Q: Misdiagnosed as Bipolar Years Ago?
Dear Dr. Phelps,
I was diagnosed with bipolar II disorder approximately 8 years ago. I
originally sought help for depression, had some major life changes and stress
going on which caused a big "shutdown".
I was on disability for 5 years. When Social Security reevaluated by status, I
did not fight their contention that I was able to work. I felt I was.
This was in December of 1999. I quit all meds at this time (didn't like
the way they made me feel). I started working in June of 2000 and have been
promoted twice since that time, doubling my income, and recently obtaining
officer status within the company. I have enrolled in night school to
finish my BBA once and for all. I work between 45-50 hours a week and take
3 upper level business classes 4 nights a week. I am enrolled at Junior
status and have an overall GPA of 4.0. My days are extremely busy and I am
tired at night. As such, my sleep patterns are normal.
My question - is it possible that I was misdiagnosed years ago? Is it
common to go so long unmedicated without incident and be bipolar? I am
starting to feel the stress of my schedule and I am terrified of going to that
place again. Did my hypomania just transfer from unfinished household
projects to work and school? If so, how bad is that? I'm very
productive. I have been noticing an increase in sick time this last year.
However, I complete and accomplish so many projects, nobody would question me on
it. What are the warning signs? When does the overachieving
hypomania become a problem? Please answer.
Dear Ms. C' --
Several possibilities come to mind: 1) right, misdiagnosis, due to the
stresses at that time; 2) bipolar all right but mild and not currently a
problem; 3) bipolar all right but enjoying a sustained hypomania, which could
imply but does not guarantee that a depressive phase will follow -- granted,
this sounds like a very long time for this level of activity going on to
be "hypomania"; or 4) there was some other factor, possibly a
reproductive hormone issue if you're now in your late 40's or even maybe in your
late 20's -- though we know very little about that speculation on my part --
which might have been setting you up to have symptoms back then but not
Is it possible to go unmedicated without incident and
"be" bipolar? Definitely yes; several studies have shown that as
many as 10% of people with a full manic episode, hospitalization and everything,
won't have another one, even without medications (I find that hard to believe,
but I heard Mauricio Tohen say it several times, and he's the (Harvard) expert
on this topic, or was then for sure). I'm pretty certain I didn't hear him
wrong and that I've seen it again in print since...
What are the warning signs? Further deterioration
in sleep is one I always listen for; yet further increase in activity with a
deterioration in performance -- too many ideas at once, can't concentrate, that
kind of thing; and having somebody remark upon your behavior, that it strikes
them as "abnormal" (presuming that hasn't happened yet, if it did,
that's a good warning). Good luck, and I hope you just stay the way you
are now! Congratulations on what you've achieved so far.
Published February, 2003