Mood Disorders: Bipolar, Anxiety, or Delusional Symptoms?

Q: Mood Disorders: Bipolar, Anxiety, or Delusional Symptoms?

Hello： Regarding my mother's condition, it appears that she is indeed experiencing emotional difficulties, primarily exhibiting negative behaviors. <br>Whether this is due to depression, bipolar disorder, or other potential causes still requires further evaluation. <br>Additional

Bipolar disorder, anxiety disorder, or delusional disorder?

Hello Doctor: My mother previously worked night shifts and needed to drink alcohol.
Last July, she was imprisoned for four months due to drunk driving.
When she returned, there were no significant issues, but she often complained about her work environment and expressed a desire to change jobs, feeling frustrated about what she could do.
However, starting in August of this year, after my boyfriend and I planned to get married and I needed to leave home, my mother became extremely anxious.
She frequently expressed a wish for me to return home every weekend, and if I could only come home every other week, she would feel very disappointed and depressed.

As time went on, her situation worsened.
She began to constantly doubt her physical health and underwent a health check, which showed no major issues.
Nevertheless, she remained convinced that something was wrong with her body, just not detected.
She has been suffering from severe insomnia for a long time, leading to drastic weight loss and other physical discomforts, which further deepened her belief that her health was compromised.
She thought she had depression and sought help at a clinic, where the doctor diagnosed her with bipolar disorder instead of depression and prescribed medication to help with sleep and relaxation.
However, after a period of taking the medication without improvement, she stopped, only resuming it occasionally when she felt unable to sleep or experienced chest discomfort.
At the beginning of this month, she suddenly quit her job, complicating matters further.
She has become extremely insecure, holding negative thoughts about everything, often saying that her life is short, her health is failing, and that she will soon run out of resources.
Recently, she has even started to imagine scenarios where she feels someone is trying to accuse her of something, leading me to suspect she may have paranoid delusions.
During conversations, she often exhibits disorganized thinking, with incoherent topics and unclear logic.
Although she hears what is said, it doesn’t seem to register with her.
She has also mentioned that her memory has worsened, and sometimes she goes out alone to the market, spending the entire day without buying anything.
Now, our family is affected by her emotional state, making it difficult for us to work peacefully, and I feel the need to return home to care for her.
However, I am unsure whether I should accommodate her belief that something is wrong with her body by taking her for a comprehensive medical examination to alleviate her concerns, or if I should directly take her to see a psychiatrist.
I apologize for the lengthy description, and I wish you all the best.

Ms. Wu, 30~39 year old female. Ask Date: 2016/12/24

Dr. Qiu Junda reply Psychiatry

Hello: Regarding my mother's condition, it appears that she is indeed experiencing emotional difficulties, primarily exhibiting negative behaviors.
Whether this is due to depression, bipolar disorder, or other potential causes still requires further evaluation.
Additionally, my mother has a co-occurring alcohol issue, which may also interfere with her condition.
As you mentioned, it is best to take her to a nearby psychiatric facility as soon as possible for proper diagnosis and treatment.

Reply Date: 2016/12/24

More Info

It sounds like your mother is experiencing a complex set of emotional and psychological challenges that may be indicative of a mood disorder, possibly bipolar disorder, anxiety, or even delusional symptoms. Given the history you've provided, it is essential to approach this situation with care and understanding.

Bipolar disorder, also known as manic-depressive illness, is characterized by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). The symptoms you've described—such as her intense anxiety about your moving out, her belief that she has serious health issues despite medical evaluations showing otherwise, and her sudden resignation from work—could suggest that she is experiencing a manic or hypomanic episode. During these episodes, individuals may exhibit increased energy, reduced need for sleep, and heightened irritability or anxiety.
Her persistent belief that her body is failing her, despite negative medical tests, aligns with somatic symptom disorder, where a person experiences significant focus on physical symptoms that cause distress or impairment. Additionally, her feelings of paranoia—believing that someone is out to harm her—could indicate the onset of delusional thinking, which is often seen in severe mood disorders.

The fact that she has been experiencing severe insomnia and significant weight loss is concerning. Sleep disturbances are common in mood disorders and can exacerbate other symptoms, leading to a vicious cycle of worsening mental health. Her negative outlook on life, feelings of hopelessness, and statements about her future are also red flags that should not be ignored.

Given the complexity of her symptoms and the impact they are having on both her life and yours, it is crucial to seek professional help. While it might be tempting to accommodate her requests for further medical evaluations to address her health concerns, it is more important to prioritize her mental health. A mental health professional, particularly a psychiatrist, can provide a comprehensive assessment and determine the most appropriate treatment plan. This may include therapy, medication, or a combination of both.

In the meantime, it is essential to maintain open lines of communication with her. Encourage her to express her feelings and fears, but also gently guide her towards understanding that her thoughts may not reflect reality. Reassure her that seeking help is a sign of strength, not weakness, and that mental health issues are just as valid as physical health issues.

In conclusion, I strongly recommend that you take your mother to see a mental health professional as soon as possible. The earlier she receives appropriate treatment, the better her chances of recovery and stabilization. It’s essential to address these issues before they escalate further, both for her well-being and for your family’s peace of mind.

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