel it building inside.
DoctorZ :

What about extreme sadness, does that ever factor into your mood swings?

Customer: Yes, especially when I reflect on family members who have died and right now, thinking about how I am going to get another job to take care of my family. I have a really hard time getting motivated to be productive.
DoctorZ :

Okay, and how often do your mood swings occur...every day, once a week, every few months they occur?

Customer: Pretty much every day. I feel totally drained most of the day, and super charged at night. I never know whether or not I will get along with my wife each day or just fight all day, and I love her very much. Every day feels like a roller coaster. It has caused a lot of problems at home and work. I am in healthcare now, and I feel like I want to settle into a job, but I have never held a single job longer than two years.
DoctorZ :

May I ask why you have not held a job longer than 2 years?

DoctorZ :

So I believe that you do not have Bipolar Disorder, as your mood swings are not typical of Bipolar Disorder and occur too frequently, so that is the good news. But I do believe that your mood swings are more caused by a mix of depression and anxiety/stress

DoctorZ :

Now you mentioned that you do not have insurance and do not have much money, so therapy may be an option for you in some places. Many therapists work on a sliding scale that can provide you with therapy for lower fees based on your income, or lack of income. Also I can teach you some therapy techniques and recommend some books to help you

Customer: I most recently lost my job due to attendance. The biggest problem I have is getting out of bed and getting going in the morning. I have left jobs for that reason, or because of the money. But, I feel like I manufacture reasons to leave when it is probably all my fault.
DoctorZ :

That lack of motivation and blaming yourself are typical symptoms of a depressive disorder

Customer: My GP prescribed me some antidepressants in my mid 20s at my request, and I hated who and what I was becoming while taking them. I was a robot, felt more depressed, could not interact with anyone, did not even come close to wanting sex with my wife. In short, I was even more miserable!
DoctorZ :

Yeah some antidepressants can lower your libido unfortunately, but it depends on the antidepressant and others have a low incidence rate of causing those side effects. You also may not need an antidepressant to help you. There is a therapy called Cognitive Behavioral Therapy (CBT) that is the most evidence based therapy that can help you. CBT's premise is that your depression and anxiety is caused by negative thoughts, so it works by changing your automatic negative thought process to be more positive and probably, which will lessen your symptoms.

DoctorZ :

Here is an example of a common and effective CBT technique that I use with patients. This link contains a technique that will help you keep track of any negative thoughts you have. You put the negative thought on paper, the emotion accompanying, the evidence to support it, and the evidence against it. Then I want you to come up with an alternative thought for the situation (more positive and plausible). This will help you change your way of thinking to be able to think more positive and not automatically go to a negative type of thinking.

Customer: Thank you for your help!
DoctorZ :

Anytime, is there anything else I can assist you with?

Customer: I really think I need to talk to someone in person. I hear the suggestion you are giving me for therapy, and already my thoughts dismiss it because one of my problems is feeling like I don't enough time to get everything done and keep my wife and kids happy. She is clearly losing patience with me and I am trying to fix myself to keep my family going and happy and healthy. Right now, we are not doing so well.
DoctorZ :

Well therapy appointments in person are only for 45-50 minutes and you can go once every two weeks, so that is not a lot of time out of your schedule. Also therapy is not a quick fix, it is a gradual approach to help you. There is also e-therapy that you can try too, this is therapy from your phone, chat, or from videochat at your home, which may be more convenient for you. The dismissive thoughts you are getting are negative thoughts that are fueling your depressive symptoms

DoctorZ :

I believe that therapy will help you greatly, but you need to give it a chance to be effective for you. I can also recommend a good book that will help you as well

Customer: Thank you! I will try!
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