Can't do it, not even if sober
October 8, 2007 7:44 AM Subscribe
I think I might have bipolar II. What now?
When I was younger (13), I was hospitalized for severe depression and suicidal ideation. I was diagnosed with Major Depressive Disorder and began a long course of treatment throughout my teens involving therapy and a veritable smorgasbord of SSRIs and tricyclic antidepressants, none of which did much good. During my adolescent years, I had many severe bouts of depression which my treatment always focused on. However, looking back on my life, I think I was misdiagnosed from the get go.
It dawned on me a few days ago that what I consider “happy” is really a semi-manic state, involving excessive energy, incredible productivity, grandiose thoughts of “having it all figured out,” immoderate planning, extreme religiosity, and often times incredibly poor judgment. I never considered that I was bipolar because I didn’t have flat out mania.
While what I experience does not qualify as mania, looking back on my life, it is definitely not what other people consider happy. And my “happy” states almost invariably lead to depressive episodes. I spend much of my time in a semi-euphoric state and much of the other time in severe depression. The times I spend in between tend to fade into depressive states because I feel the normal “happy” state is not being achieved, so I feel there is something wrong with me. I cannot live up to the great realizations I have when not depressed. Enlightenment proves more than just a step away and I crash into hopelessness. I have begun to realize that the yardstick I have been using to judge how I should be feeling all these years was one of the problems and actually feeding the cycle. After this realization, I did a little research and discovered, much to my dismay, bipolar II, and if you look it up in the dictionary, you see my name as the third definition.
As an aside, I am also a perfect example of dual diagnosis as I was a heavy drug and alcohol abuser for my entire adult and adolescent life. My substance abuse started about 6-12 months after I was discharged from the hospital. I have been clean and sober for the last 9+ months though, which is by far the longest I have been sober since that time, and has probably provided the clarity I needed to have this sort of insight into my “condition.”
From what I have read, SSRIs and other antidepressants can have a very negative effect on patients with bipolar. In addition to them being ineffective, I definitely had severe negative effects at times. For instance, I was prescribed luvox in my early 20’s. The drug sent me into a full-blown manic state culminating in a complete fugue state of at least 2-3 days. (I am just now, almost ~7 years later recovered from that experience.) Due to experiences like this, I am essentially terrified of Pfizer Avenue and will avoid it if at all possible. Which bring me to my questions.
Assuming that I am bipolar II what sort of treatments/life styles, besides traditional medicine, can I pursue to mitigate the effects it has on my life? Diets? Regimens? Vitamins? Religious rituals? I am open to pretty much anything.
If you have been diagnosed with bipolar II, what medicines were you prescribed and how did they help or hurt you?
I am open to therapy, but please only recommend it if you are bipolar of some sort, or a therapist who has treated people with bipolar. Otherwise, I feel this question will just turn into a ‘nthing of therapy. And frankly, I have been in and out of therapy my whole life and it hasn’t done much for me. However, I am open to the idea that it might help if a better diagnosis was obtained.
I am also interested in anybody’s experience with bipolar II.
Thanks for reading.
When I was younger (13), I was hospitalized for severe depression and suicidal ideation. I was diagnosed with Major Depressive Disorder and began a long course of treatment throughout my teens involving therapy and a veritable smorgasbord of SSRIs and tricyclic antidepressants, none of which did much good. During my adolescent years, I had many severe bouts of depression which my treatment always focused on. However, looking back on my life, I think I was misdiagnosed from the get go.
It dawned on me a few days ago that what I consider “happy” is really a semi-manic state, involving excessive energy, incredible productivity, grandiose thoughts of “having it all figured out,” immoderate planning, extreme religiosity, and often times incredibly poor judgment. I never considered that I was bipolar because I didn’t have flat out mania.
While what I experience does not qualify as mania, looking back on my life, it is definitely not what other people consider happy. And my “happy” states almost invariably lead to depressive episodes. I spend much of my time in a semi-euphoric state and much of the other time in severe depression. The times I spend in between tend to fade into depressive states because I feel the normal “happy” state is not being achieved, so I feel there is something wrong with me. I cannot live up to the great realizations I have when not depressed. Enlightenment proves more than just a step away and I crash into hopelessness. I have begun to realize that the yardstick I have been using to judge how I should be feeling all these years was one of the problems and actually feeding the cycle. After this realization, I did a little research and discovered, much to my dismay, bipolar II, and if you look it up in the dictionary, you see my name as the third definition.
As an aside, I am also a perfect example of dual diagnosis as I was a heavy drug and alcohol abuser for my entire adult and adolescent life. My substance abuse started about 6-12 months after I was discharged from the hospital. I have been clean and sober for the last 9+ months though, which is by far the longest I have been sober since that time, and has probably provided the clarity I needed to have this sort of insight into my “condition.”
From what I have read, SSRIs and other antidepressants can have a very negative effect on patients with bipolar. In addition to them being ineffective, I definitely had severe negative effects at times. For instance, I was prescribed luvox in my early 20’s. The drug sent me into a full-blown manic state culminating in a complete fugue state of at least 2-3 days. (I am just now, almost ~7 years later recovered from that experience.) Due to experiences like this, I am essentially terrified of Pfizer Avenue and will avoid it if at all possible. Which bring me to my questions.
Assuming that I am bipolar II what sort of treatments/life styles, besides traditional medicine, can I pursue to mitigate the effects it has on my life? Diets? Regimens? Vitamins? Religious rituals? I am open to pretty much anything.
If you have been diagnosed with bipolar II, what medicines were you prescribed and how did they help or hurt you?
I am open to therapy, but please only recommend it if you are bipolar of some sort, or a therapist who has treated people with bipolar. Otherwise, I feel this question will just turn into a ‘nthing of therapy. And frankly, I have been in and out of therapy my whole life and it hasn’t done much for me. However, I am open to the idea that it might help if a better diagnosis was obtained.
I am also interested in anybody’s experience with bipolar II.
Thanks for reading.
Wow, your story sounds exactly like mine except for the substance abuse. I had never been adequately treated for most of my life because my hypomanic episodes happened less often than the severe depression.
I finally got a really good doctor, who tried me on Lamictal. I've been more stable since then than I've been in thirty years. I really don't feel like I've had any of the emotional problems I've dealt with.
posted by la petite marie at 8:00 AM on October 8, 2007
I finally got a really good doctor, who tried me on Lamictal. I've been more stable since then than I've been in thirty years. I really don't feel like I've had any of the emotional problems I've dealt with.
posted by la petite marie at 8:00 AM on October 8, 2007
I have had very similar experiences in life. I don't want to go into a long, detailed history of my mental past, but suffice it to say I have been there. The bottom line, and the first step, is to find yourself a great psychiatrist. That is the only person who is qualified to say whether or not you are Bipolar (and even then, as you can see, it's not a sure thing!) There are many drugs you can use to stabilize your mood if you are Bipolar. I used Tegretol for many years with moderate success. There are also drugs like Lithium, Depakote, Lamictal, and many others, I am sure. Some of these have side effects you may not like, or require frequent blood tests to check their levels, so you should explore your options thoroughly. Sometimes psychotherapy is warranted for people with Bipolar and sometimes it isn't. That's a decision you (and possibly your new kickass psychiatrist) should make.
I think drugs are a good place to start looking for treatment, but they arent a magic bullet, and they don't work well for everyone. I am currently completely unmedicated and I am more stable than at almost any other point in my life. Sometimes lifestyle changes can make a dramatic impact. I am a big believer that what you put into your body, and what you do with your body in terms of physical activity has a huge impact on mental status. Remember -- even if you receive a diagnosis from a medical professional, it doesn't always mean that it is true. I tried medical and prescription avenues to manage my mental health for many years and I have found a way to be much happier without them. Figure out what works for you and then find a way to do it. Good luck! I would be happy to talk about this in more detail via email, which is in my profile.
posted by theantikitty at 8:04 AM on October 8, 2007
I think drugs are a good place to start looking for treatment, but they arent a magic bullet, and they don't work well for everyone. I am currently completely unmedicated and I am more stable than at almost any other point in my life. Sometimes lifestyle changes can make a dramatic impact. I am a big believer that what you put into your body, and what you do with your body in terms of physical activity has a huge impact on mental status. Remember -- even if you receive a diagnosis from a medical professional, it doesn't always mean that it is true. I tried medical and prescription avenues to manage my mental health for many years and I have found a way to be much happier without them. Figure out what works for you and then find a way to do it. Good luck! I would be happy to talk about this in more detail via email, which is in my profile.
posted by theantikitty at 8:04 AM on October 8, 2007
I was originally diagnosed (5 years ago) with depression, and was on a slew of SSRI's and other antidepressants up until about 6 months ago when my newest doctor diagnosed me as bipolar II. He put me on lamictal and I've been better than ever. There have been no side effects that I can think of, which has not been the case for many of the SSRI's I have taken.
As always, I try (and mostly succeed) at working out 3x a week, eating well, getting outdoors/sunshine, etc. Others will surely pound in the "exercise, exercise, exercise" routine; that's because it works.
And therapy? Well, if it hasn't worked well for you in the past, I don't know how well it could work for you now. That being said, I'm not sure if therapists have specialized methodologies for bipolars - I haven't been to a therapist since way before I was diagnosed bipolar.
Your profile indicates that you're in Antarctica, so I don't think my psychiatrist recommendations for orange county, CA, will help you.
posted by escher at 8:29 AM on October 8, 2007
As always, I try (and mostly succeed) at working out 3x a week, eating well, getting outdoors/sunshine, etc. Others will surely pound in the "exercise, exercise, exercise" routine; that's because it works.
And therapy? Well, if it hasn't worked well for you in the past, I don't know how well it could work for you now. That being said, I'm not sure if therapists have specialized methodologies for bipolars - I haven't been to a therapist since way before I was diagnosed bipolar.
Your profile indicates that you're in Antarctica, so I don't think my psychiatrist recommendations for orange county, CA, will help you.
posted by escher at 8:29 AM on October 8, 2007
Bipolar 2 is hard to diagnose so it's not a surprise you've been previously treated for depression.
Make an appointment with a pdoc and have him specifically screen you for it. FWIW Lamictal is turning out to be the drug of choice for the condition these days. I was on it for years and did very well with it.
Also, exercise, fish oil tablets and REGULAR sleep habits are all very important.
One thing to consider is having a good social support system. Anything you can do to build and maintain that will be a real plus. I mean, having supportive family, friends, church, etc. Every doc I ever saw stressed the importance of that.
Finally try to avoid as much life stress as possible in the meantime. Bipolars have a rougher time handling it and it triggers cycles (and one reason why the support system is so valuable.)
posted by konolia at 8:58 AM on October 8, 2007
Make an appointment with a pdoc and have him specifically screen you for it. FWIW Lamictal is turning out to be the drug of choice for the condition these days. I was on it for years and did very well with it.
Also, exercise, fish oil tablets and REGULAR sleep habits are all very important.
One thing to consider is having a good social support system. Anything you can do to build and maintain that will be a real plus. I mean, having supportive family, friends, church, etc. Every doc I ever saw stressed the importance of that.
Finally try to avoid as much life stress as possible in the meantime. Bipolars have a rougher time handling it and it triggers cycles (and one reason why the support system is so valuable.)
posted by konolia at 8:58 AM on October 8, 2007
Yeah, don't try any drugs that aren't legal; there's no way they could have as beneficial effects as the lords of public policy and their drugs do.
Personally a healthy dose of skepticism has done wonders for my mental health issues. And exercise.
posted by shownomercy at 10:47 AM on October 8, 2007
Personally a healthy dose of skepticism has done wonders for my mental health issues. And exercise.
posted by shownomercy at 10:47 AM on October 8, 2007
I find being overstimulated can lead to a manic episode. Too much input of the senses, particularly sound (I once had an episode triggered by a baroque piece at the symphony) and touch (such as wearing a scratchy sweater or a fussy hairstyle that I'm constantly aware of) is not good for me. To counteract it, I try and do the opposite: quiet places, no television, simple food with no strong tastes, and soft comfortable clothing. Best of all for dealing with an episode after it has started is a warm bath, because having all of my skin receiving the same sensation at once is very calming to the manic stuff.
posted by happyturtle at 11:50 AM on October 8, 2007
posted by happyturtle at 11:50 AM on October 8, 2007
I am essentially terrified of Pfizer Avenue and will avoid it if at all possible.
If you truly are bipolar, it is likely not possible. Keep in mind that active avoidance of effective treatment is one of the symptoms of being bipolar.
posted by Justinian at 12:25 PM on October 8, 2007
If you truly are bipolar, it is likely not possible. Keep in mind that active avoidance of effective treatment is one of the symptoms of being bipolar.
posted by Justinian at 12:25 PM on October 8, 2007
Mod note: a few comments removed, two-word "do drugs" answers aren't really helpful. feel free to elaborate or skip the question
posted by jessamyn (staff) at 12:51 PM on October 8, 2007
posted by jessamyn (staff) at 12:51 PM on October 8, 2007
Bipolar II here; with rapid cycling, seasonal affective disorder, and hypothyroidism. All doing great after many, many years of hypomania and suicidal depressions.
First get a formal diagnosis. I'm not sure why theantikitty feels that only a psychiatrist would be qualified to do that part, since prescribing medications is not required to make the diagnosis. As part of the diagnostic process, it would be helpful to consult with your regular doctor to do thyroid testing. Thyroid problems are significantly more common among bipolars. Thyroid disease is also easily mistaken for bipolar (or vice versa). Even if your thyroid is fine now, mood stabilizer meds sometimes reduce thyroid function, so don't be surprised if you need some treatment later.
Unless the testing uncovers a thyroid condition AND the treatment for it fully resolves all your symptoms, be firm about requesting a referral to a(ny type of) therapist who specializes in mood disorders. It's critical to be evaluated by someone who knows this disease and related ones well, because bipolar illness is so frequently missed or mis-disagnosed or incompletely diagnosed -- and the consequences of treatment for the wrong condition (e.g. using antidepressants, as you know) are too serious.
Read up on omega-3 fish oil for bipolar. The research is still new enough and incomplete enough that it's a good idea to take the hype with a grain of salt. I still remember when the new hot alternative to meds was St. John's Wort, and now we know that's as risky as the rest of the antidepressants when you're bipolar. So exercise caution. Nevertheless right now fish oil does look promising, and it holds out that lovely hope of managing the disease without all the nasty side effects. Once you have a diagnosis, and if it is in fact bipolar II, it's worth discussing with your doctor whether it's appropriate for you.
posted by nakedcodemonkey at 6:15 PM on October 8, 2007
First get a formal diagnosis. I'm not sure why theantikitty feels that only a psychiatrist would be qualified to do that part, since prescribing medications is not required to make the diagnosis. As part of the diagnostic process, it would be helpful to consult with your regular doctor to do thyroid testing. Thyroid problems are significantly more common among bipolars. Thyroid disease is also easily mistaken for bipolar (or vice versa). Even if your thyroid is fine now, mood stabilizer meds sometimes reduce thyroid function, so don't be surprised if you need some treatment later.
Unless the testing uncovers a thyroid condition AND the treatment for it fully resolves all your symptoms, be firm about requesting a referral to a(ny type of) therapist who specializes in mood disorders. It's critical to be evaluated by someone who knows this disease and related ones well, because bipolar illness is so frequently missed or mis-disagnosed or incompletely diagnosed -- and the consequences of treatment for the wrong condition (e.g. using antidepressants, as you know) are too serious.
Read up on omega-3 fish oil for bipolar. The research is still new enough and incomplete enough that it's a good idea to take the hype with a grain of salt. I still remember when the new hot alternative to meds was St. John's Wort, and now we know that's as risky as the rest of the antidepressants when you're bipolar. So exercise caution. Nevertheless right now fish oil does look promising, and it holds out that lovely hope of managing the disease without all the nasty side effects. Once you have a diagnosis, and if it is in fact bipolar II, it's worth discussing with your doctor whether it's appropriate for you.
posted by nakedcodemonkey at 6:15 PM on October 8, 2007
This thread is closed to new comments.
posted by four panels at 7:45 AM on October 8, 2007