The effect of Bipolar

[Rite760]

My sister has been on anti-depressants for 20 yrs due to severe clinical depression which she developed in her 20s accompanied by OCD. In the 20 years in between she has always been slightly depressed but ok. Last year she started drinking very very heavily almost as an alcoholic and started to forget to take her anti-depressant tablets that she's been on since that episode in her 20s, and slowly her behaviour became a bit euphoric, but when the doctor stopped her anti-depressants abruptly when she developed Pneumonia as they interacted with the anti-biotics, she suffered severe problems within 2 days of stopping them, including delusions and this was then followed by mild mania for 10 mths. It has taken until 3 months ago to decide she may have Bipolar and she has been tried on various meds. This week she has dropped from high to deep depression after they changed her tabs again. I want to ask, could it be that she had Bipolar since the first severe depression in her 20s but it has been controlled by the anti-depressants so never picked up on. Or is it that stopping the anti-depressants so suddenly triggered the Bipolar? No one else in the family has it, but my other sister has unipolar depression recently. Also, the sister with the ?Bipolar has 2 children, is it very likely that they will also develop the condition and if so, would it be in adolescence or when they are older? And is it also possible that my other sister with unipolar depression might turn into Bipolar, or if she was going to develop Bipolar would it have happened in her 20s, if this is what you think happened to my sister who has now been diagnosed with the ?Bipolar. Her doctor thinks it's just normal depression but she is worried. Sorry this is so long.

[Roger Gould, M.D.]

I don't know who ILADVocate is, but he or she gave you a textbook perfect answer to your sister's situation. I would not fret about the genetic disposition and likelihood of other members of the family becoming bipolar. Yes there is some increased vulnerability, but not enough to worry about or do anything about.

[ILADVOCATE]

Depression does not turn into bipolar. And anti-depressents if given to a person with bipolar will make them manic. She needs a mood stabilizer. The most common ones are Lithium, Depakoate and Lamictal. The safest one of the three is Lamictal. It has a good side effect profile but there is a potential for a rare rash but if monitored its safe. I took it and had no severe side effects. There are a variety of forms of bipolar, some with the depressive aspect more evident but if she had one manic episode then she has some form of bipolar disorder. If her psychiatrist is unable to help her fully have him/her make a consult to a mood disorders specialist. And drinking and/or using recreational drugs will make a person non responsive to any medication. She needs to be in a recovery program for people who are MICA (Mentally Ill, Chemically Addicted) which is the official term. Right now she needs two forms of recovery, medication and a support group such as AA to control her alcoholism. Go with her to the psychiatrist and help explain and see what they can do but talk to her about it first to make sure she's okay with it.

[Rite760]

Sorry Doctor, but wanted to add, could it also be that she has been misdiagnosed. That it's not Bipolar, that it's still the long term chronic depression that she has had all her life? Because that is how she has gone back to being now.