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Torn about Diagnosis of Bipolar II

November 18th, 2022

Hi there, I’m torn between accepting or rejecting a diagnosis of Bipolar II. A clinical psychologist diagnosed me with Bipolar II a week ago and now I am under a primary care physician to receive mood stabilizing medication this week. I don’t think I have bipolar disorder though. Can personality not sometimes resemble bipolar? I am sometimes hyperactive and able to take on a 100 projects, feel super smart and pretty and am at the top of my game. I need little sleep and in fact find sleep an annoying timewaster. Then I have times, probably more often, where I feel sorry for myself, feel ugly, stupid and can barely clean my flat or look after my pets. When I’m hyper, I harm no one, I don’t spend too much or gamble or drink or do anything that could be considered damaging. I just work really hard, accomplish a lot (I work fulltime as a project manager, am a freelance educational writer and am in the third year of a science degree for which I have had 18 distinctions so far). When I am down, I do feel very sad and think of killing myself every now and then, but I would never kill myself as I know logically this would be stupid and that I always feel better again. In my mind, I am just a highly functional individual who is able to achieve a lot, use my time to the max, sometimes feeling on the top of the world and sometimes not. I’m used to feeling like this and I have all sorts of coping mechanisms around it. I am completely alone, no family and few uninvolved friends, so my state of mood never affects anyone. I also have no support structure should it really be bipolar and should I need help. I don’t understand why I should go on mood stabilizers and antipsychotics. I’ve had no breaks with reality, just a few very minor private breakdowns where I have cried a lot. But I got over those and I was just overworked and under a lot of pressure and it didn’t affect anyone other than me. What do you do when you are torn between accepting a diagnosis and thinking it is total nonsense? I change my mind at least 20 times a day. I can’t imagine I will be able to be compliant with taking medication or accepting help. (age 38, from South Africa)

Based on what you have described here, I tend to agree with the diagnosis that the psychologist has given you. It does sound like you meet the criteria. Most people experience some ups and downs, and yes, some personalities can include some opposing traits and tendencies, but the swings that you mention here do hit some of the classic extremes that are included in Bipolar Disorder and/or Cyclothymic Disorder.

However, just because you meet the criteria for a disorder does not mean that you need to be medicated for it (or even treated). If you feel that you truly have the coping skills already in place to manage your mood and energy changes, you don’t have to pursue further treatment. But the fact that you consulted with a psychologist in the first place and state that you don’t have a support structure to rely on, indicates that you could at least benefit from the help of a therapist.

Most people with Bipolar love their highs and hate their lows, so you are not alone in this aspect. Deciding how much the mood changes impact your life and your ability to function, as well as affecting your “quality of life,” will help you with the decision to medicate. Mood stabilizers will not change your personality, they will level out the highs and lows so that you have more consistency in your state of being. But you have every right to seek a second opinion if you are still struggling with the decision whether or not to pursue further treatment. I hope this information helps.

All the best,

Dr. Holly Counts

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