My Mental Health Journey: From Depression to Bipolar Disorder - Psychiatry

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I would like to understand my current condition?


Hello, Doctor.
Last year, I was diagnosed with severe depression at a major hospital and have been consistently taking medication since then.
Later, I developed an obsession with buying dolls, which significantly increased my expenses.
After informing my primary physician about this, my condition was re-diagnosed as bipolar disorder.
After taking medication for bipolar disorder, I gained 20 kilograms.
Since I did not see any improvement at the major hospital, I sought help from another mental health clinic, where I was once again diagnosed with depression.
I have been taking antidepressants and am currently in the process of tapering off the medication.
However, I still occasionally feel very sad and have trouble sleeping.
Consequently, I started attending psychological counseling, and now I am using a dual approach.
Although I experience fewer moments of despair, I am unclear whether I have fully recovered from depression or if I am only experiencing symptom relief.
During my sad moments, I still think about self-harm and death, and when I can't make sense of certain things, I start crying.
Am I truly getting better, or is it impossible for depression to fully resolve? Thank you.

rrayyy, 20~29 year old female. Ask Date: 2023/12/19

Dr. Wu Enliang reply Psychiatry


Although I feel less despondent now, I don't understand whether I have fully recovered from depression or if my symptoms have just alleviated.
A: It's normal for people to experience emotions, and feeling down occasionally due to specific events is a normal phenomenon.
When I'm sad, I still think about self-harm and death; when I can't understand certain things, I start crying.
Am I really getting better? A: If you only feel sad sometimes and are generally doing well, you are likely on the path to recovery.
I would recommend learning emotional management techniques through psychotherapy.
Is it true that depression can never fully go away? A: Depression can generally improve.
Dr.
Wu Enliang

Reply Date: 2023/12/19

More Info


Your journey through mental health challenges, including the diagnosis of major depressive disorder and the subsequent shift to bipolar disorder, is a complex and often confusing experience. It’s important to recognize that mental health conditions can be fluid, and symptoms can change over time, leading to different diagnoses.
From what you've shared, it seems that your initial diagnosis of major depressive disorder was based on your experiences of persistent sadness, difficulty sleeping, and thoughts of self-harm. These symptoms are common in depression and can significantly impact daily functioning. However, the introduction of impulsive behaviors, such as excessive spending on collectibles, may have prompted your healthcare provider to consider a diagnosis of bipolar disorder, which is characterized by mood swings that include depressive episodes and periods of mania or hypomania.

The weight gain you experienced after starting medication for bipolar disorder is a common side effect of many psychiatric medications, particularly mood stabilizers and some atypical antipsychotics. Weight management can be a significant concern for individuals on these medications, and it’s essential to discuss any side effects with your healthcare provider to explore alternatives or adjunctive strategies to manage your weight.

You mentioned that you sought a second opinion and were re-diagnosed with depression, which indicates the complexity of mental health diagnoses. It’s not uncommon for individuals to receive different diagnoses as they progress through treatment, especially if their symptoms evolve or if new information comes to light. This can be frustrating, but it’s crucial to work closely with your healthcare providers to find the most accurate diagnosis and effective treatment plan.

Regarding your current state, it sounds like you are experiencing a mix of improvement and ongoing challenges. The fact that you are participating in psychotherapy alongside medication is a positive step. Therapy can provide you with tools to cope with difficult emotions, understand your triggers, and develop healthier thought patterns. It’s also a safe space to explore feelings of sadness, self-harm, and thoughts of death, which are serious and require attention.

You expressed uncertainty about whether you are "better" or if your depression is simply in remission. Recovery from depression is often not a linear process. Many individuals experience periods of improvement followed by setbacks. It’s essential to recognize that feeling sad or having thoughts of self-harm does not necessarily mean you are not improving; rather, it may indicate that you are still navigating the complexities of your mental health.

In terms of your question about whether depression can ever fully resolve, it’s important to understand that many people can achieve significant improvement and lead fulfilling lives with the right combination of medication, therapy, and lifestyle changes. However, some may experience recurring episodes of depression throughout their lives. The goal of treatment is to manage symptoms effectively, reduce the frequency and severity of episodes, and improve overall quality of life.

If you find yourself struggling with thoughts of self-harm or death, it’s crucial to reach out for immediate support. This could be through a trusted friend, family member, or mental health professional. Crisis hotlines and support groups can also provide immediate assistance and understanding.

In summary, your journey through mental health challenges is valid and complex. Continue to engage with your healthcare team, communicate openly about your symptoms and concerns, and seek support through therapy and community resources. Recovery is possible, and with persistence and the right support, you can find a path toward a healthier and more fulfilling life.

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