More on psychotic episode when I was 14: not likely manic

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Sarah81,

Thanks. Regarding the mania, note that I am talking about 2 different events. The original post of this thread discusses the psychotic episode I had when I was 14, while the list discusses a recent hospitalization in December. As for the time when I was 14, when I had the grandiose psychotic symptoms you mentioned, it's looking unlikely that it was mania, and you can see why in the original post. I also remember having a normal amount of sleep during that period, though I would go to bed late and get up in the afternoon while feeling groggy, and not really being more energetic than usual.

As for the speech issues, I think they are largely resolved today. They had become resolved by age 6 3/4, when they said my language was very good. I notice I can still have some problems with communication, but they are subtle. Nevertheless, I did have a delay, because I did not put 2 words together until I was 3 or 4 years old.

Re mania, yes I agree that in neither event was evidence for mania, given what you have shown here.

Glad that your speech issues are resolved. There are therapists who will happily help you with any remaining residual issues, although you need to decide whether that is important for you.

I think in colloquial terms it is enough to say you had a speech delay, but it is technically incorrect for the purposes of differential diagnosis.

Basically in a delay the child is speaking exactly like a younger child, and following the same developmental patterns- he is merely behind. A delay is quite different from a disorder, each disordered child seems to follow their own patterns.
From your information it would be technically incorrect to say you had a speech delay. Even though you were 'late to talk', from the pattern of errors made it seems clear that you had a disorder, not a delay - something you were unlikely to 'grow out of' without intervention.

Having said that just about nobody outside the speech therapy profession understands these distinctions, including psychologists!

Another thing I'll have since November is the occasional anger outburst at my parents. Sometimes I'll get mad at them and let 'em have it. Apparently, this has been getting blamed on bipolar disorder. Oh, you, you're just manic again! My dad blames it on bipolar disorder, and so my doctor seems to. However, it's not like I have this anger outburst every day, or even every week, and I'll often go for long periods without having it. When it does happen, it lasts no more than like 15 minutes and I always calm down afterwards.

I guess when I tell my doctor, she assumes it's a recurring thing, like it's happening at least every day. It seems like she doesn't consider the factors that cause it, and instead just raises my dose.

I'm really considering getting a second opinion.

Now, the closest to something bipolar seemed to happen last October, early November, with my first hospitalization in 14 years. Starting around July or August, I started to feel really fatigued and then in October I started to have panic attacks turning into rage attacks on every every few days, where I was mad about not being able to get transgender surgery. I was put on Prozac, which seemed to make them worse. I then attempted suicide by DO on Zyprexa on 11/1, which resulted in my involuntary hospitalization. During my time at the mental hospital, here are the nurse's notes. This was the hospitalization where I was first diagnosed with bipolar disorder.

11/3 (first full day):
Affect: Blunted
Mood: Dpressed
Energy level: not marked
Thought processes: Organized (no HPD)
Behavior: Appropriate

11/4:
Affect: Labile
Mood: Labile
Energy level: Normal
Thought processes: Poor concentration (no HPD)
Behavior: Anxious

11/5:
Affect: Blunted
Mood: Guarded
Energy level: Normal
Thought processes: Organized (no HPD)
Behavior: Anxious

11/6:
Affect: Appropriate
Mood: Guarded
Energy level: Normal
Thought processes: Organized (no HPD)
Behavior: Anxious

11/7:
Affect: Blunted
Mood: Depressed
Energy level: Normal
Thought processes: Organized (no HPD)
Behavior: Withdrawn

11/8:
Affect: Blunted
Mood: Depressed
Energy level: Low
Thought processes: Organized, with voices (non-specific)
Behavior: Appropriate

11/9:
Affect: Appropriate
Mood: Guarded
Energy level: Normal
Thought processes: Organized, with voices (whispers)
Behavior: Appropriate

11/10:
Affect: Appropriate
Mood: Guarded
Energy level: Low
Thought processes: Organized (no HPD)
Behavior: Appropriate, Participating in Treatment

11/11:
Affect: Restricted, Labile
Mood: Labile
Energy level: Normal
Thought processes: Loose Associations, Poor Concentration (no HPD)
Behavior: Pacing, Participating in Treatment

11/12 (last day):
Affect: Appropriate
Mood: Euthymic
Energy level: Normal
Thought processes: Organized (no HPD)
Behavior: Appropriate

This was seems to more support it, with a couple days of labile mood. Nevertheless, it seems pretty equivocal.

I see. And that disorder excludes the Asperger's, right? That's interesting.

One issue I have is communication. Like for example, I'll have a discussion with someone about a process, which I know, and they'll say the process but it sounds like they are saying it has changed, so I will ask for clarification and then proceed to be re-told the whole process, which I know, all over again.

The fact that you had a very specific psychological reason for your outburts don't seem much Bipolar to me.
Do you still have transgender feelings and if yes did you do anything about it?
I'm myself FtM-Transgender (including name change and surgery).

There is a very good book about this topic I also have:
ttp://www.amazon.com/Aspergers-Syndrome ... 50&sr=8-1&

Just a small part of the book:

"So far, few studies have investigated the link between autism, AS and transsexualism or gender identity disorder. Mukkades (2002) cites four empirical studies on gender identity, trabssexualism, and autism. Of these, Abelson (1981) was the first to assess gender identity development in an autistic child. Williams, Allard and Lonnie (1996), Landen and Rasmussen (1997) and Mukkades (2002) investigated transvestitic behaviour and found unusual preoccupations, fantasies, obsessive-compulsive behaviours, socioaffective developmental difficulties, and attachments to "feminine objects". In fact, Landen and Rasmussen (1997) suggested a possible comorbidity between autism and transsexualism. [...]"

A language disorder excluded an Asperger diagnosis, because the resulting communication difficulties often mimic the symptoms of Asperger's.

The thing with face to face communication (or text to text) is that because there are two people involved, it is up to both of those people to ensure the communication runs smoothly. What needs to be said in the communication can depend on what people know about each other prior to the communication. If you are meeting someone for the first time, and you ask for clarification on a process, then they are going to repeat the whole thing, because they assume you don't know any thing about it. On the other hand, if someone knows you well, they will realise that you are only checking up on them. In the case of not knowing someone and what it is in your/their minds, more effort needs to go into the conversation so that the other person doesn't end up going on and on about something you already know. And it needs to be done politely too, even if you are very frustrated with the other person. But conversation is the responsibility of both parties. You can't assume the other person knows what's in your mind.

Was I on track with that advice or did I get it wrong? If I am right then it is a communication error classically made by people with autism and Aspergers. But it can be made by people with a variety of different diagnoses, and by people with normal communication.

Also I have been thinking. You had a severe language disorder, which improved by age 6. The diagnostic criteria are quite clear that this is an exclusion, but it doesn't make sense to me. It seems that a person could have both Aspergers and a language disorder, and that the language disorder disguised the aspergers, and that after the language disorder was treated/recovered a person continued to show signs of Asperger - it doesn't make sense that the initial language disorder could continue to be an exclusion, even though that's what the criteria say.

Back when I was a student, I was introduced to a ten year old boy diagnosed with Asperger's. His communication seemed to be rude compared to the other kids. He was very bright, and knowledgeable, so he was often interrupting with things he knew. He was bursting at the seams with knowledge. When he played pictionary with the other kids, he picked something to draw that the other kids had no knowledge of, and was very frustrated when they couldn't get it. I was told by my supervisor that this boy didn't have a theory of mind, had no understanding that other people had different minds to him. I didn't agree with what she was saying. If he didn't have a theory of mind, then he wouldn't even bother talking to the other kids. (I did meet someone like that later in my career). I think that boy was just a bright kid frustrated by his inferior play mates and inferior teachers. Is a ten year old supposed to possess so much empathy that they can understand how and why they are different from their peers? Just because he was bright did not mean that he was mature. I just give this example to show how communication problems can depend on the situation and how they are interpreted differently depending on perspective.

Thanks Sarah81,

The communication example I mentioned was actually with a co-worker I knew well. I hate those situations because it makes me look like I don't know anything.

Thanks. I've seen studies like those before.

As for transgenderism, I'm currently living full time as a woman (MtF), and I'm on hormones. Nevertheless, I have not had any surgery yet, because I can't afford. My recent 3 hospitalizations have put me deep into debt, so I am unlikely to be able to get it anytime soon. To help my anger, I've diminished my need for surgery. I've been reading about abusive trans women who want to force themselves into women's spaces. I look just about completely male, and will not enter women's spaces. Overall, I've just stopped caring about how I look (which was my default anyway) and don't bother with socialization beyond parents. I simply go to work and then come home and spend most of my time on the computer.

I am now thinking back to when I was angry about not receiving transgender surgery and had the rages back in October. I was having a sense of entitlement, like I was entitled to the surgery. When my entitlement wasn't fulfilled, I had a strong sense of injustice. Ever since I was a child, whenever I experienced a sense of injustice, hot anger would flow through my blood. Naturally, I was going to rage.

Now, however, I have overturned that sense of entitlement. I no longer believe I am entitled to transgender surgery. I don't think it should be provided on the taxpayer's dime. It's something that if you want and you can afford, then wonderful, but if you can't afford it, then tough luck. I've found a sense of peace from adopting this position.