More Than Just a Low Mood
Erez, a junior in college, had always been known for his energy and ambition. He juggled a double major, led a student organization, and rarely missed a deadline. But during the spring semester, something changed.
He began sleeping through classes, withdrawing from friends, and losing interest in everything he once enjoyed. "I feel like I'm underwater," he told the campus therapist. "I can't focus. I don't care about anything anymore."
After an initial screening, Erez was diagnosed with major depressive disorder. He started therapy and was prescribed an antidepressant. For a few weeks, things improved. But then Erez's mood shifted dramatically. He stayed up all night working on a new business idea, spent hundreds of dollars on equipment, and spoke rapidly about plans to drop out and launch a startup.
His therapist grew concerned. "This might be more than depression," she remarked. Erez's symptoms started to include an elevated mood, impulsivity, and grandiosity: hallmarks of a manic or hypomanic episode.
Erez underwent a more comprehensive evaluation, and his diagnosis was revised to bipolar II disorder. The therapist explained that mood disorders can evolve over time, and initial symptoms may not reveal the full picture. "It's not uncommon for someone to be treated for depression before signs of mania emerge," she said.
Erez felt confused. "So, I wasn't misdiagnosed?"
"Not exactly," she replied. "Your symptoms changed. That's why ongoing assessment is so important."
With a new treatment plan, including mood stabilizers and psychoeducation, Erez began to understand his condition more fully. He learned to track his mood shifts, recognize early warning signs, and build a support system.
