Health and Psychology

"I have mood swings so I must have bipolar disorder."  The woman telling me this had a long history of difficulty interacting with other people, marginal suicide attempts that really didn't require medical attention, and rapid changes in how she felt.   "Medications haven't really helped me."

I asked about the major symptom about bipolar disorder-a manic episode.  "I have highs and lows. Sometimes in the same day."  She reported.  So I tried again to see if she ever had a manic episode.  I asked her "Did you ever have a sustained period of feeling so good you could do anything even if it's unrealistic. Like not just wanting to paint your room, but wanting to paint every house on the block."  She said "No. Nothing like that."  And a different question-"How about staying awake for several days and not feeling like you needed any sleep."  And she said, "No.  The most I've ever stayed awake is a day and a half."  

So I don't have symptoms that meet criteria for bipolar disorder.  I'm not surprised medications weren't very effective.  This seems like a personality disorder, but I need to do more assessment to be sure.  But therapy is effective for the symptoms she has.  It's not a short term form of treatment.  It's longer than a few visits.  Short term medication may help while she manages the moods, but it's not intended to be used forever.

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