Long story, need advice

This may take a while to explain, but I need some advice on the best way to move forward. I have been in the mental health system for many years now and have had various diagnosis, which would explain why I have used different boards to get support.

So over the years I have had OCD, Social Anxiety, Depression, Borderline personality disorder, Asperger's, ADHD and on the Bipolar spectrum. I have had various medications and therapy. Tried most things.

The order I listed is the order I got diagnosed. So here I am now. Due to my struggles I have spent most of my adult life out of work. Since my late teens I have suffered with mood changes. I can be so depressed I do not want to live anymore and have attempted to take my life. I also have engaged in a high level of self-harm. Aside of the depression I have had periods of time where I am full of energy, non stop talking, get annoyed quickly, sleep less, dance and sing around, make jokes cannot sit still and have a long list of plans. I could apply for jobs, volunteer work, college courses and university all at the same time. I start buying things for the things I wish to study or projects I have in mind. They never happen because I hit a low and feel totally hopeless. This has been going on for years. I do also during those times get a period where I feel on an average level.

So when I got my diagnosis of Asperger's and ADHD, I was told I was also on the bipolar spectrum, but did not fit bipolar 1 or 2. Also I didn't have BPD. This was a private assessment over a period of time. On my assessment and report it was suggested I try a mood stabiliser with my current medication. I never saw this person again due my then situation in nhs services and no finance. My psychiatrist at the time would not listen to a word I was saying. Even 5 years prior when I first met them and my mum mentioned Bipolar she was shouted at by psychiatrist. Over the years I brought it up, but it was shot down.

After being discharged I was seen by the CMHT and eventually handed over my assessment/report and was supported by a peer support service for individuals with ASD.

In almost 11-12 years this moods have been happening. Back in 2015 after an attempt I was referred to CMHT and I requested I increase my Olanzapine to twice a day. By mid last year I was feeling good, almost no depression, was exercising and had only self-harmed once. I then started looking for work, had been unemployed for over a year and half. Around the same time I reduced my olanzapine back to once a day and eventually started a new job. I only lasted 3 months. In that time, my moods were all over the place, I could be at work feeling suicidal, then a few hours later be non stop talking. I handed in my notice in total 4 times (that being the last). But an example of this is, one week I handed in my notice, the next week I was offering to work extra hours unpaid to help get work completed. I was also close to offering coming in at a weekend unpaid to help sort some stock out.

I couldn't take the moods, I was struggling big time. When I increased the olanzapine back up, it took away the racing thoughts and anxiety. I was much calmer, but had a deep depression. In the end quit my job. So now it has been about 5 weeks since increase in olanzapine. After leaving work I went through another stage where I was applying for things left right and centre, I was starting to think about attending church and wearing the cross. I was looking up decorators for my home. I have no money for this, but was going through so many ideas. I then spent money on items for my ideas of starting my own business. Slowly it has eased and for a good week or so I feel balanced. I get the odd parts of day where I feel low. I am addressing it in different ways, I make sure I go to bed at a regular time and get up the same. I have taken up running for about 20 mins in the morning and it helps me feel a bit balanced. I am eating healthy and trying to keep stress down.

So my problem is, due to my mood changes I am out of work, when I am full of energy I lose my patience with family. Like can be so easily irritable. I know a bad low is coming, but trying to manage it through the above. I get worried that when I become suicidal I will act on it.
I have asked to be referred to CMHT to see a psychiatrist. There is only one for my area. The last time I saw them, they hadn't read my notes, they told me they see people a lot sicker than me and that they don't think I need medication. They only increased my olanzapine if I agree to join a sports club. After that I had to cancel two appointments and was discharged. I know I will be seeing this same person. I know that I can when in a energised place come across as there is nothing wrong.

I just don't know what to do, I have kept a mood diary for December, I have thought about writing everything down, explaining the lows and the more energised periods. I just want some help in being able to live life. Due to my Asperger's it has limited certain areas, but the mood changes on top have just left me unable to do much. I get embarrassed going on about all these things I am going to do. I hate buying all these things. I bought a £20 photography magazine because I had an idea to start up a business. Came close to buying a camera over £300, but managed to resist. I don't have the money for this.

I am in my 30's now and have nothing to show for it. I am out of work because I cannot control my moods. I literally just ponder through most days. I have looked at medications and I just worry about all the side effects. My mood generally last 4-7 days energised and feeling great, low mood 7 + days and normal has been 7 days. The days when I felt both suicidal and full of energy also lasted about 7 days. As you can see it changes a lot. I do get periods of normal.

I just don't know what to do with this new appointment with the psychiatrist. When I saw them before I was lucky to have 20 mins if that with them. I also attend group therapy and again my mood effect how I use the group. I can either say nothing for the whole time and not get anything out or I spend the time asking the other members lots of questions and giving my opinions. I sometimes feel I don't need to be there and want to quit.

I am just so confused. It is impossible to plan anything or move forward in life. Any ideas on what may help when I see the psychiatrist?

Hi and welcome to the forum! I'm sorry to hear of your struggles over the years. It sounds as if things have been quite complicated with all the different diagnoses and difficulties in getting sufficient treatment. I can relate to much of what you've said, though, especially about your mood changes and resulting issues with work as I've had similar problems. Sending big hugs to you, if wanted.

When it comes to your psychiatrist's appointment, what has helped me is keeping a mood diary, and I've even shown a condensed version of it to my psychiatrist. I also usually take notes in with me to act as prompts, and I think especially since it's going to be a first appointment for you, I'd recommend making notes on your past episodes, symptoms, how they affect your day to day life etc. It's easier than trying to remember everything when they ask! I've also taken people close to me in appointments, to offer support and another perspective for the psychiatrist, so you might want to do that, too.

By the way, I'm in the UK and receiving treatment from the NHS, too. I know what a postcode lottery it can be and I've had my fair share of inadequate treatment, as well as good or even excellent pdocs. If you're at all unhappy with your treatment I'd recommend requesting a second opinion- it's the one thing I wish I'd done when seeing inadequate pdocs, but unfortunately I was too depressed to take action.

Hope this helps and good luck for your appointment. See you around the forum, hopefully!

Thank you for taking the time to respond and share your experience, plus suggestions for my appointment. I will definitely write everything down and keep a mood diary. I find it hard filling in the mood diary, because I just don't think it gives that much information. Like 'somewhat depressed' - functioning with some effort, able to work. I do function, but not in a major way. I literally just keep to myself, read and do food shopping. But then I feel like there is no point to life and don't know how much more I can take. Obviously this would probably come under 'very depressed', but how can I be function, but not functioning.

Sorry I have just hit a low, haven't been like this for a couple of weeks. I had been feeling so good and it was nice to be full of energy and to feel positive. Now I just feel the complete opposite. One day of this and I just don't want to face life anymore. I don't know how to change things. I was told last week that time is running out (in terms of - I am not getting younger and have never had a career). It didn't bother me at the time. But now I just feel like this is how life will be. There is no future, life is full of loss and pain. It doesn't matter how good of a person you are, how many good things you have done or said. It doesn't stop the rubbish that goes on.

Sorry for the moan. I am trying to see if I can get an appointment with a mental health nurse at my surgery, but they are fully booked for next 2-3 weeks. I don't want to say I need it, but then I don't want to get even lower and struggle. I knew this was coming, but have been trying to keep on a stable level.

I am not sure how long the appointment will be with the psychiatrist, wasn't given a waiting list estimate. So I just have to manage.