Bipolar C-PTSD vs. Bipolar

Sadielady3

MyPTSD Pro
@grit Your response made me tear up.

As I read your post, I could not help but notice, you may be outsourcing your own inner intelligence to others or professionals and they are diagnosing you with their own judgement and value based on whatever symptom you bring that day. So now it may be that, time is being spent categorizing what they think and what you think rather than spending time (as you suspected) listening to your body that left you long time ago because you were experiencing unbearable trauma against your body. We may give names to the trauma to use language and categorize it so we can talk about it intellectually, but the it gnaws at the body still...and language or diagnosis hardly ever touch the body that was traumatized enough to dissociate.

This hit me hard. I outsource most of my thinking to others. I am extremely approval seeking and lack the confidence to just make decisions for myself. The vast majority of the time I will present my ideas to other people that I trust only to have them agree with what I'm thinking. I know part of my problem right now is that I am having serious vertigo issues but because no one can find the cause for the vertigo, I feel like I'm making it up or wrong about my own experience. I rationally know that just because Urgent Care can't figure out what's wrong doesn't mean that when I see the ENT specialist that he won't be able to figure it out. It keeps feeling like something is crawling around in my ear canal but the Urgent Care doc of course looked and saw nothing. However, someone who specializes might hear that description and know exactly what to look for. I rationally can see the logic of all of that but for so many years, every time I got sick, I was told I was being overly dramatic and would even be punished for getting sick. Now I struggle to accept when I am physically unwell. Whenever I do get physically ill enough to actually seek out medical help, I usually get scolded for not resting or coming in sooner. I don't actually know how to listen to my body. Until fairly recently, I didn't really make the connection. Hearing someone else say that this can be a thing is hard. I know my brain works differently because of the trauma but I mostly just feel like a freak and feel like I should be able to do better, be better, if that makes any sense.
 

Sadielady3

MyPTSD Pro
@joeylittle Thank you for sharing your personal story. I did find that helpful. I have what I think is an excellent psychiatrist. She really does listen to me. When I was first referred to her by my therapist, she actually really listened to everything I had to say. She set my primary diagnosis as anxiety, which my therapist disagrees with, but I think is right because I'm nearly always anxious and it's when I get too anxious for too long or a significant trigger hits my anxiety hard that I start getting depressed. She subsequently then prescribed gabapentin off-label for the anxiety to see what it would do. It seems to help. My anxiety has been lower. Because of the anxiety decreasing, I have some distinct periods where I am less depressed. My therapist is seeing periods where I am more upbeat and positive about life than I used to be. He's thinking these are periods of mania/hypomania. I personally think that these are evidence that, through all of the work I've been doing in my three therapy groups and EMDR in individual therapy, I am actually reaching a better place where things aren't always so dark and hopeless. But of course, with any trauma work, there are going to be low points as well. That's what I honestly think is happening. Even looking up hypmania and discussing that concept with my husband, neither of us sees the happier points as being that. On top of all of that, depression itself can be cyclical in nature from what I've read.

I just need to take a breath and remember that this is a process. It's hard to remember because I've never gone through this process before (first time I've ever really had a psychiatrist involved that wasn't just writing prescriptions for antidepressants).
 

joeylittle

Administrator
first time I've ever really had a psychiatrist involved that wasn't just writing prescriptions for antidepressants
I totally understand. It makes a huge difference - and it sounds like you've got a good one, and she'll be a good collaborator for you. Glad to hear also that you are sharing things with your husband - the observations of an outside eye are useful, as I'm sure you have discovered.
 

Sadielady3

MyPTSD Pro
Brief update- my psychiatrist actually has been emailing back and forth with me today. Not sure why on a national holiday (maybe she's on call or something) but still good to have the conversation. She had me answer a bunch of questions and based on my answers thinks that bipolar is unlikely and is putting that on the back burner for now. She did prescribe lorezapam for the short term to help with the dizziness and vertigo issues.

I really wish there was a blood test or scan or something that psychiatrists could do to determine the diagnosis. Thanks to everyone who weighed in- it helped to keep me from freaking out.
 

EveHarrington

MyPTSD Pro
I’ll share...

my doctor says I have a bipolar type mood presentation, in my fluctuations between normal and depressed, but since I don’t go manic or hypo manic, it’s not bipolar disorder. Since I have mood fluctuations, mood stabilizers help. I take Trileptal and Gabapentin. While they’re in the same med family, Trileptal is stronger in mood stabilization while Gabapentin is stronger in controlling anxiety. I’m off the Trileptal right now and realizing it does work on anxiety more than I thought it did. (I get side effects that cause me to need to cycle on/off every so often. It’s a pain, but necessary as I’m near the end of the med road here.)
 

Sadielady3

MyPTSD Pro
I’ll share...

my doctor says I have a bipolar type mood presentation, in my fluctuations between normal and depressed, but since I don’t go manic or hypo manic, it’s not bipolar disorder. Since I have mood fluctuations, mood stabilizers help. I take Trileptal and Gabapentin. While they’re in the same med family, Trileptal is stronger in mood stabilization while Gabapentin is stronger in controlling anxiety. I’m off the Trileptal right now and realizing it does work on anxiety more than I thought it did. (I get side effects that cause me to need to cycle on/off every so often. It’s a pain, but necessary as I’m near the end of the med road here.)
I'm already on Gabapentin for anxiety. It might be worth exploring an additional med once my physical medical issues are dealt with.
 

Autumnsirens

New Here
Hi there. I literally registered on the site just so I could respond to your post. I know you posted months ago, but in case you're still searching for answers (or anyone else is), I wanted to share. I'm not going to speak to medications specifically, just my diagnoses.

This story is long but I'm going to try to summarize as best I can.

I was diagnosed with MDD, GAD, and insomnia when I was 16 years old. I had those diagnoses until I was 20 when I was diagnosed with Cyclothymia. From that point until a month ago (I'll be 35 in a few weeks), I was also diagnosed and treated for Bipolar II and Bipolar I.

Loooong story short, last year I started really questioning those diagnoses and last month I was rediagnosed, through a long assessment and lots of testing, with GAD, CPTSD, and ADHD.

I recognize the overlap between the symptoms of all these diagnoses and how easy it would be for someone to misdiagnose them. But, there are very crucial differences between them and if you don't ask the right questions, you won't get the right answers.
Most of my PTSD symptoms and some of my ADHD symptoms were misdiagnosed as hypomania or mania. Any depressive episodes I've had were viewed as organic and not subsequent to my trauma. And all because my trauma was initially ignored and noone after that stopped to ask why my symptoms were happening.

Anyway, I hope this helps someone.
 
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Sadielady3

MyPTSD Pro
@Autumnsirens thank you for your response. I also have a long story with my mental health but, unlike you, I was denied treatment at all until I got to college because my mother doesn't believe in mental illness. And, even then, my counseling experience in college was at the school's counseling center with people woefully ill prepared to work with someone with my issues. Eventually, after a psychotic break that hospitalized me after stabbing myself repeatedly with an exacto knife and a serious suicide attempt that had I not been found when I was I wouldn't have survived, the counseling center and college determined that I could only work with the counselor who was actually a certified therapist. The rest were all people working under his license.

Then, due to financial constraints, I stopped doing counseling for years. I went back to counseling about 6 years ago but at the time I was struggling with a nasty breakup that I wasn't dealing well with. I was diagnosed with GAD and it was left there. I continued with counseling in that state for over 2.5 years but I never really dug any deeper than talking about the day to day stuff that was going on with me. Therapy was a place to vent and nothing more. I quit therapy again in June 2018 thinking that I didn't really need a place to vent as I was making some changes in my life that should fix everything.

In the fall of 2019, I started going really downhill really quickly. I was a teacher and things were getting so bad that I was having panic attacks in front of my classes. I got lost on the way to work because I was dissociating out while driving. I wasn't managing a single part of my life well anymore. I called up my HMO and got back into counseling but I couldn't get an appointment until January. And so the decline into depression and serious suicidality continued unchecked for at least another month. By the time I met my therapist, I was in rough shape. A few days later, I had a panic attack so severe that I wound up in the ER thinking it might be a heart attack. The heart functioning tests showed that everything was fine but yet my heartrate couldn't rise above about 35 beats per minutes. At this point, I was pulled out of work for a month to go to an IOP program and officially diagnosed with MDD. And today, if you looked at my official medical chart, it would still tell you that I have MDD and GAD.

My therapist isn't overly interested in diagnosing me. We've discussed the fact that I almost certainly have PTSD and we do a lot of trauma work. I believe I have CPTSD, but as you noted in your blog, you can't get that diagnosis in the states. I have extensive childhood trauma but didn't really realize it until a year ago. Like you said, it never seemed that bad because it was all I knew as a kid. I think most people with trauma diminish or even discredit their experiences because it was what was normal for us. We didn't know any other experience. I currently take gabapentin for anxiety and prazosin for nightmares. My therapist, at the time that I started this thread, kept seeing me sink into these really dark depressive states that I would come out of and be fine. What I think he didn't account for was the fact that we were doing EMDR at the time and all of this trauma that I had forgotten was resurfacing. It was a lot to work through. I was also working as a teacher and that was deeply negatively effecting me, especially teaching during the pandemic.

So I guess at this point I am still searching but not necessarily for a diagnosis but instead for simple truths I was denied in my childhood and for mental wellness. If a diagnosis could help me achieve mental wellness, I am all for it. At this point I want to figure out who I really am, the things I really want, and what I want my life to look like. I've spent a lot of years doing whatever other people, mostly my mom, want me to do. And most of the suggestions, like becoming a teacher, made sense to me so they were easy to go along with. But I ended up with a good life full of friends, a successful career, and a wonderful husband but I was deeply miserable. I thought something was wrong with me. The simple truth of it was that teaching made me miserable because of how toxic it is and how much it was triggering past traumas that I didn't even know I had. It also wasn't the right place for me to do my life's work of helping people. Teaching is a helping profession but teachers are, and rightfully so, expected to help people learn things about academic subjects. That's not the kind of helping I want to do. I didn't value math and wasn't at all passionate about cramming equations down people's throats. I wanted to help kids with the things that really matter- their mental health and personal growth. That mattered to me. And while there is a small place for that in teaching, it's not the focus and is very limited. Now I'm in school to become a therapist and no longer teach. I've honestly never been happier. I'm getting better at finding my authentic voice. And all of that made all the difference in the world with my emotional disregulation and depression issues. They're still there but they don't pop up as often or as severely anymore.

I have traumatized parts as well but I don't know much about mine and I certainly haven't given mine names. At some point I will likely need to do some parts work but my current therapist doesn't do parts work and I don't feel like my journey with him is ready to end quite yet. I think, for me, the most important part of my journey at this moment is to remain in that relationship and to learn to trust another person to the point where I can speak my truths and thoughts without unraveling. I still very much struggle to be 100% honest with him. I still hide a lot of things. I'm always honest with what I say to him but I do a lot of lying by omission.

Never intended for my response to be this long. If you made it this far, my hat off to you.
 
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Autumnsirens

New Here
@Sadielady3 First, I just want to say congratulations on taking those steps to find your voice and living for you. I know how incredibly hard that can be.
As far as my years in treatment, I think I've made more progress in the last 2.5 years than I did in all the time prior to that. There was a lot of venting, like you said, but it took 7 prior therapists and 7 prior psychiatrists just to find the two that actually listened. My first two therapists were Christian Counselors, so I don't even really count that as going to therapy, anyway.

I've been working as a Peer Support Specialist for the last 10 years and I truly believe something I tell people all the time: a diagnosis is really just a list of symptoms that your therapist and doctor use to bill your insurance. That said, the *source* of the symptoms should always be considered because it can totally change the way those symptoms are treated. A huge example is anger outbursts. They can pop up with PTSD, mania, and ADHD, but you treat them all differently.
I also decided that after so many years of being jerked around by psychiatry and being on 34 different meds, if the Bipolar dx was wrong, I wanted it in writing as to why. If I ever need a new therapist or psychiatrist, I want to be able to hand them that assessment and say, "This is why it changed after almost 2 decades."
Since I got the results, reframing my experiences under the new diagnoses has given me much better language to explain what's happening in my mind and body. Tapering off of Lithium is a definite perk, too. 😁

I think some...most?...of why I've made so much progress in the last few years is because of Parts work. I never consciously named any of my Parts, the names just sort of popped into my head at some point (that's really common with Parts work). Most of what's written about IFS is for clinicians, but if you ever want to read more on it, there's a really accessible book called Parts Work: An Illustrated Guide to Your Inner Life by Tom Holmes. I think you can only get it on Amazon, but it really simplifies the concepts and also has some exercises if you want to explore your Parts on your own.

I hope that things continue to get better for you, regardless diagnosis!
 
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