# Irritability - bipolar or something else?



## Darkside (Oct 14, 2012)

Three years ago I put myself in a hospital for 2 weeks. After that I participated in an outpatient program for 6 weeks. I was given a tentative diagnosis of mood disorder. I recovered, but I still have episodes of extreme irritability. They usually pass in a day or so, and I rarely do anything except grumble and maybe curse out loud. If I scream in frustration I usually go somewhere to be alone and get it out of my system. Once or twice in my life I've become "crazy angry" and done something stupid like smash a record player (it was mine) with a bat or verbally attack someone for what I believe is something they have done to hurt me. However, I have none of the accompanying symptoms of bipolar like unrealistic goals and expectations, feeling really good or confident, fast speech, going without sleep, etc. I do get depressed on occasion but I haven't been what I would call extremely depressed (suicidal, unable to work, sleeping all the time ... that sort of thing) but maybe 3 times in my life and those times it passed within a few days.

What else can result in episodes of dysthymia and, more often, agitation/irritability other than just exhaustion and stress? I've been under a lot of stress lately because I am responsible for my 92 year old mother and because I work 50+ hours a week at a stressful job. Those are triggers for a lot of emotional turmoil for me mainly because my childhood was so messed up by two abusive parents and two abusive older siblings. But the episodes of agitation and irritability have been more frequent the past 6 months. I finally got my mother to move to Assisted Living in August, and I thought that would relieve some stress, but she calls me at least 5 times a week because someone has robbed her, she has no money, she needs a ride somewhere, she needs clothes, someone in the home has been rude to her, etc., etc., etc. The Assisted Living staff are trying to help, but short of removing her phone there is little that can be done. Most of the time I don't answer my phone, but I listen to her messages later. Even that throws me into a state with my heart racing, panicky thoughts and fast breathing -- which points to anxiety.

Maybe there is no name for this ... maybe its just who I am, but with two failed marriages in my past I'm thinking this pattern must point to a disorder of some kind. Can PTSD cause this sort of thing? Could I be narcissistic or borderline? 

Any ideas? (Yeah, I know the part about going to a therapist. I've tried two people here where I live and neither seemed interested in helping me get to the bottom of this.) I'm just wondering if I need to see a psychiatrist again or if this can be managed with therapy?


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## W00BY (Oct 15, 2012)

Both are a good idea,

A psychiatrist would be a good starting point, they may be able to recommend a good therapist also, maybe even one specializing in a particular theory they may feel would be of help.

I on a personal level would like to see you do something actively to help yourself out of this "funk" your finding yourself in, your asking yourself the right questions and I feel thinking along the right lines, there is a keenly astute, caring, thoughtful person being swallowed up when I read your posts and I hope you do take some of these steps and find some mental peace.


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## Darkside (Oct 15, 2012)

Thank you. I wonder what I am being swallowed up by? 

Life is a bitch sometimes so I wonder if this is just a passing thing caused by external stressors. I really don't want to be on medication and a psychiatrist is going to want me to take pills. I hated it before and it really didn't help. It just gave me the shakes and made it hard to work.


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## W00BY (Oct 15, 2012)

Well you talk a lot about feeling angry and frustrated at yourself and the knock on effect this has when interacting with others.

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Also a psychiatrist doesn't always prescribe they do refer on if they feel it is of use, or give you the option of meds if you want to go down that route and they feel you could use the help, I found my experiences with my psychiatrist really useful and informative, in fact for the most part it was a very positive experience.


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## Darkside (Oct 15, 2012)

I have a friend who is a retired Psychiatrist. He is out of town but will be back later this week. I've also called and left a message for the therapist I used to see. I have only seen him once in the past year, but he's a nice guy and he'll try to help. I've just got to figure out what is causing this irritability and agitation - and outbursts. I feel better this afternoon than yesterday, but I still feel shaky and I have an upset stomach ... like I have the flu or something.


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## MHealthJo (Oct 15, 2012)

Darkside, of course we don't and can't diagnose... but, don't underestimate the strength of reactions - physical, mental, and emotional - that can come with "plain old" anxiety disorders. The feelings and reactions and run-on effects can be utterly intense, and big time anger (or lots of only-just-controlled anger) can feature prominently. 

The various things associated with anxiety disorders vary from person to person, and from time to time. (They get worse with more outside stress.) But they can be so intense that the person feels convinced that it must be some more "serious" or "exotic" disorder. Not necessarily... "plain old anxiety disorders" can be a thoroughly full-on experience.

Also, "plain old depression" is often considered the "other side of the same coin". I think I have read of theories that suggest anxiety and depression might be a bit like two different ways that the body/mind is expressing or manifesting certain things. Don't forget that to have depression, you don't have to be utterly unable to work, wish to die, etc. It can come out in its own way in the individual. 

Good news? If there is an anxiety disorder there, therapy and skills-based treatments are now considered first-line for generalised anxiety disorder. (Not sure on the other anxiety disorders.) 

Psychiatrists can be seen as a very useful diagnostic and referral tool, not just a drug dispenser... also, if you struggle to get anywhere, remember that there are sooooo many more drug options becoming available all the time. If you don't find yourself getting where you want to be, remember that two different medication options can be as different as night and day. I've found that in my own case. 

While considering your options, if you're eager to learn of the ins and outs of a few possibilities, there is a good site somewhere that has a ton of good-quality "basic screening quizzes" of tons of different possible diagnoses. They are all multiple choice with five options per question, as I recall. Google a diagnosis with the words "screening" and "quiz", and I think you'll find the site.

Google Books is a great resource too. If I hadn't been on Google Books persistently googling about video game addiction once time, my husband would literally not be diagnosed and treated for ADHD right now. We knew not a thing about that disorder or that adults could even have it.  Wiki is a great tool, but Wiki doesn't always go into detail of how things can look in each individual. Sometimes a specific book on a condition will have way more detail in terms of "How this condition might look... OR might not".

As always best wishes.


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## Darkside (Oct 15, 2012)

Thanks. MHealthJo. I had forgotten what you describe about anxiety disorders. They can be intense. I've had about 4 or 5 full blown panic attacks in my life. A couple when I was in my 20s and then back to back attacks when I turned 43 within the span of a couple of weeks. They left me weak and sickly feeling for several days ... just like now.

3 years ago I was diagnosed with GAD and possible mood disorder (no one ever said, "bipolar" but I'm pretty sure it was on their short list) and they put me on Depakote, Lexapro, Wellbutrin and Klonopin. I had the shakes so bad I couldn't hold a pen to write my name. After 2 months of it I weened myself off Depakote and Wellbutrin (with my doctor's approval) and stayed on Lexapro and Klonopin. Eventually I stopped the Lexapro and Klonopin. I did well until I started taking care of my 92 year old mother in the throes of dementia while working full time. What I don't understand is that the stress of some of that is less now than it was 3 months ago, and yet I find myself standing on the edge of madness anyway.

I dread taking medicine again.


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## MHealthJo (Oct 15, 2012)

Hmm... these things just don't always act predictably and "reasonably", do they... it's strange isn't it. I'm so sorry this scary spectre is facing you again.

I'm in Australia where polypharmacy is much less common than in some places. I have no idea whether it can be a bit like: If you're in one country, you'll be prescribed ONE medicine and see what happens. If there are some major downsides, the doctor will say: "Okay. That's no good. Off that and try something else." Whereas in another country, it seems a little more like, "Okay. Start with X and Y. Oh, but to control that side effect, also take Z." No idea of the pros and cons of various approaches. 

Ugh, it's tough. Don't give up. I don't think medication can be forced on you unless there's some big danger. Perhaps try to seek out a real expert in your particular problems? Online support groups or associations can be very helpful there. Again, without the internet, I don't know how we would have found the ONE major Adult ADHD Go-To Guy in the remotest capital city in the world.


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## Darkside (Oct 15, 2012)

You've helped me narrow this down a little. I think the place to start is to assume this is GAD, but this time no full-blown panic attacks, but rather intense irritability and possibly depression. I don't feel depressed right now ... and I do know what it has felt like in the past. But these things are not rational and predictable.

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I'm in South Carolina -- not sure where to look for an "expert" except to ask around. I've tried looking online, but that has not really been of much help so far. My middle son has problems with anxiety. The other two do not - that I know of anyway.


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## David Baxter PhD (Oct 15, 2012)

Darkside said:


> I'm in South Carolina -- not sure where to look for an "expert" except to ask around. I've tried looking online, but that has not really been of much help so far. My middle son has problems with anxiety. The other two do not - that I know of anyway.



Try:

South Carolina (SC) Therapists, Psychologists, Counseling - Therapist South Carolina (SC) - Psychologist South Carolina (SC) 

https://www.nationalregister.com/Find/SearchResults.aspx 

South Carolina Psychological Association 

South Carolina SC - Counselors, Psychologists 

... or ask your family doctor for suggestions.


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## Darkside (Oct 17, 2012)

I am seeing someone tomorrow at 4 pm. Maybe she can help me figure out why I am so angry.


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## W00BY (Oct 18, 2012)

Whoop whoop!!!

Yay! hope it goes well

*supportive and genuine cheesy grins all round*


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## Darkside (Oct 18, 2012)

I liked the therapist. She thinks I might be depressed even though I don't feel depressed. Anxious, agitated and irritable yes - depressed no. Anyway, she gave me the name of a Psychiatrist so I'm going to call her and set up an appointment.

I took Lexapro once before and it helped but didn't make me feel odd like Zoloft and Effexor. But I think its expensive and I don't have prescription coverage.

She also told me to limit my contact with my mother as much as possible.


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## MHealthJo (Oct 18, 2012)

I'm glad you liked her! 

I'm trying to remember whether I've read that what you describe can be quite common in male depression? Anyway it's great that you've got access to the health professionals who can support you in being confident in the diagnosis and treatment you end up with.

The cost is crazy isn't it. I just do not understand how people get by in countries where there aren't lots of subsidised medications!! Let your doctors know that cost is a factor and they should help you find the best options taking your factors into account. They shy away from some older meds, but if you're struggling costwise and an older cheaper medicine would ease that, don't be too scared of like  tricyclics etc. I know people who are happy with them even though these days doctors will definitely go for other options first.

Sounds like a great start!


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## David Baxter PhD (Oct 18, 2012)

See also:

http://forum.psychlinks.ca/prescription-medications-and-otc-drugs/7041-free-medication-programs.html 

http://forum.psychlinks.ca/prescrip...rugs/5535-u-s-a-medication-purchase-help.html 

http://forum.psychlinks.ca/prescrip...anufacturers-patient-assistance-programs.html


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## Darkside (Oct 19, 2012)

MHealthJo said:


> I'm glad you liked her!
> 
> I'm trying to remember whether I've read that what you describe can be quite common in male depression? Anyway it's great that you've got access to the health professionals who can support you in being confident in the diagnosis and treatment you end up with.
> 
> ...



The U.S. is one of the few countries in the developed world without some form of singlepayer or universal health coverage. We spend over 20% of our GDP on healthcare while countries like Canada, England, France, Italy, New Zealand and even South American countries spend much less - in some cases half of that amount. That's why people try to buy their meds in Canada ... they are much, much cheaper. A 30 day supply of Lexapro will cost me $140.00. (even though it is generic now)


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## Darkside (Oct 20, 2012)

The therapist I saw "speculated" that my mother has a personality disorder and advised me to stay away from her. She has called me 9 times since Thursday. I've only returned one call, but she has left a half dozen messages. You'd have to know her (see my post in the Abuse Forum) but she is incredibly shallow and cares only about herself. If she wants something she thinks everyone should stop what they are doing and get it for her.

My cousin has been trying to help out, but my mother says she hates to call her ... and since I am her son she is going to call me.

I'm afraid that eventually my patience will run out and I am going to verbally "let her have it." 

It's hard to describe, but there is this little boy inside me that is cowering in a dark corner and so afraid he can't even talk. Nobody takes up for him and so he "freezes" and goes somewhere in his mind. I have to learn to take care of that little boy. I have to convince him that I can protect him so he will come out of the shadows and into the light.


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## MHealthJo (Oct 21, 2012)

Very tricky... Your post reminds me of another resource I've gotta write into an "Awesome Resources" list...

 If interested, Darkside, go to meditationoasis.com and click on Listen to our podcast. (It's all free)  Number 24 is a guided meditation to support the inner child. I cried a bit doing this one, but in a good way.

I love their guided meditations, I've found them powerful.

If you can't "get into it" at first, try some of the simple starter meditations focusing on the breath, etc.

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Oh! Another great book is _The Dance of Intimacy_, Harriet Golder Lerner - useful in figuring out how our patterns work in relationships and carefully making changes... and how to handle the inevitable ways people will try to prevent change. I can't remember, though, whether there's much content that's less relevant for men - she's written from a female perspective. You could try just checking it out in a library for this reason if interested.

Good journeying...


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## Darkside (Oct 21, 2012)

MHealthJo said:


> Very tricky... Your post reminds me of another resource I've gotta write into an "Awesome Resources" list...
> 
> If interested, Darkside, go to meditationoasis.
> com and click on Listen to our podcast. (It's all free)  Number 24 is a guided meditation to support the inner child. I cried a bit doing this one, but in a good way.
> ...



Wow. That was powerful. I've got a lot of work to do with my inner child. 

The little guy is heartbroken, feels unloved, forgotten ... and most of all angry and afraid. In the first part of the meditation I saw him in a dark corner, unwilling to come out and be with me. I coaxed him out and in part of the meditation he held my hand and we walked outside in the sunlight, and he was able to run and play a little. In another part, he came to my chair and put his head on my arm ... then he climbed into my lap and fell asleep.

In another part, I saw myself protecting him. I was telling whoever or whatever was threatening him that I would not let him be hurt. This little boy was cowering behind me peeking out from behind my legs at whoever it was that I was talking to. In this mediation the little boy was only 3-4 years old ... maybe 5.

I was amazed at how easy it was to do this ... he wants to trust me, but he's still not sure he can. I think he's trusted adults before and ended up hurt. I have pictures of myself at this age with this little impish grin and crew cut hair. Sweet and loving, but confused by what he sees.


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## MHealthJo (Oct 21, 2012)

Wow, I am so happy that you were able to connect with it so well! I was surprised by it, too - I was skeptical. I don't know how they do it but those programs are really well done.

That little boy sounds very cute and so sweet, and he deserves that love and care you are giving him. It sounds like you did very well with giving him what he needs.

Just meeting him, and him meeting you, is a very powerful thing and he now knows that you are there and you are interested in him. It sounds like just that has been a very positive thing for him.


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## Darkside (Oct 21, 2012)

I had already thought about this some and I described this same little boy to the therapist I saw Thursday. She asked me if I felt compassion for him and I really do. This meditation made that compassion stronger.

Sometimes I wonder if our inner child becomes injured not *just* by what happens to him/her but also because he doesn't know how to interpret events and the adults don't do a good job of explaining what is going on.


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## David Baxter PhD (Oct 21, 2012)

Darkside said:


> Sometimes I wonder if our inner child becomes injured not *just* by what happens to him/her but also because he doesn't know how to interpret events and the adults don't do a good job of explaining what is going on.



And because for most children it happens at a time where their natural tendency and emotional-psychological development is somewhat egocentric, i.e., "if good things happen to me it's because I am a good person and if bad things happen to me it's because I am a bad person".


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## MHealthJo (Oct 21, 2012)

Absolutely. One thing that has been so fortunate for me is that for some parts of my experience, I DID have older people who knew some of the right things to say.

My heart goes out to anyone who firstly experienced  pains that no child deserves, but even more so when there is no healthy, truthful explanation given, or intervention or support available to the child at the time.

The more good and healthy stuff you know now, Darkside, the more you can explain it in a childlike way to that child. You have done a ton of excellent things that I'm sure have already helped you make these connections you've made so far and have those explanations that will help you.

 I can't tell you how many times I have seen it make a difference to a child, when they simply get told some sort of healthy "childlike" explanation that an adult is behaving wrongly, and it is nothing to do with the child - the child is so special and important. That grown-ups can have sicknesses  in their brains sometimes and do really weird things they shouldn't do. But someone else is there, and is going to help you.

The grown-ups shouldn't be acting  this way, but sometimes when grown-ups were little they didn't have the right things that they should have got, and it can make people's brains get very silly and mixed up. Or other things can mix up people's brains too.

But that is still not your fault and nothing to do with you, and they still should figure out how to learn to not act that way. But someone is here to help you out and make sure it is okay for you, because you SHOULD get everything good and nice that you need, as much as possible.

...end quotation marks!


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## Darkside (Oct 21, 2012)

David Baxter said:


> And because for most children it happens at a time where their natural tendency and emotional-psychological development is somewhat egocentric, i.e., "if good things happen to me it's because I am a good person and if bad things happen to me it's because I am a bad person".



The worst sin is when the parent makes the child responsible for how they feel. If the parent is needy and uses the child to satisfy their emotional needs (incest) the child can grow to believe they have the power, and the responsibility, to save (emotional rescue) people. If the child is unsuccessful or refuses to make the parent feel better they come to believe they are inadequate - or worse, that they are bad.


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## MHealthJo (Oct 22, 2012)

It's so terrible. :'(

I have often pondered the concept of evil - what it is exactly, where 'sickness' ends and 'evil' begins. I absolutely believe in evil acts and choices. But I often wonder about evil "people"... what it means to be evil, rather than sick, and where that line is. I wonder whether evil people know they are evil, or whether in their utterly twisted mind, they actually believe they are "right" or justified somehow, like Hitler, etc.

David, if you ever come across an article about brainscans etc of narcissists, please post.


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## Darkside (Oct 22, 2012)

MHealthJo said:


> It's so terrible. :'(
> 
> I have often pondered the concept of evil - what it is exactly, where 'sickness' ends and 'evil' begins. I absolutely believe in evil acts and choices. But I often wonder about evil "people"... what it means to be evil, rather than sick, and where that line is. I wonder whether evil people know they are evil, or whether in their utterly twisted mind, they actually believe they are "right" or justified somehow, like Hitler, etc.
> 
> David, if you ever come across an article about brainscans etc of narcissists, please post.



I've often thought about the same thing. That might be the difference. An evil person is so perverted they never doubt or question themselves or their actions. They never have dark moments in which they say, "Oh my God, I caused that" and then feel guilty and contrite - genuinely. Scott Peck wrote about this in his book, "People of the Lie."

We all do bad things ... horrible things ... but we have a sense of shame and guilt when we realize what we've done and how we have hurt someone. An evil person has no internal mechanism whereby they even debate the consequences of their actions much less accept responsibility for what they've done to hurt someone. I suppose that is the definition of sociopathy.


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## W00BY (Oct 22, 2012)

I think the less reality a child has the more chance there is of abuse not being discovered until they are older.

I think the lack of a cohesive and stable adult in my childhood not only helped stew the abuse that was going on but also robbed me of my ability to speak up.

The confusion and uncertainty that an unstable family life/family members exhibit when your a child is certainly one of the lasting sensations for me as an adult and was the hardest part to unravel in my head as I came to terms with what I had experienced.

Some people call it the psychological abuse, I think that phrase doesn't even begin to describe what it is like.

The realization that people that should have cared and protected you, did not, the battle for the truth and to extricate your mind from the lies, fantasies and cover ups and falsities that went on and the actual experiences themselves.

Keeping a sense of what is right and wrong in such circumstances for most adults would be near impossible for a child still learning to fit into the jigsaw of society it is an mountainous task.


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## Darkside (Oct 23, 2012)

Very well said W00BY!


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