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Cyclical Moods

Question:

I thought you might be able to tell me if my “moods” could be normal or not. I have had this problem pretty much my whole life where I am never really happy and I almost never can do things that I know need to be done. If I do get anything done then my motivation doesn’t last long. Every couple of weeks I will get so bad that I will not get anything done. Then other weeks I will be ahead of schedule and right on top of things. My sister says that it’s not normal how I feel when I get in my bad moods. They usualy only last a couple of days to two weeks. Almost never more. There’s usually not any real reason although everything bad in my life comes to light when I’m in a bad mood and seems to disappear when it goes away. I’ve never had the best life but that’s normal. I had seriously thought about killing myself when I was younger (say 10 years old or so) but I was young and couldn’t even think of how to do it really. Now that I’m older I don’t think I could ever actually do it. I was just wondering if you thought my moods are normal or not. I know this isn’t a lot of information but I don’t want to take up all of your time. Thanks.

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Answer:

Most people are familiar with Manic-Depression or Bipolar Disorder as it is called today – a mood disorder where people swing over time between periods of intense depression and manic ecstasy/psychosis. Fewer people know that Bipolar Disorder is actually the end point of what is understood as a spectrum disorder or family of mood-cycling disorders that vary in intensity. In order to describe this family of disorders we first need to define our terms: A depressive episode is just what it sounds like – a period of time in which a person experiences overwhelming negative thoughts, lacks in energy, experiences no joy and often thinks of committing suicide. In the most severe cases, a person in the grip of a depressive episode may experience psychotic delusions. A manic episode is the opposite of a depressive episode. A person experiencing a manic episode experiences unlimited energy, joyful feelings, and increased drive towards risky and sensual activities such as promiscuous sex, gambling, speeding, etc. They will frequently talk a mile a minute, making no sense but internally believe themselves to be a genius and/or the Son of God. Mania frequently slides into a psychotic state wherein manic persons experience hallucinations and delusions. If depression and mania are the extremes that people can experience, we can also describe intermediate mood states. An important intermediate state is known as hypomania. ‘Hypo’ means ‘under’ just as ‘hyper’ means ‘over’ (as in the ‘over-active’ state of hyperactivity). A hypodermic needle is a needle that goes under the skin (dermis). A hypomania is an ‘under-mania’ or a ‘not quite mania’ – this name is given to persons who show periods of elevated energy, happiness, speeded up thoughts and increased capacity for work, but who do not get truly manic or depressed. Having defined the terms we can now talk diagnoses: In Cyclothymia we have a condition where people vary between hypomania and mild depression over periods of time (usually weeks or months) where a period of hypomania is followed by a period of normalness, followed by a mild depression and then back again up through normal to hypomania in a repeating pattern. Bipolar disorder itself is broken up into two forms, Bipolar I and Bipolar II. Bipolar II is a milder form of Bipolar Illness wherein a full-on depressive episode alternates with a hypomanic episode (Bipolar II individuals by definition have never experienced a full manic episode). Bipolar I Disordered individuals show mood alterations between full depressive and full manic episodes. Given this background – and your assurance that you are in good health and do not use drugs or alcohol (which could create these symptoms) – I’d say that it is possible that you may be experiencing a hypomanic or possibly cyclothymic or even Bipolar II condition. You will need to make an appointment with a psychiatrist to get a formal and accurate diagnosis made. I would recommend you do this as it is best to bring these sorts of things under control earlier rather than later.

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