Bipolar Disorder Community
menstrual psychosis or what?
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menstrual psychosis or what?

Hi, I am 38 and recently had something happen to me unlike anything before.  I was completely delusional, yet functional for a couple of weeks.  I hallucinated several voices and believed what they said... all good, like I was going to save the planet.  I am a wife and mother and it is freaking me out.  It culminated into a panic attack which I was hospitalized for for 1 night.  I am seeing a pyschiatrist who isn't sure what it was.  I was placed on birth control because it coincided with my period.  I am also taking an antianxiety/antidepressant. I have a history of pretty bad PMS and depression twice in my life related to life events.  I have never felt manic before the episode and I remember everything and even questioned the validity of it a few times during the delusions.  Any advice or thoughts would be greatly appreciated.
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I wouldn't worry too much about what caused it. I would focus on the treatment and if that makes things better. Sometimes there just isn't a category an experience neatly fits into.
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I find an increase in paranoid / delusional thinking and other psychotic/ anxiety symptoms too just before a period. The GP wanted to treat it with a contraceptive injection, but I refused and am now trying to control it with alternative methods, although I do take an antipsychotic for bipolar anyway which must help a bit. My CPN said that she has come accross several examples where this has happened to people, so you're not alone. I track my monthly cycle and prepare for the week before when things get wobbly again and try and remind myself that it will pass, very difficult though as I get irritable and speedy and impatient and difficult to reason with!  
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Avatar_n_tn
A few thoughts:

1st, having an initial psychotic episode at 38 is unusual, so it is probably not something squarely in the "psychotic family" of conditions. It is possible (although unlikely) to have an initial manic episode after having previous depressive episodes.  

There is information that link paranoid/delusional thinking with menstruation, especially with a history of intense PMS (it is sometimes referred to as premenstrual dysphoric disorder, PMDD). It is also possible for people to develop psychotic-like symptoms amidst a severe depressive episode ("psychotic depression"), as a reaction to medication, and substance abuse. Information useful for diagnosis include duration of symptoms and what was going on in your life prior to this experience (stressors, mood etc...). In addition to your work with the psychiatrist, you might find it helpful to engage in weekly counseling (assuming you're not doing that with your psychiatrist) to help with general issues of anxiety and mood management.

Good Luck.
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I can really relate to this post. The doctors have told me I have a hormonal imbalence and I get unstable before my cycles sometimes.
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Avatar_n_tn
Be careful of menstrual psychosis as a diagnosis the reason it is untreatable bipolar is because it is most likely catamenial epilepsy. It's treatable with natuaral progesterone.

Temporal lobe epilepsy is well known and between seizures mood and emotional symptoms are quite common.

See:

A Case of Recurrent Premenstrual Psychosis:
http://ajp.psychiatryonline.org/cgi/reprint/148/1/147a

Psychoneuroendocrine Aspects of Temporolimbic Epilepsy:
http://psy.psychiatryonline.org/cgi/content/full/40/2/109

I went strange every period for 4 years for 13 days at a time. I ended up finding progesterone and went on to have a hysterectomy it did not fix it but stopped it from clustering into a unbearable state.  I have a job now I used to squat in the corner for 13 days at a time  Eight years later my  daughter started going psychotic every menstrual cycle for 16 days at a time. She is now on natural progesterone only. She was diagnosed at 17 with bipolar without any investigations. She has been self treating for 2 years with natural progesterone, however still has breakthrough episodes.( Not psychosis anymore just momentary vagueness now and then) Doctors think its a joke because she has never had any classic signs of seizures. If you read the above mentioned websites it explains why.

If your problems are not cyclic play it safe and stay on your medications, but maybe experiment with natural progesterone.

The pill is unlikely to help because natural progesterone is metabolized to allopregnanolone which has very potent anticonvulsant action.

See: Catamenial epilepsy:
http://professionals.epilepsy.com/page/catamenial_patterns.html

Like any illness it has a scale ranging from mild to extreme.PMS --- Psychosis. If it is constantly linked to your menstrual cycle it should be investigated deeper. Do not rely on doctors to help you.

Lots of luck,

Kay C.
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Avatar_f_tn
Hi Diggy,

You are not alone. I too suffer from similar symptoms right before menustration and always thought it was menstrual pyschosis. Kay. C. above posted some terrific articles.

I would also highly recommend reading about gluten and the affects it has on the brain. It is linked to bipolar, depression, schizophrenia and more. After my gluten intolerant diagnosis, my nutritionist had me go grain free not gluten free. A Paleo Diet has helped tremendously. I did not have luck with progesterone cream but everyone reacts differently to hormones.

http://www.glutenfreesociety.org/gluten-free-society-blog/how-gluten-damages-the-brain-with-dr-parker/

Kristi

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Avatar_f_tn
Did you change your depression meds recently, because they may not be right for you?

Just a thought, your Doctor will help you I am sure.
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just found this site http://menstrualpsychosispmdd.weebly.com/       good reading
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Avatar_m_tn
Hello
Does anyone else have a bicornuate uterus or other uterine defects to go with this? 3 women in my family, 2 responding well to natural progesterone other had a hysterectomy. It took a while to get the dosage right but life is seamless now. I mistimed it a few times, I think I overdosed a few times,  but we both got there in the end,
I am using natpro progesterone cream.
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