Antidepressants

[jst4shanell]

Can people with BP get away with only taking AD's?  I have read on this bulletin several times, people talking about there meds only being AD's and it makes no sense to me to all.  Is there something I don't know about?

[adel_ezz]

In principle I presume they can't. So either they are not bipolar, i.e. their depression is not bipolar depression rather unipolar depression or that they take them until a little relieved then they start again on their mood stabilizers.

Most probably they are unaware of the consequences. They tried it once and it worked for a while.

The problem with this disease is that the brain system is not stable. Even if it's stable we call it in engineering metastable position. They taught us in college that there are 3 types of stability/instability. Stable means if a trigger occurs, the system returns to its original poisition, like a ball oscillating inside a cup it returns to the lowest position even if it is moved a little. Wheras metastable like a ball on a horizontal table if it moves although its displacement is horizontal it moves to ANOTHER state without falling. Then the unstable where most of us are is when the ball is on the top of a mountain and any small displacement will make it slide away. Antidepressants without a mood stabilizer will do the latter. So an MS at least makes it metastable.

In my view there is nothing called bipolar, it's like a device where a fuse was burned (a type of sacrificial overcurrent protection device). NOT that we take mood stabilizers because we are bipolars. BUT once a mania occurred something inside our brain is corrupted like a fuse. SO they have to give us mood stabilizers in order to save the brain from a mania reoccurring. Those category of people are called bipolars because they need an MS.

I sent once this view here saying that BP is a kind of physical or neurological disease like epilepsy but there were objections because the pts are kept in the psychiatric ward meaning it's a pschy disease. In my view, pschy because pts show at the time of mania psychotic features, because due to the missing fuse they get irrational that's all.

Only an opinion

[rBoulet]

Most (if not all) people taking antidepressants who are bipolar or at risk of having bipolar will end up manic. This is why you're supposed to take a mood stabilizer with it. It's like your mood is a car, and it's parked on a hill. The antidepressants take away the brakes and you start rolling, only instead of stopping at a "normal" or "stable" mood you just keep rolling past it into mania. Mood stabilizers are like adding brakes, so that you can stop at that desired normal mood.

To: jst4shanell
I kind of agree with what you're saying but I kind of don't. I do believe that it's like epilepsy in terms of it being sort of a neurological disease, but so is schizophrenia and almost anyone would interpret that as a psychological issue. It sort of is though, as a lot of the time a trigger could cause your condition to show itself, and it often comes with other psychological conditions (like OCD or borderline personality).
But shooting down your theory just because people with bipolar can have psychotic symptoms is kind of stupid. Some people with epilepsy will experience psychotic symptoms during seizures (my girlfriend used to see and hear a man when she has seizures).
On the other hand I have to disagree with the fuse thing. A lot of people, me included, experience on and off depression a long time before their first episode of mania, which is part of the illness. The illness was always there, it was just never noticed until we had our first manic episode in front of a doctor. Also if you think about the fuse theory it would point to the idea that bipolar could be caused by medication. A side effect of antidepressants is mania (some psychiatrists argue this only happens in people who were bipolar in the first place, some will argue that it can happen to anyone), the same goes for ECT. In your fuse theory you'd be suggesting that anyone who experiences this side effect is in fact bipolar and will need medication for the rest of their lives. It's arguable, but I personally disagree with it.

Sorry if I took it a little too seriously, I'm kind of in that mood where I need to type and type and type and analyze everything.

[corlenbelspar]

From what I've read people with Bipolar Disorder run the risk of going manic if they only take an antidepressant alone.

[jst4shanell]

I know from personal experience (and this has happened more than once), if I take any sort of AD, I instantly become manic.  I am susceptible to psychosis as well so it's not a good situation.  That's why I asked the question in the first place.  It doesn't matter how depressed I am, I will instantaneously become manic.  I know everyone is different, but the definition of Bipolar is opposite extremes.  Not depressed.  I don't want to sound harsh here but I feel BP is the new uninvolved diagnoses these days, like ADD and ADHD was back in the 90's.  So when I here people are only take AD's for BP, it worries me and makes me wonder a little.

[adel_ezz]

I enjoyed your analysis though you confused between our both names and the post related to the fuse is mine.

Usually a person goes to the doctor at the time of depression and this is in the majority of the cases. Only a few having hypomania realize there is something wrong going on and even for those some do not complain from hypomania. I knew someone, whom I corresponded with, who tried his best to extend this period as much as he could. So, in many cases, a person having a manic episode, would welcome the mania, break down the whole wall, never considers taking meds, embraces the episode and hang on for the ride. People crave mania, it’s like an addiction to street drugs.

Now when a person goes to a doctor during depression, the doctor doesn't usually question the possibility that he can switch to mania and he considers giving him an antidepressant. Now for some it goes well and for others it drives them manic like in my case; for I never had a hypomanic state on my own except with an antidepressant. Even for those, they call them bipolar because they need a mood stabilizer, why, because the brain got affected, it's like an insulator which has become a conductor. So even if they showed affective disorder traits, now they have become CLINICALLY bipolar (Some pdocs refer to this as Bipolar III. Not only AD's but cortisone can also cause mood changes in people who have diagnosed bipolar). To explain further, the person will have had minor bipolar symptoms going back years, as many with late-onset bipolar do. Antidepressants or other meds initiate a permanent change in symptoms, causing them to become more extreme and cross the threshold into diagnosable - or clinical - bipolar disorder. The doctor's duty is to maintain their brain healthy without experiencing more mania, and that is done by a mood stabilizer.

Considering the permanence of the disease, the book will also tell you that it's a lifelong disease and doesn't disappear. We have for example the case of the Australian nice chap John (monkeyc) who stayed 15 years away from mania and suddenly it erupted again. So it's advisable to keep the medications forever. Patients will tell you if at any time you stop them then you will need higher doses when you restart on them again and this happened to me personally.

As to any trigger can make the illness shows up, this can happen of course but not in most of the cases. But as soon as the mania shows up the book says chances are 100% that it will reoccur again and again and nothing can be done now except to save the brain by an MS. Triggers now become more effective than before and become more functional. i.e. the brain becomes more vulnerable because its status has now changed to clinical bipolarity.


To:jst4shanell
>>I feel BP is the new uninvolved diagnoses these days, like ADD and ADHD was back in the 90's

I agree totally with you. It's the "disorder of choice" these days just because they don't know

[corlenbelspar]

People might only be taking an antidepressant because they usually only go to the doctor when they're depressed but then I'd think they'd be diagnosed as depressed instead.

[CrzyBeautiful1]

Like corlenbelspar said, many ppl only seek help when they are down and often get misdiagnosed with depression. This is was has happened to me for the past 11 yrs. I have been on just about every AD and have been on extremely hight doses of them, and just now finally got the proper diagnosis. I just started my new meds so I'm hoping for the best. But from what I have heard and read, someone with bipolar needs and AD and a MS both. An AD alone can cause manic episodes to be much worse.