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My modest understanding of bipolar disorder
Being an engineer I believe that all phenomena are governed by equations only. Causality is my principle. Now after years of reading, contemplating my illness I came to the following conclusions:
At firt: Emil Kraepelin theory (father of BP):
High mood + High energy = Mania
Low mood + Low energy = Depression
Low mood + High energy = mixed states, person is irritable, angry, having rage, he is suffocated (worst phase and very difficult to resolve, shoemakers - I mean pdocs - are bewildered thus giving it names like dysphoric mania, agitated depression, totally illogic of course because you can't mix mania with depression)
Bipolar people oscillate continuously between the above 3 phases, because their thermostat is broken.
Moreover, people will tell you that BP2 is better than BP1 because the issue in the former is depression while in the latter is psychosis. Usually you start by being depressed and the shoemaker - who is lazy enough in not to think about the case thoroughly, and having so many other patients making him earn a good living - doesn't give himself a chance of reflexions to check whether this is unipolar depression or bipolar one, so the automatic response for the 5 minutes meeting with him is to write to you an antidepressant. If you are lucky he may add an AP to cover it up. If not, he drives you manic so when you go to see him again he labels you with BP. Of course the symptoms get worse. You struggle to combat mania (although they tell you, I mean the shoemakers, it will extinguish itself with time, but by then you will lose control over your brain). The best drug in this case is a typical AP and not an atypical one, eventually you land in depression, Only the fortunate patient lands smoothly. But then you need to stand up again, hence the vicious circle. But worse the kindling effect due to the repeated episodes.
I happened to have posted a few years ago saying: if no depression, no BP, this view I still hold. If you don't have depression, you don't need an AD, so no mania. Only very few cases in which the person is manic by himself or better hypomanic, usually most if not all of the cases are a mistake of the pdocs, an abuse of the drugs.
Now the illness is called mood disorder and not energy disorder because it's the mood where lies the clue, although the mixture of both is crucial. Mood stabilizers' job is to maintain the mood stable. OK, but the 3 conventional and historical musketeers (lithium, tegretol, depakote) are plenty of side effects so are the rest of the drugs of course. Besides, they were originally designed to stop the mania, why?, for the angry people, dangerous, etc…. Perhaps lamictal helps depression !! Coming to BP2, mostly depressed so there is no solution except an antidepressant, but this is not a solution as I said. Usually the guy after a while turns into BP1 after abuse of the AD. He has mixed states. The trick is to lower your dopamine but without lowering your mood. An atypical AP is not bad here.
Now BP is very difficult to resolve, except ONE day if they discover an antidepressant that doesn't drive you manic in order to up your mood. Only then this illness is resolved. So to help yourself until then (if this occurs one day) is to combat depression if you have some energy of course to spend by sports, eating fish, supplements, tryptophan etc.. but beware of AD's as much as you can. Taking an AD is equivalent to saying make me alive today and I accept that you kill me tomorrow.
At firt: Emil Kraepelin theory (father of BP):
High mood + High energy = Mania
Low mood + Low energy = Depression
Low mood + High energy = mixed states, person is irritable, angry, having rage, he is suffocated (worst phase and very difficult to resolve, shoemakers - I mean pdocs - are bewildered thus giving it names like dysphoric mania, agitated depression, totally illogic of course because you can't mix mania with depression)
Bipolar people oscillate continuously between the above 3 phases, because their thermostat is broken.
Moreover, people will tell you that BP2 is better than BP1 because the issue in the former is depression while in the latter is psychosis. Usually you start by being depressed and the shoemaker - who is lazy enough in not to think about the case thoroughly, and having so many other patients making him earn a good living - doesn't give himself a chance of reflexions to check whether this is unipolar depression or bipolar one, so the automatic response for the 5 minutes meeting with him is to write to you an antidepressant. If you are lucky he may add an AP to cover it up. If not, he drives you manic so when you go to see him again he labels you with BP. Of course the symptoms get worse. You struggle to combat mania (although they tell you, I mean the shoemakers, it will extinguish itself with time, but by then you will lose control over your brain). The best drug in this case is a typical AP and not an atypical one, eventually you land in depression, Only the fortunate patient lands smoothly. But then you need to stand up again, hence the vicious circle. But worse the kindling effect due to the repeated episodes.
I happened to have posted a few years ago saying: if no depression, no BP, this view I still hold. If you don't have depression, you don't need an AD, so no mania. Only very few cases in which the person is manic by himself or better hypomanic, usually most if not all of the cases are a mistake of the pdocs, an abuse of the drugs.
Now the illness is called mood disorder and not energy disorder because it's the mood where lies the clue, although the mixture of both is crucial. Mood stabilizers' job is to maintain the mood stable. OK, but the 3 conventional and historical musketeers (lithium, tegretol, depakote) are plenty of side effects so are the rest of the drugs of course. Besides, they were originally designed to stop the mania, why?, for the angry people, dangerous, etc…. Perhaps lamictal helps depression !! Coming to BP2, mostly depressed so there is no solution except an antidepressant, but this is not a solution as I said. Usually the guy after a while turns into BP1 after abuse of the AD. He has mixed states. The trick is to lower your dopamine but without lowering your mood. An atypical AP is not bad here.
Now BP is very difficult to resolve, except ONE day if they discover an antidepressant that doesn't drive you manic in order to up your mood. Only then this illness is resolved. So to help yourself until then (if this occurs one day) is to combat depression if you have some energy of course to spend by sports, eating fish, supplements, tryptophan etc.. but beware of AD's as much as you can. Taking an AD is equivalent to saying make me alive today and I accept that you kill me tomorrow.
I would recommend you address this same post to the community as a whole so that people in the forum can answer you
Hello,
I don't know if I have bipolar disorder or not. I am an international student in the UK and I don’t feel like going to a psyhiatrist in a foreign country. The campus GPs are very bad and I wouldn’t trust them and wouldn’t feel comfortable talking to them about my problems. My parents took me to a couple of psyhologits while I was in high-school but I didn’t have that strong depression symptoms then. My depression problems got much worse when I started my university and my parents are far from me and there is nothing they can do from home.
So if I state some of my symptoms, could you please let me know if there might be a chance I could have BP or any other problem that require medical help?
1. According to other people I could have a very nice life. Fot example I am studying a very difficult degree (Engineering) to a very good University in the UK where I get good marks, I have a nice boyfriend , very loving parents that supported me in every way possible. However I have very frequent moments where I feel so low about myself and I hate my life and myself and I am disgusted about myself people society and I hate everything. I start crying without being able to stop and I feel that everyone is miserable. I see other people living similar lifes to me and they are happy about it, they accept life the way it is and I hate them for that.
2. My boyfriend is very nice to me and most of the time everything I want is to protect him and make him happy. However there are moments triggered by very stupid and insignificant facts (like he getting a better mark than me for example), when I want him to die and I tell him that. And after that I feel so bad. But I experience very frequent transitions from extreme modes and I start hating people I love for insignificant and very minor reasons (almost no reason at all).
3. I have paranoia.
4. Extra stress and preasure because of my dreagree falls on me every day. I have moments when I cry and cannot sleep because of thinks that are very little likely to happen.
5. I cannot sleep just because I have scenarious in my head that are pure fiction.
6. I am affraid of everything I am not even comfortable of driving by myself, I allways imagine terrible thinks. I am extermely sesitive.
7. I have episodes of extra energy and I wanat to save everyone of this planet and then I realise I am a horrible person and there is nothing I can do about anything. And then the depression comes.
8. I get easily distracted and loose all my energy.
I know what I mentioned above might be problems that everyone experience at some point in life. However, my depression became unbearable and I am sure that I have at least a depression. I would appreciate if someone could tell me weather I should see a doctor or not. I think some pills could be of great help as I would stop feeling like this and become a much more ballanced person. However I cannot get depression medicines without a doctor’s prescription.
I don't know if I have bipolar disorder or not. I am an international student in the UK and I don’t feel like going to a psyhiatrist in a foreign country. The campus GPs are very bad and I wouldn’t trust them and wouldn’t feel comfortable talking to them about my problems. My parents took me to a couple of psyhologits while I was in high-school but I didn’t have that strong depression symptoms then. My depression problems got much worse when I started my university and my parents are far from me and there is nothing they can do from home.
So if I state some of my symptoms, could you please let me know if there might be a chance I could have BP or any other problem that require medical help?
1. According to other people I could have a very nice life. Fot example I am studying a very difficult degree (Engineering) to a very good University in the UK where I get good marks, I have a nice boyfriend , very loving parents that supported me in every way possible. However I have very frequent moments where I feel so low about myself and I hate my life and myself and I am disgusted about myself people society and I hate everything. I start crying without being able to stop and I feel that everyone is miserable. I see other people living similar lifes to me and they are happy about it, they accept life the way it is and I hate them for that.
2. My boyfriend is very nice to me and most of the time everything I want is to protect him and make him happy. However there are moments triggered by very stupid and insignificant facts (like he getting a better mark than me for example), when I want him to die and I tell him that. And after that I feel so bad. But I experience very frequent transitions from extreme modes and I start hating people I love for insignificant and very minor reasons (almost no reason at all).
3. I have paranoia.
4. Extra stress and preasure because of my dreagree falls on me every day. I have moments when I cry and cannot sleep because of thinks that are very little likely to happen.
5. I cannot sleep just because I have scenarious in my head that are pure fiction.
6. I am affraid of everything I am not even comfortable of driving by myself, I allways imagine terrible thinks. I am extermely sesitive.
7. I have episodes of extra energy and I wanat to save everyone of this planet and then I realise I am a horrible person and there is nothing I can do about anything. And then the depression comes.
8. I get easily distracted and loose all my energy.
I know what I mentioned above might be problems that everyone experience at some point in life. However, my depression became unbearable and I am sure that I have at least a depression. I would appreciate if someone could tell me weather I should see a doctor or not. I think some pills could be of great help as I would stop feeling like this and become a much more ballanced person. However I cannot get depression medicines without a doctor’s prescription.
I don't have time for a full reply, but as to the last paragraph, it's actually the opposite. Up to the DSM-IV-TR, mania caused by an AD did NOT count as bipolar, but it will in the DSM 5. Kinda sucky, but it gives you a perspective of what the situation has been (or was supposed to be) in terms of diagnosing people up til now (although I personally think a manic reaction to an AD is certainly suggestive of BP, even if it's not proof).
thank you very much for your mail.
I am not a bipolar expert to confirm facts but I gather from my readings how usually the pt become diagnosed as having BP, and many will agree on that. And for this I don't need to advance sources: Besides, neither me nor you, can judge whether or not the no of BP pts has increased over the years or it's a matter of better current diagnosis.
But I know well that for example in soft bipolarity like it used to be my case for example ( Some pdocs refer to this as Bipolar III). 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.
Some meds can do the above, and others can cause short-term bipolar symptoms in some people. It could be that those people have some of the genetics of bipolar, but not enough for a diagnosis; but a course of cortisone, as a common example, can cause them to display strong symptoms. Many drugs, like antidepressants and cortisone, can also cause mood changes in people who have diagnosed bipolar.
concerning without lamictal you are lost, I meant it's one of the few MS that helps in depression. About lithium though, which is quite established its antisuicidal effect,lithium is probably more effective in preventing mania than depressionand and many sites will tell you this. i.e. Lithium aids to control manic episodes, but is not as effective at controlling depressive episodes. This is why patients who respond to lithium most effectively are those with manic depressive psychosis and a predominate behavior of mania. Patients whose behavior alternates between manic and depressive often, do less well with lithium treatment (Kolb, 1973, Modern clinical therapy. Philadelphia, PA, USA: WB Saunders Company). The other MS have more or less same effect, simply because historically speaking it's the mania which was clear to authorities while depression can be confused for unipolar and not bipolar and as you said some BP pts do not manifest manic episodes with AD's so no need to check whether they have unipolar depression or bipolar one..
you are right seroquel helps for depression and my knowledge the only FDA approved for that. But believe me, when feeling depressed a bit I reduce it and find myself better until I become high so I up it again it's exactly like a balloon when you drop a quantity of sand in order to fly higher.
As for the vitamin B, I take neurobion (B1, B6, B12) and it's not cycling coz it occurred at least 15 times, I start taking it then after 3 days I start not sleeping well eat more higher, etc..so I cut it and become depressed a bit so I adjust the seroquel and 3 consecutive years elapsed while I am walking on a string and try not to lose my balance. BP is awful
Finally, I thank you for telling me that in the DSM-5 a mania under AD doesn't qualify for BP, although most pdocs I visited will object to this view. Apparently this view that a manic episode under AD doesn't qualify for BP is backing a view setforth by the known BP scientist Hagop Akiskal, coz I remember having read once in one of his articles (canot remember where) that he adopts this view
Finally thank you for this brain storming I needed it
Ezz
I am not a bipolar expert to confirm facts but I gather from my readings how usually the pt become diagnosed as having BP, and many will agree on that. And for this I don't need to advance sources: Besides, neither me nor you, can judge whether or not the no of BP pts has increased over the years or it's a matter of better current diagnosis.
But I know well that for example in soft bipolarity like it used to be my case for example ( Some pdocs refer to this as Bipolar III). 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.
Some meds can do the above, and others can cause short-term bipolar symptoms in some people. It could be that those people have some of the genetics of bipolar, but not enough for a diagnosis; but a course of cortisone, as a common example, can cause them to display strong symptoms. Many drugs, like antidepressants and cortisone, can also cause mood changes in people who have diagnosed bipolar.
concerning without lamictal you are lost, I meant it's one of the few MS that helps in depression. About lithium though, which is quite established its antisuicidal effect,lithium is probably more effective in preventing mania than depressionand and many sites will tell you this. i.e. Lithium aids to control manic episodes, but is not as effective at controlling depressive episodes. This is why patients who respond to lithium most effectively are those with manic depressive psychosis and a predominate behavior of mania. Patients whose behavior alternates between manic and depressive often, do less well with lithium treatment (Kolb, 1973, Modern clinical therapy. Philadelphia, PA, USA: WB Saunders Company). The other MS have more or less same effect, simply because historically speaking it's the mania which was clear to authorities while depression can be confused for unipolar and not bipolar and as you said some BP pts do not manifest manic episodes with AD's so no need to check whether they have unipolar depression or bipolar one..
you are right seroquel helps for depression and my knowledge the only FDA approved for that. But believe me, when feeling depressed a bit I reduce it and find myself better until I become high so I up it again it's exactly like a balloon when you drop a quantity of sand in order to fly higher.
As for the vitamin B, I take neurobion (B1, B6, B12) and it's not cycling coz it occurred at least 15 times, I start taking it then after 3 days I start not sleeping well eat more higher, etc..so I cut it and become depressed a bit so I adjust the seroquel and 3 consecutive years elapsed while I am walking on a string and try not to lose my balance. BP is awful
Finally, I thank you for telling me that in the DSM-5 a mania under AD doesn't qualify for BP, although most pdocs I visited will object to this view. Apparently this view that a manic episode under AD doesn't qualify for BP is backing a view setforth by the known BP scientist Hagop Akiskal, coz I remember having read once in one of his articles (canot remember where) that he adopts this view
Finally thank you for this brain storming I needed it
Ezz
Cite your sources. You are making claims based on your personal thoughts and experiences as far as I can tell, with no actual data to back you up. Especially on the "only a small minority of the people with bipolar have it in the absence of antidepressant use". There has certainly been an increase in diagnosis in recent years, but it's hard to say how much is people identifying bipolar II that was previously listed as major depression (and plenty of people with the MDD diagnosis do not take drugs for it) and how much is a popularization of a diagnosis.
All drugs have side effects. One particular person might get lucky with any particular drug, but if it works, it will have side effects for some.
Your writing is a little tough to follow, but what I think you're saying is that all mood stabilizers are primarily anti-manic, which is not true. For something to be a mood stabilizer, it must by definition have anti-manic properties, but plenty of them have anti-depressant qualities as well. For instance, I believe depakote does better against mania than lithium, but lithium beats it when it comes to depression, and does particularly well with suicidality.
I really don't know what you mean by "if you are not at ease with lamictal you are lost". Please clarify.
The dose of seroquel you're on is hardly in the antipsychotic/mood stabilizer range--it's more of an antihistamine where you are. Also, while seroquel is not FDA approved for bipolar maintenance, it is approved individually for mania and bipolar depression, and is approved as an add on therapy. That's right: if you're bipolar and not usually on meds and you fall into a depressive state, seroquel is approved to treat just that.
While I don't know of any antidepressants that are 100% safe in terms of not triggering mania in bipolar, wellbutrin has a pretty good track record. It's rather unique as far as antidepressants go (has effects on dopamine and norepinephrine, not serotonin), which probably helps. There are plenty of bipolar people who tolerate other antidepressants just fine, especially if they're on a mood stabilizer as well. Wellbutrin turned out to be a bad choice for me personally, but not because of mania (and it did work on the depression, which is what it was for).
Are you sure it was the vitamin B that caused the mania, or were you just cycling again? It can be very hard to tell cause from effect, especially if it took a long time after starting the vitamins for you to get manic.
Finally, until the DSM-5 comes out (if the DSM is what they use where you are), a manic/hypomanic event caused by an antidepressant WILL NOT qualify you as bipolar. They're changing that, so it will be true in the future, but the rules for the last many, many years have been that only having a manic episode in reaction to an antidepressant does NOT qualify you for the bipolar club. They probably unmask it in certain people, in that the drug-induced episode causes some more careful scrutiny that uncovers symptoms that started pre-drug, but I highly doubt that they "make" anyone bipolar who wasn't heading that way already.
All drugs have side effects. One particular person might get lucky with any particular drug, but if it works, it will have side effects for some.
Your writing is a little tough to follow, but what I think you're saying is that all mood stabilizers are primarily anti-manic, which is not true. For something to be a mood stabilizer, it must by definition have anti-manic properties, but plenty of them have anti-depressant qualities as well. For instance, I believe depakote does better against mania than lithium, but lithium beats it when it comes to depression, and does particularly well with suicidality.
I really don't know what you mean by "if you are not at ease with lamictal you are lost". Please clarify.
The dose of seroquel you're on is hardly in the antipsychotic/mood stabilizer range--it's more of an antihistamine where you are. Also, while seroquel is not FDA approved for bipolar maintenance, it is approved individually for mania and bipolar depression, and is approved as an add on therapy. That's right: if you're bipolar and not usually on meds and you fall into a depressive state, seroquel is approved to treat just that.
While I don't know of any antidepressants that are 100% safe in terms of not triggering mania in bipolar, wellbutrin has a pretty good track record. It's rather unique as far as antidepressants go (has effects on dopamine and norepinephrine, not serotonin), which probably helps. There are plenty of bipolar people who tolerate other antidepressants just fine, especially if they're on a mood stabilizer as well. Wellbutrin turned out to be a bad choice for me personally, but not because of mania (and it did work on the depression, which is what it was for).
Are you sure it was the vitamin B that caused the mania, or were you just cycling again? It can be very hard to tell cause from effect, especially if it took a long time after starting the vitamins for you to get manic.
Finally, until the DSM-5 comes out (if the DSM is what they use where you are), a manic/hypomanic event caused by an antidepressant WILL NOT qualify you as bipolar. They're changing that, so it will be true in the future, but the rules for the last many, many years have been that only having a manic episode in reaction to an antidepressant does NOT qualify you for the bipolar club. They probably unmask it in certain people, in that the drug-induced episode causes some more careful scrutiny that uncovers symptoms that started pre-drug, but I highly doubt that they "make" anyone bipolar who wasn't heading that way already.
Adel, the Deplin is a prescription by your dr. If your pharmacy does not have it in stock he should be able to order it.
AD's make me hypomanic. I have tried just about all of them. Not for me. Lamical, Depokote and a very long list of other meds were bad for me. I am very sensitive to meds. Lithium has been good though. I only had side effects in the beginning but no more and it's been maybe 3 or 4 yrs now.
I often ask myself if the AD's kicked into gear the Bipolar. I took them long before I was diagnosised and after for a short while. I guess at this point it doesn't matter because I can't go back but I sure am curious.
AD's make me hypomanic. I have tried just about all of them. Not for me. Lamical, Depokote and a very long list of other meds were bad for me. I am very sensitive to meds. Lithium has been good though. I only had side effects in the beginning but no more and it's been maybe 3 or 4 yrs now.
I often ask myself if the AD's kicked into gear the Bipolar. I took them long before I was diagnosised and after for a short while. I guess at this point it doesn't matter because I can't go back but I sure am curious.
thank you for your constructive comments.
Of course I am aware that BP existed long time before the drugs were there; otherwise Emil would not have discovered it before he thought how to cure it. Indeed, one can have the illness without taking an AD. But this constitutes a very small minority of the population, and of course I couldn't be one of them. Only when I took an AD that I (became) a BP pt. If you contemplate the statistics of BP worldwide, you discover that everybody has it nowadays, the reason is the drug abuse, especially AD's.
There exists though a percentage who are by nature hypomanic and those we found them in the streets and any social gathering, they are anxious and feeling high, but they don't need to be fideled with by drugs.
As for mood stabilizers, if you are not at ease with lamictal you are lost. Because I hate to differ with you but that most of the MS around are for mania mainly and even from the historical point of view, although they say otherwise. Again depakote causes ovarian cysts in young girls with all its consequences. Lithium is plenty of side effects, the least is tremors, tegretol perhaps the least but still has itsadverse effects, headaches...etc.. you need to do blood tests everynow and then. There exist others, many others, but each is develish. I am on seroquel 100mg not bad but also full of other things.
You know really if the medical circle can come out with an AD that doesn't bring mania, a very weak AD something that makes you just stand up they would have made a great favor to us. My vitamin B makes me manic after a while. There was someone here suggested deplin (folic acid) I live in the middle of nowhere I tried to buy tryptophan but in vain
thank you anayway
Of course I am aware that BP existed long time before the drugs were there; otherwise Emil would not have discovered it before he thought how to cure it. Indeed, one can have the illness without taking an AD. But this constitutes a very small minority of the population, and of course I couldn't be one of them. Only when I took an AD that I (became) a BP pt. If you contemplate the statistics of BP worldwide, you discover that everybody has it nowadays, the reason is the drug abuse, especially AD's.
There exists though a percentage who are by nature hypomanic and those we found them in the streets and any social gathering, they are anxious and feeling high, but they don't need to be fideled with by drugs.
As for mood stabilizers, if you are not at ease with lamictal you are lost. Because I hate to differ with you but that most of the MS around are for mania mainly and even from the historical point of view, although they say otherwise. Again depakote causes ovarian cysts in young girls with all its consequences. Lithium is plenty of side effects, the least is tremors, tegretol perhaps the least but still has itsadverse effects, headaches...etc.. you need to do blood tests everynow and then. There exist others, many others, but each is develish. I am on seroquel 100mg not bad but also full of other things.
You know really if the medical circle can come out with an AD that doesn't bring mania, a very weak AD something that makes you just stand up they would have made a great favor to us. My vitamin B makes me manic after a while. There was someone here suggested deplin (folic acid) I live in the middle of nowhere I tried to buy tryptophan but in vain
thank you anayway
Thank you for taking the time to write the post! I laughed my *** off at some stages (the shoe-maker) even though BP is no laughing matter... I'd rather laugh than cry.
I am still in the very beginning of finding out what is going on with me. I had a hyper-episode 3 weeks ago (I thought I finally broke through by quitting my job and that I was happy at last! but then developed a very upset stomach and after 5 days decided I'll see my GP). The shoe-maker told me: oh no, you either have major depression or Bipolar Disorder. Here is a dose of Valpro to start you off with and please see me for the next 4 days on suicide watch!
WTF? not sure yet. seeing my GP and the Psyco doc today again. I have had a horror of a medical history and after 2 open-heart surgeries and some other major stuff I was expecting major depression.... but the anti-depro's did not work and I was still sad to say the least... but I kept on smiling and to the world I am Smiley and they can not handle anything else... but now I have to face that maybe I have BP....
one thing for sure: an illness does not defy me! I defy my illness. And as far as possible, I'll keep on Smiling causing it makes my wrinkles fade :)
I am still in the very beginning of finding out what is going on with me. I had a hyper-episode 3 weeks ago (I thought I finally broke through by quitting my job and that I was happy at last! but then developed a very upset stomach and after 5 days decided I'll see my GP). The shoe-maker told me: oh no, you either have major depression or Bipolar Disorder. Here is a dose of Valpro to start you off with and please see me for the next 4 days on suicide watch!
WTF? not sure yet. seeing my GP and the Psyco doc today again. I have had a horror of a medical history and after 2 open-heart surgeries and some other major stuff I was expecting major depression.... but the anti-depro's did not work and I was still sad to say the least... but I kept on smiling and to the world I am Smiley and they can not handle anything else... but now I have to face that maybe I have BP....
one thing for sure: an illness does not defy me! I defy my illness. And as far as possible, I'll keep on Smiling causing it makes my wrinkles fade :)
You are completely disregarding the fact that bipolar disorder existed long before antidepressant drugs came out. And there's also a huge variability in presentations of BP. Some come with more depression, and do get mistaken for depression, but an episode of full mania is sufficient for a BP I diagnosis--no depression required. And yes, some people do go back to normal on their own eventually, although others flip flop with no middle or have swinging gradients between depression, mixed states, and manias. Other people are manic for years, either constantly or intermittently, without ever having touched drugs (while drug abuse is a common problem/symptom in BP I, there are plenty of people who don't have that particular symptom and are still really manic).
Lamictal is actually one of the few drugs approved for monotherapy (as in it is the ONLY drug you take) in BP I. It increases the time between relapses, although it seems to do better with depression than with mania. It still counts as a mood stabilizer though. I am currently on it as my sole mood stabilizer, and it is working quite well, thank you very much. I also take buspar for anxiety, but that's not an antidepressant.
It's pretty well known that SSRIs (and other antidepressants) CAN cause mania in someone with bipolar, but it's not a guarantee. Some people with BP have no problems with them (prozac didn't change anything about my hypomanic symptoms that I can remember, although it's tough since I didn't know it was BP II at the time). Other people are ok on an SSRI as long as they are stable on a mood stabilizer first, and some just can't touch them. Screening is vital and is too often not done, but it's tough. I have major trouble remembering being anything but depressed when I'm depressed, and I don't tend to have very long hypomanic episodes, so even though the first psychiatrist did do a (very simple) screen, he didn't catch it. It didn't help that I hadn't heard of BP II, and knew I wasn't BP I, and the screening questionnaire was geared towards BP I. But even then, I might have denied it/forgotten any symptoms due to the horrible depression I was in at the time. So then I was on prozac for a year.
But if you find the right mood stabilizer, you won't generally need to look at antidepressants, because mood stabilizers DO help with depression as well as the mania. Some seem to be more geared towards mania (like zyprexa) while others seem to be used more when depression is the issue (like seroquel and abilify), but they all act on both. Lithium even has some evidence of being rather good at decreasing suicidality in particular.
Lamictal is actually one of the few drugs approved for monotherapy (as in it is the ONLY drug you take) in BP I. It increases the time between relapses, although it seems to do better with depression than with mania. It still counts as a mood stabilizer though. I am currently on it as my sole mood stabilizer, and it is working quite well, thank you very much. I also take buspar for anxiety, but that's not an antidepressant.
It's pretty well known that SSRIs (and other antidepressants) CAN cause mania in someone with bipolar, but it's not a guarantee. Some people with BP have no problems with them (prozac didn't change anything about my hypomanic symptoms that I can remember, although it's tough since I didn't know it was BP II at the time). Other people are ok on an SSRI as long as they are stable on a mood stabilizer first, and some just can't touch them. Screening is vital and is too often not done, but it's tough. I have major trouble remembering being anything but depressed when I'm depressed, and I don't tend to have very long hypomanic episodes, so even though the first psychiatrist did do a (very simple) screen, he didn't catch it. It didn't help that I hadn't heard of BP II, and knew I wasn't BP I, and the screening questionnaire was geared towards BP I. But even then, I might have denied it/forgotten any symptoms due to the horrible depression I was in at the time. So then I was on prozac for a year.
But if you find the right mood stabilizer, you won't generally need to look at antidepressants, because mood stabilizers DO help with depression as well as the mania. Some seem to be more geared towards mania (like zyprexa) while others seem to be used more when depression is the issue (like seroquel and abilify), but they all act on both. Lithium even has some evidence of being rather good at decreasing suicidality in particular.
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