Sounds pretty typically bipolar to me. You could have bipolar II, which doesn’t have very high manias, but the irritability and anger and rapid change sound like rapid cycling to me. The carelessness is also typical of mania. Do you buy stuff you don’t need? Spend way too much?
Is your suicidalness because the pain is too much, or does it seem more like a kind of random idea? You can get suicidal during the down side of a mania, and it’s different from the kind of suicidalness you might have at the depth of a depression. During a depression, it seems like things are horrible and worse than any feeling you have ever felt before, and what’s worse, is that you feel like it will never end. The only way out is death.
A manic suicidality is more sudden. I’ve never experienced it because I don’t get that kind of mania. But it is like one of those brilliant ideas that suddenly appears and you might leap on it and try it before you can have a second thought. That’s because mania—the downside of a mania—can be very painful as well. You can be paranoid. Maybe hear voices. Feel like everyone is out to get you. Feel like disaster is about to occur.
Worse, you’re not really there any more. Whatever is going on in your mind is keeping your regular self away so completely you may not be aware of anything that is going on. Some people don’t even remember what happened later. Or if they do, it is from such a distance it’s as if it happened to someone else. No control. Very scary. You feel like you aren’t yourself and get so scared that you will never be yourself, and that can make you consider suicide, too. This does not sound like what you’ve felt, though. You’re concerned about family, and that is typical of depression suicidal ideation. It is what keeps most people from doing it. So it’s a good thing.
Now, as far as diagnoses are concerned— you can go to five different shrinks and get five different diagnoses. So what you think is very important. One shrink might tell you you have borderline personality disorder, and the other will say bipolar, the next depression, and another might say schizo-affective.
What your diagnosis is isn’t as important as how you treat it. The major reason why it is important to try to distinguish between depression and bipolar is because if it is bipolar and you treat depression, you can kick off a manic episode of epic proportions. This can be very bad.
You sound like you need a mood stabilizer, which means you’d probably be called bipolar. When you see the shrink, make sure you bring up all your concerns about your moods and investigate carefully if you need a mood stabilizer. Tell him or her you don’t think it is just depression, and you don’t want to take an anti-depressant without a mood stabilizer.
You are asking this question because you think you are bipolar, and if you think that, you’ve probably been researching it. You know. Trust what you know. You know better than the shrink does.
Lithium is considered the “gold standard” as far as mood stabilizers go, but younger shrinks don’t like it as much. It does have long term kidney side effects, but I’m told that on today’s therapeutic doses, those side effects are much less likely. I hope so. I’m on it. That’s all I’m on, these days. One or two more years I think, and if I’m still stable, I’m going to try going off.
There are hundreds of combinations of meds. Many anti-depressants of at least three different kinds. Six or so mood stabilizers I know of. Anti-thises and thatses. You’ll probably have to try several different meds to get to where you want to be. That’s normal. Don’t get discouraged (hah!) Seriously, the best advice my shrink gave me was to hold off on making any major decision for 3 months. This bought him time to mess with my meds. It took two years to get me within shouting distance of where I wanted to be, and he had to make me give the 3 month promise a couple of times, but it makes sense.
You’re depressed. It’s chemical. It will end if and when the meds are right. It’s not you. The pain does not last forever. You can stick through it. Death is not the only way to fix this. I have seen enough people come through bipolar and depression to feel very confident when I tell you that you will get better.
Oh. One last piece of advice. Find a good bipolar and depression group. That is a major component in getting better. Very, very helpful. It is amazing being in a room full of smart people who share all the symptoms. My group is getting very interesting. It happened by accident, but I think it is becoming a kind of story telling competition. There is someone else there who is also very talented—makes his living as a writer, actually. We’re the “heavy hitters” in the group, according to our leader. We usually go last. There’s a kind of energy…. no. I’m getting distracted. This is for another question. Sorry. But I think group is very helpful. Also individual therapy. And meds. The therapeutic triumvirate. And it doesn’t matter whether it’s bipolar or not—these things help. Group is free, often.