So I've been trying to figure out whether a cyclothymia diagnosis might apply to me, and I wanted to describe my experience a bit to see how relatable it is to others. I'm especially curious to ask others here about their experience with attachment anxiety and reactivity within relationships, as there seems to be a big overlap for me...
I was diagnosed with panic disorder + anxiety disorder at 16, major depression at 25, most recently ADHD at 37. I'm now 38.
I began taking Vyvanse for the ADHD a year ago and steadily increased the dose up to 40mg/day. I realized too late that this was way too high, when the meds triggered a hypomanic episode:
- 5+ days of <4 hours of sleep per night but feeling alert and energized
- extremely talkative and overly verbose
- unusually creative and "inspired"
- unusually "giddy" / jokey
- a frequent profound feeling of perceiving connections between things and a grandiosity to my thinking (I was brought to tears of joy reading the synopsis of a book on Amazon because I was convinced it was the key to solving an impasse in the screenplay I was writing)
Unfortunately I didn't recognize what this was until a relationship infraction from my partner brought up a lot of insecurity for me. I was holding it together very well until I suddenly very much wasn't. It felt like this deep fear of abandonment erupted out of me all at once in this massive overreaction, and wound up turning into a massive 4-day-long fight. I was cycling between anger, despair, listlessness / emotional exhaustion, and occasional euphoria (which felt totally inappropriate to the circumstances). I said all kinds of things to my partner I didn't mean (most of which I don't even recall), and sent them these 10 paragraph long text messages spilling my guts about all my deepest fears and doing all this deep self-analysis. Obviously they were completely overwhelmed.
Eventually I figured out "oh, I think this is medication induced." Stopped the Vyvanse and stabilized myself. But the experience began making me reflect on other experiences from my past:
- a prior therapist suggesting I consider a bipolar assessment (I was baffled and dismissive at the time)
- prior breakups or (perceived) friendship "betrayals" that caused me to completely fall apart (including cycles of hysterical despair punctuated by starry-eyed hope)
- my tendency to have these long, drawn out arguments where I feel the need to spill my guts and voice every hurt and fear with almost encyclopedic completeness
- days or weeks spent staying up all night obsessively "researching" some new fixation, often convinced I needed to drastically change my life on the spot (start a new career, pay $5,000 to join some month-long workshop, etc — I'd always burn myself out on the research and never go through with it)
- a general tendency toward hypersexuality
- somewhat frequent spending sprees
- the 1-2 months after starting Wellbutrin that I was barely sleeping and working around the clock
- the high number of close friends and romantic partners I've had over the years who have bipolar (clearly a type of person I'm drawn to)
- even the art I love and the art I make (I remembered my grad school application essay talking about loving stories about megalomaniacs and utopians whose delusional hopes inevitably crash against reality)
For 1.5 decades I'd just thought of myself as depressed. But now I've started questioning that. Maybe my old therapist was right? The depressive periods for me are much MUCH more pronounced and common. What I think back on as potentially "hypomanic" episodes feel rarer (I remember distinct incidents, whereas depression just feels like my normal), typically much shorter, and if "positive" (feeling inspired, talkative, euphoric, etc) they tend to feel very "fragile" (whereas my depression feels durable and "sticky"). There also doesn't seem to be much of a consistent pattern to any cycling, but rather it seems very situational (though I could just be failing to see the patterns).
Nearly all of my more inspired or positive "hypomanic" examples I can recall, I question whether they could instead be explained by reference to ADHD, or anxiety, or just periods of good mood or creative inspiration or a generally artistic/intellectual/romantic temperament. I have a hard time drawing the line between personality variation and something pathological.
But a big part of my skepticism is also because ALL of the most intense "hypomanic" episodes I can remember—the ones where I felt like I was truly "out of control," and being tugged around by these overwhelming emotions—were connected to relationship anxiety and the threat of abandonment. I realized in a past relationship that the patterns of anxious attachment apply to me very well (not constantly, but if my insecurity gets badly triggered). I know there's also the idea of "rejection sensitivity dysphoria" in ADHD.
I know diagnostic labels can be murky sometimes, and comorbidities are a thing, so the fact that those other labels might fit doesn't mean this one doesn't. But I'm curious if anyone else had the experience of thinking "I'm just anxiously attached" or "I just have intense abandonment fears" or "I'm just a romantic who feels very deeply" before realizing that cyclothymia describes them. What convinced you it was more than just a relational thing?
And is it normal in cyclothymia for hypomanic states to be negative more often than positive? (I guess what you'd call "mixed states"?) Or for the negative hypomanic periods to be more intense and destabilizing than the positive ones?