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Is this diagnosis of bipolar disorder accurate?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Bharat Udey

Medically reviewed by

iCliniq medical review team

Published At May 22, 2018
Reviewed AtAugust 25, 2023

Patient's Query

Hello doctor,

I have been diagnosed with bipolar disorder two years back. Another doctor changed the diagnosis to light bipolar. The last one told me it is just depression and anxiety. I had mood stabilizers, antidepressants, and Modafinil tablets. Due to an overdose, I gained a lot of weight. So, I gave up on the medications cold turkey and started work outs and medications. I consulted a homeopathic doctor and started medications for depression and anxiety. I plan to go a nutritious diet for managing the depression, which lasts for three to four days when I am not stressed and longer when I am. Can a person be hypomanic for more than three weeks if he is bipolar-2? I used my willpower to accomplish more as I was moving to another country. I prayed more and started doing all the things systematically with planning. As my faith got increased, I started to become compassionate with people, and very confident about things. I was very optimistic about getting a new job and believed that God would give me everything I needed. I felt most of the favorable things happening in my life as god's actions. I felt very happy and present at the moment. I was not euphoric. I was not talking excessively, not irritable, or low on sleep. I slept for seven hours at night. I was not jumping from one idea to another or jumping from one activity to another but I was finishing tasks systematically in a calm way. Suddenly, I felt bored and depressed one day as I was not able to follow up on my exercise, diet, sleep, and prayers. Then, within two days all the systems in my life crashed. I felt depressed and anxious. But, I did not cry. I feel angry and lost in thoughts about my past. I just sit with my phone the whole day and eat a lot for many days. Then my efforts come back to get back into the system. I connect the feeling of happiness that was there a few days ago as euphoric and being productive as hypomanic. Is this bipolar 2 or just depression due to unsystematic living? If the praying and systematic part were hypomania, then if I maintain a good nutritious diet plan, do yoga and exercise twice a day and sleep for six to seven hours a day to fight the depression part, will the hypomania be controlled?

Answered by Dr. Bharat Udey

Hello,

Welcome to icliniq.com.

From the above description, it is quite clear that you have an affective disorder. It can be bipolar 2 disorder where episodes of hypomania alter with episodes of depression. But, these switches are occurring more frequently on a day to day basis. The depressive episode itself is not clear as it lasts for few days only and not as per the diagnostic criteria where it should last at least for 14 days. Hence, I would say it is more of a cyclothymia like condition where there are fluctuations in the mood on a day to day basis and does actually meet the criteria for either depressive episodes or manic episodes. Hence to be clear, if these fluctuations in mood are causing you distress or dysfunction in your daily life and are not remitting on its own, only then you can consider pharmacotherapy. Otherwise, you can continue with non-pharmacological measures as you are doing already. Take care.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Bharat Udey

Dr. Bharat Udey

Geriatrics

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