Bipolar and Ocd: Similarities? During Manic Episodes Do You Have Trouble with Obsessive Thoughts?

[ILADVOCATE]

Obviously, I know the difference between bipolar and ocd. But I notice during moodswings, mainly manic I have obsessive thoughts. Not always disturbing ones but they can difficult. And this must be true for some other people as well. I don't know if there is any overlap between the two disabilities but to some extent there must be as a person going on a spending spree may be a compulsive spender or they might be having a manic episode and binge spending. I know that before recovery that I would spend a lot of money and becoming obsessed with having certain cd's. It wasn't always a matter of money. There was an obsessive element. Or wanting to travel somewhere for no reason on impulse. The impulsive behavior was manic but there was an obsessive nature behind it as well. Have people been through this as well? Perhaps someone could explain.

[ILADVOCATE]

Abilify is activating. It can't make a person manic. But it can cause insomnia and on occasion nervousness. That's correct. Lamictal in higher doses can sometimes worsen mania. I was taken off it for that reason. Generally at standard doses its well tolerated though. That's why Lithium is the most effective mood stabilizer overall and the only one developed for mood stabilization originally. If you are on 3 antipsychotics together it puts you at risk for certain long term side effects. One is much safer. Seroquel does work not only as an antipsychotic but as a mood stabilizer and actually more in that regard than Abilify. Ask the people who take it here. If your psychiatrist is agreeing you should be on a working dose of Seroquel and that alone I would go along with that. That's the best plan and I would say anyone would agree, including any psychiatrist you would speak to anywhere.

[adel_ezz]

About lamictal and abilify causing mania, this I was not precise and i am sorry for it. Yet lamictal OK it's an AC and abilify an AP (2nd gener. atypical) but both are working well for depressed people more than for manic like lithium say. some people find abilify perfect, many though brought anxiety to them they feel agitated and brings insominia this is why it's better taken in the morning and this i am definite about reading it from responses of patients, it isn't like seroquel which tends to be sedating yet both as AP can work as MS. Same for the AC lamictal it is best used for depressed people. Of course one assumes since both are MS then they are good for BP in general but one finds that lithium is good especially for mania and for lessening suicidal ideation, etc.. others depakote works perhaps for cyclers etc... so although my guess could be right my conclusion is of course wrong since i had no proof. Still what i meant is that since both work upwards then i EXPECT that the person will be tense, contrary if you use lamictal and seroquel because they equalise each other as seroquel is a strong antimanic.
i hope i corrected my mistake.
as to trying to prove that i am not BP on the contrary i can admit it and am in fact admittimg it, except that no one can say that AP cannot work as MS which you keep telling me that I should use an MS meaning not AP. However you have a point you and ILADVOCATE that 3 AP's is funny. Yes indeed, but i am OK so why going into the dilemma of trying a new thing. But don't you think i am worried of what i am taking, because as you said i can be manic from inside and a very simple straw can turn me manic. Of course i am on my nerves, but i am calculating the risk so long as i still don't crash into depression
thanks
ezz
ezz  

[monkeyc]

And this is what sometimes bothers me.

You see OCD and BP ARE very different things hence my comment on gateway diagnoses - the problem is that what looks like OCD can easily be something else to the untrained eye and most first line diagnoses are made by general practioners who know nada about mental illness beyond basic books and symptoms lists - at no time did I say OCD was not real I said that OCD and BP can and do share the same characteristics in come behaviours and this makes diagnosis hard - I also pointed out that ADHD is often a misdiagnosis for BP and in particular a worrying one as Ritalin can be very bad for BP's.

Now to your comment about BP onset - Its not remotely relevant as to BP being new to your family - its not always genetic or runs in families and it is entirely possible to be both OCD and BP no one says it is not - I am frankly bored with the argument that you caught OCD from something else - it doesnt work like that and you and I both know if adel - denial is denial.

Now you made a comment on Lamactil and Abilify causing mania.  I would like to see a source on this as theyre both Anti Psychotics and they do not cause mania - in fact neither of them have this as a listed or known side effect.  Lamotrigine (Lamictal) does have some anti depressant effect due to its action but it works as a mood stabiliser to control mania not cause it.

Thanks to my little episode of suidical ideration I have been getting an education lesson first hand in Anti Depressants and Anti Psychotics as im now taking Zyprexa for sleep and a big dose of Effexor and I have a pretty good working level of knowledge of AD drugs anyway with a history with SSRI's and having taken Mirtazapine, Prothiaden and now Effexor - All AD drugs can cause mania to bipolars which is why a mood stabiliser is needed - this is not a guess Adel this is documented  reality and the right combination of MS and AD are vital.

The problem I see is this - you are trying very hard to prove to yourself you are not bipolar.  I advised you get a second opinion 3 months ago, clearly you are suffering from manic episodes and clearly you are under medicated.

However reading web forums never gives the full picture - for example my old GP prescribed me Endep (amitryptiline) as an AD - its an older Tricyclic and I never took it - had the full pack of 50 50mg pills here ad was going to use them on thursday night in one hit.  BUT as my psych pointed out this is a drug that should NEVER be given to bipolars and it says so on the prescriber database - had I actually taken it I would have gone dysphoric at best and suicidal at worst as its very bad for us.

If you do not educate yourself you can have issues BUT that does not mean you should believe everything you read - reputable sources are resputable sources.

[ILADVOCATE]

Well that's just because its a public thread. Its a matter of confidentiality. And perhaps we should continue this particular aspect of the conversation in pm's if you wish. Thanks. People pick their particular screen name for their own reasons. I do advocacy for people with disabilities (in the independent living model) as a volunteer so that's how I got mine. Ask other people if you want.
  Anyway, back to topic, although anti-depressents can worsen bipolar, Lamictal is a mood stabilizer and an effective one at that. Abilify is an antipsychotic. They will help it. Sometimes antipsychotics can work on ocd. It depends on the person. Medication to be honest is still an art, not a science but they are learning and certain things are a known quantity. I think the sites on the "links" page should give you more cogent information.
  

[adel_ezz]

You thought I am trying to convince people of my ideas. On the contrary monkeyc helped me a lot and i am pleased to have somebody around for help. I feel he really cares, no doubt about it and i am not trying even to win in the discussion. All of you are more learned and besides, you have unfortunately a longer history of BP, however this is a forum and we are doing a brain storming. We are just trying to resolve a subject which nobody were able so far to resolve. How could we!! For instance people can report cases in which the meds were lovely for years then at a certain point in time they prove inefficient. Can you explain that. I usually read what you, monkeyc, bulldozer, leftcoastchick and the rest are saying whether i participate or not in the discussion I said before it's a jigsawpuzzle where i do my homework to grasp piece by piece. For example your friend with lamictal and abilify benefited for his OCD because both look like an AD, but beware if he is BP he can soon - hope not - have mania because both work upwards.
thanks a million

one point interesting though, i notice everybody keeps his true name in discretion. OK this is understood. Perhaps nobody likes to be called BP, even when you post the program asks for your nickname, apparently it is taken for granted  that nobody displays his true name. It seems - and that is so in another forum - that people guess this may cause them trouble. OK but why bizarre names, people from the west part of the globe can call themselves nicknames like john west or emily fitzgerald or chris appleyard or Jack smith etc... etc..., whereas from the eastern part nicko blakhoff or suki yakashima, why so complicated names even to spell.
"adel"

[ILADVOCATE]

  I think what he was pointing out was not our ideas about different diagnoses but concerns about your treatment. Actually the person I know who has ocd and bipolar with psychotic features now takes Abilify and Lamictal and it keeps the symptoms relatively in check. We just all had the concern of 3 antipsychotics being prescribed to you at once which clearly is not a good thing but you had said you were getting that updated to one antipsychotic which was Seroquel which at a working dose would be effective for psychosis and mood stabilization. There's still a potential you could have ocd as well and my psychopharmocologist never said I didn't have ocd. He just said the medications for ocd would not be a good idea for me as being SSRI anti-depressents they would set off mania. If there were a working medication for ocd that weren't in this category he would probably prescribe it but he's looking to treat what he can. I have an excellent working anti-psychotic, but need to find a better mood stabilizer but right now my and his concerns and primarily neurological treatment. I've found ways to manage the ocd symptoms and I really couldn't tolerate more medications. They are concerned I'm on enough medications already as per interactions.
  But as for yourself if you didn't have bipolar they would be nothing wrong with asking about an anti-ocd medication but there is the concern of them worsening mania but there's no reason, no to try cognitive behavioral therapy for ocd if that seems warranted. That can be helpful and might be a good way to resolve what medication can't treat.