~*~BiPolar Folks~*~

[faithgirl]

Originally Posted by CurveControl

dose increase of the lamictal? It should be ok. If I have a bad (read 'mean') reaction to an increase it takes a couple of days and I can feel it creeping up.

Is that the reaction you usually have? You get mean? To just the Lamictal or to other drugs as well? I went back to taking the Klonopin but My temper is getting out of control. Not always, but when something is trying for me, I just get angry. I've been on the increased dose of Abilify since Thursday so I wonder if that's it? I was really suspecting the Cymbalta though. I am thinking I just need to make another appointment with the pdoc.

[djalomo]

Maybe you might need to go back down a notch on the Abilify? On Geodon I felt great at first but got INSANE a few weeks in at a higher dose - I'd NEVER experienced true road rage before - it was like nothing else I'd ever felt in terms of anger/rage for absolutely nothing. The Adderall years were pretty close though, but I was generally always at about a 7 or 8 in terms of anger, and after a few weeks on Geodon I'd be smooth sailing with NO anger/rage then all of a sudden I'd get behind the wheel and want to murder somebody. It was weird too - I'd get these insane cravings for juice when it happened. And I never drink juice, I never crave fruit. But I'd carry those Odwalla juices around me and once the sugar got in my bloodstream I felt like the rage would calm.

[faithgirl]

But I'm only on 5 mg. The regular dose is 30 mg I think.

[djalomo]

Originally Posted by faithgirl

But I'm only on 5 mg. The regular dose is 30 mg I think.

Ahh what were you on before? THe thing with my drug at least is that the speed of the titration is what makes all the difference. Even at a super low dose if I increase too fast I'll be mixed and restless. 50 up to 75 did that, i went back down to 50 for another week and then wehn i tried again at 75 it was ok.

[faithgirl]

I was on 2 mg before this. I can't wait until we find the right combo to make me feel human.

[djalomo]

Originally Posted by faithgirl

I was on 2 mg before this. I can't wait until we find the right combo to make me feel human.

hmmm maybe you need another few days back down at 2, and then go back up to 5? i wouldn't up the Klonopin for the anger, that seems like it would set you up for resistance to it eventually. but your doc might have a better idea. for me Celexa made me niiiiice and calllllllm and really really even as far as anger - so did Paxil. If it's not the Abilify maybe they can wean you off the Cymbalta and onto another AD that helps with calming. On Celexa I didn't need a benzo at all for anxiety/rage, etc.

[faithgirl]

No, I really can't up the Klonopin becuase it would knock me out. I don;t want to anyway. I do think it is holding down some of the anger/rage though so without it, it would be REALLY bad. I'm thinking it's the Cymbalta, but I have tried so many ADs that I have no idea what's even left to try. You really think dropping the Abilify a couple of days would help?

[djalomo]

Originally Posted by faithgirl

No, I really can't up the Klonopin becuase it would knock me out. I don;t want to anyway. I do think it is holding down some of the anger/rage though so without it, it would be REALLY bad. I'm thinking it's the Cymbalta, but I have tried so many ADs that I have no idea what's even left to try. You really think dropping the Abilify a couple of days would help?

Hmmm which AD's have you tried? I have anxiety issues and as a result have a lot of irritability unmedicated, and the AD's docs seem to go to that have properties to help with anxiety/irritability as well seem to be Celexa, Paxil and Prozac. (Prozac did NOT have that effect on me though.) Effexor, Pristiq, etc. drugs in that class made it a little worse. I didn't stay on Cymbalta or Lexapro long enough to feel a difference.

When is your appointment again? Definitely address this with your doc. He also will prob most definitely take calls between appointments and advise you that way.

But yeah, when I titrated up too fast on Lamictal that time I was a bear. EVERYONE and EVERYTHIGN was annoying me bad. Bad bad bad.

I still have some issues with anxiety, I'm taking Xanax right now but want a better solution. Celexa KILLS my anxiety cold but in the past did nothing for my depression. I'm wondering if Celexa+Lamictal is going to be my ultimate coctail that addresses everything. I'd love that.

[faithgirl]

I've taken Zoloft, celexa, trazadone, Buspar, Cymbalta, Prozac, Pristiq and Lexapro. Had problems with all of them, but I never really gave Lexapro a real chance. It cost $106 and i wans't gonna pay that. I did call my insurance and I can get 90 days supply for $50.00 if I do the mail order. Go figure. I wouldn't mind trying that one again. I think I am going to give them a call since my next appointment isn't until 8-24. I have too much stress at work to let this go on.

[djalomo]

Originally Posted by faithgirl

I've taken Zoloft, celexa, trazadone, Buspar, Cymbalta, Prozac, Pristiq and Lexapro. Had problems with all of them, but I never really gave Lexapro a real chance. It cost $106 and i wans't gonna pay that. I did call my insurance and I can get 90 days supply for $50.00 if I do the mail order. Go figure. I wouldn't mind trying that one again. I think I am going to give them a call since my next appointment isn't until 8-24. I have too much stress at work to let this go on.

Hmm yeah call and tell him.

The drugs you mentioned are mostly in different classes, so if it makes you feel better your options aren't even CLOSE to exhausted. Can your doc give you samples of the meds before you buy them? My internist and pdocs do this usually. That way if I have a weird reaction I didn't have to buy it. If they don't have samples in house I wonder if they can contact the drug companies to get some?

[djalomo]

Also - Faithgirl I'd forgotten about this, but my old pdoc (who was great but left the practice) I remember on my first or second appointment we were talking about all of my issues, and he said this:

Tell me, if I could fix 3 of your problems - in order, what would they be?

I loved that he was honest about this - that he couldn't fix everything at once, but wanted to know at the time what my priorities felt like they were and what was feeling the WORST at the time. The concept was that this COULD change, but what needed the most help right now?

Mine were

1. Depression. The depression. Just take the depression away. I wanted to pass time until I died. I thought about getting a second job to make it go faster until I died.

2. The anxiety. That cloud of doom. Make it go away. I couldn't talk to strangers or even, say, my eye doctor or receptionists or make appointments and keep them. I couldn't do social engagements either. It was affecting my work and life in general.

3. Sleep. I need sleep.

And that's how he decided on my first med. It really, really fit the bill at the time and was a miracle. But on my 4th appointment or so I was willing to compromise some of the anxiety for something that was more weight-neutral, because the weight gain was freaking me out.

So, know that it's something that might be dynamic and change with time. You might find something that works for a few years, and then something can change and that's ok you can change your treatment with the right doc.

It REALLY truly is more of an art than a science.

[faithgirl]

It's funny he didn't give me any samples of the Abilify and when I found out how much a months worht was, I called the office and asked if I could get some and the receptionist said my pdoc doesn't sign for samples, but she had some and would give them to me. I don't know why he wouldn't have them himself? The way I normally react to ADs, I definitly want samples in the begining.

[faithgirl]

I'll keep that in mind about the meds maybe needing to change over time. I like the top 3 things, too. I need to think on that and let him know these are my top problems and can we focus on them.

[djalomo]

Originally Posted by faithgirl

It's funny he didn't give me any samples of the Abilify and when I found out how much a months worht was, I called the office and asked if I could get some and the receptionist said my pdoc doesn't sign for samples, but she had some and would give them to me. I don't know why he wouldn't have them himself? The way I normally react to ADs, I definitly want samples in the begining.

Ahhh I forgot how expensive Abilify is. What size city are you in? I wonder if their access to reps from the companies make a difference. I think the "signing" thing might be a lingo translation she said badly - like maybe he doesn't write scrips for samples? That sounds weird though. I don't remember it working that way. I always got a scrip WITH my samples even though I had months of samples at a time. Yeah that just doesn't sound right. Are you sure she's a receptionist and not a PA or someone else that is allowed to write prescriptions? how weird. If I had samples I'd give them to you.

[djalomo]

Originally Posted by faithgirl

I'll keep that in mind about the meds maybe needing to change over time. I like the top 3 things, too. I need to think on that and let him know these are my top problems and can we focus on them.

You know that question REALLY struck a chord with me when he asked - and I actually responded even without hesitation. It didn't occur to me though to catagorize them before. It was really one of the first times I felt like a doc was absorbing my needs and processing it and problem-solving.

He was actually the first doc to that didn't try to do completely talk-therapy. He was just like "ok, this is an organic issue, i'm not disputing you have other issues that therapy would help with, but let's fix the chemistry right now" and that was that.

[faithgirl]

She answered the phone, so I assume she was a receptionist or something. I am sure she got permission before I came in as I had already gotten to the drug store. But she did just tell me to come in and get them. Also, when I was there a drug rep came in and asked if she had enough Abilify and she said yes. The drug rep did not ask to see the doctors. Maybe she was a PA and she answers the phones to answer patient's questions? When I get samples from my regular doc, I do not get an RX until we know it is going to work.

[faithgirl]

None of the pdocs do talk therapy in this area. You have to gomto a therapist for that. I like that my pdoc asked good questions ans seemed empathetic. Did you ever get a new pdoc?

[djalomo]

Originally Posted by faithgirl

None of the pdocs do talk therapy in this area. You have to gomto a therapist for that. I like that my pdoc asked good questions ans seemed empathetic. Did you ever get a new pdoc?

I'm still in transition. One more appt. with my current doc who practically let me die (ok hyperbole there lol) and then in August I have an appt. with someone who was recommended by my internist. He's hard to get into though - I booked this appoint. in June.

[faithgirl]

I hate that they take so long, but maybe that's becuase they are good? I am so glad mine had a cancellation. I had called the day before syaing I really needed to get in and when they had the cancellation, they called me.

[CurveControl]

Originally Posted by faithgirl

Is that the reaction you usually have? You get mean? To just the Lamictal or to other drugs as well? I went back to taking the Klonopin but My temper is getting out of control. Not always, but when something is trying for me, I just get angry. I've been on the increased dose of Abilify since Thursday so I wonder if that's it? I was really suspecting the Cymbalta though. I am thinking I just need to make another appointment with the pdoc.

With the lamictal it is ONLY if I increase too fast. I can increase, But only a very small amount at a time, then I am fine. It isn't the increased dose that does it, it is the sudden increase.

Wellbutrin made me mean too but that is an AD and some will make me a little hypomanic, but that one made me hypomanic and mean.
AD's do not work well for me.

[Houston Heather]

I was pretty hyper this morning, wanted to go SHOPPING! Then the lithium kicked in and I am slooooow.

When I had my nap it was very detailed, so I'm still a little manic. I can always tell by my dreams.

[faithgirl]

I called the pdoc and they are going to squeeze me in as soon as they can. i cannot take this anger. I have no patience for anyone. I am back at work and I want to hit one of these idiots. As you can imagine, I am a charming person to be around right now.

[faithgirl]

Originally Posted by Houston Heather

I was pretty hyper this morning, wanted to go SHOPPING! Then the lithium kicked in and I am slooooow.

When I had my nap it was very detailed, so I'm still a little manic. I can always tell by my dreams.

In my dream this morning I dreamed I was back at work and kept saying the 'f' word and that's a word I never say.

[EzraDuncan]

Is it possible to go from bipolar to just depression?

[CurveControl]

Originally Posted by EzraDuncan

Is it possible to go from bipolar to just depression?

No. It is possible to be depressed with bipolar, but unless you were misdiagnosed toy do not get over BiPolar and change to just unilatteral depression.

It is a brain chemistry thing. There is a big difference in the chemical balance (Imbalance?) in unilateral depression and BiPo. That is why often just use of AntiD can exacerbate BiPo symptoms rather than help them.

BiPolar is a spectrum disorder where you can go from severely depressed to extremely manic, at its worst (BiPo I) with lesser degrees being diagnosed with BiPo II, and some with even less variation, but still out of the norm as cyclothemia.

I spent a lot of time depressed. Since hypomania feels good, productive most people do not even look for help unless they are in a depressed state.

I will look for a diagram I saw, I don't remember which site so give me a few minutes.

[EzraDuncan]

Originally Posted by CurveControl

No. It is possible to be depressed with bipolar, but unless you were misdiagnosed toy do not get over BiPolar and change to just unilatteral depression.

It is a brain chemistry thing. There is a big difference in the chemical balance (Imbalance?) in unilateral depression and BiPo. That is why often just use of AntiD can exacerbate BiPo symptoms rather than help them.

BiPolar is a spectrum disorder where you can go from severely depressed to extremely manic, at its worst (BiPo I) with lesser degrees being diagnosed with BiPo II, and some with even less variation, but still out of the norm as cyclothemia.

I spent a lot of time depressed. Since hypomania feels good, productive most people do not even look for help unless they are in a depressed state.

I will look for a diagram I saw, I don't remember which site so give me a few minutes.

I was Dx bipolar and took a whole lot of Rx but I think I was just in a bad situation in life and my Dr. was an idiot.

I almost never have mania anymore, just friggin depressed.

[CurveControl]

.

Bipolar disorder usually lasts a lifetime. Episodes of mania and depression typically come back over time. Between episodes, many people with bipolar disorder are free of symptoms, but some people may have lingering symptoms.

Doctors usually diagnose mental disorders using guidelines from the Diagnostic and Statistical Manual of Mental Disorders, or DSM. According to the DSM, there are four basic types of bipolar disorder:

1. Bipolar I Disorder is mainly defined by manic or mixed episodes that last at least seven days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, the person also has depressive episodes, typically lasting at least two weeks. The symptoms of mania or depression must be a major change from the person's normal behavior.
2. Bipolar II Disorder is defined by a pattern of depressive episodes shifting back and forth with hypomanic episodes, but no full-blown manic or mixed episodes.
3. Bipolar Disorder Not Otherwise Specified (BP-NOS) is diagnosed when a person has symptoms of the illness that do not meet diagnostic criteria for either bipolar I or II. The symptoms may not last long enough, or the person may have too few symptoms, to be diagnosed with bipolar I or II. However, the symptoms are clearly out of the person's normal range of behavior.
4. Cyclothymic Disorder, or Cyclothymia, is a mild form of bipolar disorder. People who have cyclothymia have episodes of hypomania that shift back and forth with mild depression for at least two years. However, the symptoms do not meet the diagnostic requirements for any other type of bipolar disorder.

[EzraDuncan]

Originally Posted by CurveControl

.

Thank you for that

[CurveControl]

Originally Posted by EzraDuncan

I was Dx bipolar and took a whole lot of Rx but I think I was just in a bad situation in life and my Dr. was an idiot.

I almost never have mania anymore, just friggin depressed.

almost never is still occasionally. If you have had mania in the past your diagnosis doesn't change, your mood does. You do not get cured. You may go into a neutral state for months or years, a remission of sorts, But the underlying brain chemical issue is still there.

There are studies being done linking it with a type of seizure disorder, a shift in brain chemicals that can precipitate an episode, or, as in some epiliepsy, external stimulation can cause the reaction. I do not know if it will be proven, But the fact that anti seizure meds seem to work well seems like a promising start to me. I think that in that light BiPo will be less stigmatized.

I don't know what the situation was in your life.
You may want to look for a second opinion if you think you were misdiagnised, Either way if you are bipolar and in a depressed state then your medications are not doing the job, and need to be adjusted.

If you quit meds because you felt 'better' then you are not alone. Most BiPos do quit treatment because they feel better or decide the dignosis is wrong at some point. Most relapse. Usually, again, they do not look for meds again until they are really depressed.

I, Personally, am the last one to see when I am hypomanic. My DH, Friends or kids have to point it out to me. Because to me hypomanic feels 'normal' to me. It helps to have someone who is willing (and not afraid) to point out when you are too 'up'. We are pretty good at spotting too 'down' ourselves.

[Houston Heather]

What Molly said.

When I am mixed, I often wake up hypomanic, very cheerful and up until around 3, when the depression shows up and kicks me around until bedtime. UGH.

Depression sucks royally. I am about equal parts manic and depressed, but many people I know seem to run mostly depressed, with a little mania. Personally, I'm a huge fan of lithium.

I took my evening dose and my "depression chaser" a small additional lithium capsule, and I went from "My life is hopeless" to "Let's plan a fun trip this weekend" within an hour.

Molly, my doc is a teaching doc, and he always has residents sit in because I don't mind. They get a real earful sometimes! I think the last one is still recovering from the sexual side effects of SSRI's discussion and my herbal remedy's (Black Cohosh) effacy.

Ezra, I can give you the name of my doc if you'd like. I see you're local.