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Just Diagnosed Bipolar II

I've had at least 3 episodes of major depression with GAD in my lifetime. I sought help about 5 years ago and was put on Effexor 225 mg. It worked wonderfully for both anxiety and depression. About a year and a half later, I felt it had stopped working. I was then put on Paxil, and it didn't feel nearly as effective as Effexor. About a year later, my doctor tried Lexapro with even less success than Paxil. I stopped taking Lexapro because it felt completely useless (still felt dysthymic and anxious), and a few months later I fell into a pretty bad depression. My new doctor put me back back on Effexor, and within about a month it lifted me out of my deep depression. However, I didn't really feel "right" as I did the first time on Effexor. I was very keyed up, agitated, anxious, irritable, my mind raced, and I couldn't concentrate on anything because I'd get distracted so easily. However, I was NOT euphoric or grandiose. Therefore, the thought of mania or hypomania never crossed my mind. I am probably more in a mixed state/ rapid cycling, but I didn't know there was such a distinction at the time. My doctor said I was hypomanic and gave me a startup kit of Lamictal. On my next visit, he diagnosed me as bipolar II. In two days, I will be up to 100 mg Lamictal, and my Effexor dose has been reduced down to 150 mg for the time being.

At the time these symptoms first came to light about 2 months ago, I had no idea what was happening. The most obvious symptom then was the distractability and inability to concentrate at work. I thought I was just experiencing bad anxiety with a new twist--that of inability to concentrate. I thought I had suddenly acquired ADHD. I agree with my doctor's assessment, but it came out of left field. I was shocked. I had never thought that I could be bipolar because I can't remember any hint of hypomania in my life.

I've been experiencing doubts as to whether I am truly bipolar II. I'm 27 years old and have never experienced these symptoms before now. I've been taking Effexor, so I keep thinking that these symptoms are merely med induced (although Effexor didn't do this to me the first time I took it) and that I'm really not bipolar. If anything, I would think that I am somewhere on the bipolar spectrum, but not bipolar II. Am I in denial or just being logical? The DSM states that med induced hypomania cannot qualify as BPII, but rather BPIII. I don't want to split hairs over the diagnosis, and I realize that the most important thing is that the mood stabilizer strategy works, but I still need answers.

So did Effexor cause my hypomania/ mixed state, or did it just bring to light an underlying bipolar disorder? What came first, the chicken or the egg? I realize that this is probably a controversy in the psychiatric community. If indeed I am bipolar and it is just emerging at the age of 27, I can't help but think that it will only get worse. Is it hard to say what my condition really is, or is it clear-cut?
20 Responses
242532 tn?1269553979
These are the right questions, and you are right to pursue them until you get an answer that makes sense,but first of all, if in fact that is the diagnosis, it does not mean that you will get worse as you get older.

It sounds like you are in good hands and the mood stabilizer is right for now, but if you really want to get some solid information, talk to your doctor about getting you stabilized, then trying to get off the Effexor, and after that off the mood stabilizing drug to see what happens...If it was the Effexor that caused the excitability, which it can, then you will know that by this experiment.  Go slowly with this, better to be safe.
Avatar universal
Hi Chancey,

I have bipolar 1 diagnosed when i was 28, my shrink says probably because of my antidepressents.  They do cause hypomania and mania in some people but it's not common.  For years i think i may have had bipolar 2 since i was 20 until one day 8 years after i started taking antidepressents i went into a mania that would last for 2 months and i stayed in hospital for the whole time.  I would feel happy that your doc did diagnose you will bipolar 2.  I hope this means that it won't progress to bipolar 1.

Avatar universal
Hi, I hope you're feeling better, I too take effexor, and was weaned off, because of surgery, and now I'm gradually getting back to my regular dose. Patiently waited for it to kick in again because of depression and anxiety. Maybe you only need your dosage ajusted. My doc told me, since I had to go off for 6 weeks, that I'd probably have to up it a little, at least for a while. I think switching around medications sometimes just makes it worse. It seems like if it helped all along your body may need a little more. I 'd stick with the effexor for now. Good Luck, and try and stay positive, I know it's hell.  Bonnie
Avatar universal
Hi Bonnie,

My doctor had me lower my dose from 225 mg to 150 mg and I'm actually starting to feel better. In the past, 225 mg was a good dosage for me, but this time it caused me to have this alleged hypomania. It helped my depression, but then it caused me to be wired, anxious, have really bad insomnia, racing thoughts, etc. So if anything, my dose was too high.

Right now I'm trying to figure out if I'm really bipolar II or if this episode was just a bad reaction to Effexor.
Avatar universal

So do you think that if meds induce mania or hypomania that one is truly bipolar?
Avatar universal
I have thought of that myself too all i know is i had a ton of symtoms more then some who 'are truly bipolar' so i have experienced it and now when i come off my meds (my doc has tried this) i still get mania/hypomania.  So my shrink says i will need my lithium the rest of my life and apparently lithium does not usually work if you don't have bipolar.  All i know is i'm happy and i'm well.  Hope you will feel this way soon too.  Sorry you are going through this.
Avatar universal
hello all, I was diagnosed with bipolar with rapid cycling. I have had OCD in the past now it seems to be social aniexty is this chemical in nature? I cannot afford any new medicine i am on 3 already. I hate it so much I am lonely all the time because i can't talk to people. I have attacks if i go plcaes myself so Iam depressed because I am so dependent on others.(mywife) I hate my life what can I do. I am mean to my children sometimes I wonder if they are better of without me.
Avatar universal
my mom has not yet been diagnosed with anything. She shows signs of bipolar, not quite sure which one. she has not been herself for 7 months now. She was initially prescribed lexapro and klonopin. She previously had been taking valium daily for the last 15 to 20 years for stress. I think the valium just stopped working and she also experienced several life changes 7 months ago. She was convinced shortly after starting the lexapro that she had had a stroke in her sleep. She said she had this tingling feeling up the back of her head and neck and down her leg that lasted over an hour. That was the start of many self diagnosed illnesses that through 2 mri's, a cat scan, and many doctors visits and test were proven to be false. Of cource no one ever gave her an exceptable explanation for the very real to her feelings. Unfortunately her psych doc did not insist on a set meds schedule so she went on and off the meds and ended up having what I think were withdrawals (she hates the word withdrawal) but she thought they were life threatening illnesses or conditions. We ended up comiting her for 30 days in a mental hospital. She was paranoid, suicidal, she paced contanstantly, was convinced she was "shutting down", and screamed help and shut-up all day. The hospital took her the lexapro and klonopin within a few days and put her on risperdol, remeron, ceroquil, valium, and a heart med. She was sedated and severly depressed. They offered no counseling because they said it wouldn't help till her meds started working. After three weeks they met with us and said the meds were not working like they wanted and preposed shock therapy, we said no!! I asked if it was possible that she was bipolar and having a reaction to the anti depressants and recomended lithium. They said coincidently that was their next med to try if we refused shock therapy. So instead of taking her off some of the meds expecially the anti-depressants they just added lithium to the drug cocktail. They released her and she slept for a month only getting up to eat. Recently we have taken her off all the meds and she is still about the same as she was when we addmitted her to the hospital. From what we could tell she is no better on the meds than off. I think they had her on to many and they were fighting one another and some were just not right at all for her. She is going through withdrawals now but thinks it is toxisity and that her left lung has collapsed because she was taking so many meds together. She no longer wants to live and has given up hope of getting better and the doctors can offer no hope only to commit her again. The medical community has FAILED my mom, it sickens me that they call themselves doctors, they really don't care. All the doctors do is medicate they never talk to her or try to find out what is really wrong with her. At this point we are just day to day. Has anyone out there been through this?? Help I could really use some advice and a little hope wouldn't hurt.
Avatar universal
Am I going to receive a response? I just noticed that people who posted after me have received responses, so I was just curious.
Avatar universal
Hello Everyone..I was just recently diagnosed with BipolarII disorder and I am having a hard time dealing with it, I am giving people close to me a rough time and finding myself up and down. I feel like I have nobody to talk to and go thru periods of lonelyness quite bit lately. I really need some friends to talk to. I don't get on the internet too often these days but if anyone can talk to me my e-mail address is ***@**** or my phone number is 254-640-9339. I know this might seem desperate but unfortunately  I am.Please somebody write or call me. I would like to know more about this.
Avatar universal
Hello love 4 mom, my heart goes out to you hon.
Your mom is so lucky to have you as a child.
I didn't look to see if you signed your name or not , so i don't know if you are female or male.
Anyway i just thought that i would re-enforce the fact , that your mom no doughtedly is going through withdrawel's.
If she was on these drug's for more then a month.
I wonder what her origanal problem was to start with?
I really feel for you.
I sure am glad you refused shock treatment for her.
I was diagnoised with bipolar in 1999, i had so many problem's it was horrible.
If you could just get your mom to the right phychiatrist, to try the right med for her, she would feel so much better, if it is mentally.Tey must try many different med's , till they find the one that work's for her.
I know you said she had test, i just wonder if they have missed anything.
I know you have had her extencively checked.
So the odd's are she is mentally disabled.
This can be a real problem.
Especially for those that have no experience at drug addiction(withdrawel) mental health.
These are such complicated subject's.
How long has she been depressed.
Write me via email and we can try and get to the bottom of it.
I am willing to try and help you.
I know a lot about both subject's mental health and drug addiction.
I volunteer at a clinic an hour away from my home.
and have also been as i said diagnoised with bipolar myself.
I am 51 yrs old, and feel i have been around a while. So if i can help , i would be happy to try and help you.
Even be someone to just run thing's by.
My email is ***@****
My heart and prayer's are with you.
Avatar universal
I have read that antidepressants can cause manic episodes in patients that are predisposed to the disease. They say you are at higher risk if manic depression is somewhere in your family tree. I have suffered with major depression for six years now. I had been on Effexor for five of those years and in Nov. was swiched to Cymbalta because of Effexor's side effects that were only getting worse with time. In Dec. my dose was upped to 60mg and with no time I began having episodes in which I had lots of energy and felt elated. I also began to love spending lots of money, like an addiction.(I could not afford this spending, but did it anyway)The depression still existed and only got worse, then along came the suicidal thinking which ended me up in the mental hospital. One psychiatrist there said it was just major depression, another said I was bipolar. I had never been told this before and it scared me terribly. Have you read all the side effects of the medicine that they put you on for bipolar? I feel like all these doctors with their evaluations and plans to put us on medicine, is all guesses. After talking to me for ten minutes, they're ready to play Russian Rullet with my emotions, my life? I decided, screw 'em. I found a good psychologist that takes the time to get to the true heart of the problem. He doesn't just listen like councilors do and he doesn't just prescribe medicine crossing his fingers that they'll help. He is a life coach and also practices neurofeedback. Go to www.neurofeedback.com to find out more about neurofeedback. Also, checkout www.bipolarworld for more very helpful info. on the meds that are given out to us that are used for many treatments with the hope by the doctor that they might work for us. Antidepressants have altered my personality and caused  me enough problems, I sure am not going to let a doctor guess and put me on anything else for bipolar when that might not even be my problem. It's too risky. Remember it is always our choice to accept the treatment that is suggested for us. If it doesn't feel right and doesn't rest well with you, look elsewhere. This is our lives at stake, they may have went to school and have a big fancy title, but we're all individuals and what works for one, may not work for all. We have a whole world of information at our fingertips.  Take advantage of it and educate yourself as much as possible on the subject. Be strong and always remember it's ok to speak our mind, it's ok to refuse treatment. It's our God given right to protect ourselves. Good luck!
Avatar universal
Please go to www.neurofeedback.com Get as much information on this subject as you can. When all medicines have failed, this has been proven to work. Please don't give up on her. There are listings on this web site for doctors and their location that provide this service. You can also go to www.I.S.N.R  There are tons of websites on neurofeedback (also known as biofeedback) that can give you lots of information on the subject to help you decide that this will help her. I have just recently discovered it myself and have found a wonderful psychologist in Memphis that offers this treatment. Until I found this, I had no hope. Also, go to wwww.bipolarworld.com and read the articles by Simon Sobo, M.D. His articles made me realize how the medical world is failing many of us by guessing with their meds for our treatment. His articles made me realize that there has to be more out there. And when you feel hopeless, go to Yahoo Health Groups and join the lifecoach group.(it's free,like this one) There is page after page of inspirational stories and quotes that we all at times need. Good luck love4mom, there is hope.
Avatar universal

Thanks for your response...After being diagnosed bipolar II, I've been scouring the internet. I've probably read Dr. Phelps' extremely informative website on bipolar II 10 times.


I've visited bipolarworld and just about any other relevant website. I have been obsessed with this.

I know how you're feeling about medication right now...I've felt the same way before and then taken myself off of it. I figured I had learned enough about my moods and coping that I could stave off any episodes cognitively. Boy was I wrong. Both times I discontinued my meds, I fell into deep depressions. I know meds have drawbacks, but right now they're the lesser of two evils. I AM TOO SCARED of falling back into depression.

I wish you luck in your pursuit of a med free life.

Avatar universal
I don't know what to do for my husband or if I can do anything to help anymore.  He was diagnosed as Bipolar last year, when he was hospitalized (a mental facility).  Since, he's been on and off lots of meds and tends to abuse them and self-medicate and overmedicate.  He's been on everything under the sun.  He was back in the hospital, this year, and just released last Friday.  He was in from 13 Feb through 22 Feb.  When he was released, he was prescribed Lithium, Abilify, Klonopin, Wellbutrin, Adderal 10 mg XR and Neurontin.  This was by the hospital dr.  Yesterday, he went to his primary and got more Adderall, at 30 mg. regular and a Valium (not sure of the dosage).  

To me,  it sounds and looks like he's getting ready to start abusing his meds, again.  As it is, he was supposed to take 2 Lithiums in the morning.  He's already decided to reduce it to 1.  He's done this for a long time.  He's also a VERY good manipulator, very pursuasive and tends to lie A LOT.

Should I call his primary doctor?  Call the place where he goes to Intensive Outpatient Therapy?  I just don't know anymore, but I really don't think our marriage will survive this....because I just can't stay on top of his game anymore.

Please feel free to responde here or send an email, to me, directly to ***@****.

Avatar universal
I was diagnosed with BPII as well and having the same problems with med induced mania. I am still wondering if I am truly bipolar despite what everyone tells me.

This is the DSM-IV criteria for Bipolar II:

However the DSM-IV criteria for Manic Episode states:

"E. The symptoms are not due to the direct physiological effects of a  substance  (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).

Note: Manic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar I Disorder."

So that means I'm not Bipolar I?? but Bipolar II?? Since under the criteria for Bipolar II doesn't mention the med induced mania... It's really confusing. I've been on meds so long, I'm not even sure if I had mania without meds before.

The problem is I need to take a mood stabilizer along with an anti-depressant to counteract the mania. And I NEED something for the depression part so I have to take mood stabilizers for the med induced mania it seems.

Avatar universal
BTW I just got on the starter kit for Lamictal recently as well, along with Zoloft. You can email me at: ***@****

Maybe we can figure this out since I don't know anyone else who has had the same problem.
Avatar universal

To all those who wonder if they're "truly" bipolar... In the last 16 years I've been diagnosed as PTSD (late '80s), then bipolar II (by major Hopkins specialist) and now , who knows?  While the PTSD was undoubtedly correct and took about 5 years of intensive therapy and medication to treat, the bipolar II was/is remains difficult as a diagnosis. I've been blessed to have both good therapists and a good psychiatrist over the years.  The one time I did very poorly was when I did have a not good enough pschdoc. (Rapport is everything!).

I still have PTSD problems occasionally but it's hard to tell how thatmight also be related to bipolar II.  I've also had some severe anxious periods (large worries, pacing for days, inspired solutions,etc.)that struck everyone as hypomania.  Chicken or egg? The most I have learned is that biological presdispositions are probably very important.  Most likely, something (like PTSD) triggered an underlying "predisposition" to bipolar hypomania in me.   But it is really hard to tell the difference between that and some clever PTSD coping mechanisms...
I suspect that what I'm saying strikes you as little help. It all depends on so much stuff- life, biology, etc.  You might not have much trouble in the future.  What I do know is that studies have found that people who've gone untreated stand a huge chance ot more episodes with more frequency- in other words things get worse.  But most of that evidence is for bipolar I. Bipolar II is much less obvious and newer (less studied) so who knows the probable course? I err on the side of caution myself.

  Finally I've learned over the years that the diagnosis is a "label" or category in which to slot you.  It is truly important for insurance purposes but not all treatments work for everyone.  In addition, because of studies and extensive case reports, new additions of the DSM recategorize everything. As my doc once said, I'm treating your symptoms not your category...
Hope this helps some,

Avatar universal
Hi Everyone,

  I've read alot of your messages and I too was diagnoised with bipolar 1,10 years ago and was put on atleast 8 meds that eventually sent me to the emergency room, too many meds to name. I then found another dr. and was diagnosed  with bip 11, my symptoms are deep depression, bad mood swings, happy one day crying out of control the next. This crying is only seldom the depression is dailey .I am know taking 200 mg of lamictal and 3mg xanax a day. I sometimes get paranoid . not to the point that someone is after me, but to the point of losing my job or someone at work doesnt like me . I sometimes sit in the house and watch tv all day I don't enjoy doing anything and I mean anything no desire to enjoy what short life I have...My poor husband is LOST he doesnt know what to do for me, I've told him you cant do anything for me . The lamictal worked for a short time but know my mood swings are becoming so severe.My anger is to the point of acting like a loonie. I would like to know what is the difference between bipolar I and II. Which is the most severe and what are the symptoms, Loved ones are telling me to try lithium, I've heard that this med makes you a zombie, is this true. This is my first message . Thanks for any reply Lee21
Avatar universal
I was diagnosed with BP two years ago - having experienced massive depression bouts most of my life which I have self managed without medication.  I had no idea that I was manic, I just thought everyone was kidding when they couldn't stay up for days on end and couldn't follow the quickness of my thoughts...But life was no fun - BP brings with it the almost impossible task of being "happy" in the normal sense of the word.  I was only diagnosed when i was at the brink of "not wanting to be here"....I am now on Epilim and take my purple pill every day - I never want to go to that place again (even though I miss the manics a bit).  And finally, during my research it's very clear that people who were misdiagnosed with depression and given SSRIs etc are likely to get med induced BP2 manic - where if they had never had the meds they might have gone through life without any manics.  It's the luck of the draw - I had a great doctor who realised that my depressed state was cyclical and referred me to a shrink rather than giving me pill first.
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