Bipolar Support Group

Hi all. I've spent most of my time in the bipolar forums because I have been diagnosed as bp2. I had previously been diagnosed as having PMDD. Well over time, I totally forgot about it and started treatment for bipolar only. Well, recently I had a depressive episode that had me prepared to go out on medical leave indefinitely! As soon as my period came on good, those thoughts seemed totally ridiculous. Now a week after my period, I feel like I'm on top of the world and nothing can stop me. Like clock work around ovulation time I expect the depression to come back again... What if I really am not bipolar!? What if I am only PMDD!? I am so hopeful that this is the answer to all of my questions!

I hope that you are diagnosed with the illness that is easier to handle for sure. I know little about PMDD but it almost sounds like some people's bipolar rapid cycling. But if it is like clock work with your period, then I'd definitely get that reconfirmed so you get the RIGHT medications. What kind of doctor would treat PMDD? A gynecologist? An endocrinologist? I'd go to the one that is most familiar with it.

I think it's very good getting to the root of ones overall health! I hope that you get it all figured out!

You would go to a gynecologist. The symptoms are almost identical with bipolar depression. Its amazing. The thing that has me most suspicious is that I have not been hypomanic in many months. Only when I was aggressively taking antidepressants. Then too, at the beginning of each period, I have this feeling of relief, like everything is suddenly going to be ok. I was prescribed an SSRI to take 14 days before the start of my next period. I'd bet my paycheck, it works! I'm not gonna stop my biolar meds until I get an ok from my pdoc, but I'm pretty sure I'm on the right track.

Here are the symptoms that make up the diagnosis of PMDD. All of the symptoms do not need to be present, and they may vary from month to month. At least 5 are required to make the diagnosis, including at least one of the first four.*

Very depressed mood, feeling hopeless

Marked anxiety, tension, edginess

Sudden mood shifts (crying easily, extreme sensitivity)

Persistent, marked irritability, anger, increased conflicts

Loss of interest in usual activities (work, school, socializing, etc.)

Difficulty concentrating and staying focused

Fatigue, tiredness, loss of energy

Marked appetite change, overeating, food cravings

Insomnia (difficulty sleeping) or sleeping too much

Feeling out of control or overwhelmed

Physical symptoms such as weight gain, bloating, breast tenderness or swelling, headache, and muscle or joint aches and pains

I'm just saying, I can see how it could be a mistake. I am seriously hoping it was anyway.

Post edited by: highandlow, at: 03/05/2012 08:17 AM

They can be so similar I thought I was PMDD for years, especially when the pill helped my moods somewhat. I even tried charting my moods for awhile to see how closely they matched my period (pre-bipolar dx) but I was inconsistant in my charting.

I think it's good that you aren't stopping your bipolar meds though until you see your pdoc because I do think bipolar symptoms can get worse around our cycle too. Mine do and I am sure I am bipolar.

I hope you do have the easier to treat dx. Not that PMDD is not serious, it certainly is. But my hopes and thoughts are with you.

It sounds like your psychiatrist ought to be able to help you clarify this also, as this is a DSM-IV-TR diagnosis. Or at least be able to describe his/her thinking on why he/she would rule it out.

One of the tricky things about diagnosing is that so many disorders have the same symptoms. For example, anxiety, depression, mood disturbance, lability, feeling out of control. At least a half dozen DSM-IV-TR disorders that I can think of off the top of my head have these symptoms as prominent features. That's where a pdoc's knowledge of etiology (development of the disease) is essential, along with the subtle aspects of clinical presentation.

One of the problems with the DSM-IV-TR is that by breaking disorders down into behavioral components it loses a lot in the translation.

As an aside, it is also possible to have two disorders at the same time. You may have PMDD which exacerbates your bipolar. Or, a cyclothymic disorder which exacerbates your PMDD. Only a trained mental health professional, like a psychiatrist, can tell for sure. I encourage you to consult with your psychiatrist, or to seek a new psychiatric consultation.

I go in to see my tdoc on wednesday. I will ask her to pass the message along. I'm not due to see my pdoc again until June. I really hope I don't have both.