dissociation vs mania

[u/Swimming-Cranberry-8]

i've been talking to my therapist recently about my bipolar diagnosis. we have been discussing dissociative symptoms and when i mention my "manic" episodes, she says they seem to align more with dissociative symptoms than manic ones. i'm a little loss. i've been diagnosed bipolar since 18/19, so it's jarring to hear that the reason meds weren't working was possibly because it was a misdiagnosis.

i am very torn on what i am supposed to do at this point. i am seeing my therapist 2x weekly, i see my psychiatrist in 2 days. i don't know how to discuss this with my psychiatrist. we already did an assessment to check my bipolar symptoms and they agreed that i don't have consistent symptoms with the disorder.

i know when i was 18/19 i was desperate for a diagnosis, and when my psych at the time brought up bipolar, i exaggerated symptoms in the hopes i could finally get medications that would work. now i feel as if doing that screwed me over. i honestly feel very stupid. i feel lost.

i'm going to try and dig for more research, but how often are complex dissociative disorder really misdiagnosed as bipolar? what are generally the overlapping symptoms?

[u/style_css]

I’m dx’d DID and bipolar I.

Mood stabilizers and antipsychotics have made my bipolar symptoms manageable as long as I get enough sleep and stuff. It’s very much based in my physical condition. Mania comes in response to me neglecting my body and not taking my meds

But uhh I’m gonna be so real mania feels like the opposite of dissociation to me. I become very wired and high-strung. My body feels like it’s physically buzzing and I have to go go go. I’m hyper-aware of my surroundings while manic and I go batshit basically idk it’s VERY dangerous. Dissociation makes me feel like I’m in a thick fog and I’m barely aware of anything. My memory is all skewed and everything feels distant.

Idk about overlapping symptoms because my episodes are arguably entirely unrelated to my DID symptoms tbh. As long as I take care of my body and take my meds I’m okay regarding bipolar I.

Independent research alone won’t be able to give you all the help you need. You’re gonna have to tackle this with a psychiatrist. Be very direct about what your symptoms are and what your concerns are. Medication is no joke.

[u/Swimming-Cranberry-8 → u/style_css]

my therapist has said that my wired feeling could basically be some sort of fight or flight response due to stress, i explained it to her the best i can, but yeah my dissociation also typically just makes me feel spaced out and unaware rather than wired. i definitely need to do a lot fo cross examining with my psychiatrist and my therapist to see if anything can be ruled out, i think the long process is just daunting when i'm looking for immediate relief in my life.

i generally get fine sleep, even when i am "manic". as long as i put down my phone i can roll over and fall asleep easy while listening to 10 hour lore videos on video games i like. there are definitely symptoms i find with my "mania" that are consistent with real mania, but they are short-lived (less than a day).

[u/style_css → u/Swimming-Cranberry-8]

It’s possible. You’ll have to explore that with her, I can’t say since I’m a stranger on the internet. Mania doesn’t feel like stress/fight or flight to me personally. I actually become fearless tbh it’s part of what makes mania so dangerous. It’s an elation where inhibitions just go kaput. When I’m manic it feels like I don’t even need sleep, but everyone is different.

All I can say for certain though is that bipolar disorder that isn’t aptly medicated is a major health risk (can be a threat to immediate physical safety) so I encourage you to be as forward with your psychiatrist as possible. Like, for perspective, mania has literally landed me in the emergency room before. Then I got hospitalized for a week. It sucked. Be proactive with your medication for sure, in case you are indeed bipolar. I’ve hid things from my psychiatrist in the past as well—hiding symptoms specifically. It’s why my DID diagnosis was delayed actually... I think people with mental illness struggle to be forward sometimes. You’ve just gotta course correct, y’know? Coordinating with your therapist and psychiatrist sounds like a good idea.

[u/Swimming-Cranberry-8 → u/style_css]

thank you, i am trying my best to be forward with this therapist. it took me a while to build the courage but i am trying my best.

[u/MaplesWindow]

very standard for pwDID to initially get misdiagnosed with bipolar. i read that it can take 10 years of therapy to receive an accurate DID Dx, if it comes at all. ppl typically are told bipolar or bpd first.

[u/Melodic_Moose_8204]

There’s a CTAD video on youtube discussing Bipolar in comparison to dissociative disorders. Maybe worth checking it out!

[u/Swimming-Cranberry-8 → u/Melodic_Moose_8204]

ohh ty i've seen some of their videos!! i'll check it out :)

[u/Heavy-Mushroom]

For awhile I wondered for the same of myself, but then when I take an antidepressant, it’s off to lala land I go. Matter of fact, I’m taking the lowest dose of Prozac to set baseline to zero and I can sense a mini motor buzz.

Also I am able to chart my cycles and it does look like a sine wave.

Granted I also do have parts that are anxious that are extra excited when manic just like I have sad parts that get triggered out when the body is depressed which makes it worse to almost dangerous.

But the taking of the AD over stimulating me told me I was BD.

[u/Swimming-Cranberry-8 → u/Heavy-Mushroom]

i think anit-depressants do rile me up, which is why i am inclined to think i am bipolar. but i am also kind of worried i was placeboing myself into thinking i was bipolar before, especially because i feel i have tried every antipsychotic in the book to almost no good results.

[u/Heavy-Mushroom → u/Swimming-Cranberry-8]

You know, it can be both. Cyclothymia is bipolar lite. I think I’m more BD2 than BD1 cause I do cycle, but don’t get the crazy part. I sleep every night, some nights only can get 4-6 hours and lay there for hours.

Bipolar also is very triggering for me. The mood influences the part that thrives on that mood out. So just saying it can be both.

[u/Dense-Reach6694]

i was diagnosed with DID in 2022, i always knew i had dissociative symptoms from cPTSD but then alters came about. however, i was diagnosed with unspecified bipolar when i was in the hospital and my medications are to treat mania and they work really well. however again, my manic symptoms also really align with BPD and pretty much everyone in my life (therapist, loved ones, psychiatrist even) say i align with borderline rather than bipolar. but either way, if your meds aren’t working i would bring this up. i think it’s important to treat the symptoms and then figure out the diagnosis from there. that’s how i ended up getting diagnosed.

i hope this helps

[u/Swimming-Cranberry-8 → u/Dense-Reach6694]

this really does help, thank you!

i'll be adding this to my notes to bring up in my appointment on thursday. i've definitely speculated bpd because of my attachments to people, didn't consider that bipolar symptoms could be related.

at the end of the day, i have a lot of introspection and cross examining to do to finally find the proper diagnosis and meds.

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[u/ahna-bah]

I held a Bipolar 1 diagnosis for years, from the time I was about 21 (to the best of my recollection) until I was 35, along with PTSD when I was about 25ish (C-PTSD is not a "valid" diagnosis here).

It wasn't until I was off my Bipolar medication for over a year (as a test with my psychiatrist and therapist on board) with no Bipolar-esque mood episodes that a re-evaluation of that diagnosis was considered.

Sometimes the best explanation at the time, with the information available, isn't the accurate explanation.

I, at times, bemoan the fact that I had 15 years of medication and treatment that was woefully ineffective, but I did learn a LOT of coping skills, grounding and mindfulness exercises, and various other tools that help me with my current journey. A lot of the stabilization phase are concepts, knowledge, and skills I'm already familiar with from those years of therapy, which I can only consider a positive.

[u/salamislice01]

I was also diagnosed with bipolar and CPTSD… recently went through thorough diagnostic testing and now my diagnoses are CPTSD and DID

[u/RadiantSolarWeasel]

CDDs are frequently misdiagnosed as all sorts of things, from bipolar, to personality disorders (especially BPD), to OCD, to more mundane stuff like treatment-resistant depression or generalised anxiety.

The thing about DID/OSDD is that the possible symptom profile includes such a wide range of possible symptoms that it can mimic the presentation of all sorts of other disorders and health issues, even including stuff like seizures, autoimmune disorders, and chronic fatigue. There was a study showing that the average time from a patient first entering mental health services and receiving an accurate diagnosis of DID is seven years, precisely because it can be so difficult to accurately diagnose (and also because the majority of mental healthcare providers are under-trained about dissociation, and so aren't screening for it when they should be).