[jc1898]

I'm sure a lot of people deal with absurd mood swings but lately mine have been unbelievable. Today about 2 hours ago everything felt like it was getting better. I was happy, blasting music and dancing around my apartment and within 20 mins I started to feel like a zombie and now I'm dead and everything feels so strange. The past week I've been having terrible mood swings. Is this DP or depression you think?

 

[Wendy]

Stress and anxiety are very common causes to mood swings, but another is depression. Although I wouldn't jump to the latter unless you consult with a professional first.

 

[Sa-lB]

I have bad mood swings.

I can be very happy one minute then all it takes is one single thought to make all that change.

I think it's part of anxiety/depression.

 

[thingsfeelstrange]

I think mood swings can be a symptom of any mental disorder, DP included.

 

[*Dreamer*]

The term "mood swings" implies manic-depressive disorder or as it is now called, bipolar, which is a completely different disorder.

One with any illness can be enthusiastic for a time, then lose all hope. This is not a symptom of DP/DR.
I have better days and worse days and some terrible days.

Bipolar is a very serious disorder that however can be controlled very successfuly, or not so successfully. You would have manic highs where you might engage in self-destructive behavior and even have psychotic episodes and then fall into a suicidal depression. There are various types of biploar, some which tend to be on the more manic side, others more on deep depression.

EDIT: this is a very simple description of bipolar, but if one has it it is quite evident and needs immediate medical attention.

I'd say don't self-diagnose and scare yourself.

 

[*Dreamer*]

I really wish folks would not self-diagnose. You're going to scare yourself more often than not.
A cancer patient may have times of hope, and times of despair. With DP/DR I feel the same. It is chronic for me. I have days where I can get lot done and have hope. Other days I can't get out of bed. That is not bipolar.

http://www.merckmanuals.com/professional/psychiatric_disorders/mood_disorders/bipolar_disorders.html?qt=bipolar&alt=sh

Mania:
A manic episode is defined as ≥ 1 wk of a persistently elevated, expansive, or irritable mood and persistently increased goal-directed activity or energy plus ≥ 3 additional symptoms:

• Inflated self-esteem or grandiosity
• Decreased need for sleep
• Greater talkativeness than usual
• Flight of ideas or racing of thoughts
• Distractibility
• Increased goal-directed activity
• Excessive involvement in activities with high potential for painful consequences (eg, buying sprees, foolish business investments)
•

Depression:
A depressive episode has features typical of major depression (see Depressive Disorders); the episode must include ≥ 5 of the following during the same 2-wk period, and one of them must be depressed mood or loss of interest or pleasure:

• Depressed mood most of the day
• Markedly diminished interest or pleasure in all or almost all activities for most of the day
• Significant (> 5%) weight gain or loss or decreased or increased appetite
• Insomnia (often sleep-maintenance insomnia) or hypersomnia
• Psychomotor agitation or retardation observed by others (not self-reported)
• Fatigue or loss of energy
• Feelings of worthlessness or excessive or inappropriate guilt
• Diminished ability to think or concentrate or indecisiveness
• Recurrent thoughts of death or suicide, a suicide attempt, or specific plan for suicide
Psychotic features are more common in bipolar depression than in unipolar depression.

-----------------

Also, a bipolar diagnosis is NOT the same as clinical depression. Bipolar is treated with mood stabilizers. Clinical depression is treated with antidepressans. If you give an antidepressant and not a mood stabilizer to someone who is in a depressed due to bipolar state they can go into a severe manic epsiode. These symtpoms are obvious, and mania is obeserved by others. Someone with mania can also become violent.

 

[Guest]

Major 'mood swings' are not just limited to people with bipolar. People with DID have massive mood swings as well but the main difference between bipolar and DID moods swings is the amount of time between the swings. People with DID often have mood swings when different alters appear and can be completely random with seemingly no distinct pattern at all (to the untrained eye), whereas bipolar swings have more of a pattern and cycle.

Unfortunately b/c most psychiatrists are so naive and arrogant about DID many people are misdiagnosed and wrongly medicated for years and years before they get the proper diagnosis and the help they need. 7 years mismanagement is the average with DID and I don't think DPD is far behind. So when people diagnose themselves and treat themselves accordingly, they're probably doing a better job than the so-called experts anyway.

 

[Queen Frick]

Most of the time I'm on-edge and can have "mood swings" that I even surprise myself with. If someone scares me as a joke there is really no telling how I'll react. Usually I'll either get extremely pissed or upset with them because of my anxiety. I'm not bipolar and would guess I "snap" when someone triggers my anxiety.

 

[*Dreamer*]

Major 'mood swings' are not just limited to people with bipolar. People with DID have massive mood swings as well but the main difference between bipolar and DID moods swings is the amount of time between the swings. People with DID often have mood swings when different alters appear and can be completely random with seemingly no distinct pattern at all (to the untrained eye), whereas bipolar swings have more of a pattern and cycle.

Unfortunately b/c most psychiatrists are so naive and arrogant about DID many people are misdiagnosed and wrongly medicated for years and years before they get the proper diagnosis and the help they need. 7 years mismanagement is the average with DID and I don't think DPD is far behind. So when people diagnose themselves and treat themselves accordingly, they're probably doing a better job than the so-called experts anyway.

Dear Zed,
I will have to disagree merely because I have known a lot of people with mental illness and currently work with them and am open about my DP, depression and anxiety myself. I also discuss things with psychiatrists (I get a new resident psychiatrist every year -- cheaper -- and I quiz them about all sorts of things.) I have seen many doctors over the years as I have moved as well quite a few times. Also, unfortunately, my mother was a psychiatrist.

I also was seen by 2 doctors who were founding members of the ISSMPD now, ISSD-T. (MPD was changed to DID and is still not well understood).

I have never read or come across something indicating there is a similarity between DID and bipolar. BIpolar is far more easily recognized and far more common. I have a cousin with schizoaffective with heavy bipolar traits. You could never mistake his illness for DID. I also work with a woman who has bipolar (NAMI advocacy work).

DID is not well-understood. It would also appear to be associated with Borderline Personality, and appears more frequently in women than men (last I read). Someone with Borderline could initially be mistaken for someone having a manic episode, yet on the other hand nowadays ... and I wish I could convince you ... resesarch into bipolar is rather advanced considering how difficult it is to understand any brain disorder. DP and DID and the other dissociative disorders fall to the bottom of the research pile.

My doctors in the 80s (two psychoanalysts) from the ISSMPD/ISSD-T never mentioned any similarity between MPD and bipolar. They worked with dissociative disorders and trauma. They are friends of Torch, Kluft, etc. Those individuals have also changed their stance on MPD now DID.

There are more specific treatments and medications for bipolar that have been used for years. There really aren't any for DID. Also, I would also consider DID rare. In all my years interacting with folks with all types of mental illness, I believe I have met two women with what I would call DID. Their problems involve actual loss of time. That is, leaving work and heading to the dentist, but having no recollection of the time they left work and "found" themselves in the dental chair. Neither has mood swings. Both are seriously depressed. One works, the other cannot function.

An unfortunate thing happened in the 80s -- creation of false memories and multiple alter personalities. Doctors were sued. Patients had to be treated to reverse the damage done by ANALYSIS and the creation of alters This was all done with good intentions ... in some cases. I lived through this time and it was a dark time in the history of psychiatry. I feel it contributed to poor interest in research into the dissociative disorders. Doctors ran from it like the plague. It destroyed a number of careers and ruined the lives of many patients.

I DO have a very strong POV on this. But I tell you it comes from years of experience with psychiatrists, patients, relatives with mental illness, friends with mental illness, coworkers with mental illness, and friends whose children with mental illness.

If you read the books of Kay Redfield Jamison -- Doctorate in Psychiatry at Johns Hopkins who has bipolar herself (she cannot practice as a therapist since she revealed her life long illness) you will see there is little similarity, and each case of bipolar is unique in its presentation.

And if you read the Merck Manual description link, bipolar swings do not necessarily have a specific pattern and cycle. They are all over the place depending on each person. I gave the basic info above.

I don't think people are understanding the true definition of "mood swing." It is sort of being used like "nervous break down." Neither really have any meaning anymore. Jamison prefers to keep the term manic-depressive vs. bipolar, but I understand why that was changed. It also is abundantly clear why Multiple Personality Disorder was changed to Dissociative Identitfy Disorder. Many will argue, but even those treating individuals who presumably had MPD, retracted that diagnosis and admitted to helping create alter personalities.

All medicine is evolving. Psychiatry is lagging as you can't open up someone's skull when you go in for an appointment.

IMHO,
D

 

[*Dreamer*]

Most of the time I'm on-edge and can have "mood swings" that I even surprise myself with. If someone scares me as a joke there is really no telling how I'll react. Usually I'll either get extremely pissed or upset with them because of my anxiety. I'm not bipolar and would guess I "snap" when someone triggers my anxiety.

Frick. I agree with what you describe. In the past, I had a short fuse, would get very angry and agitated in certain situations. That is not bipolar. It is not really a "mood swing." It is an outburst ... it is lack of an ability to maintain a balance in reactions to things. That is something of a BPD quality. But it doesn't mean you have BPD either. I was never diagnosed with that as it has some VERY specific symptoms that are pretty well researched.

See the work of Marsha Linehan ... back in the 1980s and 1990s.

 

[*Dreamer*]

Note, most of the people I work with who have a mental illness -- you would never know they had one. They use a million tools to improve and maintain their quality of life. Others I know cannot function at all and are on disablity.

 

[inferentialpolice]

Dear Zed,
I will have to disagree merely because I have known a lot of people with mental illness and currently work with them and am open about my DP, depression and anxiety myself. I also discuss things with psychiatrists (I get a new resident psychiatrist every year -- cheaper -- and I quiz them about all sorts of things.) I have seen many doctors over the years as I have moved as well quite a few times. Also, unfortunately, my mother was a psychiatrist.

I also was seen by 2 doctors who were founding members of the ISSMPD now, ISSD-T. (MPD was changed to DID and is still not well understood).

I have never read or come across something indicating there is a similarity between DID and bipolar. BIpolar is far more easily recognized and far more common. I have a cousin with schizoaffective with heavy bipolar traits. You could never mistake his illness for DID. I also work with a woman who has bipolar (NAMI advocacy work).

I line up with Zed on this one. Studies that have bothered to assess for dissociative disorders within the putatively bi-polar population have shown that as many as 1-in-3 registered as having a dissociative condition, which can therefore be the basis of their mood swings. The interesting point of this result is that if someone can be self-reflective enough regarding their subjective dissociative experiences to register in the diagnostic interview, then perhaps the dissociation-aware psychotherapy should be tried first, with psychomedications used only adjunctively to the extent necessary to promote uptake of the therapy. (ie, grounding and initial affect regulation) If the patient is not amenable/motivated for targeted psychotherapy, then the fallback would be the medication-oriented bi-polar treatment regiment. In my research billet I've seen many so-called bi-polars register on the dissociative spectrum for a dissociative disorder, and dissociation aware treatment result in those folks having amelioration of their symptoms and draw-down on their bi-polar medications. Links to two studies assessing for dissociative disorders within bi-polar populations are at: http://ge.tt/89BBe0s1?c

 

[inferentialpolice]

I should also add that there is a bi-polar-over-diagnosis epidemic in the USA, as described at:

http://www.madinamerica.com/2015/01/caused-american-child-bipolar-epidemic/

 

[*Dreamer*]

I think this has gotten off track from my original point.

Per Wikipedia: easier than my writing this out -- definition of mood swing

"A mood swing is an extreme or rapid change in mood. Such mood swings can play a positive part in promoting problem solving and in producing flexible forward planning.[1] However, when mood swings are so strong that they are disruptive, they may be the main part of a bipolar disorder.[2]

Mood swings are universal, varying from the microscopic to the wild oscillations of manic depression,[3] so that a continuum can be traced from normal struggles around self-esteem, through cyclothymia, up to a depressive disease.[4] However most people's mood swings remain in the mild to moderate range of emotional ups and downs.[5]
The duration of mood swings also varies. They may last a few hours - ultrarapid - or extend over days - ultradian: clinicians maintain that only when four continuous days of hypomania, or seven days of mania, occur, is a diagnosis of bipolar disorder justified.[6]
In such cases, mood swings can extend over several days, even weeks: these episodes may consist of rapid alternation between feelings of depression and euphoria.[7]"

-----------------------
Also, if one reads any book on DP specifically Dr. Sierra's extensive research -- my point is -- "mood swings" are not considered a symptom of DP. Having good days and bad days are normal for everyone, but folks here seem to be describing serious swings that I would attribute to bipolar.
--------------------

In the PDF I downloaded ... didn't download the second one yet.

The purpose of the study was looking at bipolar with COMORBOD DP. That is the DP came along with the bipolar, and it affects the outcome of treatment success:

Purpose of the study:
The aim of this study is to compare
the demographic data between patients with pure bipolar disorder
and comorbid dissociative disorder and to investigate the possible
effects of comorbidity on treatment

Bipolar disorder patients with comorbid dissociative disorder,
are tend to be mostly women and also tend to be younger patients,
and they have higher depression scores.

Higher DES scores is
related with longer hospitalization duration in bipolar patients.
Commitment of suicide numbers and hallucinatory behaviors
are higher in the existence of dissociative disorder comorbidity.

Dissociative psychopathology is not a rare comorbidity in bipolar
disorder and seems to be an important predictor for treatment and
suicidal thoughts and threats for inpatients bipolar patient"

--------------
DP can indeed be comorbid -- that is be a secondary symptom or exist alongside many mental illnesses, however the implication here is that those of up with DP and anxiety have extreme mood swings. This is sort of putting the cart before the horse.
There have been people here with bipolar who also have DP. There are people with schizophrenia who also have DP. The MAIN diagnosis came with the DP, not the other way around.
---------------

And this is a completely different topic here:
As for overdiagnosis of bipolar in children -- that is not my expertise and I don't know enough about the phenomena which could be related to better diagnostic abilities. Child psychiatry is more difficult than adult psychiatry as the young brain is still developing and changing. I believe overall, an individual's brain really finishes developing around age 25. I think a longer time for males than females.
In infancy there is a huge change, then in the teen years.

Bottom line again.
I don't think it is fruitful to make a huge generalization that normal ups and downs are serious mood swings that really point to bipolar.
As far as I know, no literature on DP (which we are dealing with on this site) indicates mood swings as part of the criteria.

And interesting, one person I recall here who definitely had bipolar also had DP, but upon taking ... Klonopin ... the DP went away. The bipolar remained. His primary diagnosis is bipolar. A woman I work with at work has a confusing diagnosis that really can't be pinpointed, but she has had psychotic episodes, severe depression, etc. I explained about my DP/DR. She said in her darkest days she had a long period of DP/DR -- she was even unable to express herself properly. But her primary diagnosis is not DP. And she said that switching antipsychotic medication "switched off the DP/DR.

I am just very bothered by generalizations.

Every person here is unique. And if you look at the diagnostic criteria for dissociative disorders, there is no indication that mood swings are a part of the diagnosis. DP can be secondary, or it can exist alongside illness.
------------------
Best,
D

 

[Guest]

Dreamer you don't have to be an expert on child psychiatry to see the over diagnosis and over medication of children in this world.

In fact it's not just children being over diagnosed and over medicated… it's all ages. Children have been the latest 'target'. It's easier to drug children than love them so it seems….

Read 'Mad in America'.

 

[inferentialpolice]

Dreamer, your last posting evidences many of the same mistaken understanding that the general field of psychiatry has about the nature of dissociative disorders. DD's are on a spectrum, with the higher order symptom complex exhibiting a subset of symptoms that make up the lower spectrum disorder. So for instance, DDNOS and DID's TYPICALLY have depersonalization to an extent that would, if viewed separately, meet the criteria for DPD. Therefore, if one assess just DP/DR, and does not evaluate for the other dissociative elements, the result could be lots of folks diagnosed with DPD who are really DDNOS or DID. (I am using the DSM IV names here) So while mood swings are not characteristic of DP, they ARE characteristic of the higher-order DD's. To be clear then, someone with DPD who experiences mood swings should be evaluated for possible higher order DD, and that should be excluded before going with co-morbid DPD and Bi-polar. If they register with a higher order DD, then rather than go onto a medicine regime that is calculated to be for life, a possible "less harm" step would be to go with a course of dissociation-targeted psychotherapy (with medications possibly used temporarily) to see if one can gain traction on the symptom complex from that vantage. Certainly, if someone with these symptoms owns up to having come from a "house of crazy" childhood, then the odds of any mood swings co-morbid with "DPD" really being a higher order Dissociative Disorder are even stronger. Ultimately, the reason to differentiate mood swings as being from a higher order dissociative condition vs. organic bi-polar is the treatment regiment that is used first line. If the patient has these symptoms, and is motivated to introspectively look at their early dissociative experiences, then I am suggesting that dissociation-informed psychotherapy is the better first choice. If someone has an invalidating past but is in denial about that, or who doesn't want to look, or who likes the idea of a pill, or who is invested in a "medical" explanation of their symptoms, or who does not have intact reality testing sufficient to participate in introspective work, then first choice would likely not be dissociation-targeting psychotherapy.

 

[Sa-lB]

Can I just ask where Bipolar and DID came from? this person was asking if anyone could relate to their symptoms. They weren't self diagnosing or saying they think they have bipolar.

I hear a lot of people say they have ''mood swings'' I don't think it means they are saying ''am I bipolar?'' the op actually said is this dp or depression............

Probably scared them half to death.

 

[inferentialpolice]

Can I just ask where Bipolar and DID came from? this person was asking if anyone could relate to their symptoms. They weren't self diagnosing or saying they think they have bipolar.

I hear a lot of people say they have ''mood swings'' I don't think it means they are saying ''am I bipolar?'' the op actually said is this dp or depression............

Probably scared them half to death.

The OP raised a false dilemma "Is this DP or depression you think?" -- responders are simply pointing out that mood swings are more characteristic of underlying disorders discussed here but not mentioned by OP. Also, it is commonly the case on this board that DP+other-dissociative-symptoms is still discussed as Depersonalization Disorder, when in fact the greater symptom complex being posted about ("DP+") is more suggestive of higher order dissociative conditions.

 

[*Dreamer*]

Dreamer you don't have to be an expert on child psychiatry to see the over diagnosis and over medication of children in this world.

In fact it's not just children being over diagnosed and over medicated… it's all ages. Children have been the latest 'target'. It's easier to drug children than love them so it seems….

Read 'Mad in America'.

Dear Zed..
I don't want to get into a dispute re: the problems with psychiatry in general, or the difficulties diagnosing and treating children who have mental illness. I have read that book and a few others like it. As I recall Mad in America goes back to the history of the evolution of mental health care which like all areas of medicine was barbaric.

The mentally ill, to this day, are treated like second class citizens. That is why I am a mental health advocate.

And I simply said, I do not claim to be an expert in psychiatry, but do not claim to know the full scope of a specialty which is child and adolescent psychiatry. (and I will state the bulk of individuals here do not know or understand that much about mental illness in children.) I however, personally know children who are mentally ill. "Normal" folks and a lot of people are "anti-psychiatry" without truly understanding the medical basis of brain disorders.

But I will again state a few things I do know:
1. It was believed for years that children never got mental illness. Hence if there is an increase in mental health disorders in Western countries it can be attributed in part to an awareness and acceptance of this fact. Researchers, (not psychiatrists or psychologists, etc. alone), are very aware of it.

2. Trying to get mental health care worldwide is very difficult. And one has to seek it out. Many have no money to pay for it, or even pay for medications. Medcaid insurance in my state has been cut by 50% so even adults who need medictions will stop receiving them by this summer unless legislation is changed. I'm focusing on trying to change legislation. Also working on helping to educate educators in schools and colleges to be aware of young people with problems. Early intervention is KEY and it doesn't always guarantee long term success in treatment

3. Mental institutions released seriously disturbed individuals in the '60s and '70s leaving them no place to go. There is no longer long term hospitalization offered unless you have a lot of money, or you you become financially destroyed. In the US there are fewer beds or NO psychiatric units in hospitals now. Psychiatrsts charge ridiculous fees -- $300, $400 a session.

4. People are ashamed to seek mental health treatment and are ashamed if their children exhibit problems.

5. In many countries, mental health isn't even dealt with at all. If you are trying to survive you don't even get regular medical care for common illnesses.

SPOILER

If you wish to see a powerful documentary on a 15 year old's entire life ... where he was disturbed as a child ... and subsequently took his own life at 15, you will see a child who was diagnosed with bipolar at a young age. If by watching this you do not believe what you are seeing, I can't say or do anything else.

* If you can't get to the link, go to YouTube and cut and paste. This is beutiful work, and it should convince many here that they DO NOT have bipolar, extrreme mood swings, etc. There is also a clearer representation of "flat affect" and of a young boy, without DP/DR, who is obsessed with death and dying.

"Boy Interrupted"

Noteable is that the family has a history of depression.
A diagnosis wasn't made until after he attempted to jump off the roof of his public school. He was hospitalized and after a time given a diagnosis and treated with mood stabilizers that helped for a time. So did a special enviornment.

Most people cannot afford this.And no one pulls anyone off the street and gives them medication. The usual fate of a seriously mentally ill individual in the US is a revolving door of perhaps some time functioning, then decompensation, hospitalization, living on the street, going to jail, homelessness, and ultimately death by others or by suicide.

Again, I have been involved in mental health advocacy for about 30 years. I have a good bit of knowledge, yet would never claim to be an expert. I am also very open about my own illness which allows others to open up. You would not believe the number of my friends who have bipolar, depression, OCD, anxiety, etc. who never mentioned it years ago. I graduated high school in 1976. My MA in 1983. We didn't talk about such things. Also, many friends confide in me about their children. I can only direct them to various support services, mainly "Family 2 Family" support where they can talk with other parents, and figure out what to do.

Excellent Documentary about a 15 year old boy who died from suicide -- he had bipolar. Made by his parents who are filmmakers, it shows the joy and pain from birth to death. It's 90 minutes long so I don't expect many people will watch it, but it is well worth it if you have the time.

But a VERY important point. NO ONE has to take the medications prescribed by any doctor. One needs to do research to measure risk/benefit. If parents do not educate themselves, if we can't talk openly, if kids can't talk openly about how they feel ... well, I am simply for opening up dialogue.

In terms of barbaric treatment. My father was a cardiovascular surgeon who graduated from medical school in 1933. At that time treating lung and heart disease was so primitive my father said, "50% of my patients die on the operating table." The change in heart and lung treatment in his lifetime even surprised him. Instead of cracking a chest open to remove a cancerous lung has evolved to procedures where doctors can PULL A LUNG OUT THROUGH A HOLE IN YOUR CHEST -- without opening the chest cavity.

We have to advocate for ourselves.

 

[*Dreamer*]

If you watch this extremely sad documentary. I ask you ... what options would you have with your own child. Many here are very young. I'm 56. Unfortunately, I have learned and seen a lot about mental illness in my life.

1 in 6 Americans have a serious mental illness. That is a fact. These vary in severity. MANY do not get proper treatment. Some do.

http://www.nami.org

http://www.activeminds.org (This is for young people struggling -- I recommend it to anyone here) A wonderful organization.