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My diary entry

LivAgain

Hi everyone,

I've recently been keeping a diary, and recently I confronted something I'd never really addressed myself, and it's worrying me quite a lot. I've edited out a couple of really personal bits or bits people might find upsetting, and I've hidden names but I thought I'd share this entry with you and see if any of you could relate.

When I use personal pronouns, it's usually because I'm addressing the void!

I've always had a feeling that something isn't right. Over the last two years as I have learnt more about Asperger's, a lot of it can be put down to that, but there are other things which I'd really like an explanation for, if you can.

Sertraline has given me the opportunity to "step outside myself" and really think about my behaviour and the thoughts I have, which is a good thing. I have begun to reflect on some of the times when I have felt not just different, but not well.

Since I was very small - toddling - I've had extreme fluctuations in mood. These aren't the Aspie 0-100 reaction "meltdowns"; I know because I have those too. Asperger's is, I have learnt, mostly a condition of logic. Ergo, the 0-100 reactions usually have a trigger (even if it seems small to neurotypical people). But the ups and downs I experience, and always have done, aren't that logical. They take place over weeks, and my mood eventually ascends or descends; on this constant cycle. For example, for a few weeks I will feel charged with excitement, then for a few weeks after I'll feel drained, exhausted, exposed and unhappy. Nothing cheers me up. I'll lie in bed and cry and feel intense pain in my chest, which, before sertraline, I used to put down to anxiety. Now, I think it's more a stony ache of sadness. Sometimes I'll look out of my window at the endless sky and I'll see the beauty in it but its endlessness makes me feel so helpless. This has varied in prominence throughout my life, but the changes in mood often aren't particularly influenced by external sources.

Another thing which confuses me is my manicism (this is showing a red squiggly line which means it's not a real word. Mania?). I know lots of people who are on the spectrum, and so does Mum. However, we both agree that "manic" isn't a word we'd use to describe them, yet it is often a word used to describe me - along with "hyperactive" and "high-spirited". My school was once asked to do a questionnaire regarding the possibility that I had ADHD, and I scored highly for hyperactivity and low for inattention. (My former psychiatrist) said I was "a bit more out there" than the average Aspie. What's more is that I feel a lot of my issues aren't caused by my not being sure what to do socially, but that I'm so manic I frighten people away. I know that no two autistic people are the same, but I haven't met another ASC person who experiences my "mood swings".

Moreover, my dreams are very colourful. When I'm at my best and my worst, I can do magical things. One thing I never feel is confined.

What does this mean?

 

 

  • Former Member
    Former Member

    There is an interesting article at http://www.autismspeaks.org/blog/2014/05/22/mental-health-awareness-mont...

    It suggests that "However, we believe that bipolar disorder is mistakenly over-diagnosed in those with autism. In part this is because some of their symptoms can overlap"

  • Perhaps. It did all seem a bit general...I once watched a documentary where Stephen Fry talked about his bipolar, and he said his condition was in fact called cyclothymia, which is nicknamed "bipolar light" in the States, and my psychiatrist kept referring to "classic bipolar". But I still don't think I've got it! Smile Underdiagnosis of mental health conditions in females is a topic which needs looking into though, so I'm glad people (including yourself) are keen to research and educate themselves.

  • And here is exactly what I was looking for:

    http://www.health.com/health/condition-article/0,,20274376,00.html

    On P2: "Bipolar II disorder features a more moderate form of mania known as hypomania, which is easier to mistake for an ordinary mood swing. While the prevalence of bipolar I is roughly the same among men and women, it has been suggested that bipolar II appears more often in the latter.

    Rapid cycling, in which four or more episodes of mania or depression occur in a year, is also thought to be more common among women, perhaps because it is more closely associated with bipolar II. The same is true of so-called mixed mania, in which manic and depressive symptoms occur simultaneously."

    And yes, women are under-diagnosed.

    So whilst your psychiatrist is private, do still question because it could still easily be a case of him/her not being aware of the differences with female presentation, just as with autism.  So this is a different aspect than the bar being set too high, it's lack of expertise with females.

  • Exactly.  And I am on a mission now to find out if bipolar presents differently in females!  (just to satisfy my curiousity)

  • Wow, thank you for all the info! ADHD is a definite no-no - I have been assessed and I wasn't considered to be inattentive in a way characteristic of ADHD. And I'm fairly certain I don't have any of the others! But it is all very interesting. Yes, it's quite difficult to look for triggers as it just happens and always has done; until recently I thought it was usual and it happened to everyone.

  • Hi, I totally agree with the things you've said about CAMHS not diagnosing unless the case is very severe, but my psychiatrist is private. And yes I am female. Smile Yes, I do feel that sometimes I'm in the doctors' "hysterical box", but after what was explained to me this morning, I'm fairly convinced that bipolar isn't the issue. On the other hand, obviously I don't know enough to say for sure, and even if it is the case, I'm sure the truth will out eventually, just as it did about my being Aspie (after a lifetime of being told by all sorts of professionals that I definitely wasn't).

  • Just did a quick Google out of interest.  Without even clicking the links that came up, I can see that the following conditions can have similar symptoms to bipolar:

    • schizoaffective disorder
    • ADHD
    • Borderline Personality Disorder
    • depression
    • schizophrenia
    • hypothyroidism or hyperthyroidism
    • drug, alcohol or other substance abuse
    • psychosis from steroid use

    The last 3 are probably the least likely in your case.  ADHD is a big co-morbid with spectrumites, have you been assessed for that?

    It might also be an idea to look for patterns in your diary of anything that correlates with the periods of mania and the periods of depression in case there is an environmental trigger.  From what you said in your first post though, it didn't sound as if there was a noticeable trigger.

  • No worries.  What does concern me a little, is that this sounds a bit like an issue there is locally to me (and from reading lots of anecdotal evidence of others in other areas it could be a national issue) with not diagnosing children with ASC via CAMHS.  Many parents feel the NHS bar is set too high and this is why many high-functioning ASC children are failing to get diagnosed and getting fobbed off with "some autistic traits but not enough for a diagnosis".  It is known that CAMHS isn't fit for purpose as there is a Government inquiry underway and the NAS "You Need to Know" documents make it very clear.  I do have concerns, that because the NHS is cash-strapped, they will only diagnose the most severe cases of a condition frequently.  I doubt you can be a little bit bipolar any more than you can be a little bit autistic, a little bit pregnant or a little bit diabetic.  I am presuming here that your psychiatrist is an NHS one BTW.

    I know that with autism and ADHD/ADD females are better at masking things and try harder to fit in, sorry I'm unclear if you are female or not, but if you are, I do wonder whether this is also the case with bipolar.  ADHD, schizophrenia, ASC, bipolar and severe depression are all genetically linked.  And I'm sorry to say, that there is still in this day and age, a culture of mysogeny, we are just overwrought, hysterical females that's all.

    Just be cautious that you are not being fobbed off.  I don't want at all to convince you that you have it if you don't, but there are just so many cases of the NHS fobbing off and failing to diagnose - because to support diagnosed conditions costs services.

  • Thanks so much for your help, but I chatted to my psychiatrist this morning and he doesn't think it's a cause for concern just yet. He explained that there is "quite a high threshold" for diagnosing bipolar and I wouldn't meet the criteria. However, he said it was something I should have my eye on as he told me I definitely have a manic tendency and a depressive tendency (I know that bipolar used to be known as "manic depression", but just because I have those two tendencies, it doesn't mean I'm bipolar). But thank you so much for thinking of me and sourcing those links; it's really kind of you. Smile

  • Hello IntenseWorld,

    I copied and pasted the sites you've suggested to LivAgain.

    Have a look at this: http://www.nice.org.uk/nicemedia/pdf/CG38niceguideline.pdf

    Also, you could try this: http://www.health.com/health/condition-article/0,,20275236,00.html (if you don't like that one if you Google there are others).

    And this is interesting: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2590592/

  • I did also post you shortly after some links, including an online bipolar test, but as there are links the post has been queued for moderation because of the tightened security because of recent spamming, so it hasn't posted yet.  I doubt mods will be back on until Monday so it won't appear until then most likely.

  • Hi - I think they're OK at the moment; thank you for asking. I'm on quite a high dose of antidepressants so I'm not noticing it as much, but I'm ever so slightly manic at the moment. How are things with you? Smile

  • Hi - thank you for your reply. Smile I have had bipolar mentioned to me before, but it's usually by other teenagers who don't understand what bipolar is and think they've all got it because they have hormonal mood swings. That said, I once got so worried about it that I asked our local ASC specialist (because I thought she might have a fairly good understanding of these things) when I saw her at a course I was speaking at, and she said I wasn't, but there are a lot of things which don't add up and, since the start of my journey on medication, I've noticed that, since I was tiny, a lot of my mood patterns aren't particularly "normal". I'm going to see my psychiatrist this morning (because mood doesn't ever seem to be something we've addressed with the various professionals I've had experience with) so I'm going to have a really detailed chat to him and see what he thinks. Thanks again!

  • As you likely know, co-morbidities are very common on the spectrum >70%.  You sound as if you could have bipolar, which is also genetically related to ASC.

    However, you could also just be prone to mood swings that isn't anything as extreme as bipolar.

    You could ask to be assessed for it to be sure.  Sometimes, Aspies can be very morose and reflecting, I think some of us make good poets.  We can really get into the moroseness of life...but then I guess we get more reason than most to see the down sides to it.