Help! I'm Feeling Unstable & Out of Control! Is This Bipolar?

[johnnyky]

I wonder if someone on here can give me advice. I suspect I may have bipolar disorder which is the root cause of my anxiety symptoms & panic issues. I have yet not been diagnosed, but I have reasons to suspect this. For years, I have had mood swings from happy & social to very angry & pent up rage & sometimes I feel out of control in my head. Sometimes these changes occur within one day, and most other times I have many days in a row where I feel like I'm bouncing off the walls & constantly interested in sex & having sex with random people. I have never been seriously suicidal, although I have thought about it. I do have days when I feel really down & depressed though. I have a lot of avoidance, but this is more due to anxiety than feeling depressed. I don't sit and cry for days. However, for many years, I have had hypersexuality and felt the need to sleep with a ton of people and have meaningless sex for no apparent reason. In the past few years I don't have nearly as many hookups as I once did, but I still seek them out & last week I had 4 different sex partners. I know this is not normal but it's awful because I feel hyper & not in control. I get in this zone & only care about having sex with a new exciting partner even if just one time, and sometimes I dress differently for each partner. Like for instance I have an athletic persona when I'm hooking up, but in my everyday life I am more nerdy & stylish if that makes sense. I am ashamed to say it but I have had hundreds of sex partners & it is like this manic urge that I have to fulfill. That seems to be my primary symptom, other than racing thoughts and occasional mood swings, but I am not violent or seriously suicidal. I do have numerous random violent thoughts throughout the day though (but haven't seriously contemplated acting on them). I've never had a huge problem sleeping at night, but I do have spells where I dread bedtime for no apparent reason & have trouble falling asleep. I ever majorly abused alcohol or drugs, just the basic experimenting, never anything major and currently I have been clean for 4 years, but the hypersexuality impulses continues and it's like I feel out of control. If I do have bipolar, I know it's not the end of the world, but it concerns me because sometimes I feel out of control of my thoughts & impulses & I worry where that might lead. Not sure if it would be Bipolar I or II, but I seem to have only primarily manic issues, and very little depressive states. I feel sad & down sometimes, but this rarely lasts more than two days. But my manic sexual impulses & mood swings & high energy can last as much as a week or more, sometimes several weeks in a row. I know this can't be normal. I also have periods of frenetic shopping where I buy tons of stuff & just can't stop myself, until I max out my credit cards. It's like either the sex or the spending is beyond my control when the impulses hit me. I also alternate between these grandiose thoughts of myself thinking I am better or above everyone else & other times when I feel so inadequate that I shut myself in.

I don't ever hallucinate, or hear voices, but I have racing thoughts and sometimes rapid speech (though beta blockers seem to help a bit for that) and am very anxious and paranoid often. I do have these random blurting out of phrases sometimes & sometimes talk to myself or think angry thoughts about random strangers. I don't know why. I have taken most of the online bipolar tests and most say I have a moderate to high likelihood of having bipolar. Of course I know those tests aren't scientific. My mom also has serious mood swings & anger outbursts, and these major victimization tendencies needing to be the center of attention. Unlike me though, she is virtually anxiety-free but is still ill at ease around unfamiliar people. She isn't hypersexual like I've been either. But my anxiety issues are greater than hers. And her mood swings are much greater than mine, but my racing thoughts and hyper sexuality is greater. I don't want to tell my psych about her at all because I feel I'd be betraying her and she is my best friend in the whole world. But maybe genetics count for something?

I have had one session with a psychiatrist recently, which was a big step for me, who thought based on that meeting that I have social anxiety & panic disorder, and he said, "your not out manically having sex with tons of people so I don't think your bipolar." But, I turned a bit red at that moment, but I DIDN'T tell him that in fact I have done just that for years, because I was ashamed and afraid to do so. He has me on paxil & xanax until I see him again in 3 weeks. I know I should have come clean to him about all this, but I just thought he would judge me. But since I've been on paxil a few weeks I am starting to feel VERY out of control & more hyper than I have ever felt.

Here's my question. What should I do? Should I tell him all of this? For years I thought anxiety was my main/only problem, but these angry violent outbursts and constant thinking about sex and revolving around that constantly has me thinking it's bipolar.  My next session with my psychiatrist is in two weeks. About manically having sex with tons of people & racing thoughts & feeling like I sometimes am two different people? How is bipolar diagnosed, and how many sessions does it take? Does a psychiatrist diagnose it? And I assume if I do tell him about all of this, it's strictly confidential and between he and I?  Also, I know it's impossible online, but do my symptoms sound more like bipolar I or II if it is bipolar? Thanks so much for listening, just not sure what to do or what to think. I am feeling out of control like my head is going to explode.

[johnnyky]

I don't have a problem with my current psychiatrist he treated me with respect and was pretty attentive & listened to me on my first session with him. He didn't make me feel as if I was being talked down to. At the time I wasn't in what I have come to recognize as a manic phase, and for years have just written off my symptoms or tried to ignore them. Plus mania for me feels mostly good, so usually I don't feel the need to bring them up. But I know I do now, because of risky behavior that I do when I'm manic, and occasional bouts of severe anxiety & even borderline depression.

It was my fault for not telling my psych any of that, so no point in switching doctors since that's not an option for me now anyways, plus I liked my psychiatrist overall. All I told him was about how I feel anxious & panicky, but I am beginning to realize now that all my years of strange behaviors & mood swings may be due to a form of bipolar and not anxiety. So it was my fault for not opening up to him. But since I felt reasonably comfortable with him, I definately will the next session.

I have heard men seem to have more manic symptoms and women more depressive, but that seems way too simplistic & even sexist. Bipolar knows no boundaries! I suspect some of my uncles have it, and even my mom.

I feel better today, coming off of what has been about 2-3 weeks of near constant mania, hypersexual, racing thoughts, angry outbursts, aggressive behavior, & intense thinking in my head to the point of feeling like my brain would burst. I also had a couple of bouts of severe paranoia which disturb me, because that is a fairly new symptom for me. But today I woke up, and I feel calmer, stable, more myself. I guess mania can make one feel exhausted because I feel physically and mentally drained!

I am fortunate to even have a psychiatrist, my gp doctor was nice enough to refer me to him, and he saw me without delay. I will open up to him next session entirely and tell him the whole truth, and leave nothing out. I have written some notes down for myself to show or tell him so I can give him a good picture next time.

[89NotAgain]

Very good I liked your ideas. Yep get another Psychiatrist! As for the fear of being "Judged", don't concern yourself with that. Trust. You n your doc have a professional relationship and you need to feel safe. I agree that a new doc would be better.

[johnnyky]

Thanks so much for the nice responses. I will look some more online (if I can settle down enough to). I will be seeing my psych soon but if feeling still unstable tomorrow I will call & ask to get in sooner. I have had these symptoms for years. I first thought I had anxiety/panic disorder or even ADD, but I get these days on end where most of the day I feel VERY on edge, irritable, "high", & wired. Like the past week or two. It's not 24/7, but I feel wired & amped up for like 90% of the day. And I am thinking about sex constantly & wanting to hook up with random people (why I don't know but I have done this for years and had hundreds of sex partners).

I don't think I am or have been psychotic, although I do feel people are staring at me & judging me very often & even when driving sometimes I feel I am being followed I know this is not normal. I noticed when I took Trazodone once for sleep, I felt good but it made me even more manic than usual.

I have never had major depressive episodes in that I don't cry or lay in bed for days because I feel depressed. It seems that usually I am either manic, paranoid, or somewhat stable. But I do have a LOT of avoidance & self-imposed isolation so maybe that is considered a form of depression. Up to now, I always assumed it was anxiety-related. I will tell my psych everything the next time.

These manic feelings scare me though. Today marks the 10th day or so I have felt manic. It's not 24/7, every minute, but it's the majority of the time. It's like my brain feels it's going to explode.

I called the clinic today and the they said the therapist could fit me in soon which is comforting.

Thanks again for all the responses. Guess I'll keep taking my paxil until told not to. Xanax is helping a bit at night to calm me down.

[Crystal413]

Anonymous88 gives you excellent advice. I agree with everything she has said. You were very thorough in your description. I would definitely print this out for your dr to read. He will get the full picture without anything being left out. You need the correct diagnosis in order to get the correct medication.

[Anonymouse88]

I don't have time to do a full runthrough, but here are a few of my thoughts:

First off, you always have to be honest with your doctor.  They can't treat you properly if you aren't, and the treatment they give you based on incomplete or inaccurate info can even be harmful.  And your information you tell your doctor is by law strictly confidential in the US (look up HIPAA) and in most countries.  There are sometimes exceptions if they think you're an immediate harm to yourself or others, or in cases of abuse (like doctors being mandated to report suspected child abuse), but 99.999999% of the time, your privacy is protected.  If your mother came in and asked what you'd said about her, they'd have to have your permission in writing to tell her.

Second off, your symptoms do sound very suspiciously like bipolar, although you seem to only have manic symptoms.  There's a diagnostic checklist for mania and hypomania, and I suspect you would fit enough items to qualify, although I can't say for sure over the internet.  If it's bipolar I, you only need to have had a full blown manic or mixed episode, no depression required.  Bipolar II requires a hypomanic episode and a full depressive episode.  There's also a "not otherwise specified" category (NOS) if a clinician thinks you are bipolar but you don't fit in any of the designated categories.  I suggest looking at the psycheducation.org website to learn more about the different flavors of bipolar and different presentations.  Psychiatrists or psychologists can diagnose bipolar, and it can take one session or many sessions depending on how the person presents and what kind of history they give (BP II gets missed a lot because people only come in when they're in a depressive phase, and they forget to mention hypomanic symptoms they've had).  With my current psychiatrist, I went in because I was massively depressed, but had read up on BP and told her I thought I might have it, and she asked why I thought that, I told her, and she agreed.  The anxiety diagnosis took several months, since I didn't realize how much of a problem I had, having lived with it all my life.

With that being said, I would see another psychiatrist if possible, because his comment about "you're not out manically having sex with tons of people so I don't think your bipolar" says to me that he knows very little about bipolar, since hypersexuality is not a necessary symptom.  It's classic, but there are plenty of bipolar people out there who never get hypersexual.  If changing docs isn't an option, come clean now about the hypersexuality, and make sure to mention the spending sprees as well.  

Coming back to the issue of treating you for the right thing, antidepressants (SSRIs) can make bipolar WORSE, especially if you're not on a mood stabilizer.  DON'T stop taking your meds without permission, but you need to call him ASAP and tell him what's up, especially since you're feeling worse.  Call up the office and ask them to put you in if someone cancels so you can see him sooner in person if possible.  If you're too embarrassed to talk about it, write a letter.  Heck, print out this post and bring it on in.

I have to go, but feel free to message me or post here and I'll probably get back to you within a day or so (I'm quite busy nowadays, but some things are important).