Psychiatry & Psychology--General/Bipolar?

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Question
Hi. I am a 38 year old female who was diagnosed with bipolar disorder in 2008. Since the age of 13, I have found myself depressed more often than not, with episodes of hypomania few and far between and intermittent periods of normalcy. I am currently on no medications for it or anything else.

I sometimes have auditory and visual hallucinations, with the auditory ones occurring more frequently than the visual ones. I can usually identify them as being unreal - they sound like a radio that has been turned on very suddenly, then they fade as though the volume is gradually turned down. I also sometimes get strange and illogical ideas that I only recently realized are considered unusual. For example, I will feel like it's really a different era than the present one, and as a result everything feels wrong - everyone is dressed wrong, the cars are all wrong, etc, because they don't fit the era I feel like it is. I know that it isn't really that era, but the idea persists, and I can't shake it.

I have always been something of a loner, but recently I have gone beyond simply not wanting to be around people to feeling unsafe among them.  They all somehow look and seem ominous, as do many environments such as bars, theaters, etc. Everyday objects also seem to have a "scary" edge to them, especially shadows. Even though I know it's illogical, I often feel like someone is watching me or someone else is around when I know I'm alone. This feeling worsens at night. I'm suddenly very anxious around groups of people, whereas before I could just ignore them. Along with the new feelings of anxiety and fear, I intermittently find myself having difficulty putting my thoughts into sentences, and forgetting things. My memory has always been terrible, but it is much more so now. I feel generally confused and out of sorts most of the time. I often feel unreal or like what I'm experiencing is a dream, and while those feelings often go along with my depression, they are much more intense now.

I'm wondering - do all these things tie in with bipolar disorder? If so, why all of a sudden would they start after all this time?

Answer
Hi, Dawn, thanks for your question. You asked, "I am a 38 year old female who was diagnosed with bipolar disorder in 2008 ... do all these things tie in with bipolar disorder?"

I'm not a believer in diagnoses in general, and especially not Bipolar Disorder. It seems like some psychiatrists diagnose every single patient with BPD, so now it's meaningless, at least as far as I'm concerned. When someone says they or another person is BPD, I stop listening to the 'diagnosis'.

Also, I never give anyone their diagnosis, even if I have to formulate one, either for billing or a report. It serves no purpose for people. Most people are like you - you are wondering 'is this BPD'? You've stopped thinking of yourself as a unique individual, and have started thinking of yourself as a label (BPD).

Also, there really is no such thing as a clearcut diagnosis. Everyone is different, with unique strengths and weaknesses. There never has been, and never will be, someone who fits a diagnostic category completely, and is completely not other diagnoses. The point is that a diagnosis never completely fit you anyway - you never could have been 'the diagnosis'.

So, I probably haven't answered your question, and I'm sorry about that. This is a pet peeve of mine. Doctors who tell people 'you are X disorder' should have their license revoked, because it doesn't help people. There really is no way to 'understand' these things, from an intellectual perspective, and especially by the person who is experiencing it. It takes another person, from the outside, to observe you, ask questions, in order to really understand what might be going on here.

But, I can say that, if one can tell that the 'hallucinations' are not real, it's unlikely they are hallucinations.

Instead, think of yourself as unique. Revel in your strengths, work hard on your weaknesses. You are not a 'bad' person just because you cannot dunk basketballs like the Shaq. We all have problems. None of us are the best in the world and none are the worst. No matter how good you have it, someone else has it better, and no matter how bad, someone is worse off.

If you want help improving your life, go seek counseling from a professional. If you don't want to improve, then don't go. Live your life to the fullest. Love someone and let that person hurt you, cry, and then love again.  

Psychiatry & Psychology--General

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Bruce Borkosky, Psy.D.

Expertise

any related to psychology, especially related to forensic psychology

Experience

15 years as a licensed psychologist, 15 years in private practice. My practice began primarily doing individual and group psychotherapy, is now devoted to assessments, but I occasionally do take on clients in therapy.

Organizations
American Psychological Association

Education/Credentials
B.A. psychology, B.A., music, Ohio Wesleyan U., 1978 MCS, computer science, University of Dayton, 1984 MA, psychology, Miami Inst. of Psychology, 1991 Psy.D., psychology, Miami Inst. of Psychology, 1993 post doctoral training in Neuropsychology, Fielding Institute, 1995-1997

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