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What causes numerous mood swings alternating with periods of mild symptoms of depression?

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Posted on Mon, 18 May 2015
Question: beginning as a child i was hyperactive. I had problems at school and seperated from the class. I was suspended for aggressive behaviour. as i got older 20's i had intrusive upsetting thoughts and fear of contamination. I was diagnosed with ocd. I also suffered depression. My life has been filled with poor life choices and problems.

I have an over active mind and do everything to excess but in a ridiculous way. for e.g i would work renovating houses and then go straight to work a a nurse. I would work 25 /30 night shifts in a row. I also nearly always dream of battles and heroic acts?

my marriage broke up. I was obsessed with sex and loyalty. My mind was racing and my behaviour and mood personality changed dramatically. My wife still cares deeply about me and described it as the total opposite of myself. Those who knew me stated I was using their term off my head. I have always talked a great deal and can go off at tangents. I sometimes do not want to talk or say things but somehow feel compelled. I slept with other women which even my wife stated was not the person she knew. i have stolen things and have grandiose thoughts and behaviour

having been divorced over a decade around five years ago i was looking after a terminally ill man in his home when not having thought about my split from my wife and with no warning i attended work and broke down crying with all the feelings of sorrow and regret re events of my marriage break up. I called my wife and discussed this. What was frightening was these events were not in retrospect but as though had just happened.

I have always had issues with work, relationships and my behaviour could be odd e.g i took my dog to meeting with my manager. I am extremely impulsive, reckless, and take huge risks. I owned 17 houses. I bought houses without looking at the, i gave a criminal 30,000 cash, I loans thousands and thousands of pounds. Sometimes i felt compelled. I was purchasing 1.3 million pounds property without rational decision making. i can be gentle, understanding or unrealistic angry. Oddly i sometimes want to be quiet and in the background yet i put myself centre of attention.

There are a lot of other aspects of my behaviour, actions however you get the idea doctor. recently i have had huge problems at work due to my actions behaviour. I was diagnosed 2 years ago with ankastic personality disorder by a nurse practitioner.
I tried to see a psychiatrist but could not get past the nurse.

i was a staff nurse over 17 years and i am aware a little knowledge is dangerous, however do believe i lack intellect and many others within mental health stated i have awareness and insight into myself. Having spoken to one of your colleagues he feels my history does not suggest bpd but bi polar. I would agree. I can be happy singing them my mood drops. I can only describe this as sudden. it can last days or weeks. Oddly i can be very depressed yet elated and singing, this can be at work.

I certainly am not misery or frugal with money, nor am i ordered in my life. I am reckless and extremely impulsive identified by many others. I am a perfectionist in elements of my life. I not believe i have ankastic personality or it is not my primary illness ie co morbidity as with my ocd.

I would appreciate your opinion. thank you. XXXXXXX
doctor
Answered by Dr. Srikanth Reddy (41 minutes later)
Brief Answer:
Difficult to be certain

Detailed Answer:
Hello,
Thanks for choosing health care magic for posting your query.
I have gone through your question in detail and I can understand what you are going through.
You will agree with me that diagnosing based only on the history is not very right but your history does suggest that you are probably having a cyclothymia. This illness is very similar to the bipolar disorder except that the intensity of the symptoms at peaks is less than that of depression/mania. Even this requires use of mood stabilizers like divalproex sodium (500-1000mg) or lithium (400-800mg) to stabilize the mood and to think rationally. Also quetiapine is a good drug for this illness in the dose of 400-800mg.
Also the fact that you had so much hyperactivity in the past as a child and now there are epsides of intattention, you need a detailed evaluation for the presence of ADHD. Manytimes cyclothymia can cooccur with ADHD as well.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
bit.ly/dr-srikanth-reddy
                                                                                                                                                                                                                                                                                                                                               
Wish you good health,
Kind regards
Dr. Srikanth Reddy M.D.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Srikanth Reddy (15 minutes later)
I understand and yes I put you on the spot really. It must be difficult to assess with 100% accuracy from my history. I appreciate your help and honesty. I don't believe i am the right person to make reach conclusions on my own mental health, yet i cannot help but conclude bpd especially ankastic fits with history or presentation. That being said I am not qualified to make that evaluation.







Again Thank You. Warm regards. XXXXXXX
doctor
Answered by Dr. Srikanth Reddy (2 minutes later)
Brief Answer:
Anakastic personality can be there

Detailed Answer:
Hello
With the kind of perfection you expect from life with a history of OCD, yes anakastic personlaity is very likely. But then cyclothymia is still my best guess. It would be wise to see a psychiatrist for these symptoms and get some medicines prescribed. That will surely help you.
Kind regards
Dr. Srikanth Reddy MD
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Srikanth Reddy (30 minutes later)
Thank You,
My last question. My rational for doubt surrounding ankastic personality is mealy that is given I have ocd the perfectionism would be evident, moreover, the associated misery, frugal behaviour and being orderly could not be further from who I am. Moreover, I have insight and awareness which I did not think fitted with a personality disorder.

My impulsive behaviour and spending has been devastating in my life. To so degree having ocd has not always been a bad thing, withstanding extremes. I have found the benefits of antidepressants limited, however this is subjective I realise.

Given you best guess it would make sense. Can my reckless behaviour and impulsiveness be attributed to mood disorder as you outlined, as I find it so hard to understand my actions. Thank You, XXXXXXX Ps I had a breakdown 2 years ago and it was the most painful experience of my life. I wish people understood the affect mental illness has on all aspects of life.
doctor
Answered by Dr. Srikanth Reddy (42 hours later)
Brief Answer:
Anakastic personality is not very likely

Detailed Answer:
Hello
Yes I agree with you that most of the symptoms and experiences that you have had go more in favour of mood disorder. Anakastic personality is less likely but then it is possible. Insight may be present in personality disorder as well in some cases.
Hope this helps
Kind regards
Dr. Srikanth Reddy
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Srikanth Reddy

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What causes numerous mood swings alternating with periods of mild symptoms of depression?

Brief Answer: Difficult to be certain Detailed Answer: Hello, Thanks for choosing health care magic for posting your query. I have gone through your question in detail and I can understand what you are going through. You will agree with me that diagnosing based only on the history is not very right but your history does suggest that you are probably having a cyclothymia. This illness is very similar to the bipolar disorder except that the intensity of the symptoms at peaks is less than that of depression/mania. Even this requires use of mood stabilizers like divalproex sodium (500-1000mg) or lithium (400-800mg) to stabilize the mood and to think rationally. Also quetiapine is a good drug for this illness in the dose of 400-800mg. Also the fact that you had so much hyperactivity in the past as a child and now there are epsides of intattention, you need a detailed evaluation for the presence of ADHD. Manytimes cyclothymia can cooccur with ADHD as well. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback. In future if you wish to contact me directly, you can use the below mentioned link: bit.ly/dr-srikanth-reddy Wish you good health, Kind regards Dr. Srikanth Reddy M.D.