Your Symptoms: Depression or Bipolar Disorder?

Q: Your Symptoms: Depression or Bipolar Disorder?

Hello： It seems that you are indeed troubled by some emotional issues. <br>I wonder if you have been experiencing long-term stress over the years. <br>Since you have previously sought treatment for irritable bowel syndrome, I encourage you to also address your emotional concerns

I am not sure if I have depression or bipolar disorder?

In recent years, my temper has been getting worse.
Whenever I encounter something upsetting, I feel like yelling at people or even wanting to harm them (though I have never acted on it).
I've noticed that I sometimes get nervous when speaking to others, which causes me to stutter; I don't understand why this is happening (it didn't used to).
My ability to express myself is not as good as it used to be, and I struggle to convey what I want to say.
I also fear that others won't understand me, which frustrates me, and I'm worried about what they think of me and whether they dislike me.
However, I also fear being the center of attention, which makes me even more anxious (I feel like running away).
I have irritable bowel syndrome, which has improved, but in the past, I would experience unexplained stomach pain that required emergency care.
I sometimes have thoughts of self-harm, although I have never acted on them; whenever I'm in a bad mood, these thoughts arise.
I also struggle to sleep well, as my mind is constantly racing.
I want to rest, but I can't.
Sometimes, I feel too lazy to engage in social relationships, which has led to poor interpersonal connections.
Now, I overthink my friends' actions, wondering if they have negative thoughts about me or if something is wrong.
I constantly worry that they don't want to hear me speak, which makes me feel very lonely and paranoid.
Yet, I don't want to feel this way.
I present myself as generous and cheerful in public, but privately, I find myself overthinking everything.
I can offer advice to others, but I can't seem to apply it to myself.
I feel unhappy every day and find myself overthinking.
Doctor, I am unsure if I am experiencing depression, bipolar disorder, or paranoia.
What should I do?

Pani, 20~29 year old female. Ask Date: 2016/06/10

Dr. Qiu Junda reply Psychiatry

Hello: It seems that you are indeed troubled by some emotional issues.
I wonder if you have been experiencing long-term stress over the years.
Since you have previously sought treatment for irritable bowel syndrome, I encourage you to also address your emotional concerns by visiting a nearby mental health clinic (consultation does not necessarily mean you have to seek treatment).
If you feel hesitant, you might consider reaching out to local counseling services, such as contacting Teacher Zhang or a helpline, who can provide you with appropriate guidance and support.

Reply Date: 2016/06/10

More Info

It sounds like you are experiencing a complex mix of emotional and psychological symptoms that can be quite distressing. Based on what you've described, it is important to differentiate between depression and bipolar disorder, as both can have overlapping symptoms but require different approaches to treatment.

Understanding Your Symptoms:
1. Mood Fluctuations: You mentioned that your temper has been getting worse and that you feel angry or want to lash out when unhappy. This could indicate mood instability, which is a hallmark of bipolar disorder. However, if these mood swings are not as extreme as the manic episodes typically seen in bipolar disorder, they may align more with depressive disorders.

2. Anxiety and Social Interaction: Your feelings of nervousness when speaking to others, fear of judgment, and the tendency to overthink social interactions suggest anxiety, which can co-occur with both depression and bipolar disorder. The fear of being judged or misunderstood can lead to social withdrawal, which you also mentioned.

3. Cognitive Difficulties: You noted that your ability to express yourself has declined, and you sometimes struggle to articulate your thoughts. This cognitive impairment can be associated with depression, where individuals often experience difficulties with concentration and memory.

4. Physical Symptoms: The mention of irritable bowel syndrome (IBS) and physical discomfort can also be linked to anxiety and depression. Stress and emotional turmoil often manifest physically, leading to gastrointestinal issues.

5. Suicidal Thoughts: The presence of suicidal thoughts, even if not acted upon, is a serious concern and is common in both depression and bipolar disorder. It is crucial to address these thoughts with a mental health professional.

6. Sleep Disturbances: You mentioned having trouble sleeping and a racing mind. Sleep issues are prevalent in both conditions, but in bipolar disorder, they may be more pronounced during manic or hypomanic episodes.

Next Steps:
Given the complexity of your symptoms, it is essential to seek help from a mental health professional. Here are some steps you can take:
- Consult a Psychiatrist or Psychologist: A mental health professional can conduct a thorough assessment to determine whether you are experiencing depression, bipolar disorder, or another condition. They will consider your symptoms, history, and any potential triggers.

- Therapy: Engaging in therapy, such as cognitive-behavioral therapy (CBT), can help you develop coping strategies for managing anxiety, improving your communication skills, and addressing negative thought patterns.

- Medication: If diagnosed with depression or bipolar disorder, medication may be recommended to help stabilize your mood and alleviate symptoms. This is something that a psychiatrist can discuss with you.

- Support Groups: Connecting with others who have similar experiences can provide a sense of community and understanding. Support groups can be a valuable resource for sharing experiences and coping strategies.

- Lifestyle Changes: Incorporating regular physical activity, a balanced diet, and mindfulness practices can also help improve your overall mental health. These changes can reduce stress and enhance your mood.

Conclusion:
Your symptoms are significant and warrant professional attention. It’s important to remember that you are not alone in this struggle, and help is available. Seeking support from a mental health professional can provide you with the tools and strategies needed to manage your symptoms effectively. Please take care of yourself and prioritize your mental health.

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It is recommended that you: 1. Discuss the above situation further with your attending physician. 2. Alternatively, visit another psychosomatic clinic to see if any relevant examinations are necessary. Thank you, and wish you good health!