View Full Version : What's the problem with hypomanic episodes?


Fuzzy12
11-05-12, 10:12 AM
Skip to the bolded part at the bottom of the post if you aren't interested in the preamble.

I think, it's very likely that I have bipolar disorder. Probably type II. I mean it's either bipolar II or its not bipolar at all. I don't seem have full blown manic episodes. Just mainly feelings of euphoria/bliss/excitement, increased energy levels, increased self confidence, much more social/outgoing, less inhibited, eat & sleep less, etc.

So from what I've been reading it seems that most anti depressants can induce switching into manic or hypomanic states and they often increase the rate of cycling. They've clearly had that effect on my mom and slightly less clearly on me as well.

I've been reading some papers about the use of anti depressants on bipolar disorder and apart from switching/increased cycling rate, also the anti depressants seem to be less effective in treating bipolar depression with higher early non-response rates.

Anyway to get to the point (:doh:) how do the mood stabilisers help. As I understand it, they prevent you from having manic states. Do they help with depression as well or do you have to take a mood stabiliser along with an anti depressant?

Anyway, to get to my real point ( :D :doh:) why are hypomanic episodes so undesirable? For me they are rare & precious episodes of feeling good. I don't want to miss them. I'm scared that if I take mood stabilisers I'll be just depressed. Or am I misunderstanding something? I don't think I act dangerously or harmfully (to me or anone else) during those episodes. Or is the gap between depressive and hypomanic episodes the problem? Does feeling hypomanic make the depression more difficult to bear? I think, it does..but I still wouldn't want to miss out on the hypomanic episodes.

T-Rex65
11-05-12, 10:32 AM
I've never heard of the hypomanic episodes themselves being bad, unless of course you do things like gamble, go on shopping sprees, sleep with people you ordinarily wouldn't, etc. Maybe there is a chance that a hypomanic episode could spiral into fullblown hypermania? Or, like you mentioned, maybe they are bad because the spiral down into depression can be more dangerous because the person's mood is unstable rather than just low. Or, and this is pure speculation, perhaps hypomania in a person who knows they are bi-polar could be bad because the person knows at some level that the pendulum is bound to swing the other way.

I agree with you, though. If hypomania could be controlled at a low, constant level, it sounds like a good way to live.

T-Rex65
11-05-12, 10:34 AM
I just saw another thread that reminded me of another possible reason. During hypomania, a person may take on too many projects, make too many promises, too many social plans, etc. that they will later regret when the mania wears off. While I don't think I'm bi-polar, I do find that when I'm in a good mood I make plans that I wish I hadn't later on when I'm feeling down. I'm afraid that it makes me look like a flake to my friends and family.

Fuzzy12
11-05-12, 01:56 PM
Do impairments have to be present for a bipolar diagnosis as with ADHD? I looked up some kind of rating scale today. I forgot the name. Something like MQT or MBT.

Anyway, it said that the problems caused by the manic phases need to be quite serious to warrant a bipolar diagnosis. I have all the symptoms but most of the impairments seem to occur when I'm depressed.

T-Rex65
11-05-12, 02:12 PM
I don't know. I would think that impairment should not be necessary for a bi-polar diagnosis. My reason for thinking this is because some medications, anti-depressants in particular, can trigger a manic episode or make the episodes much worse. So even if it's not an impairment, it would be much safer for your doctors to know when they are prescribing medications for other conditions.

Of course, this is just me talking off the top of my head. Don't believe me without doing more research.

crystal8080
11-05-12, 04:58 PM
From what I understand people with bipolar II are generally more depressed than hypomanic/manic. But hypomania/mania isn't just an escape from depression. It can cause you and the people around you a lot of hurt. AND if you are bipolar staying on a mood stabiliser can help the disorder from progressing and getting worse.

Some people stay on a stabiliser and only add an antidepressant when its needed. So kinda the other way around...you always take the mood stabiliser. You may find that its the mood stabiliser is what you have needed all along, not the AD.

I still think you should take the advice that Shamrock gave me. Ask your doctor to try a mood stabiliser. If it doesn't work - it doesn't work. But a doctor will be more receptive to trying a drug than you trying to fit into a diagnosis. Why haven't they put you on drug trials already? They just keep throwing ADs at you...I guess they are waiting for you to snap?

Rebelyell
11-05-12, 06:40 PM
Whats bad bout it is you feel so freaking good n so high you do rash things you normslly wouldnt do in a normal state of mind n when you come down n you reliaze what you did its not only destructive its depressing an regretful n can be dangerous.like having wild uninhibited sex not that i know bout that but i have felt so good n gone over 100mph on my cycle n thatin itself could of had many bad consequances

Abi
11-05-12, 06:46 PM
There's also the less common dysphoric hypomania that some of us like me and sarah get, where we become agitated, irritable, ragey and paranoid and go around telling people to f*** off. Not so nice.

dogluver358
11-05-12, 07:13 PM
Like abi said, it can become dsyphoric where you are much more volatile and may do rash things. There is the chance that you are an undiagnosed BP I and one day you'll have a full blown manic episode. I started out as BP II. They are two different disorders, one can't turn into the other one. But you may one day have a full blown manic episode if you're bipolar ii is really bipolar I.

A mood stabilizer does help depression. It evens your moods out, they're not just for mania. Lamictal for example does help in bipolar depression. I know hypomania sounds fun, but one day, trust me it will get out of control and you will do something you really regret.

On top of that, there is a theory called kindling. Where each time you have an episode it is more likely to happen again and with more frequency. And severity.

Also, there is evidence that mania and hypomania do CAUSE LOSS of grey matter in the brain. Everytime you have one you loose some of the matter in your brain and you do NOT get this back. Some evidence shows that lithium may in fact help increase grey matter that has been loss. But point made here is, it can cause irreversible brain loss and changes in your brain.

Rebelyell
11-05-12, 07:29 PM
I had that problem before i went on ads.someone would say something stupid that they thought was funny.Id done get all edgy irate n agitated cuss em all get out n wanna kick some onez ***

hanikamiya
11-05-12, 07:43 PM
Apart from what's been said: Going back to depression. As far as I'm aware, that's the period during which suicides are most likely to occur, because people feel horrible and judge everything they did in the last time from that horrible mood, not from the better mood before. And suicides are much more likely in people suffering from bipolar than from unipolar depression. I guess there might be a reason for that. Probably the knowledge that you will suffer again and again and again?

And, of course, they aren't as inhibited as sufferers from unipolar depression when their suffering has become so bad they wish everything would just end. (Honestly, that's probably what saved my life. I was too low-functioning to come up with a serious plan of killing myself that wouldn't traumatize bystanders.)

Rebelyell
11-05-12, 08:30 PM
I think I like driving fast,blowing money like its water and buying toys is most of the time Im depressed and when I o something that makes me feel good it cranks me up and turns off the depression for a good long while till the next episode.

mirandatoritess
11-05-12, 09:07 PM
ADHD is like a drug. You will have one day in which you are so high that You feel extremely ambitions and feel like you can do anything. (for me I am euphoric, hyper, and restless[good and bad]). The next day or a few hours later you come off this high like a drug withdrawl and you crash bad. You are like "I was nowhere near where I was yesterday.....aka depressed for a while". To answer your question: knowing that this high will wear off and the crash sucks. I dont have the very extreme highs and lows that biopolar people have but I have pretty high highs and really bad "lows". I dont have the highs and lows over a period of months; rather, it is over an entire day. Trust me it sucks.

Rebelyell
11-05-12, 09:19 PM
yeah Ive been dxed as BP 2 an adhd mirandabut I dont know I have days like that too and the next day or hours later its like i cant do anything right or just dont have any ambition or feel like things arent gonna work out or be good like that again etc.Why cant I be one speed?

Andi
11-05-12, 10:12 PM
What goes up, must come down and the more bouncing you do, the more damage you cause not only to relationships but also to regions of the brain that cause mood regulation and memory. Some studies suggest that cycling can cause damage to the brain as seen in neurodegenerative diseases like Alzheimer's disease, Parkinson's disease, and multiple sclerosis. Mood stablizers help control the symptoms, minimize the damage, and there are studies that show long-term lithium treatment to provide protective effects. Lithium has also been shown to increase both the amount of the amino acid NAA and gray matter in the brain.

I would highly recommend working with your doctor to find a cocktail to help you maintain a stable mood.

mirandatoritess
11-05-12, 10:35 PM
What goes up, must come down and the more bouncing you do, the more damage you cause not only to relationships but also to regions of the brain that cause mood regulation and memory. Some studies suggest that cycling can cause damage to the brain as seen in neurodegenerative diseases like Alzheimer's disease, Parkinson's disease, and multiple sclerosis. Mood stablizers help control the symptoms, minimize the damage, and there are studies that show long-term lithium treatment to provide protective effects. Lithium has also been shown to increase both the amount of the amino acid NAA and gray matter in the brain.

I would highly recommend working with your doctor to find a cocktail to help you maintain a stable mood.

higher you go the harder you fall

ana futura
11-05-12, 11:17 PM
From what my friend with a bp dx told me, it sounds like a mood stabilizer just makes you feel "normal". It's like a light switch goes on and you feel like you were always supposed to feel. She doesn't miss the mania, at all.

mirandatoritess
11-05-12, 11:19 PM
From what my friend with a bp dx told me, it sounds like a mood stabilizer just makes you feel "normal". It's like a light switch goes on and you feel like you were always supposed to feel. She doesn't miss the mania, at all.

interesting......mood stabalizers dont work at all for me. Well neither did Adderall. that just made me outright depressed.

mirandatoritess
11-05-12, 11:29 PM
Whats bad bout it is you feel so freaking good n so high you do rash things you normslly wouldnt do in a normal state of mind n when you come down n you reliaze what you did its not only destructive its depressing an regretful n can be dangerous.like having wild uninhibited sex not that i know bout that but i have felt so good n gone over 100mph on my cycle n thatin itself could of had many bad consequances
Oh yeah in my high state, I can act kinda rashly.

ana futura
11-06-12, 12:18 AM
interesting......mood stabalizers dont work at all for me. Well neither did Adderall. that just made me outright depressed.

But you don't have bipolar, right?

mirandatoritess
11-06-12, 01:01 AM
But you don't have bipolar, right?
I know, but my doctor doesn't believe in stimulants so he prescribed me Wellbutrin. I should tell him that it doesn't do much. :D. If I wern't so depressed on Adderall, I might reconsider. Then again, that was in 6th grade when I tried it..... so I might actually do so.

mirandatoritess
11-06-12, 10:40 AM
What goes up, must come down and the more bouncing you do, the more damage you cause not only to relationships but also to regions of the brain that cause mood regulation and memory. Some studies suggest that cycling can cause damage to the brain as seen in neurodegenerative diseases like Alzheimer's disease, Parkinson's disease, and multiple sclerosis. Mood stablizers help control the symptoms, minimize the damage, and there are studies that show long-term lithium treatment to provide protective effects. Lithium has also been shown to increase both the amount of the amino acid NAA and gray matter in the brain.

I would highly recommend working with your doctor to find a cocktail to help you maintain a stable mood.

Are you talking about mood stabalizers like Wellbutrin?

Fuzzy12
11-06-12, 11:06 AM
Are you talking about mood stabalizers like Wellbutrin?

Is wellbutrin a mood stabiliser? I thought it was an anti depressant or a smoking cessation aid (that's what it's prescribed for in the UK).

dogluver358
11-06-12, 01:05 PM
Apart from what's been said: Going back to depression. As far as I'm aware, that's the period during which suicides are most likely to occur, because people feel horrible and judge everything they did in the last time from that horrible mood, not from the better mood before. And suicides are much more likely in people suffering from bipolar than from unipolar depression. I guess there might be a reason for that. Probably the knowledge that you will suffer again and again and again?

And, of course, they aren't as inhibited as sufferers from unipolar depression when their suffering has become so bad they wish everything would just end. (Honestly, that's probably what saved my life. I was too low-functioning to come up with a serious plan of killing myself that wouldn't traumatize bystanders.)


I don't know. It's even more likely that during a mixed episode (mania and depression at the same time) suicides are more likely to occur because you are dperessed but have the energy and impulsivity from mania to actually carry it out.

dogluver358
11-06-12, 01:07 PM
Is wellbutrin a mood stabiliser? I thought it was an anti depressant or a smoking cessation aid (that's what it's prescribed for in the UK).

It's technically classified as an anti-depressant. Used to treat depression, off label in smoking cessation, ad related weight gain, and ADHD.

mirandatoritess
11-06-12, 07:26 PM
Is wellbutrin a mood stabiliser? I thought it was an anti depressant or a smoking cessation aid (that's what it's prescribed for in the UK).
yes it is a mood stabalizer

ana futura
11-06-12, 08:02 PM
yes it is a mood stabalizer


No, Wellbutrin's not a mood stabilizer in the sense that we are talking about. Wellbutrin is an SNRI. When people refer to mood stabilizers for bp, they are talking about lithium, anti-convulsants like lamictal, and anti-psychotics.

Wellbutrin is not usually used for BP, it can induce mania

http://en.wikipedia.org/wiki/Mood_stabilizer

ana futura
11-07-12, 05:00 PM
Wellbutrin is an SNRI.


Eh, I was almost there. It's not an SNRI, it's an atypical anti-depressant.

Still, it is NOT a mood stabilizer.

This is just from an ehow article, but it explains very plainly the difference between anti-depressants and mood stabilizers-


Antidepressants:
The purpose of an antidepressant is to treat depression by lifting mood. This is the best way to treat the condition for many sufferers. Antidepressants can also be helpful for patients with panic disorder or attention-deficit disorder.

Antidepressants can be unhelpful or even dangerous in some cases, such as when taken by a patient with a bipolar disorder. They can cause the patient's mood to escalate into a manic episode. Some patients with depression respond poorly or not at all to antidepressants.

Mood Stabilizers:
Mood stabilizers are most often prescribed for bipolar disorder. Instead of lifting the mood, they regulate both the high and low extremes. Mood stabilizers might also be used as supplements to antidepressants.

I''m sure if you google you will find more.

mirandatoritess
11-10-12, 12:19 AM
Eh, I was almost there. It's not an SNRI, it's an atypical anti-depressant.

Still, it is NOT a mood stabilizer.

This is just from an ehow article, but it explains very plainly the difference between anti-depressants and mood stabilizers-



I''m sure if you google you will find more.


Oops my B :D

Lightning
12-02-12, 06:44 AM
1 - Got a PSP Go and Impulsively spent U$1000 on over 30 games in one night, the credicard company froze my card and called me asking if was everything ok.

2 - I started Game Design College and I got so excited about it, ordered a dozen books, subscribed to training sites, bought a new expensive laptop, and felt I was so smart and capable that I could learn all by myself and change my major to Computer Science, so I started skipping classes and being arrogant. (yup, I loose the semester).

3 - Now I was in Graphic Design College. We had photography classes, and man I got really messed up. I had a camera at home and I started taking to college, I would take pictures of everything and everyone, at the most inconvenient times. In the end everyone would look me as if I was crazy, and well, when I was better I got so ashamed and depressed, I had to get out.

4 - You meet a girl and threat her as if she was the most important person in the world, and you are so intense and passionated about her, that she actually starts to have feelings for you, I mean, you do things for her that only a fiancÚ would do, getting in her personal life and being part of her day to day activities, and in about 3 dates you are living a married life, so suddenly you just change and and breaks the girls hearts, and there is nothing you can do to fix it (she had a boyfriend)

PS - Remember, all those are fallowed by periodes of depression

Raye
12-02-12, 08:09 AM
why are hypomanic episodes so undesirable? For me they are rare & precious episodes of feeling good. I don't want to miss them. I'm scared that if I take mood stabilisers I'll be just depressed. Or am I misunderstanding something? I don't think I act dangerously or harmfully (to me or anone else


I didn't read all the replies, but i am assuming, and I mean this is my opinion that most hypomanic episodes are stereo typed to be dangerous to themselves/others..I knew my pdoc was hinting at bi polar when the first things she asked were... do you spend money impulsively or have sexual intercourse with people you normally wouldn't, on times you feel good.
I told her NO, I NEVER FEEL GOOD :doh:(sorry for yelling)

keliza
12-02-12, 04:04 PM
I've browsed through the answers you've already gotten, and they're great. Here's the reason hypomanic episodes can be problematic, in a nutshell:

1. The more mood episodes you have of ANY kind, the more prone you become to mood episodes in the future. It's called the kindling effect. The more unrestrained mood episodes you have, the more volatile your mood episodes become over time. That means when you allow yourself to keep having untreated hypomanic episodes, you are actually setting yourself up to have more depressive episodes and more full-blown manias in the future. Hypomania might feel good now, but you're allowing your condition to become worse as you experience more and more untreated mood episodes.

2. Hypomanic episodes can still lead to questionable behaviors, although they tend to be much more subdued than full-blown manias. You still might not like the outcome of some of your more impulsive choices during hypomania, especially if you're already naturally impulsive due to ADHD.

3. Hypomania, if left alone, can escalate into full-blown mania in some people with bipolar disorder, generally people with bipolar I disorder. BPII doesn't ever have manic episodes, but just because you've never had one before doesn't mean your hypomania can't turn into mania for the first time. There's always that risk, and once you start having manic episodes, you could have many more of them in the future. And they are NOT always fun, contrary to popular belief. Most of mine are extremely irritable manias.

Treating your disorder with a mood stabilizer isn't going to make you depressed all the time. The goal of a good mood stabilizer is to act as both a floor and a ceiling for your disorder. That means that if your treatment is working ideally, you will have fewer episodes, and those episodes will be much less intense. The medication puts down a floor, meaning you don't go as low as you would untreated, as well as a ceiling, meaning you won't go as high as you would untreated. They don't stop mood episodes completely in most people, but they do decrease the frequency and intensity of episodes.

crystal8080
12-03-12, 02:42 AM
I've browsed through the answers you've already gotten, and they're great. Here's the reason hypomanic episodes can be problematic, in a nutshell:

1. The more mood episodes you have of ANY kind, the more prone you become to mood episodes in the future. It's called the kindling effect. The more unrestrained mood episodes you have, the more volatile your mood episodes become over time. That means when you allow yourself to keep having untreated hypomanic episodes, you are actually setting yourself up to have more depressive episodes and more full-blown manias in the future. Hypomania might feel good now, but you're allowing your condition to become worse as you experience more and more untreated mood episodes.

2. Hypomanic episodes can still lead to questionable behaviors, although they tend to be much more subdued than full-blown manias. You still might not like the outcome of some of your more impulsive choices during hypomania, especially if you're already naturally impulsive due to ADHD.

3. Hypomania, if left alone, can escalate into full-blown mania in some people with bipolar disorder, generally people with bipolar I disorder. BPII doesn't ever have manic episodes, but just because you've never had one before doesn't mean your hypomania can't turn into mania for the first time. There's always that risk, and once you start having manic episodes, you could have many more of them in the future. And they are NOT always fun, contrary to popular belief. Most of mine are extremely irritable manias.

Treating your disorder with a mood stabilizer isn't going to make you depressed all the time. The goal of a good mood stabilizer is to act as both a floor and a ceiling for your disorder. That means that if your treatment is working ideally, you will have fewer episodes, and those episodes will be much less intense. The medication puts down a floor, meaning you don't go as low as you would untreated, as well as a ceiling, meaning you won't go as high as you would untreated. They don't stop mood episodes completely in most people, but they do decrease the frequency and intensity of episodes.

:goodpost:

Exactly! Floors and ceilings! I wish I knew years ago because now I have this pendulum swinging, and it is scary and frightening and completely unpleasant.

I do not look forward to being "up". I also find medication is like padding for the intensity. Now I have padding to absorb some of the energy as the pendulum swings. I would be much LESS afraid of taking mood stabilisers than the alternative - untreated bipolar and the fallout it brings.

ADDPanda
12-03-12, 03:32 AM
Anyway, to get to my real point ( :D :doh:) why are hypomanic episodes so undesirable? For me they are rare & precious episodes of feeling good. I don't want to miss them. I'm scared that if I take mood stabilisers I'll be just depressed. Or am I misunderstanding something? I don't think I act dangerously or harmfully (to me or anone else) during those episodes. Or is the gap between depressive and hypomanic episodes the problem? Does feeling hypomanic make the depression more difficult to bear? I think, it does..but I still wouldn't want to miss out on the hypomanic episodes.

I'll chime in. I haven't been official diagnosed with BP. It's something that my family and I have suspected since high school. (I'm in my late 20's now.) However, I have always shirked away from discussing these symptoms with my psychiatrist. I'm not sure if I'm scared of the meds changing my personality or of the stigma that so many associate with the diagnosis... It's weird. I'm usually so rational when it comes to these things.

But it's getting to a point where I am pretty sure I need to take action. I have had 3 destructive hypomania/mania cycles in the last few months. But that's a topic for another post.

In my experience, hypomania/mania has been a mixed bag. An example would be last week. One of my triggers is stress. I had a second-round interview for a company near my home, followed the next day by a two-day long job interview that I have to fly out to DC for.

In the beginning, the hypomania is a good thing. It got me motivated and psyched to do my best. In fact like someone had mentioned earlier in this post, it's hard to notice the hypomania in the moment. I thought I was just excited, feeling great for new opportunities.

Then Friday came and hello mania! I began getting racing thoughts. Mine are action items that I'm compelled to do. It was maybe 1am at night and I am writing down anything and everything that pops into my head. Apparently, I was also developing a spreadsheet tool for amortizing my car's monthly payments complete with interest rate slider. (I had no idea I even made this until I got home today and saw this really well designed and well laid-out spreadsheet.)

So, somewhere around 3am my thoughts raced so fast that I have no idea what happened. All I know next is I'm in a casino at a poker table. So, after no sleep Friday night, I sit at a poker table all day losing about $1,000. After I lost all that money, it was around 10pm Saturday. I stay at a friend's house who lives close to a large mall in my state. Early on Sunday and somehow not tired after not sleeping two nights in a row, the impulsive is still strong and I've spent around $700 at the mall... no not on presents... on stuff I don't need. Hehhh.

I'm feeling better right now, but still wired. It kind of scares me the things I do when I have these moments because it seems like I "black out" for a lot of it, but am still fully conscious. Since it's gotten to this point, I'm definitely gonna be talking to my p-doc.

ADDPanda
12-03-12, 03:49 AM
Sorry to double post. But I failed to respond to Fuzzy12's full question.

Fuzzy12, I am with you on embracing part of my hypomania/manic. I believe this is one reason I'm so reluctant to talk to a specialist about BP.

When I get racing thoughts, I try to write them down. They're often really insightful and offer good tips (and some are just nonsense too LOL). Also, I do my best work when I'm hypomanic. My work is more efficient, the deliverables are higher quality, and the amount of calcs/analysis I churn out is impressive.

Not even gonna mention that spreadsheet I did between 3:30am-4:00am in a manic cycle. Would normally take a couple of hours, and even then I'd be lazy about the formatting.

So I agree that these hypomanias can perceptively seem like a boon to our lives, and for some people they are. But I've reached the point where my hypomanic episodes are turning into full-on manias that I either don't remember or remember very little of. And during those manias, my behavior can be really reckless and often financially devastating.

Just my $0.02

Fuzzy12
12-03-12, 07:26 AM
Thanks everyone for the replies!! :)

I know you are right but I'm still not convinced I've got bipolar disorder. Even my hypomanic episodes don't sound as extreme as some of your experiences. I'm worried though that if I present my case truthfully to the psychiatrist, that she will diagnose me with bipolar. I know, I should just leave it up to her and trust her judgment but well, I don't. I still think that ADHD might be my problem. :scratch:

So if she does diagnose me with bipolar I will most probably get prescribed mood stabilisers. It's tempting because the anti depressants aren't doing much for me but then I definitely have a much, much, much bigger problem with depression than hypomania. Maybe something like lamictal that works on both depression and mania would be good. I'm curious to see though that if I ignore it will I have a more manic episode? At least then I'd know for sure.

I'm worried about the side effects. I'm worried about putting on weight with mood stabilisers. I know, it's stupid but then again my eating disorder is causing me more problems than the hypomanic episodes. In fact, so far, my hypomanic episodes have caused NO problems. On the contrary. I understand what you are saying, that the episodes will get worse and more frequent, and that there might be a certain amount of brain damage and also that the mood stabilisers might finally just make me feel right.

I just want to know for sure, what's wrong with me. I'm not convinced by my hypomanic episodes. I think, they aren't extreme enough. I think, they just might be periods of normalcy, euthymia. I wish I could find a psychiatrist I really trust. But then I suspect that unless a psychiatrist tells me exactly what I want to hear I wouldn't trust their judgement. :doh:

BY the way ADDPanda, I love your ID. It makes me imagine a manic, hyperactive panda, which considering that they are seriously lazy buggers, invariably makes me smile. :D Sigh, I'd hate the thought of a depressed panda though. :(

tudorose
12-03-12, 07:53 AM
My DH used to work with offenders. There was one guy who robbed seven banks in seven days during a manic episode. He was very remorseful when he got stable but it didn't stop him from going to prison.

Fuzzy12
12-03-12, 07:59 AM
Isn't it possible that anti depressants can cause mania/hypomania even in non-bipolar people? I've read that if you are bipolar, the risks of anti depressants inducing manic episodes are higher but can't the anti depressants induce mania even if you are not bipolar? My mom has had manic episodes (much more extreme than mine). I've always suspected that she might be bipolar but her prescribing GP insists that her mania is caused by her anti depressant (she is taking a tricyclic). They've adjusted her dose and in the last couple of years she hasn't really had any manic episode.

Oh no, that's not true. :eek: Her last manic episode (well, I thought she was manic) was in April. :eek: I don't know. I'm just being silly, I guess. I really don't know why I'm so reluctant not only to get mood stabilisers prescribed but even just to see the bipolar disorder specialist. I really should, especially considering that it might run in the family. :scratch:

tudorose
12-03-12, 08:26 AM
I have ADHD (just ADHD no BP). I do not get manic episodes. I am hyper but I don't get it in episodes like people do with mania in BP.

I have seen mania in my children with anti-depressants but it was 24 hours a day 7 days of week of them acting like a pain in the ****. There were no 'episodes' They were not elated and happy. They were completely out of control and it did not stop until we stopped the meds (which didn't take long as we couldn't take it anymore).

My son HFA did not react well to paxtil and DD (ADHD) did not react well to tricyclics.

Andi
12-03-12, 09:11 AM
Anti-depressants either make me suicidal or manic. I'm BPII/ADHD-I/GAD/SAD and due to medication, I had a full blown manic episode that lasted long enough for me to blow through 10k cash for just "stuff", bought a car and had online affairs...oh and a really clean house. After the mania, it took me 2 years to come out of the depression. Abilify and lamictal helped pull me out of the hole but it took my best friend to keep me going and push me to get out, get fresh air, walk, etc. My cocktail is what helps keep me stable, floor/ceiling is a great explanation, but medications can only do so much. As with any condition, there is a level of lifestyle change to consider too. It can be little things, like I can't watch a horror flick without triggering my anxiety. I can't drink too much caffeine without brushing hypo and anxiety. I also have FMS and although Lyrica is by far the best medicine I have ever taken for pain, it makes me mean and hateful. If I don't exercise during the winter and do low levels of light therapy, my SAD kicks in and I hit a deep depression.

BTW, because of my severe episode in 2003-2005, I have lost a significant amount of my memory. It was like an epic etch-a-sketch moment, with one shake, everything was gone. There is a 6month gap during the break where I remember nothing. I use to remember everything, names, faces, numbers, events...if I took the time to read it or talk to you and actually listened, I would remember it forever. Now? Not possible. So that means, most life events, I have difficulty recalling. In addition, my childhood, my kids growing up...most of those memories are gone. If I had known I was bipolar and was on mood stablizers, the likelihood of me losing everything that I have, may not have happened.

keliza
12-03-12, 04:42 PM
Thanks everyone for the replies!! :)

I know you are right but I'm still not convinced I've got bipolar disorder. Even my hypomanic episodes don't sound as extreme as some of your experiences. I'm worried though that if I present my case truthfully to the psychiatrist, that she will diagnose me with bipolar. I know, I should just leave it up to her and trust her judgment but well, I don't. I still think that ADHD might be my problem. :scratch:

So if she does diagnose me with bipolar I will most probably get prescribed mood stabilisers. It's tempting because the anti depressants aren't doing much for me but then I definitely have a much, much, much bigger problem with depression than hypomania. Maybe something like lamictal that works on both depression and mania would be good. I'm curious to see though that if I ignore it will I have a more manic episode? At least then I'd know for sure.

I'm worried about the side effects. I'm worried about putting on weight with mood stabilisers. I know, it's stupid but then again my eating disorder is causing me more problems than the hypomanic episodes. In fact, so far, my hypomanic episodes have caused NO problems. On the contrary. I understand what you are saying, that the episodes will get worse and more frequent, and that there might be a certain amount of brain damage and also that the mood stabilisers might finally just make me feel right.

I just want to know for sure, what's wrong with me. I'm not convinced by my hypomanic episodes. I think, they aren't extreme enough. I think, they just might be periods of normalcy, euthymia. I wish I could find a psychiatrist I really trust. But then I suspect that unless a psychiatrist tells me exactly what I want to hear I wouldn't trust their judgement. :doh:

BY the way ADDPanda, I love your ID. It makes me imagine a manic, hyperactive panda, which considering that they are seriously lazy buggers, invariably makes me smile. :D Sigh, I'd hate the thought of a depressed panda though. :(

Truly the only thing you can do for yourself is go to the specialist, present your symptoms as truthfully and honestly as possible, and don't fixate on the label. Do you want to get better or not? If you do, you have to STOP with this mindset that only an ADHD diagnosis will do, and getting diagnosed with bipolar disorder isn't going to "work" for you. Why are you so concerned about it being diagnosed as ADHD, versus something else? Why does it HAVE to be ADHD?

I'm not asking rhetorical questions, I'm asking you this honestly. What does the diagnosis matter? What matters is that you get an accurate picture of what's going on for you neurologically and psychologically, so that you can work with a professional to formulate an appropriate treatment plan and get yourself healthy and functioning again.

I do understand the idea of not wanting a bipolar diagnosis. I saw 3 different specialists over the course of 6 months before I would accept my diagnosis, because I didn't want it. I have a handful of close family members with bipolar disorder, and I saw what it did to them. Alcoholism, drug abuse, jail, overdoses, rehab. I grew up watching them and I felt very strongly that, "No, this cannot be me, you're wrong. You're just wrong."

It wasn't until I saw the 3rd psychiatrist, one of the absolute best bipolar specialists in my area, that we sat down and talked about it at great length. I finally came to accept that yes, this is my diagnosis, but NO, that does not mean I'm damned to a life of pain, addiction, persecution, and failure. That is a path, but not the only one. You don't choose what your diagnosis is, but you do choose what you do with it and how you pursue (and maintain, and reevaluate, and pursue, and maintain, and reevaluate, lather, rinse, repeat) treatment.

Bipolar II disorder (which I suspect you probably have) does not look like bipolar I disorder, and you probably think of BPI when you imagine what bipolar disorder "looks like." Full-blown mania can and does look very different from hypomania, but that doesn't mean that BPII isn't a type of bipolar disorder. Like you described, patients with BPII have overwhelmingly more depressive episodes than hypomanias, 10:1 or greater, and usually view hypomania as a reprieve.

I would really encourage you to check out this website about bipolar disorder. I was recommended it by a couple of reliable folks when I was first learning to accept my dx back in 2009, and it helped me a lot. Full disclosure, this is one psychiatrist's website with his point of view on many subjects, but he backs everything up with a large amount of data, not just clinical anecdotes, and he is very clear about what is his own personal observation and what is rooted in scientific data.

http://www.psycheducation.org/

Specifically, you might benefit from reading the information in the section, "Mood swings without 'manic' episodes: Bipolar II: more than plain depression, but never delusional or psychotic."

http://www.psycheducation.org/start/BPIntro.htm

I think he does a good job delineating the different types of bipolar disorder, how they are similar and yet different, and how someone with BPII can easily be overlooked, making diagnosis difficult and often delayed by years.

ADDPanda
12-03-12, 05:37 PM
I'm worried about the side effects. I'm worried about putting on weight with mood stabilisers.
Fuzzy, this is one thing that makes me really reluctant to get a BP diagnosis as well.

The side effects sometimes seem like more trouble than the episodes. I suspect, for me at least, this is a form of denial. If I were to really do a cost/benefit analysis of the side effects vs. the after-effects of a manic episode, there would be no question that I should be medicated. But as you've stated the hypomania isn't causing any harm for you, so I understand your judgment against meds.

Lightning
12-04-12, 10:57 AM
Do any of you take Lithium?

Fuzzy12
12-04-12, 12:20 PM
Truly the only thing you can do for yourself is go to the specialist, present your symptoms as truthfully and honestly as possible, and don't fixate on the label. Do you want to get better or not? If you do, you have to STOP with this mindset that only an ADHD diagnosis will do, and getting diagnosed with bipolar disorder isn't going to "work" for you. Why are you so concerned about it being diagnosed as ADHD, versus something else? Why does it HAVE to be ADHD?
.

Thanks for the links Keliza. That website is great and explained a lot of things to me. According to his explanation, I would most definitely be somewhere on the bipolar spectrum, I think. Also reading up more on mood stabilisers on his website has reassured me a bit about their effect, in particular on depression.

The reason why I'm more interested in ADHD is because most of the symptoms that really, really trouble me and impair my life seem more consistent with ADHD. I know that bipolar can give rise to cognitive impairments as well but my specific symptoms just seem to fit ADHD better. I haven't had any problems with hypomania so far. I know that can change, maybe even very quickly and without me realising, but right now my few episodes of hypomania have been nothing but a relief -> Happy times.

However, according to his experience, lamotrigine works very well on depression and also does not cause weight gain (which is a major concern for me, since it probably would trigger my eating disorder). Also, depression is much more prevalent and more of a problem than hypomania. But then apparently both lithium and lamotrigine deal with depression quite well. Considering that none of the anti depressants helped much (or never worked for long enough) it sounds like a good option. Definitely something that's worth trying.

I don't know what and if the specialist will prescribe me of course, if she does diagnose me with bipolar disorder II. From the two telephonic conversations we had she doesn't sound very flexible or cooperative but let's see.

ana futura
12-04-12, 04:14 PM
I have ADHD (just ADHD no BP). I do not get manic episodes. I am hyper but I don't get it in episodes like people do with mania in BP.

I am a little different. I do swing a bit, but it's completely situational-
see an old friend = hyper!
road trip = hyper!
presents = hyper!

have a lot of homework to do, but it's not due for a while = completely lethargic
due tomorrow morning = hyper!

I'm an impulsive shopper, I always have been. I don't go on sprees, I am constantly at risk.

The only time I've experienced BP type manic symptoms was from a weird reaction to dexedrine (which hasn't repeated :scratch: ) and that felt totally different from my normal hyperactivity.

When I'm hyper, it's like my brain shuts off, I am completely in the moment and just react to stimuli. It's a very physical feeling. It's not really that pleasant, because this is when I do the most damage socially. I have lost friends because of spazz out episodes. When I'm hyper is when people tell me to shut up or calm down. I always get reprimanded at work for it- which immediately puts me in a bad mood.

It can be fun, but there's nothing about ADHD hyperactivity that makes me crave it. I'm not in control of my actions. When I think about, I actually prefer being calm.

What I felt with the dexedrine induced "mini-mania" was more mental- my brain was just too active.

keliza
12-04-12, 05:33 PM
Thanks for the links Keliza. That website is great and explained a lot of things to me. According to his explanation, I would most definitely be somewhere on the bipolar spectrum, I think. Also reading up more on mood stabilisers on his website has reassured me a bit about their effect, in particular on depression.

The reason why I'm more interested in ADHD is because most of the symptoms that really, really trouble me and impair my life seem more consistent with ADHD. I know that bipolar can give rise to cognitive impairments as well but my specific symptoms just seem to fit ADHD better. I haven't had any problems with hypomania so far. I know that can change, maybe even very quickly and without me realising, but right now my few episodes of hypomania have been nothing but a relief -> Happy times.

However, according to his experience, lamotrigine works very well on depression and also does not cause weight gain (which is a major concern for me, since it probably would trigger my eating disorder). Also, depression is much more prevalent and more of a problem than hypomania. But then apparently both lithium and lamotrigine deal with depression quite well. Considering that none of the anti depressants helped much (or never worked for long enough) it sounds like a good option. Definitely something that's worth trying.

I don't know what and if the specialist will prescribe me of course, if she does diagnose me with bipolar disorder II. From the two telephonic conversations we had she doesn't sound very flexible or cooperative but let's see.

I have never experienced weight gain on a single mood stabilizer I've taken. I've been put on Lithium, Lamictal (lamotrigine), Gabapentin, and Trileptal. The last 3 (all anti-epileptics) gave me acne, but that was the only major side effect I experienced on them, with the exception of Lamictal giving me a rash after a year of being on it, so I had to stop. I was really disappointed by that, because it was the most effective drug I've ever taken, except that it didn't entirely control my manic episodes. But it was fantastic for depression and racing thoughts in general. Lithium made me feel like I constantly had the flu and gave me huge bruises all over my body, but that's apparently an extremely uncommon reaction.

The mood stabilizers that tend to cause the most profound weight gain are Lithium and the atypical antipsychotics (AAPs, such as Seroquel, Risperdal, Zyprexa, etc.) Tegretol sometimes causes weight gain, but not always. No drug is guaranteed to do anything one way or the other, but those drugs tend to cause weight gain more commonly than others. I refuse to take AAPs, not because of weight gain but because of the side effect profile. Everyone is different though.

The thing about ADHD and bipolar disorder is that they can be hard to tell apart sometimes. Sometimes I'll get in a mood and I don't know if I'm just having a swing of ADHD-C energy, or if it's the onset of a manic/hypomanic episode. My psychiatrist waited THREE YEARS before referring me to an educational psychologist to be evaluated for ADHD. Not because she didn't suspect ADHD, but because she wanted to be 100% certain that my ADHD-like symptoms weren't caused by untreated bipolar disorder.

After 3 years, once I was stable on my meds (yeah, it took that long... bipolar disorder sucks) she was able to see that yes, I still had residual symptoms that looked a lot like ADHD, so she made the referral. And I didn't mind waiting because I wanted her to be certain, and not to be diagnosed with something I didn't have because of something I already did have. Sometimes I did not appreciate the wait, but overall when I look back I am glad that she watched and waited like that. I would rather have a psychiatrist who is cautious about diagnosis and medication than one who is overzealous in making a diagnosis and throwing pills at me.

Once we decided to make the referral and get diagnosed, it was all a very fast procedure, took about 2 weeks from the time I contacted the EdPsych until the appointment where I got my results back and was diagnosed. And I suppose at any point during those 3 years beforehand I could have self-referred to an educational psychologist to be evaluated. But I trusted my psychiatrist and her process, ultimately. Maybe that wouldn't work for some people, but it was right for me.

ana futura
12-04-12, 05:50 PM
Are bipolar manias actually productive? Like do you accomplish things quicker than normal?

My hyperactivity has never led to any productivity (except the mad dash to finish a paper, but I have a feeling my "mad dashes" are as productive as most people are normally.)

Usually if I'm hyper I'm less productive, because I'm so distractable.

I'll also do things that make things harder for myself in the long run- like get inspired to build a shelf, but discover I have no screwdriver. That's okay! Use a knife! Then I strip the screw heads, and have to buy more screws.

keliza
12-05-12, 12:24 AM
Are bipolar manias actually productive? Like do you accomplish things quicker than normal?

My hyperactivity has never led to any productivity (except the mad dash to finish a paper, but I have a feeling my "mad dashes" are as productive as most people are normally.)

Usually if I'm hyper I'm less productive, because I'm so distractable.

I'll also do things that make things harder for myself in the long run- like get inspired to build a shelf, but discover I have no screwdriver. That's okay! Use a knife! Then I strip the screw heads, and have to buy more screws.

It totally depends on the person, and even the individual manic episode. I've had manic episodes where I renovated entire rooms of my house. I did an entire bathroom over the weekend--ripped down wallpaper (in an 8-hour straight marathon), painted everything, fixed the cabinets, fixed the pipes, changed the fixtures, the whole shebang. It was great. I didn't eat much over those 2 days, or sleep, or drink water, or do anything but attack my bathroom with the fervor of the Spanish armada... but I did get it done.

I frequently do room make-overs, I don't know why, that just seems to be my go-to when I'm manic. If my mom calls and asks me what I'm doing and I say, "Painting!" she immediately asks, "Are you manic?" because she just knows that's such a common event for me. I've also done murals on doors or walls in my house, including rental houses that were not mine to paint, which caused some issues with landlords. I don't know if you could call those projects "productive" in the strictest sense, but I do get a lot done.

It wouldn't be so bad except that I ignore everything else to finish the task, exhaust myself and often make myself sick from lack of sleep/eating, sometimes really injure myself but don't notice the pain until after the manic high wears off, and can spend several hundred dollars (that I don't have) in one drop on painting/renovating supplies. They love seeing me walk through the door at Lowe's. I don't know if I'll ever get on top of my credit card debt... fortunately I only have one card and I maxed it out, so at least I can't do any more damage with it.

Other times I have manias where I'm so irritable, paranoid, and suicidal that I can't get anything done, I just pace and yell a lot and often break things. One time I went all over town finding fliers for houses for sale, even though I was not moving any time soon and could not afford a down payment on a house even if I was. Then I got paranoid that someone was following me, so I bought a ton of cleaning supplies, drove out to a rental property my family owns, and cleaned and painted for a while. But then I was sure that I was hearing voices of people outside the house surrounding me, and all I could do was hide in the corner of the bathroom with no windows and cry because I was sure they would get me. That usually leads to a great deal of self-harm/suicide attempt to try and make the thoughts/feelings stop.

So just in that you can see examples of different kinds of manias and how they might be productive, or not at all. Usually though, a manic person is filled with so much energy and inspiration that they find some kind of outlet for it. It might be that they feel inspired to renovate a room in their house, or buy a new car, or have sex with as many people as possible. The impulses and direction of that energy depends on the person. It's not an issue of character (that is, "worse" people don't do "worse" things while manic), but of impulse and the kind of deep-seated 'id' desires you have that come bursting through the surface of your conscious behavior while you're manic and uninhibited.

ana futura
12-08-12, 03:22 AM
Very interesting, thanks.

My productive spells always end prematurely- I'll get inspired to paint the bathroom, have a half day of high energy productivity, get tired, and then leave it half painted until I move out (Yes, I did that)
These periods always seem a little manic to me- because I am experiencing an unusually high level of productivity, and I'm really into what I'm doing and I feel a bit different than usual, but my final output is still way below an NT's.

I spend money in increments- if I get a new hobby I'll make several small purchases over a period of days or weeks- 10$ here, $50 there. I rarely spend more than $150 in one go, but I did buy an expensive bike once impulsively. I can't imagine ever going to the store and blowing $500 all at once on supplies for a new hobby (even though I'm sure all my spending added up over the month would equal one manic shopping trip)

keliza
12-08-12, 08:19 PM
I've left painting/renovation jobs half-way done too, if the manic episode happened to end before I finished it. A little while back when I moved out of my apartment I had to paint over a mural I'd started while manic, but I was not manic when I was fixing it. I didn't realize how TIRING painting is! Now I understand why people make such a big deal out of repainting an entire room. I used to think it was so easy, you could get it all knocked out in a few hours... because I had never tried doing it in a normal state of mind. That was really a "wow" moment for me, to realize just how potent mania can be.