Mood Disorders Expert Forum
Have a dx but now tons of questions?
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Welcome to the Mood Disorders Forum. Questions in this forum are being answered by Peter Forster, MD and topics covered are anxiety, bipolar, depression, panic disorder, post traumatic stress disorder and stress.

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Have a dx but now tons of questions?

Can anyone tell me what's the difference between being dx with Major mood disorder and depression? I finally went to get help and the dr dx me with this, she also said while depression can go away major mood disorders don't.

I'm confused, I really thought this was depression or PTSD.  What should I ask to get an easy explanation about this? any info on what this means is greatly appreciated and I'll ask questions when I go back next week.  I don't have PTSD so maybe what she's referring to is BiPolar?

I know I've had depression problems my entire life; esp mood swings that worsened in the past 2 years after heart surgery, but I just thought it was depression related. I've always been under alot of stress, suffered bouts of depression, anxiety & Ocd episodes.

When I look up major mood disorder, I get a ton of things like depression, manic/depressive, bi polar etc with no real information on what this means.   I will ask my dr when I go back and discuss more but I wanted to do some reading before I go back.  Any recommended reading I can do?

I was surprised though she said depression can go away but major mood disorders never go away, you just have episodes throughout your life that are major then as you age they tend to be more frequent and closer together.
Also, has anyone been on LAMICTAL?
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I just read this from Dr. Forster "Lamictal induces the metabolism of estrogen" can you explain what this means?

I have severe endometriosis and adenomyosis; no chance of pregnancy - hubby had a vasectomy 8 years ago.  Could Lamictal cause my cycles to be farther apart and lighter? If so, I would be so happy =)
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Last things first, Lamictal can lower blood levels of estrogen. This probably would not make your cycles be further apart, it could make them lighter.

"Major mood disorder" is not a diagnostic category in the psychiatric diagnosis manual. My guess would be that your doctor is referring to one of two types of depression that are "recurrent" - meaning they happen over and over without treatment - recurrent unipolar depression and bipolar depression.

Of the two types, several things in your post make me think that she may be talking about bipolar depression. The best book on this subject that I know of is "Why am I still depressed?" which is a book about depressions in the "bipolar spectrum" that, despite being written by a psychiatrist, is actually a pretty good and pretty easy read.
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I don't understand what your doctor is trying to say but I'm hazarding a guess that she means that depression may be treated but that bipolar is managed.

A mood disorder is either depression or bipolar (or some subgroup of these).

I would ask specifically about your diagnosis and ask to have that explained.

Depression is based on low mood whereas bipolar (or manic depression) is based on periods of both high and low moods (a manic phase and a depressed phase).

In the past I have found the dsm-iv helpful for clarifying diagnostic criteria for each disorder.  You could try Googling dsm-iv for bipolar and dsm-iv for depression.

I have never been on lamictal.  The doctor will be better able to explain this.
The information I have supplied on depression and bipolar is very, very basic.  Check out the dsm-iv.

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Thank you Dr. Forster, I was hoping that's what it meant from reading some; which would be very helpful in my case.

I will ask specific questions when I go back; since she said I didn't have depression maybe she meant bi polar because of my mood swings, which Jaquta explains what I've been going through - I'm either jumping over the moon or I'm ready to lay in bed until I die. I'll read up on both and talk to my dr.

Since a heart procedure 2 years ago; my symptoms worsened dramatically - I used to be able to mange what I felt with just self 'pep' talks, but after I've noticed the more time that goes by the worse it's getting and no 'happy' spells in between just a feeling of I wish my body would shut down so I don't have to go through this and be in so much pain all the time...does that make sense?

Medically I've gone through more than my share since then and going through more now; extreme pain daily and I feel trapped because I can't drive, can't really be outside because here in FL it's heat all year - it makes me faint; much more fainting (life long issues) and my brain will be more damaged (mild now)...I fainted about 6 weeks ago and severely sprained my neck...I've had a pacemaker/defibrillator implanted and meds for syncope for 2 years and nothing has helped.

thanks for all the help =)
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It does make sense.  From that perspective it sounds like depression.  
I think, based on what you've written that your doctor thinks that you have bipolar.  You could just ask her directly if she thinks you have bipolar.

I think that there is a bipolar community forum at medhelp and I think that members there may be better able to answer some of your questions.  Sometimes it is good to hear how others experience their illness and cope, etc.  It may also help you identify similarities, etc, if they exist.  If it doesn't fit then it's OK to discard it too.  You need to work through a process of finding out what works best for you.

Have you spoken to a psychotherapist?  This could be helpful in working through issues.

I think that low mood can make our pain seem more intense but I think that too is something that needs to be worked through, perhaps physically (with a doctor) and psychologically (with a therapist).   Jon Kabat-Zinn has written a book called Full Catastrophe of Living (or something similar) about how mindfulness meditation can be used in pain management.  If you're interested that could be something to look into.

Feeling trapped and dependent causes a whole host of other issues.

Have you considered relocating?  Another location may not be your first choice but it may enable a better quality of life.  Unless there are other ways to manage being in the heat.
Are you sure it's the heat that is making you faint and not something related to your heart condition?  Was just a thought.

My mother has a history of fainting and of head injuries and is heat sensitive.  She wears a sunhat, etc and works in the shade where possible but usually limits what she does to short periods.  She also tends to do more in the early hours before the temperature gets too high.

I would ask your doctor about psychotherapy.  I feel that talking would be helpful for you.
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I've just started the process of going to find out what's wrong, I've put it off for way too long.  I just saw the first psychiatrist and going to go through therapy. From reading parts of the book Dr. Fortner suggested from websites and about Bi Polar; I'm pretty sure it's that but I'm going to make sure the dr tells me.

2 years ago I went through testing for a week to find out what was wrong; which was a long grocery list of diseases including some malignant heart arrhythmia's and Dysautonomia, HOCM.  The heat intolerance is from my autonomic dysfunction, and I wish we could move my husband owns a pool business and there's no way we can relocate to a cooler climate.

Sometimes I have a reason for fainting like the heat, most other times there's no reason but they think it's due to my HOCM and ANS issues; because during my tilt table test my heart stopped when I fainted.

No meds have helped, no lifestyle changes or interventions and I had a pacemaker/icd implanted to try and alleviate some of the problems; which hasn't helped much - last month I fainted hitting my head on the tiled tub edge and severely sprained my neck; which has made me much more irritable than normal, if that's possible.

oppps sorry to drone on, thanks for the forum suggestion I did join it; MH has been a great place of support for me the past 2 years.

thanks for taking the time to reply =)
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You're extremely lucky you didn't do more damage when you hit your head.  One positive I guess is that being in a relaxed state you are likely to sustain less severe injuries.  I guess I would be a little cranky too if I had all that going on.  It must feel terrifying.

There is a cardiologist on the weight loss and healthy lifestyle expert forum.  If you can form a question around that he may be able to offer advice.

I guess once you better understand what is going on with your health it will be easier to make decisions.  It would be good to have everything as sorted as possible.

You're welcome.  I too have found medhelp a great place for support.  It has also allowed me to contribute which I think has helped me to feel connected, etc.  It can be good for the soul.  Feel like you're giving a little back instead of taking all the time.  I expect you'll understand what I mean even if I haven't communicated it very clearly.

Good luck and take care.
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oh wow I didn't know there was a cards dr there also, I've posted in the heart disease forum but thanks for the tip, I'll go and ask.  With my lifelong battle with fainting and arrhythmia's I just never know when or how it's going to happen, thankfully I've only fainted once while driving.

I'm wondering the connection with head injuries and some of my health problems because I've hit my head so many times over the past 35+ years sometimes being unconscious for hours at a time till someone finds me.

I understand completely =)
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I just checked out that forum I mentioned and think the doctor must be on leave as he's not accepting posts.  I should have checked before I opened my mouth but it could be a good one to keep an eye on for when he does return.

There are also neurology expert forums.

I too have hit my head numerous times over the years, plus had a near drowning, and wonder whether my symptoms are a consequence of that versus a mood disorder.  It can be hard to be objective and I guess it is best left to the experts.  Sometimes I think that they would be more motivated to find solutions if it were them or a family member going through it.
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no problem =) I understand; I'll keep an eye on the forum

my neurologist, cardiologist and primary all think the damage I've sustained are part of my problems...the CNS & ANS they say are messed up to do so much damage over the years.

sorry to hear about the problems for you also; near drowning scares me so I don't swim or take baths any more...my last psych dr didn't understand why that was a problem; so I told her why and found a new dr...

hope you find some answers also =)
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Yet your husband owns a pool business.  It would be a huge risk to go and then pass out though.  Sounds especially limiting.

Sometimes it's hard to completely comprehend until you are in a similar situation yourself.  You would expect more understanding from a doctor though.  I would anyway.

Everything happens for a reason, even if we don't understand why at the time.
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I can't tell you how many times I've worked with him bent over a pool to test the water and felt dizzy...after my testing & diagnosis I wouldn't go near water again - even our spa (we sold it) and the bath tub.  Sometimes I have no warning at all about fainting and just black out; yet SSA told me was no problem lol even told me to take a taxi to work since I am not allowed to drive ever again.

I was just on the surface waiting to break apart when I had my heart problems; dealing with SSA all my medical problems sent me over the edge and broke apart every coping skill I had before; like I shattered in a million pieces...had it not been for my support groups and great family I don't know what I would have done.

2 years ago was my wake up call to slow down and enjoy life and stop taking things for granted...
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btw; I was dx with Bipolar, PTSD as well as anxiety d/o, depression and agoraphobia
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Funny how we all end up with multpile diagnoses.  I wonder why when we go to get our physical issues seen too that we don't end up with long lists of those too?  ??

I try to enjoy life a little more too.  Heck, if I feel more relaxed reading Mills and Boon, then instead of feeling guilty for reading this trashy medical romance novel (which can be very educational mind you), I'm going to enjoy it and remind myself that life is too short to not take pleasure in things that I want to do and that resonate with me.  Life is hard enough as it is with an alphabet soup of medical and psychiatric conditions.

We never know when we're going to be snuffed out so we may as well make the most of life and reasonable health while we still have it.
I hoped that 'snuffed' hasn't offended.  I use it for me at this time.  Maybe at the moment I feel more vulnerable and don't believe that I will have a lot of control over the outcome.
Old age and illnesses can help prepare some people in the process.  I feel fated to die in an accident or as a result of a medical condition.
Has reminded me that I want to discuss death with my doctor.  Seems funny how health professionals say you live with one foot off the cliff but don't actually provide any sort of counselling.  Also funny how with mh issues you can go from acceptance to ?fear and a number of other emotions.
Having health issues sometimes mean that you do look at mortality more.

My older sister would be rolling her eyes about now and saying, How morbid.

We do have so much to be thankful for in our lives.
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I've wondered how much emotional stress and problems have made me sick and if there's a direct connection between emotional/physical problems.

I know I've read that stress can make you physically sick and my emotions make me stressed many times.

do those of us who take meds for mental/emotional problems get sick less often since they may help?
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There is a link between physical and mental health.  I think that good mental health makes dealing with the physical issues much easier.

I think that there has probably been a strong link between my emotional health and well-being and my physical health.

I severely overtrained when I was younger (8+ hours of stenuous execise everyday with no rest day).  I was so motivated to achieve yet I didn't have the energy to stand.  Is amazing that you can be that driven, or addicted, and push yourself through that.  I was OK, or so I thought, until I ended up in hospital from a severe asthma attack.

Opposite to that has been my experience of depression where I haven't even been able to motivate myself to put my shoes on to get out the door (and where climbing Mt Everest has seemed much more manageable).  It has been hard to process how debilitating the mental aspect actually is.  Is even harder trying to explain it to family members who can't seem to grasp the concept.  Why can't you walk 50 metres and turn off a gate valve?  Physically I could, mentally I couldn't.

I have never physically vomitted with stress and anxiety although I have been close.  Stress has affected me in other ways through gerd, migraines, etc.  I was diagnosed with early stage breast cancer a couple of years ago which the surgeon said was rare in someone my age.  I wonder if stress has sped up the disease process.  All the questions sometimes make you feel a little bit neurotic too.  Are these just due to anxiety or are they valid or real?  Chicken/ egg.  Half full vs half empty.

I think that you would perhaps get sick less often than you might otherwise would have.

I once asked my doctor if having a break down made me stronger than him.  I think that wounded his ego a little and he said no.  I guess being sick has both advantages and disadvantages.  I think that most people who experience mental health issues become stronger and more resilent.  I guess that we have to confront weaknesses that others haven't had too.  I guess rather than being stronger or weaker it exposes us as humans.

People should only accept treatment that helps.  I use to think that it should be mandatory for doctors to trial medications.  I see that has inherrent flaws though and realistically you can't expect a well person to take meds that they don't need.

I think that if you need meds to remain well that they should at least keep you at a baseline.  Anything below that level and you may experience more unwellness.
Another question is, do psych meds make people sick?

If you're specifically talking about meds for bipolar then I think that a well managed condition will mean less sick days.  Consultations with good doctors is important.  I say good doctors because there are so many rubbish ones out there who seem more interested in fixing patients according to their own value and belief systems and who end up doing more damage in the process.
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:(  wow you've been through alot sorry to hear that; and I'm griping because of my heart stuff when cancer is what really scares me.... dealing with chronic illnesses is rough physically and mentally isn't it.


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Heart stuff is way more debilitating than say a cancer picked up in its early stages.  I guess I was lucky that I had symptoms and therefore it was something picked up and treated early.  I expect it could have become quite invasive otherwise.

I think that cancer is less debilitating than some mental illnesses.
Ironically I was quite happy to be told that I had cancer and needed to travel away from home to be treated.  I think that the surgeon was shocked that I seemed happy about it.
It was a shock though as I was confident that everything had been fine.  The surgeon said that he triple read my slide.

The reality of the process was somewhat different to my expectations though and ended up being quite stressful.  It seems quite surreal and overwhelming to have to consent to significant surgery.  You may have found this too with your heart issues.

I struggled with surgery physically and that affected me emotionally causing me to become quite depressed.  I developed an infection and ended up on iv antibiotics over Christmas.  I then had to attend a wound clinic for over a month and that become most annoying.  I got sick of the comments and questions too.  That's deep, does that hurt?

Other treatment just left me feeling exhausted and sleep deprivation didn't help.  I saw the psychiatrist, walking in the car park near where I was staying, who threatened me with ect.  This was also quite difficult for me.

I still haven't received any psychological support regarding my breast issues and I guess for the most part have just pushed it away.  One male T did say that women with similar breast issues end up with ptsd but that was the extent of the emotional support.

I think health is something that many of us take for granted and even compromised health too.  Sometimes that compromised health can be better than what it could be (although hard to appreciate until you too have that taken from you).

I think that we should perhaps embarce some things versus being afraid of them.  If we take each moment as it arises we can cope.  Regarding our health, the most we can do is be proactive.  Do what is best for us and see our doctors, etc when we have issues.

I think that you would be extremely unlucky to have more stuff thrown at you but believe that you would have the tenacity and support to cope.

I still believe that mental illness is one of the hardest things to have to work through.  Is probably amazing that other professionals give psychiatrists such a hard time.  Good mental health seems fundamental to so many things.
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