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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by bark2323 on March 7, 2004, at 12:41:19
Ok, I have some questions. First of all, I want to hear any opinions on whether Im actually BP2 or not. That has been my diagnosis by a # of docs, including the one Im seeing now, which I have agreed with in the past, but now I am not sure. The main reason Im not sure is because Ive been rapid cycling for about the past month, mainly hypomania, so my doc wants to try to switch medicines so I have gone off my mood stabilizer (trileptal) to see if it is actually useful at all anymore before making a med change. But I have been normal throughout this time off (although to be fair I was entering 'normal' a few days before I started to go off). My anger may be higher than normal, but thats about it. Shouldnt I be cycling more now without it, assuming this is not just the natural next phase I would be in? I am also on 4mg klonopin and 100mg seroquel (and provilgil, but thats irrelevant to what Im getting at), which I know are sometimes used as adjuncts, but they have only ever been useful for anxiety and sleep, respectively, so I dont think they would all of the sudden become stabilizing now. I know I have recurrent depressions. My hypomanias, if thats what they are, consist of high energy, uninhibited/innapropriate behavior and socializing (when not in this state, I am if anything socially phobic), sometimes anger, constant need to be productive and incredible speed in doing so, spending, inability to relax (or even want to), feeling mildly euphoric, and distractability. I know this descriptions is one of a hypomanic person, but I want another explanation, and I cant find one. I guess I know the diagnosis fits me, but right now I cant seem to actually stick to that. I also have a lot of other supposedly bipolar-type traits such as in the way I respnd to antidepressants, sleeping patterns, etc. I guesss what I need is someone to say something (preferably from personal experience, Ive pretty much read every book, abstract, article (when its free), etc) that can help me to either rule every other possibility out or else give me reasons to question the diagnosis. It would also be great if I could just hear personal stories from people who have been through this thought process and what they have found out after going through it. And any alternative explanations, no matter how outlandish are also welcome. I know you are probably wondering why I dont see the obvious answer in what I have typed, and in a way I do see it, but in the back of my mind I just dont believe it. Maybe this is because I have not been truly depressed in over a year and I like the flip-side which has dominated the past month or two, although sometime irritability can be out of control and of course that is not fun. I know while 'up' insight is impaired, but could my insight be impaired while euthymic simply because I have dropped the mood stabilizer? I guess what I need is something to just accept this is part of me (although up until now I have accepted it for a # of years) or not, since my doc just pretty much does whatever I say. Its not that hes bad, he just trusts me and is open to what I have to say, but maybe a bit too much. I am sorry for the length and confusion in this, but I am confused/conflicted myself right now. I know (well I assume) yall are not doctors, so dont worry about that sort of thing; I can hear or read what a adr has to say anytime. Thanks to anyone who has actually taken the time to read this whole thing, and to those who respond.
matt
Posted by bark2323 on March 7, 2004, at 13:04:39
In reply to bipolar or not (long), posted by bark2323 on March 7, 2004, at 12:41:19
Just went out to smoke and remembered a few more things. When up, I also can be pretty paranoid, think I see 'signs', and other minor cognitive things like that. And since Ive been off the trileptal (which by the way has been about a week since I finished tapering) I have had a few days of some hyperactive/eccentric behavior and have felt unusually good during those times. But those days have been just that, one day of it. I have felt a sort of burned out feeling a lot lately though. And when I was supposedly rapid cycling the depression that followed each hypomanic period was minor and only lasted like 2 or 3 days, which is less than half the time of the hypomanias, so that is part of the reason the "depression always follows" argument (which I do believe is true), isnt enough for me right now. I would go into past history (meds and otherwise) but every sentence I type will be just one more someone will decide is too much to respond to and I really need help with this so I cant afford that unless someone asks. Ok I will stop.
thanks,
matt
Posted by rainyday on March 7, 2004, at 13:18:00
In reply to bipolar or not (long), posted by bark2323 on March 7, 2004, at 12:41:19
I am BP2 and have GAD. So far I think that BP2 is a pretty broad label - we have to be put *somewhere* that mainly assists in a medication selection to help in controling symptoms. I would think that for any of us to be text-book BP2 would be well nigh impossible. That is what makes us so wonderfully human.
My personal experience is that the hypomania is so quick in cycling that my p-doc does not want to prescribe a mood stablizer. Besides becoming irritable, I am also taller, smarter, and more slender when manic. How very fab! I also believe very strongly in the cyclic nature of this disease. For example (and this is pretty far out) I believe that the phase of the moon affects my cycling.
My meds are effexor xr, buspar, and xanax. Hope this helps.
Posted by bark2323 on March 7, 2004, at 13:55:24
In reply to Re: bipolar or not (long) » bark2323, posted by rainyday on March 7, 2004, at 13:18:00
thanks for responding, and yes it does help. In particular, it reminds me to not get bogged down in the DSM, labels, etc. I do that a lot, obviously. As for the mood stabilizer thing, I like your docs opinion, albeit mainly because I do not want to be on one. Trileptal did help with depression though and it didnt dull me. Obviously depression is what I worry about since the up side is minor (compared to true mania and its consequences)and not particularly bad (well actually for most of it its particularly good). Its funny you mention effexor since that is the only antidepressant I ever responded to well withought it negatively impacting me in the long run (although it did stop working like other ones did). I really dont want to take antidepressants though because they do seem to breed depression after they help, at least for me. That is a moot point right now though, since I feel fine. I think the key for a lot of it is just getting the right amount of sleep, and if something bad does happen, zyprexa is a magic bullet that workes in like 3 days for me. Hehe sorry I sound like Im giving you advice. Just trying to figure out what Im thinking (and if I get what youre saying), and then maybe see what is right/wrong with my thoughts. Thanks for responding so fast, not to mention the reminder that whatever my little dsm code may be, thats not actually me.
who can make a simple thank you a mini-essay?
matt
Posted by B2chica on March 7, 2004, at 15:04:26
In reply to Re: bipolar or not (long), posted by bark2323 on March 7, 2004, at 13:55:24
wow Matt...when i read your first post i had to make sure i didn't write it. I was Dx with BP2 last fall and seconded just a few weeks ago by pdoc. Since then i've told a few people, and those that i thought would be my best support are sure that it's all in my head. This has messed with me a little and even though this Dx explains A LOT about my behavior since i was 14 there is a part of me that just wants to be SURE. i've written down several questions that are making me wonder and i'm going to ask my pdoc on wednesday.
I too have primarily hypomanic episodes these can last a few days or a few months, i've only had 1 major depressive episode (did effect work in bad way) but i had a lot in my life at time...maybe just stress?? However, i'm feeling the depression back since i've started these new drugs...part of me wonders is it the drugs that could have brought this on?
I also am reverse i go from D-M-I rather than mania first.
-I guess my advice to you would be similar to what i plan to do this week. Ask you doc these questions. tell him why you're not sure make him/her explain exactly why they've labeled you Bp2.
if you were better on effexor why did you stop?
i tried it first and it made me cycle Real Fast and extreme! i still don't remember much of November. Currently on strattera (ADHD)and Symbyax.
B2c.
Posted by bark2323 on March 7, 2004, at 16:26:57
In reply to Re: bipolar or not (long) » bark2323, posted by B2chica on March 7, 2004, at 15:04:26
Its weird how it can be both comforting and scary to be able to relate to someone in this arena.
I am sorry you have found those around you responding the way they are, but Im sure you know they just probably dont know how to rrespond to a thing like this (or just dont want to believe theyre friend is hurting in a way they cant help), and though obviously I have no way of knowing, it has been my experience that this "all in your head" stuff people say fades as they understand more. Although no one has said that to me recently (theyve known for a long time), I have been thinking it myself and god it all becomes so confusing! How can you ever know for sure? How do you know if youre treatment is helping or hurting you? How do you know where you end and 'it' begins? like you, I see myself/my life in this disorder and everything Ive read about it, but here I am again questioning it, looking for one thing to tell me something like every matt perry (my name) has/does not have bipolar disorder.
Anyways, for me I started out at the age of 13/14 (hehe more coincidances) with my first depression, also the worst, and up until like the past year or 2 that was my main problem. I'm 22 now by the way. I also switched around that time from D-M-I to M-D-I. The depressive stuff seems to be fading, both in time and intensity, while hypomania is becoming more and more prominent. This would be a great situation if not for the irritability, suspiciousness/paranoia, and that unable-to-stop feeling that come in at the end. And of course the fact that I sometimes do things I really regret. But now I feel fine and it is tempting to believe "it was all a fluke" regardless of how foolish I know that sounds. I agree with you about stress, except it seems to actually fuel me. There is plenty of evidence that BP is biological, but environmental factors obviously affect us biologically. It is definately possible meds can worsen depression, especially if you are not frequently depressed and it coincides with some prescription, although I think its pretty rare for the population as a whole for the drugs you list at the bottom. I stopped effexor when it stopped working after I had got up to 450mg and tried various augmentation strategies. I then switched dr.s and the new one put me on trileptal as a mood stabilzer and it turned out to be good against depression. I will bring questions to my doc (also on wed). I just worry because the last time I saw him I remember him saying your bipolarity is really coming through, coupled with the fact I am not on a m.s. while waiting to start a new one, will simply look like "lack of insight". And maybe it is. Do you get that feeling like theres 2 of you, one who looks at the evidence and decides, and one that simply decides youre fine and wont stop looking at the evidence until it sees what it wants?
matt
Posted by B2chica on March 7, 2004, at 17:12:27
In reply to Re: bipolar or not (long), posted by bark2323 on March 7, 2004, at 16:26:57
ok matt, you're freaking me out a bit. i swear you are taking words from my mouth.
>How do you know if your treatment is helping or >hurting you?
this is Exactly what i've been asking myself and plan to ask pdoc.
>How do you know where you end and 'it' begins?
i've been struggling with this too but i did find a few nice quotes that have helped me decide:
"Bipolar disorder is living with a mind you can't trust. What a clinician calls 'moodswings' are, to us, changes in who we are. They occur without reason or notice and are completely outside our control."
My biggest fear is to have my thoughts and feelings invalidated because of a label. you know "oh she's just being manic don't listen to what she says."etc...etc.. (second biggest fear is being hospitalized...i've had nightmares for years about this- still not sure if i can stand to see gothica...
I agree with the hypo, most descriptions make it sound pleasureable, it would be if it didn't include a rage that would turn ghandi into ted bundy. I feel some paranoia but it's mostly that i think everyone is talking about me behind my back, i know it's not real so i try not to act on it. Also the hypo can get to the point that i can't complete anything at work (start lots though), and then the confusion sets in cuz stuff goes so fast, then frustration cuz everyone is so freaking Slow!>But now I feel fine and it is tempting to believe >"it was all a fluke" regardless of how foolish I >know that sounds.
Oh my God, this is Exactly how i feel!!! My words Exactly...a fluke...>I will bring questions to my doc (also on wed)
are you kidding me???i've always felt there are two of me, i analyze and overanalyze Everything. I can be quite "clinical" about things mostly cuz the otherside of me lives on emotion, i'm either too empathic which brings on depression so i shut that side off and become clinical to understand (almost like it was someone else that i'm advocating for).
And do agree with the "all in head" issue. My husband though still denies there's anything wrong, has been a little more sensitive and watching me lately-i've been pretty down (this morning really sucked, constant S.ideation) but i think he just needs time.-BTW did i mention i'm ADHD/Bp2 -hence the name;^) incase i already did tell you...that's the adhd talking...CRS!
B2c.
Posted by alathea on March 7, 2004, at 23:14:49
In reply to Re: bipolar or not (long) » bark2323, posted by B2chica on March 7, 2004, at 17:12:27
>I agree with the hypo, most descriptions make it sound pleasureable, it would be if it didn't include a rage that would turn ghandi into ted bundy. I feel some paranoia but it's mostly that i think everyone is talking about me behind my back, i know it's not real so i try not to act on it. Also the hypo can get to the point that i can't complete anything at work (start lots though), and then the confusion sets in cuz stuff goes so fast, then frustration cuz everyone is so freaking Slow!
This is weird. I came to this board because my pdoc has been trying to convince me for EIGHT years that I'm BP, and I keep resisting it, so I wanted to see what other people supposedly 'like me' are like, and if they're like you guys, then I'm afraid he's right. Not that I haven't already come to some level of acceptance, I just always come back around and decide it's all in my head again. Most recently I found myself up against the harsh reality of the fact that I can't finish school or keep my son or my marriage if I go off my meds (I went off my meds just to find out, it wasn't pretty).
One of the biggest reasons I didn't believe my Dx was because of the furious manic thing--I had some idea that mania was supposed to be all euphoric and crap--I just get raging blazing furious and hate everything and lose control and get paranoid etc etc etc.....
Posted by bark2323 on March 8, 2004, at 13:25:54
In reply to Re: bipolar or not (long) » bark2323, posted by B2chica on March 7, 2004, at 17:12:27
This is becoming very intriguing. Luckily I'm not in my psychic/'everything is a sign!' type mode too heavily or else these coincidances would be too much.
Anyways, I really liked that quote. And I agree with the label thing, in fact sometimes I end up doing it to myself. Cant really comment on hospitalization, as Ive only experienced it twice, but it wasnt really scary to me (although definitely not my choice of places to be).
Now as for overanalyzing, that is yet something else I can identify with. Especially when it comes to someone's response to something I said/did. Like right now Im thinking that youre thinking Im lying about all these similarities, and now I am thinking that you are thinking I said that to specifically make you think I am not, which means next you will think I knew that would happen so I did it just to throw you off, etc. I once had a friend like this and there were times when we literally couldnt talk to each other since we could not stop reading into even the most simple statements we made, especially since we knew we were both of this mindset. We thought we knew the last thing in the other person's mind would be from the very beginning of a conversation. We ended up having to twist what we would naturally say into something else so the other person would analyze that statement into what we really meant. We had to take a break from the friendship in order to make this stop, even though we knew we were doing it. Dont know why I talked so much about that, just a strange thing. Sorry if it doesnt make any sense, and I know it diverged from the type of over-analyzing you mention, but if you know what I mean, you know how annoying it can be. One half of yourself is always hopelessly watching the other half.
I am sorry you are feeling down lately. I know that is such a stock response, but I really do hope it gets better soon. Talking on here is helping me to feel some closeness, and though I am not depressed right now, hopefully you feel that too, so I guess my point is keep talking to someone, anyone! I feel like Ive really not said what I started out to and missed responding to something key, but my mind is kind of jumpy today, so sorry about that.
matt
PS- I gotta ask, what time is your appt wed? Mine 3:15 or 3:30.
Posted by bark2323 on March 8, 2004, at 14:02:30
In reply to Re: bipolar or not (long), posted by alathea on March 7, 2004, at 23:14:49
This is really becoming hysterical. We all have this secret wish to come on this board and find someone who will say "no way, youre fine" (despite the fact we know we are grasping at straws and we realize we do this questioning-acceptance-questioning over and over). Well maybe I should change "we" to "me". But I think this is better, even if it is not want we/I want.
Im having similar problems with the meds/BP/school thing right now too. Sometimes my performance is enhanced in the early parts of the up-swing, but the rest of the time it is not, to say the least. But the next step is to try lithium again, and I cant risk cognitive impairment, especially if it is ineffective and therefore that is the sole thing I get from it. Plus I dont really know why he (the doc) thinks that will work, considering that it is supposedly pretty bad for rapid cycling, although he says he has had some good results with it despite of what is said in the literature. Well, thats about it for now. Thanks for responding.
matt
Posted by B2chica on March 8, 2004, at 14:20:31
In reply to Re: bipolar or not (long) » B2chica, posted by bark2323 on March 8, 2004, at 13:25:54
hey matt, my head is spinning a little from your post but the scary thing is i understood completely. i used to have a friend like that, we too ended up parting ways but for other reasons.
-and actually there was a point were i was analyizing what you were saying and wondered is he just saying this but then i stopped and said to myself to quit looking for something that's not there! So you weren't entirely off.My appt. at 9:30 wed. morning.
did you mention that you're in school? how's that going. I'm working full time and taking two classes. some days i can't even read a sentence and otherdays i can write several papers.
i am feeling better today, i'm glad cuz i have two papers to write tonight. It's weird really. Sat night and Sunday were absolutely horrible, all i could think (obsess) about were different ways to knock myself off and now i feel just fine. I almost feel like i was lying about how i felt cuz it changed so quickly and feel perfectly normal now...guess i'm still getting used to this thing.
I'm seriously considering getting a small tattoo on my wrist cuz...well you can guess. What do you think? is girls and tattoo bad combo?
BTW i live in the midwest.
Heads up, my guess is this post will get redirected to social anytime now.
B2c.
Posted by Dr. Bob on March 8, 2004, at 20:29:27
In reply to Re: bipolar or not (long) » bark2323, posted by B2chica on March 8, 2004, at 14:20:31
> Heads up, my guess is this post will get redirected to social anytime now.
Right, here's a link:
http://www.dr-bob.org/babble/social/20040305/msgs/322198.html
Thanks,
Bob
This is the end of the thread.
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