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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10643
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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Am I bipolar or have bpd? I have very up and down moods, can

Customer Question

Am I bipolar or have bpd? I have very up and down moods, can be crazy, hyper, silly then depressed in one day, but also several days of intense euphoria, feeling superior, drive revklessly, spend impulsively. Mostly depressed though - anxiety, guilt, self-hate, intense irritability, nastiness. I've been off for weeks with depression and will have suicidal ideation, but no actual plans. My partner feels I am unpredictable but loves my high moods. I don't know what my baseline is but am capable of being calm and 'normal' sometimes. I am on escitalopram but this doesn't seem to be helping at all. No known history of bipolar or bpd in my family although everyone has depression. I've had quite serious depression and anxiety since I was about 5. I will fixate on things like the end of the world. No one seems to acknowledge that there may be more going on than unipolar depression and anxiety. Please advise!
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Z replied 1 year ago.

*This website DOES NOT constitute treatment and only provides information and advice. For treatment (therapy and/or medications) you must go to a licensed professional in your area. Please note that anything said here is not private or confidential, as this is a public forum.

Hello and thank you for your question. Typically an individual with a true Bipolar Disorder will have cycles of Mania/Hypomania (symptoms include anger, irritability, increased energy, grandiosity, racing thoughts, pressured speech, less need for sleep, impulsiveness, and recklessness) that last for a few days to a few weeks. Than the individual will either go into a Euthymic State (normal mood functioning) for an indeterminate amount of time or a Depressive Cycle for a few months. If the individual goes into a Depressive Cycle, which lasts for a few months, than once the cycle is over the individual will either go to a Euthymic state or a Mania/Hypomania Cycle. Nearly 75-85 percent of people with Bipolar Disorder will have less than 3 Mania/Hypomania Cycles in a 12 month period, and anyone who has 3 or more Mania/Hypomania cycles in a 12 month period are considered rapid cycling.

Individuals with BPD will mostly have negative mood swings of anxiety, depression, and anger...and they will be rapid mood swings as well often fluctuating withing a day, a few days, or a week. Typically an individual with BPD will be considered unpredictable as their mood swings are not cyclical in nature like with Bipolar Disorder. Also individuals with BPD will have simultaneous symptoms of impulsivity, recklessness, poor interpersonal relationships, anger outbursts, suicidal ideations, and issues with attachment/abandonment.

While I cannot diagnose you without a face to face evaluation, because you respond positively to the Paroxetine (Seroxat), most likely you do not have a Bipolar Disorder as the symptoms of Bipolar Disorder would worsen on an antidepressant. It does sound like there is a possibility of you having BPD or at least some BPD traits.

I hope this answers your questions and gives you some guidance on this issue. Please let me know if you have any questions or concerns as I am happy to assist and support you regarding this issue.

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