Psychiatry & Psychology--General/Second opinion

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I've asked this previously but I wanted to get a second opinion, I hope you don't mind. I was told that this may be related to hypoglycemia, but the response seemed really generic.

Question
19 - Male.
I believe that I have been suffering with depression 'on and off' throughout most of my life. I've never once been to the doctors about it, I don't know why, but I hate the thought of talking to someone about it. The only time I have ever truly discussed it with anyone, was when I was a small child (11 - 13yrs). I used to refer to, what I now believe was depression, as the "horrible feeling". When I was a child, this horrible feeling was an un explainable feeling I would get at night (only at night). I would feel incredibly guilty and terrified about the future (losing my parents, and the thought of me dying of old age terrified me) - I would cry on the nights that the 'horrible feeling' occurred and would quite often end up trashing my room or start acting erratically, I think this was an attempt of distracting me from this 'horrible feeling'. I hid how bad this feeling was, by only discussing the feeling now and again with my parents (I never truly told them how bad it was, again I don't know why). The only thing that eventually stopped me from having this 'horrible feeling' was reading. I would religiously read a book every night, until I was too tired to have this 'feeling'.

I then believe that my depression returned when I was 14-15, I would feel incredibly guilty, I would find things, that didn't usually upset me,  very upsetting, I would have regular panic attacks and I was just a state. It was my father who told me that he thought I had depression (that's when I joined the dots and realised that this is how I felt as a child, this is what I used to call the 'horrible feeling'). My constant depressive 'state' started to ware off after a few months but it never fully went. Going forward I would become depressed at random times during the years. My friends used to refer to these periods of times as my 'disappearances', as I would completely drop off the radar. I never told them why.

Since then, my condition has both got much better and much worse. I'm very rarely constantly depressed however, I am up and down like a yoyo.

These 'ups and downs' have only become more noticeable over the past 12-16 months and more recently, hence why I am posting this, the differences between the ups and downs have become quite frightening. Previous to the past few months, I was having periods of approximately 1 month being positive and then 1 month of being very, very negative.

Until recently, the times where I was positive were times where I felt 'normal', I would be outgoing, talkative, productive at work etc.. Etc.. As for the periods of time where I was negative, I would be very very low. Lonely, guilty, hopeless, just in a terrible state.

I am writing all of this today because for the past month I have felt amazing, I have been overly positive about everything. For some reason, I have been seeing everything in a different light and I have been looking for the positive in everything. I have been both hugely productive in college and work and I have been much more enthusiastic about life in general. I know it sounds strange but this frightens me. It does not feel like a natural positivity, I feel like I'm seeing everything in a different light, until now. What made me write all of this is that tonight, once again, I feel myself going downhill. I feel lonely, I've been crying and my positive outlook has completely disappeared. So now I'm pretty sure I'm going to have another month of feeling very very low until all of a sudden, I wake up happy again.

I'm now starting to get really concerned, as the differences between these up and down periods, appear to be getting more and more significant. Previously it was just feeling 'normal' to then feeling really really low but now it's going from feeling ecstatic to feeling really really low..

When I read up on the symptoms of bipolar, I struggle to find one that I don't have, but I hate self diagnosing myself, as I'm never too sure. So, I'm hoping you can give me some guidance, advice or opinion on what it is that's wrong with me, if that's ok.. As I'm really starting to get worried.

Thank you for your time.

Answer
You need (now go back and read that verb again) a little help, amigo. And getting it will be quite painless.

You need a diagnosis by a competent mental-health professional and this is why I suggest a psychiatrist. Depression, and bipolar, and their variants can now be quite effectively treated. One arm of this treatment is medication, and nobody is better trained to prescribe and monitor these pharmaceuticals than a psychiatrist. I think you have to be referred by a GP, but the bother will be worth it, and (depending) a single visit might suffice.

(You write so well that you could outline your experiences as above, and offer a printout to the practitioner as a faster and more accurate way to provide your relevant history but of course, if wished, you'll be glad to just be interviewed.)

Now to the other arm of treatment. Your symptoms might well continue coming and going, and you want the minimum dose of drug(s) that works to your satisfaction. You can get help not in preventing but in dealing with them. The profession that specializes in discussing how to interpret and cope with these symptoms is clinical psychology. (Given your evident intellect I'd suggest looking for one who does cognitive behavioural therapy.) You can find a clinician on your own, or ask the psychiatrist for a recommendation.

Nobody should have to go through such ups and downs. Or downs anyway. Help is available. Please put some energy into seeking it.

Thanks for asking us, and the best of fortune in getting this resolved.

Alan  

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Alan Auerbach

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Taught psychology for 30 years, authored four textbooks. Specialize in introductory and industrial/organizational psychology, but will tackle wider range of areas.

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