As a psychiatrist, I often see patients who struggle with persistent depression and anxiety, even after trying various treatments. This is known as treatment-resistant depression and anxiety, which can feel discouraging and hopeless. However, it is essential to consider the possibility of something deeper at play, something we can address and manage with the proper knowledge and treatment.
One commonly overlooked factor is the bipolar spectrum. You might think that bipolarity only involves extreme mood swings, but it can be more nuanced. The bipolar spectrum refers to milder forms of bipolar disorder, which often go undiagnosed or misdiagnosed as other conditions, like anxiety or depression. Sometimes, these conditions coexist with bipolarity, making it harder to identify.
One way to identify if you might be experiencing the bipolar spectrum is through hypomania. Hypomania is a milder form of mania, a key symptom of full-blown bipolar disorder.
So, how does this relate to treatment-resistant depression and anxiety? Well, individuals with bipolar spectrum may experience persistent irritability and anxiety rather than the typical symptoms of severe depression and mania or hypomania; their hypomanic irritability and anxiety can lead to mild depression, mood swings, constant worrying, rumination, and overthinking.
It is important to remember that treatment-resistant depression and anxiety often have underlying causes that may not be immediately apparent. By understanding the nuances of the bipolar spectrum, we can allow for more targeted treatment to combat the symptoms of depression and anxiety that were once thought to be resistant to treatment.
Bipolar Spectrum Diagnostic Scale (BSDS)
20-question screener for bipolar spectrum diagnosis