View Full Version : ADHD and/or Bipolar II


katastrophee
02-21-13, 05:40 PM
Hi all,

I apologize in advance for the length.

Like most of you, my life has been filled with a series of evaluations by different pdocs - all trying to figure out what is "wrong" with me. I developed panic disorder and depression in college (I was about 20) and although I recovered I have always felt like I am very, very different from everyone else.

Several years after recovering from panic disorder ("recovered" is a relative term - I have occassional panic attacks now but I know what is happening and can ride them out without completely freaking out), I became depressed again. I had just made a career transition from working in an office environment to working based from home where I set my own schedule. This was REALLY HARD. Shortly after that I heard about ADHD and everything finally made sense. I went to see a psychiatrist and started taking Wellbutrin (a Godsend!) and Prozac, which I had taken before. Shortly after that I added Focalin.

I suddenly had a lot more control of my mind although I had no idea how to be "normal". My habits didn't change much, but I felt better, was much more alert, and the background "noise" in my head faded out significantly.

Then about 1 3/4 years ago it seemed like I started getting worse. I was doing a lot of traveling and a year ago my mom was diagnosed with pancreatic cancer (although she was cured with surgery - a miracle!). I have become less motivated and much, much more impulsive. As an example, I have purchased around 250 bottles of nail polish in the last year. I do love nail polish, but even I know that is a bit out of control. My Focalin started pushing me into more of a euphoric state although I still wasn't managing to get much done. I talked to my pdoc and he suggested trying Adderall. I started taking the short-acting form to try and find a good dose for the XR.

Because I have been steadily worsening over the last couple of years, my husband pushed me to find a new pdoc. My old one didn't take my insurance anyway, and was a 45 minute drive away (not that I cared about that). My husband finally insisted upon it because he is about ready to walk out the door because he can't deal with my impulsivity and lack of trustworthiness.

I went to see my potential new pdoc two days ago and after discussing my medical and psychological history for an hour, he told me that he is concerned that my issue is due to Bipolar II vs. ADHD (or both). One of my first pdocs suspected I was bipolar many years ago. My grandmother (and aunt as it turns out - both on mother's side) was bipolar and at the time I saw this pdoc (8 years ago?) I was having severe mood swings that correlated with my monthly cycle. It was later discovered that the swings were due to the higher-estrogen dose of birth control pill I was taking, but we didn't know that at the time.

That pdoc added lithium to my Prozac which was VERY BAD. That was the only time in my life I can actually say I felt somewhat manic. I remember I was out late every night, blew all of my paychecks the second they hit my hand, actually cheated on my boyfriend and felt borderline out of control. I kept calling my pdoc and telling him how I was feeling and he kept upping the lithium dose. Finally I couldn't stand it anymore and I went to an outpatient mental health clinic for help. They took me off the lithium and found me a new doctor.

I have never heard about Bipolar II, or any bipolar spectrum disorder for that matter. When my newest pdoc mentioned it, my first thought was "CRAP, NOT AGAIN!!! I AM NOT BIPOLAR!!!" He explained it a bit more and it made some sense. Then I came home and spent the next several hours (gotta love hyperfocus) reading up on it. I now think it is a distinct possibility. I have felt somewhat hypomanic for several months now. Stimulants seem to make it worse so I have been avoiding them a lot of the time.

My main confusion is around how I can be hypomanic AND have evidence of depression (almost complete lack of motivation) at the same time. My husband told me (after I got home the other day) that he has always suspected I was bipolar. I am so confused now and because I know that a lot of the symptoms of Bipolar and ADHD can overlap, I am trying to decide what I can do to help piece together the entire picture for myself and my doctor. The bottom line is, I don't care WHAT I have, I just want to deal with it. I can't live like this anymore. My reaction to lithium scares me. That whole experience soured me on going to a pdoc in general....

I plan to read through some posts this afternoon, but does anyone have any advice or thoughts to offer? Anything would be much appreciated. It helps to know there are others out there dealing with similar issues.

Aerodita
04-09-13, 01:52 AM
Hi there,
I am new to the Forum. I was recently diagnosed with ADHD and Bipolar II disorder as well, or hypo-mania.

What Ive noted in myself is that sometimes I get these randoms bursts of creativity and imaginativ-ity, I feel elated and euphoric but not overwhelmingly so, I just feel incredibly positive and good about life. These are all the nice things I love about the hypo-mania, on the other hand, sometimes depending on the day, I might also overindulge in a "few extra nail polishes" and little things. The impulsiveness is annoying but I have gotten better at controlling it just by accepting the fact that I have this problem so I need to be on the look out for it. I have never done anything dangerous or outlandish.

Personally I don't mind my hypo-mania, it makes me different, in a good way, because it gives me that edge to dive further than the norm or conformed thought process. Some of the best authors, scientists, physicists, and great historical figures have been labeled or at the very least suspected hypo-maniacs.

I do at times also feel rather depressed as well. I think its mostly because of the stress and anxiety brought on by the ADHD monster I am constantly battling. Im 24 years old now, and Im just so tired of constantly having to work under pressure to finish last minute things that I procrastinated on and I lay in bed and think about how I accomplished nothing all day. I'm very disappointing in myself at times, at times I border on self loathing due to my under-achievements.

My psychiatrist did point out that my hypo-mania (and IQ) actually aided in balancing out/making up for my ADHD- related issues. Which is probably very true.

I was afraid that the stimulants that I would be taking for my ADHD could possibly send me over the edge on a manic trip but actually that did not happen. I take Vyvanse currently and I found that it actually just made me a better person overall, the best me I could be or always wanted to be, it elevated me to a normal level of functioning. Unfortunately, after a month use, those effects only last for about 3hours. I suspect my psychiatrist will be increasing my dose.

Im not sure if all my rambling would help any (might be in a bit of a hypomanic state right now haha) but for whatever they are worth, I hope you can find comfort in knowing that there are others out there that such as yourself, and that you are not alone.

Sometimes I ask myself,[ and maybe im just attempting to rationalize my situation, (haha)] weather it would have been better to have been born an innately good, pristine human being or if there is a higher honor to valiantly fight against your evil and corrupt nature to be a good. Sigh, I just dont know.

fracturedstory
04-09-13, 05:59 AM
One of my first pdocs suspected I was bipolar many years ago. My grandmother (and aunt as it turns out - both on mother's side) was bipolar and at the time I saw this pdoc (8 years ago?) I was having severe mood swings that correlated with my monthly cycle. It was later discovered that the swings were due to the higher-estrogen dose of birth control pill I was taking, but we didn't know that at the time.

This happened to me too. I remembered my GP getting me to stand on scales so he knew the right dose to take for the pill. I protested saying my clothes and shoes were too heavy to give my accurate weight.
8 months later I'm put on anti-depressants after trying to kill myself. I can't help think if my GP would have done a more thorough job at weighing me, or listening to me when I said I weighed less (I've been checking my weight most mornings since I started dieting) I might not be stuck with PMDD, and I wouldn't have these concerns about that turning into bipolar.

Anyway, sorry. I'm just overwhelmed with anger right now. Unmedicated PMDD. Late period. Kind of in limbo here.

It's interesting what triggers my depression. All throughout this horrible cycle I will talk about suicide causally, then that leads to even more depression. But the focus is more on my autism and my failure to understand people, communicate effectively and days of extreme hate towards them. It's focused on my unemployment and the only ADHD part is about how I'm jumping from task to task, struggling to start things, hardly ever finishing. I feel like such a failure and then I get depressed.

I say this because maybe your depression is related to bipolar...I mean, if you didn't pick up on that already. I'm good at pointing out the obvious to people who already know it.

Fuzzy12
04-09-13, 06:33 AM
As far as I know, BP and ADHD are often co-morbid though sometimes they can be misdiagnosed as BP and ADHD share a lot of symptoms.

You can be hypomanic and depressed at the same time. There is something called a mixed state, which includes both depressive and hypomanic symptoms. Stimulants are known to induce mania so psychiatrists usually try to bring your BP first under control before they start treating ADHD with stimulants.

BP often runs in the family so if your grandmother and aunt were bipolar, it increases the likelihood of you being bipolar too.

Lithium isn't the only medication for BP. For BP II, often lamotrigine (or lamictal) is prescribed. If lithium didn't work well for you, it's worth trying a different med.

By the way, I'm glad your mother is fine now. That must have been really stressful.

keliza
04-09-13, 04:05 PM
That is such an interesting response to Lithium. That medication is usually an excellent anti-manic, so the fact that it made you switch into manic-like symptoms is bizarre and intriguing. I'm sorry, I don't mean to make it sound like your illness is a spectacle, but I've never heard someone describe having that reaction to Lithium.

It may interest you to know that panic disorder and bipolar disorder are very frequently comorbid (meaning they occur together). The lifetime prevalence of panic disorder in people with bipolar disorder is 1 in 5 (20%) (http://ajp.psychiatryonline.org/article.aspx?articleID=170831), which is twice as high as unipolar depression, and 26x higher than the rate of panic disorder in non-mood disordered subjects. So there is clearly a strong connection in the brain between bipolar disorder and panic disorder, for whatever reason.

There is also evidence that the comorbidity rate for ADHD and bipolar disorder is extremely high (http://psycnet.apa.org/index.cfm?fa=search.displayRecord&UID=2009-01810-018) - as many as 47% of adults with ADHD have bipolar disorder, and around 1/5 of adult bipolar patients have ADHD. That's compared to around 4.4% of the general U.S. population, and an average 2% of the world population. (Interestingly, the U.S. has the highest rate of bipolar disorder in the world, for whatever reason (http://www.cnn.com/2011/HEALTH/03/07/US.highest.bipolar.rates/index.html).)

My point being that if you have been diagnosed with panic disorder and ADHD in the past, it would not be out of left field for you to meet the criteria for a bipolar disorder diagnosis. Everything you describe sounds suspiciously like bipolar II disorder, from the family history to the chronic, low-level hypomanic behaviors (250 bottles of nail polish screams hypomania/mania to me, and the out of control behavior on Lithium is classic mania) to the cycling major depressive episodes.

Of course, a manic response to medication does not indicate bipolar disorder, as people without bipolar disorder can very rarely respond in a manic way to certain psychiatric drugs. But the fact that you have hypomanic-type episodes outside of the medication response sounds more BPII to me. Also, Fuzzy is right about the mixed states, you can have symptoms of depression and hypomania at the same time. When the disorder used to be called "manic-depression" or "manic-depressive illness", it was more accurate as a diagnostic label. Irritable depressions and dark manias are not uncommon expressions of the illness.

I think it would be worth it for you to try some other mood stabilizers, like Lamictal (which is especially well-known for treating bipolar II depressive episodes) or Trileptal (a milder anti-manic than Lithium or Depakote). A psychiatrist who is familiar with bipolar disorder would be good for you. They're all trained to deal with it, but some doctors like to specialize in certain things, like anxiety disorders or mood disorders. Look for someone who works with a lot of mood disorders, and/or adult ADHD.

Sammy2013
11-26-13, 10:20 AM
Dont give up.

It's really tough when your going at faster than light speeds and suddenly your ship falls apart.

It's very common for a co-morbidity with bipolar and attention deficit disorders; one theory is because they both involve a believed deficit in dopamine production in the brain.

The first thing is first, instead of taking one step forwards and two step back, take your time and try to get the basics.

1.) find what medication you have which might put you at risk for mood instability. SSRI's and stimulants are notorious in the BPD world for causing mania/depression. Try and find your drugs interaction and if needed (with the help of pdoc) reduce them.

2.) Stabilize your mood
and a working concoction of mood stabilizers, anti psychotics (low dose for daily sleep) and other meds. I like to think bipolar like driving down a desert road with no lights and without a speedometer or break peddle. The right combo lights up the road and tells you how fast your going.

3.) life style
Stay active, stay healthy, stay close to friends. Always have something productive to do everyday. Whether hitting the gym, cooking with molecular gastronomy, reading a great book and hitting the town. Have a happy active activity.... daily. Keep it structured and ritualized.

EAT 3 times daily. don't forget breakfast. if to skip any meal NEVER breakfast.

Abstain from alcohol, illicit drugs "marijuana". MJ can especially lower LT functioning in BPD and other disorders. I do believe in moderation but the dangers are ever the more evident with our sub type.

Finally.) Keep at it all of the above. One day it wont feel like work anymore.

Daydreamin22
11-26-13, 09:00 PM
I'm with you. Want to read this later.