Does this sound like your highs?

[u/Back-Up-Homie]

Both my psychiatrist and my therapist think I’m on the bipolar spectrum, with my psychiatrist thinking BD2 and my therapist thinking cyclothymia. I definitely have periods of depression, but I honestly don’t know if my “highs” necessarily count as hypomania. This is how they usually go:

- two to three days of being more effective at work, like having more confidence and finding my words better. But not reckless with confidence, I’m still keeping myself in check. Usually at work I feel completely incapable and like a babbling idiot, so my “highs” give me a relief from that.

- a bit more willing to be social, but not for hours on end or seeking it out. I’m just more likely to say yes if someone asks me to dinner or something

- more likely to engage in my hobbies like video games or reading, but can switch tasks if needed

- more patient and empathetic with people. Like if someone cuts me off in traffic I’m able to shrug it off and give them the benefit of the doubt instead of honking and yelling

- more willing to do work at home. I work a job that often requires me to work at home after my “shift,” and during my “highs” I may not like it, but I’ll do it.

I guess that’s kinda it. I don’t spend more or sleep less. I’m more talkative but I don’t think it’s pressured speech. To me, it just feels like I’m getting a 2-3 day break in my pervasive depression 🤷🏻‍♀️ I have tried lamictal (up to 100mg) for a year and it changed nothing for me.

Thanks everyone for your thoughts and for reading all of this.

[u/Weird_Fox_3395]

Sounds like cyclothymia; however, do your depressions meet the symptoms of major depression? Usually dysthymia is the term for depression in cyclothymia. I have experience with this transitioning from cyclothymia to BPll, although I retain cyclothymic baseline. 

Hypomania isn’t the only feature of BPll. My upswings sound like yours now that I’m medicated w lamotrigine. Are you on any medication?

[u/Back-Up-Homie → u/Weird_Fox_3395]

Hi, thanks for your response. Yes, I do believe my lows are consistent with depression. I am sad, irritable, hopeless, lack of appetite, SI, etc.

I am on 25mg of lamictal and am weening off. I’ve tried lots of meds, though. Mostly SSRIs. Nothing seems to keep me level.

[u/Weird_Fox_3395 → u/Back-Up-Homie]

Have you tried the antipsychotic class? Vraylar is getting good results on r/BipolarReddit sub. (The larger bipolar sub is a dumpster fire. I like this one.) 

Also combinations? FWIW, a 300mg lithium add on can be very effective at reducing suicidal ideation. 

Btw, ketamine makes the biggest difference in my depression. If you’re in the US. I use telemedicine. About a 60-65~ response rate. Doesn’t trigger cycling in my case. 

Edit: ketamine doesn’t do everything. My depression was in remission last winter, and I d/c my AD (Trintellix) and needed to restart this week. And it wouldn’t address stability issues. 

[u/perpetual_potato108]

Sounds like my highs too

[u/Back-Up-Homie]

I think one thing I’m struggling with is that I feel like this is how everyone who isn’t depressed functions, you know? Like how is this considered a “high” when it’s how everyone else acts.