I’ve been dealing with mental health issues since childhood, I’m in my mid 20’s now. For the majority of my life I have had the diagnosis of depression and generalized anxiety disorder. A few months ago I had to be in a partial hospitalization program due to cognitive decline in the setting of compounding personal life stressors. At this program they diagnosed me with Major depressive disorder and generalized anxiety disorder, there was some question about OCD and ADHD but no diagnosis was made for either of those. I left the PHP program and now have a psychiatrist and psychologist. My psychologist thinks my depression is not unipolar and I would tend to agree with that. I have a hard time knowing I’m in a hypo manic type state and I feel like those are rare for me, I’m more so a depressive individual. I’ve described feelings to him that he says borders on if not is fully a mixed episode. He has diagnosed me with unspecified bipolar disorder. I’m my life I’ve trialed and failed 20 medications for mental health as well as sleep (I deal with bad insomnia). With my new psychiatrist so far I’ve tried Vraylar, but the akathisia no matter what we did to combat it (propranolol, clonazepam, extended release alprazolam, and taking the drug every other day due to its long half life) was too much so then I tried Auvelity which almost caused a pseudobulbar like effect where I would cry and laugh at the wrong times. Auvelity also messed with my sense of proprioception and left me too spaced out at times without improving my mood. Currently I take Venlafaxine ER 225mg, Lamotrigine 100mg, Propranolol 40mg BID, 1-2mg Clonazepam PRN, Eszopiclone 3mg at night, and Daridorexant 50mg at night.

With all of that background information out of the way, I am having a hard time online finding information and understanding my diagnosis of unspecified bipolar disorder. I find information on Bipolar I and II as well as cyclothymia but I’m wondering does bipolar disorder work on a spectrum? I have tried looking through NCBI articles but I haven’t found much. I guess I just am curious if this is a diagnosis you run into much and if there is any education or (non-medical) advice you could offer me. If Lamotrigine doesn’t work, my psychiatrist is saying intranasal ketamine would be his next recommendation since I have tried so many different medications with no success.