View Full Version : Why bother treating bi-polar any way


meadd823
08-08-07, 05:03 AM
There are some who have distinct or even previously diagnosed bi-polar who well don’t want to take medications to control the symptoms because basically pills ain’t no fun

Now I have personally observed that male tend to be more resistant to treatment than females. Although I personally attributed this to good old fashion stubbornness and testerone driven pride. Recently I have observed that males in mania tend to be more euphoric than females in mania. Many of the wonder bi-polar women in my life tend to become manic and “witchy” is a nice word for it. In my ADD style CEU cram sessions bi-polar became my next subject of study { look out austics you are next I have three more hours to go by next weekend I ran out of new bi-polar courses}

I am ADD but not crazy apparently 2/3erds of all women experience dysphoria during mania – in other wards they don’t like the way it make them feel. They experience things like irritability and anxiety. According to the same source slight over half of all men experience mania as an euphoric state – it is more fun {which by the way is unfair –IMHO}
So ladies be cool and patent with your male bi-polar cohorts when they deny that mania is a bad thing because apparently their mania may not feel the same as yours. Do how ever feel free to drag them kicking and screaming over here so they can learn why this wonderful feeling needs to be medically treated {If they have ADD mentioning the subsequent depression may not help}

During this coarse study I took through Med Scape there may be other reasons to treat bi-polar besides relieving your close friends and family of your Dr Jeckle and MR. Hyde emotional roller coaster ride.

For my medically minded scientific readers.

The Neurobiology of Bipolar Disorder (http://www.medscape.com/viewarticle/558735)

Brain-derived neurotrophic factor (BDNF) is important for synaptic plasticity and dendritic growth and essential to long-term memory. It has been implicated in a variety of neural processes as a function of stage of development in both animals and humans. BDNF acts at one of a series of neurotrophic factor receptors that are tyrosine kinases (Trks); they have important intracellular and transcriptional effects on a variety of neurochemical systems, especially those implicated in bipolar disorder such as mitogen-activated protein kinase (MAPK), phosphatidylinositol 3-kinase (PI3-K), and phospholipase C (PLC) alpha signal transduction pathways.[1] Both lithium and valproate increase BDNF levels[2] and increase the rate of neurogenesis,[3] suggesting that these mechanisms may play a role in the therapeutic effects of these drugs
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ADD translation – the more episodes you have the more you may be damaging your brain. . . . after the coarse I looked the information up not only to verify the accuracy of my ADD brain , bug across my screen + video coarse = huh what the feet was that. . . . I found plenty out there indicating this is not one experts opinion

Below please find some more reader friendly information for my less medically inclined readers who may prefer English over Medical jargon.

If the title below doesn’t grab your attention well you either need to take your ADD pills or throw some cold water on your face.

As if being ADD wasn't enough. . . . . what we need now is not



Bipolar disorder shrinks the brain (http://www.news-medical.net/?id=27886)


British researchers have found that people who suffer from manic depression or bipolar disorder as it is more often called, also experience a loss of brain tissue and an accelerated shrinking of their brain.

The researchers at the University of Edinburgh say the tissue loss is greater in people who suffer multiple episodes of the illness and is associated with a decline in some areas of mental ability.

This study shows for the first time that bipolar disorder - a condition characterised by periods of depression and periods of mania - is associated with a reduction in brain tissue and proves that the changes get progressively worse with each relapse.

The researchers believe the discovery has implications for future research into the disease, and also on the way the condition is treated.


The researchers compared MRI scans of the brains of 20 patients with bipolar disorder and an equal number of volunteers without the condition and saw that everyone loses a small amount of tissue over time.



But in those with bipolar disorder, the loss of grey matter, where nerve signals are processed, was greater than in the control group and supports the theory that cognitive function is impaired in bipolar patients as they age.
The research team found that MRI's carried out four years apart on those with bipolar disorder showed a loss of brain tissue in the areas controlling memory, face recognition and co-ordination.


The researchers also found that those who lost the most grey matter had the most episodes of mania and depression and the biggest decline in brain function.


Study leader Dr. Andrew McIntosh senior lecturer in psychiatry, says the study could not show whether the loss of brain tissue was a cause or consequence of the disease but it is possible that repeated episodes of illness harm the brain and lead to the decline.

***End Quote




Speaking not only of the brain the person below throws in a few other medical condtions that may also be worhty of consideration. I have one on the comorbidites and percentages already typed up but do not wish to over whelm.



Bipolar Disorder FAQ Part I - Overview to Bipolar (http://www.mcmanweb.com/bpfaq1.htm)

So bipolar is just a mood disorder. Simple as that, right?

Wrong. The conventional wisdom has been that bipolar is an episodic illness affecting mood, with often long periods of remission between moods while an illness such as schizophrenia is a chronic illness affecting cognition that progressively worsens. Now psychiatry is revisiting that distinction. What the experts are finding is that even between episodes, many people with bipolar experience residual symptoms and subtle cognitive deficits that can get worse over time.




That's the last thing I need to hear.

Don't panic. The brain also has infinite ways of repairing itself. But brain imaging studies and studies of post-mortem brains do show smaller volumes in certain parts of the brain and larger volumes in others for bipolar patients, which may affect learning and memory and function. The good news is that some of the medications for bipolar may protect against further deterioration and even reverse the damage. Studies on rats have found that two bipolar meds, lithium and Depakote, cause new brain cells to grow, and a study on humans found lithium produced the same result. Also, nutritional supplements may be good brain food.





Is there anything else I should know about the nature of bipolar disorder?

Yes. People with bipolar disorder tend to suffer from at least one other mental illness, as well, including anxiety and panic, and alcohol and substance use. According to one major study, 61 percent of people with bipolar I have a lifetime substance use disorder (note, the percentage at any one time would be a lot smaller).




Does bipolar disorder affect other areas of the body?

Yes, unfortunately. People with bipolar disorder die seven years younger than those in the general population, independent of suicide. Most of the research on the mind-body connection relates to depression, but we can apply much of those findings to bipolar.





Such as?

The risk of heart disease is doubled in people with depression, and a previous depression is often the greatest risk factor for heart disease and other ills, over smoking, drinking, high blood sugar, and previous heart attacks. Depression has also been connected to diabetes, bone loss, stroke, irritable bowel syndrome, and possibly cancer.



How serious a problem is bipolar disorder? {do we really need to ask = looks pretty darn serious to me}



The Stanley Bipolar Foundation Network, which admittedly gets the sickest patients in its clinics, recently released this data: 85.1 percent had been hospitalized in the past, on average three times. The rate of suicide attempts was 50.3 percent. A third were currently married, another third single, and the rest were separated, divorced, or widowed. Despite the fact that approximately 90 percent had high school diplomas and a third had completed college, almost 65 percent were unemployed and 40 percent were on welfare or disability. According to Mark Bauer MD of Brown University, speaking at a conference in 2001, thirty to 50 percent of bipolar patients remain chronically ill.





That's pretty depressing news. {Do read the last part before keeling over of that deperssion induced heart attack okay}

Yes it is. The good news is we can dramatically improve our chances by being smart in managing our illness, which involves a good working relationship with your psychiatrist to get you on the right meds (and then being compliant with those right meds), and making treatment and lifestyle choices that contribute to our mental and physical well-being

***End Quote

~All Bold, Underlining and Text Color Changes to Source Material Mine~

So the bottom line ADD translation = if you have bipolar and you want to keep your brain intact and functioning then perhaps treatment isn’t such a downer after all. {CF do ya think that guy in general still wants to debate the necessity of bi-polar medical treatments = he doesn't know me very well- :rolleyes: }


I felt an even bigger weight lift from my heart when I read the stuff above than I did with during my study on bi-polar comorbid conditions {long story another post} When I read this stuff and it made my cry more than any happy ending in a romantic novel and ever could.


My daughter was diagnosed bi-polar after an antidepressent induced manic episode. I was often thrashed by other parents for placing my 13 year old daughter on a medication like depoke. . .. . . to all those who thought I was just drugging my daughter for the hell of it

“KISS THIS and I don’t mean my ruby red lips” Ya get the picture.

Note to Moderators - Feel free to move this into any section you deem best if my placement was incorrect - catagorizing isn't my strong suite. . . . . . I have a brain but still got a touch of ADD = :o

Crazygirl79
08-08-07, 05:08 AM
Well...it's been suspected that I may be Bipolar along with the other things and I haven't even bothered getting dxd with it...why cause firstly I hate psychs...they annoy me, secondly I don't want to be doped up to the eyeballs on meds and thirdly I've been coping with severe depression and mood swing since I was 11 and I was UNmedicated most of that time...I know when I'm about to "crash" and I take care of it myself...pure and simple!

Selena

Scattered
08-08-07, 08:17 AM
Okay -- for the sake of discussion ....

FIrst, I think that most people (except those currently enjoying a euphoric state) would grant that a full blown bipolar disorder requires medication in most if not all cases.

Here comes the problem -- from the reading I've done recently on the topic, it appears that more and more gradients are being added to the spectrum -- these include Bipolar II; cyclothymia (sometimes called Bipolar III); medication induced mania (sometimes called Bipolar IV); depression with relatives who have bipolar (sometimes called bipolar V) -- forgive me if I have any of the numbers wrong - I'm just doing this from an ADD memory of what I read yesterday.:rolleyes: Then there are conditions suspected of being softer bipolarities yet like: Seasonal Affective Disorder (SAD), Premenstral Dysmorphic Disorder (PMDD), Post Partum Depression, Borderline Personality Disorder, and some even suspect Generalized Anxiety Disorder. Exactly at which point along the spectrum (if all these things end up eventually being formally included on the spectrum) does it become necessary, or even a good idea, to medicate?

In the past I've been diagnosed with either depression or anxiety and worked through both successfully (in spite of my undiagnosed ADD) with a good therapist and no medication, although medication was an option that was offered. More recently I tried an SSRI and ended up with some permanent facial tics, so my opinion is definately a bit jaded.

All medications have side effects and medication for bipolar can have some pretty diccy ones for some people. It comes down to weighing the risk of the medication against the risk of not taking medication. I tend to be a believer in spectrum disorders -- whether it be Autistic Spectrum or Bipolar Spectrum or whatever. I believe all disorder do need to be taken seriously and treated, but when does it make more sense to treat these disorders with lifestyle changes (managing stress, diet, supplements, exercise), cognitive behavioral therapy, and such verses medication. I wonder how often medication actually makes some of these conditions worse, especially if the "trial" of medication picks the wrong one first (IE: giving SSRI medication to someone who turns out to be bipolar - does that trigger their bipolar vulnerability).

The class I took on line from Dr. Ratey discussed how hard it is to change the medical establishment's thoughts on how to treat disorders like depression. New research is indicating the exercise may be as good (and some studies show actually better) than anti depression medication without the side effects profile. Exercise also increases BDNF! Exercise can also reverse brain shrinkage and actually grow the brain!!!

Omega III fatty acids have also been shown to be helpful in treating depression and have an action somewhat like lithium. Cognitive Behavioral Therapy has research backing up its effectiveness in treating depression, anxiety, etc.

I was reading that SAD lights in the winter have been shown to not only reduce seasonal affective disorder, but reduce the mild summer manias if they were used the previous winter.

I know sometimes lifestyle, counseling and such isn't enough and that medication is needed. I'm just truly puzzled (this is a question I'm still wrestling with myself) about where along the bipolar spectrum it make sense to take medication?

Scattered

Crazy~Feet
08-08-07, 09:22 AM
Note to Moderators - Feel free to move this into any section you deem best if my placement was incorrect - catagorizing isn't my strong suite. . . . . . I have a brain but still got a touch of ADD = :oI absolutely LOVE it here and wouldn't dream of moving it elsewhere! I certainly hope the rest of staff is cool with that?

So ladies be cool and patent with your male bi-polar cohorts when they deny that mania is a bad thing because apparently their mania may not feel the same as yours. Do how ever feel free to drag them kicking and screaming over here so they can learn why this wonderful feeling needs to be medically treated {If they have ADD mentioning the subsequent depression may not help}

So the bottom line ADD translation = if you have bipolar and you want to keep your brain intact and functioning then perhaps treatment isn’t such a downer after all. {CF do ya think that guy in general still wants to debate the necessity of bi-polar medical treatments = he doesn't know me very well- :rolleyes: } Ahahahaha! I am pretty sure he is going to continue to try, though. And then again there are many who believe that bipolar is a pretty cool thing to have...when its mania/hypomania that they are experiencing. I see this sentiment ALL THE FREAKING TIME!!

I try to be an understanding and supportive person. I really and truly do! But I have to admit that there is a rotten little corner of my heart that gets absolutely FURIOUS when somebody with BP posts about how great manic episodes are, and why are they considered a bad thing. Or how "cool" it would be to be able to experience hypomania ...and this is often coming from persons WITHOUT a BP spectrum disorder!! ACK!

Treatment can be a real downer sometimes. It can be downright discouraging when medication after medication fails to help you maintain stability. I am very, very grateful to our "Cycling Team" for all the times they have been there for me. I am so sad for people who do not have this type of support or choose to refuse the support that we offer them. That's just a crying shame.

There are some who have distinct or even previously diagnosed bi-polar who well don’t want to take medications to control the symptoms because basically pills ain’t no fun

Ya know what? I am very much a realist when it comes to this. This is what my daddy would call "a tough one". My brother would call it "a DWI moment...that means Deal With It". Maybe pills are not fun...and who ever promised you that life would always be fun? Who even promised that life would be easy?

I'd dearly love to see the contracts that anybody got stating these options as facts. I personally doubt very much that such a thing exists.

My daughter was diagnosed bi-polar after an antidepressent induced manic episode. I was often thrashed by other parents for placing my 13 year old daughter on a medication like depoke. . .. . . to all those who thought I was just drugging my daughter for the hell of it The exact some thing happened with Spacemania...and for anybody interested, she happens to be an active member here. She is intelligent, sweet, extremely creative and full of life...and most definitely bipolar.

She was diagnosed after first going hypomanic on a SSRI antidepressent, although we did not realize at the time that this was what was happening to her, and had a different psychiatrist back then, you know the type...the type that thinks inattentive ADHD is depression :rolleyes:... then experiencing a severe and irritable, mildly psychotic mania when administered Adderal without knowledge that she was also bipolar and would need a stabilizer to continue with stimulant treatment for ADHD.

I have had many trials and tribulations with BP meds and so has she, at the tender age of 11. I persevere and I encourage her to do so as well...why? Because of the reasons clearly stated in the studies above. I am dead certain that my own BPII has progressively become worse over the time that I was improperly treated, or not treated at all...and I would rather be rolled in broken glass and then dipped in alcohol than to see her walk that frightening path herself.

“KISS THIS and I don’t mean my ruby red lips” Ya get the picture.
Yes indeedy, I medicate an 11 year old child, and she has DRASTICALLY improved!! The tendency for the pediatric form of BP to present as a lot of hypomania, mixed episodes and rapid cycling is incredibly painful to witness...and its scary for them to experience. Space is one smart little cookie and has been taught from day 1 that if she has a problem, I am here to listen to her and try to help in any way I can.

When her extremely pressured speech was driving everybody around her crazy and we begged her for just a few moments of silence, she would tell me "Mom, I can't, I just cannot stop talking! What's wrong with me??". When she had her moments of depression and would berate herself and refuse to be consoled, I saw myself and my heart broke for her. I would gladly bleed for my child and I can do nothing but help her to seek treatment and try not to feel the crushing weight of guilt, to forgive myself because it was ME who passed this tragic gene to her.


If anybody thinks they have a right to question my decision to medicate Spacemania...the reply is posted above and I mean that sincerely, in spades!!

I live in fear that my older children have bipolar..despite the arguments she presents to me, Missing (another active member here) seems to me quite the candidate. Her depressed periods are truly bleak and terrible to witness, and they just so happen to come...and then go. She is 18 and has the right to make her own decisions, but I often wonder, and naturally, I worry. As far as my toddler is concerned, it is way to early to tell. The possibility has been discussed though, with her father and with our psychiatrist. We will deal with that as a family, if or when that possibility proves to be a real issue.

I also live with the very real possibility that for me, the years of improper and inadequate treatment may have already taken their toll. I worry that one day, the switch will flip, and I will no longer be able to classify as BPII...that I will be then become a BPI, with all the dangers of psychotic manias that that DX entails. I wonder:

If I flipped over into BPI and became psychotic...would I know that, before I possibly did something tragic and irreversible?

justhope
08-08-07, 09:29 AM
Tammy....thanks for that info..I think....LOL
I am glad there is some good news....and sometimes just like for us, education is a good thing for everyone who knows and loves us. :)

KZ...hugs sweetie...you know I understand about the whole children thing..and regrets....hang in there...


Scattered.
I always like your unique perspective on things. I find it interesting ...about the different spectrums you have researched. I have done some, but not that extensive into the spectrums...interesting because my initial dx was Cyclothymia.../ BPII...perhaps his handwriting , in typical Dr. fashion had a III not a II...anywho....I am def a rapid cycler.

To add my 2 cents into your post....I totally here what you are saying about meds. And for those who don't need them. Great....
I lived 24 years before I got the ADD dx. 25 before the depression....34 or so for the PMDD and mild social anxiety disorder...and 36 for the BP...

I survived...without meds. And I mean, survived. I understand that sometimes the cure is worse than the disease. But for me...I will take my chances ...and possibly shorten my life span...to have a few years of quality of life. I have walked around my whole life with a hole. It was not filled until I got my BP diagnoses. And although it was not easy to swallow. It made sense.
My journey with meds has been mild compared, to many...like CF and my sister. I have had some bad experiences...with SSRI's ...made me like a zombie....Concerta who gave me TD but not perm. And so forth.
However, the combo I am on now...has little to none. And my life is managable for the first time in almost 40 years.

You asked when should someone in the realm of spectrums start meds...when they have tried all the alternatives...like you mentioned above, which I totally agree with...and their life is not manageable. That is when. When they are able to pull the blinder's off...and realize...that it's not something they can control. No matter how much they want to. Denial for any spectrum of BP is a dangerous thing. And if the spectrums are true to the research I have done..and what Tam's did. Unmedicated, can lead simple cases of Cyclothymia...BPII's to full blown BPI's ..and that is really the danger zone. As we see here wiht many of our BPI friends. The darks side stays much longer and is more extreme...and then the heavenly side...well can be literally destructive....I have experienced only short amounts of both milder forms...since I cycle up so fast , by the time I am drowning in one..the other one comes for a visit.

But I can tell you...if I knew ...that staying the same as I was prior to Sept of last year....would lead me facing further brain destruction...and full blown BPI...no thanks. I will take a stupid pill.
I wish I had had them years ago. I have done so much damage in my life...because of the missing of the diagnoses....it's sad. While I don't "stay" in regret. There are things , I can't take back, and can't redo...or ever get to do...Perhaps if I had been diagnosed....I could have. I sure would have faired better with my kids...my relationships..and my careers....
And I have been successful in my later years....same job for 8 1/2 years at a large Firm...where I moved up quickly...and I bought a home...etc. But you know what....and I am not bragging here...I am smarter than just that. I could have done more. Much more. If I had more control over my up's and downs.

Being consistant in every aspect, such as organization, motivation, emotionally etc...is key to being able to do "great" things, and I use that loosely....including being a good mom...and I can tell you...if you have the extremes I have...or some of us here....you CAN'T do it...the up's and down's hold us back. IMHO....I am happy I have accomplished what I have and not swallowed that bottle of pills that looks good to me sometimes...or quit my job and run off with the mailman...but now that I approach life with less extremes... I see some of my dreams coming true. I see having more success with my younger children,,,versus the mistakes I made wiht my BP son.

And there is not a question in my mind...after 15 years of not being dx with BP himself...he is NOT a candidate for CHOICE of meds. And I don't medicate my younger kids. They are both ADD as the day is long. They function, and I let them stay off ...until they don't. But Keenan, even medicated...has lost the last 3 years of his childhood. He will be incarserated until he is an adult. And I believe if he had been caught earlier, if I had...and he had , had meds...we might have been able to save him too.

So I hear what you are saying...and I am glad you have made it work for you. But with much of the medical proof showing that the early stages or precursor specturms can't go untreated since it can change to the dreaded BPI stages is simply not an option. And while I have managed to survive, and simply that is all I have done for years, is survive or exist...I simply refuse to not do whatever I can to slow it down. And my strong opinion is BPI's there are NO options to not medicate. Death is close enough to us in the "milder" spectrum...for them it's almost a given, on treatment. Never mind without.

I tried all of those things above, Scattered. (I do agree with the Omega's/ vitamens/exercise though, very important) even with all of those things...my extremes...were still too extreme and not bearable. Now with some of those things...and my medication...they are. I am not cured, I still cycle...but it's manageable.
I guess for me it's like having cancer...and deciding after trying all the "alternative" meds...that I will just have to do the chemo thing...be bald...sick for awhile..but have quality of life...not quantity....

Living miserable, and below your abilities, not in control of your own destiny ...is NOT living to me. And I don't want to live "longer" that way. Given the choice, simply put. I would rather live a shorter span...being able to be my true self.







Thanks again, for sharing your perspective as always I enjoy your posts...but here is mine...

Hope :) ..

Crazy~Feet
08-08-07, 09:33 AM
Selena, you know that I like you, right? I do have to speak my own mind, however, you ought to know by now that I would do so, ok?

Well...it's been suspected that I may be Bipolar along with the other things and I haven't even bothered getting dxd with it...why cause firstly I hate psychs...they annoy me That's very sad. I love my current psych, he has been a lifesaver for me and for Space. I also have had rotten psychs...and I fired them ;). I stay informed and knowledgeable because its MY treatment, ya know?


I've been coping with severe depression and mood swing since I was 11 and I was UNmedicated most of that time...I know when I'm about to "crash" and I take care of it myself...pure and simple! Ok...then I am quite curious as to just how you take care of it then? Since we do not know whether you do, in fact, have BP, we really cannot say what the deal is. Maybe you are able to "take care of things" simply because the issue is not BP at all. Other issues can cause mood swings, after all. BP has a definite pattern to it that other types of mood swings lack.


I don't want to be doped up to the eyeballs on meds I have got to say that my first gut response to this is resentment. Do you honestly think that I am "doped up to the eyeballs"?? I wonder what makes you believe that BP treatment means "doped up" in the first place?

It is, of course your choice to do what you will, I will not deny that.

Crazy~Feet
08-08-07, 10:30 AM
Okay -- for the sake of discussion .... And as long as I moderate this section? There will be room for discussion ;) I promise you that.

FIrst, I think that most people (except those currently enjoying a euphoric state) would grant that a full blown bipolar disorder requires medication in most if not all cases. Agreed. I am sure that Jesse, our recent addition to the Cycling Team, who has a DX of BPI would more than gladly agree as well. I cannot claim to speak for him though...but I hope he makes it in here and offers us his 2C worth. We all have a lot to learn from his experiences.

Here comes the problem -- from the reading I've done recently on the topic, it appears that more and more gradients are being added to the spectrum -- these include Bipolar II; cyclothymia (sometimes called Bipolar III); medication induced mania (sometimes called Bipolar IV); depression with relatives who have bipolar (sometimes called bipolar V) -- forgive me if I have any of the numbers wrong - I'm just doing this from an ADD memory of what I read yesterday.:rolleyes: Then there are conditions suspected of being softer bipolarities yet like: Seasonal Affective Disorder (SAD), Premenstral Dysmorphic Disorder (PMDD), Post Partum Depression, Borderline Personality Disorder, and some even suspect Generalized Anxiety Disorder. Exactly at which point along the spectrum (if all these things end up eventually being formally included on the spectrum) does it become necessary, or even a good idea, to medicate?
Whew! I don't know all that you have been reading, but it sounds very complex, and much more complicated than I like things to be. I do have ADHD after all :D..I personally go by the DSM-IV-R criteria, because this is what doctors are currently provided with for use in diagnosis.

Bipolar I Disorder--Diagnostic Features (DSM-IV, p. 350)

The essential feature of Bipolar I Disorder is a clinical course that is characterized by the occurrence of one or more Manic Episodes or Mixed Episodes. Often individuals have also had one or more Major Depressive Episodes. Episodes of Substance-Induced Mood Disorder (due to the direct effects of a medication, or other somatic treatments for depression, a drug of abuse, or toxin exposure) or of Mood Disorder Due to a General Medical Condition do not count toward a diagnosis of Bipolar I Disorder. In addition, the episodes are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified. . . .




Bipolar II Disorder--Diagnostic Features (DSM-IV, p. 359)

The essential feature of Bipolar II Disorder is a clinical course that is characterized by the occurrence of one or more Major Depressive Episodes accompanied by at least one Hypomanic Episode. Hypomanic Episodes should not be confused with the several days of euthymia that may follow remission of a Major Depressive Episode. Episodes of Substance- Induced Mood Disorder (due to the direct effects of a medication, or other somatic treatments for depression, a drug of abuse, or toxin exposure) or of Mood Disorder Due to a General Medical Condition do not count toward a diagnosis of Bipolar II Disorder. In addition, the episodes are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified. . . .




Criteria for Major Depressive Episode (DSM-IV, p. 327)

A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

Note: Do not include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations.


depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g. appears tearful). Note: In children and adolescents, can be irritable mood.

markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others)

significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains.

insomnia or hypersomnia nearly every day

psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)

fatigue or loss of energy nearly every day

feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)

diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)

recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

B. The symptoms do not meet criteria for a Mixed Episode.

C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).

E. The symptoms are not better accounted for by bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.




Criteria for Manic Episode (DSM-IV, p. 332)

A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary).

B. During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:


inflated self-esteem or grandiosity

decreased need for sleep (e.g., feels rested after only 3 hours of sleep)

more talkative than usual or pressure to keep talking

flight of ideas or subjective experience that thoughts are racing

distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)

increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation

excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

C. The symptoms do not meet criteria for a Mixed Episode.

D. The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.

E. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatments) or a general medical condition (e.g., hyperthyroidism).

Note: Manic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar I Disorder.




Criteria for Mixed Episode (DSM-IV, p. 335)

A. The criteria are met both for a Manic Episode and for a Major Depressive Episode (except for duration) nearly every day during at least a 1-week period.

B. The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.

C. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).




Criteria for Hypomanic Episode (DSM-IV, p. 338)

A. A distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days, that is clearly different from the usual nondepressed mood.

B. During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:


inflated self-esteem or grandiosity

decreased need for sleep (e.g., feels rested after only 3 hours of sleep)

more talkative than usual or pressure to keep talking

flight of ideas or subjective experience that thoughts are racing

distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)

increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation

excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

C. The episode is associated with an unequivocal change in functioning that is uncharacteristic of the person when not symptomatic.

D. The disturbance in mood and the change in functioning are observable by others.

E. The episode is not severe enough to cause marked impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features.

F. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).

Note: Hypomanic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar II Disorder.

Underlining mine.

It is my understanding and I just researched this yesterday, so my memory is as good as it can be given ADHD impairments, that cyclothmia is recognized and considered to be very mild, although I am pretty sure that due to the progressive nature of BP spectrum disorders, it might be a prudent idea to medicate at this point.
In all honesty, I cannot say that the other options you presented qualify as BP spectrum at this time. Maybe one day after more research they will. I myself would NOT consider them to be BP spectrum as of this date, and the choice to medicate or not medicate would then be at the discretion of patient and doctor, of course.
In the past I've been diagnosed with either depression or anxiety and worked through both successfully (in spite of my undiagnosed ADD) with a good therapist and no medication, although medication was an option that was offered. More recently I tried an SSRI and ended up with some permanent facial tics, so my opinion is definately a bit jaded. You are very cool for admitting this, ya know that?

Not to be rude or confrontational, but your diagnoses are what they are and are not bipolar, am I right? At least as far as you can tell?

All medications have side effects and medication for bipolar can have some pretty diccy ones for some people.OK I need you explain this. I have a problem with this every single time I see it stated, with regards to the stimulants I take and the current medication cocktail I take for BPII. You see...I do not seem to have side effects at all. None that I would take any note of anyway. Certainly some of my medications are sedating, they are meant to be, so that situation does not qualify as a side effect.

Yes, I have had some BP meds with truly horrendous side effects, and I discontinued them and took a chance on a different med once more. I do not know what I would do if my only chance at stability meant I had to tolerate some rotten side effects.


It comes down to weighing the risk of the medication against the risk of not taking medication.Agreed.

I tend to be a believer in spectrum disorders -- whether it be Autistic Spectrum or Bipolar Spectrum or whatever. I believe all disorder do need to be taken seriously and treated, but when does it make more sense to treat these disorders with lifestyle changes (managing stress, diet, supplements, exercise), cognitive behavioral therapy, and such verses medication.I'm with Hope on this one, Scatt. When life becomes unmanageable through any other means, then you medicate and you do not balk at that. To do any less in my opinion is just asking for trouble...and that trouble very well might be of a serious nature, indeed.

I know I remember reading, somewhere, at some time, that of all the people who succeed at committing suicide, BPs topped the list. Darn if I can remember where that came from now, though! But that does present a frightening possibility, and a perspective that some people with BP really, really need to take into consideration.

I wonder how often medication actually makes some of these conditions worse, especially if the "trial" of medication picks the wrong one first (IE: giving SSRI medication to someone who turns out to be bipolar - does that trigger their bipolar vulnerability). I wonder this too. I know that I have had my share of "bad medicine", including many years of SSRIs and they indeed made me worse... and yet...I always stayed hopeful and continued to try. That is something I can only attribute to myself, however, because I cannot speak for others. I am one stubborn and determined female. I do not quit, that is not an option in my life.
The class I took on line from Dr. Ratey discussed how hard it is to change the medical establishment's thoughts on how to treat disorders like depression. New research is indicating the exercise may be as good (and some studies show actually better) than anti depression medication without the side effects profile. Exercise also increases BDNF! Exercise can also reverse brain shrinkage and actually grow the brain!!!
This is all wonderful news...exactly how does it apply to BP though? I understand the bits about brain shrinkage and so forth...but I do not suffer from depression UNLESS its part of a BP cycle. I do not take antidepressents either :). I attribute a lot of my side effects from antidepressents to my undiagnosed BP, although certainly not all of them...antidepressents can be nasty little buggers!!
Omega III fatty acids have also been shown to be helpful in treating depression and have an action somewhat like lithium. Cognitive Behavioral Therapy has research backing up its effectiveness in treating depression, anxiety, etc. Again, I only have depression as part of a cycle and I honestly believe that BP depression is a horse of a different color when compared to say chronic major unipolar. And I wonder if the action of Omega III fatty acids that resembles lithium resembles it to what extent? Because I believe that what I need is something that is known to stabilize mood disorders quite well. I prefer "known to work" as opposed to "helpful" but that's just me.

I was reading that SAD lights in the winter have been shown to not only reduce seasonal affective disorder, but reduce the mild summer manias if they were used the previous winter. This is also good news, although I do not even know what a mild summer mania is! Is it a part of BP, or not? I know that many of my hypomanias were a far cry from mild, though, I do know that.

I know sometimes lifestyle, counseling and such isn't enough and that medication is needed. I'm just truly puzzled (this is a question I'm still wrestling with myself) about where along the bipolar spectrum it make sense to take medication?
Hope put this quite eloquently and I have to admit that I concur:

You asked when should someone in the realm of spectrums start meds...when they have tried all the alternatives...like you mentioned above, which I totally agree with...and their life is not manageable. That is when. When they are able to pull the blinder's off...and realize...that it's not something they can control. No matter how much they want to. Denial for any spectrum of BP is a dangerous thing.

This also applies to my experience as well:

So I hear what you are saying...and I am glad you have made it work for you. But I tried all of that Scattered. (I do agree with the Omega's/ vitamens/exercise though, very important) even with all of those things...my extremes...were still too extreme and not bearable. Now with some of those things...and my medication...they are.
Medications have made a difference in my life, for the better, that nothing else can compare with.

I do sincerely apreciate a lot of the points you brought up here today however! There is always the chance that your info may really help somebody and I thank you for that. :)

Crazy~Feet
08-08-07, 10:34 AM
KZ...hugs sweetie...you know I understand about the whole children thing..and regrets....hang in there...


And right back at ya, my cycling sistah! :)

justhope
08-08-07, 11:14 AM
Selena...
You know I like you as well. But I have to second KZ as well. :soapbox:
It's very crucial to those of us over here..to be "real" with self. In fact it's a matter of survival, literally....So please don't think we are attacking you. But we are not "passive" observers over here. And sometimes we have to be tough with each other to "shake us awake" .....seriously....

I have to wonder too, how do you "treat" your crashes? I am very interested to hear another way to handle them..without meds, if you are indeed BP...or heck even just plain old depressed. Cause my understanding is part of the reason it's a disorder, disability, or illness...which ever you prefer, is because you CAN'T control it. That is the difference between a crappy day and depression?

And well I am not offended at the 'ignorance" and I don't mean stupid, I mean ingnorance, as in the true sense...lack of knowledge...to most peoples opinion on medications for Bp.....this is why I love to educate...and break the Ignorant Stigma society in general has. I am on meds...I also would ask...do I seem Doped to the Eyeballs? If you have experienced this before. I am sorry. I have only experienced this when I was on the WRONG meds or WRONG dosage. I have been on my cocktail for almost a year now...I never felt more clear.

Crzy, it's your life dear. My opinion...find another doctor......, and I don't mince words...but please make sure you are being honest with yourself...about being able to "control" your depression...or why you are " avoiding" getting a diagnoses. I didn't like it, myself, but it enabled me to deal with the "true" issues I had.

Scattered
08-08-07, 11:26 AM
You asked when should someone in the realm of spectrums start meds...when they have tried all the alternatives...like you mentioned above, which I totally agree with...and their life is not manageable. That is when. When they are able to pull the blinder's off...and realize...that it's not something they can control. No matter how much they want to. Denial for any spectrum of BP is a dangerous thing. And if the spectrums are true to the research I have done..and what Tam's did. Unmedicated, can lead simple cases of Cyclothymia...BPII's to full blown BPI's ..and that is really the danger zone. As we see here wiht many of our BPI friends. The darks side stays much longer and is more extreme...and then the heavenly side...well can be literally destructive....

Excellent post, JustHope! Thanks -- I find that really helpful. It makes sense to try the other options first, but to continue on to meds if they don't provide sufficinet improvement.


But with much of the medical proof showing that the early stages or precursor specturms can't go untreated since it can change to the dreaded BPI stages is simply not an option.

I was reading in Dr. Ratey's book Shadow Syndromes that "fully 1/3 of cyclothymics will progress to Bipolar I". I guess that means that 2/3rd won't, so this is where I start thinking that it makes a lot of sense like you said to try and stabilize things with other options first. I am always for treating these things -- it's just that treatment doesn't exclusively or always mean medication.

And my strong opinion is BPI's there are NO options to not medicate. Death is close enough to us in the "milder" spectrum...for them it's almost a given, on treatment. Never mind without. I don't know of any safe options for Bipolar I that don't include medications, I just left the door open a crack, because I don't know everything and our understanding of the mind is an on going process.

I am really delighted that the medications are improving your life and not causing you problems with side effects. That's great!:)

Thanks for sharing!
Scattered

Sky81
08-08-07, 12:29 PM
I often wonder if my little sister had been medicated early on, she may not have gotten so bad later in life. She was clearly bipolar as a child. She was extremely hard to deal with.....She would cycle rapidly and if you happened to set her off (which was very easy) there would be a trail of destruction in her path, that was time consuming and sometimes expensive to clean up.......no one noticed that there was anything wrong with her until she downed a bottle of tylenol when she was 16....then she was in an out of the hospital for the next 7 years.....and only recently seems to be stabilized and getting her life together.


If I flipped over into BPI and became psychotic...would I know that, before I possibly did something tragic and irreversible?

I've experienced psychosis only once before. I was actually in a mixed state at the time. I was able to notice it. I was able to feel it, and I often though if you ask yourself if you are psycotic you can't possibly be psychotic....but that's not true.....

I started hallucinating. I began hearing voices, and having visual hallucinations....which were pretty scary. Once that started to happen I knew it was time to start treating it, I had suspected it for a couple years, and was misdiagnosed as having ADHD.....which now may not be a misdiagnosis after all.....I was probably ADHD as a child (I was actually diagnosed with it), and I later devloped bipolar disorder.

Now I wonder if I had been treating the bipolar disorder at it's onset (right around puberty) I might have saved myself a lot of money and I wouldn't have behaved so recklessly and gotten into so much trouble when I was younger.

If it weren't for watching it happen to my sister I wouldn't have probably noticed it as quickly, if even at all.....so it's not totally inpossible to not recognize it if you know what to look for.....

My boyfriend is actually against me taking medication, and he has no understanding od the disorder and doesn't care to learn about it. He argees that I'm "crazy," but he believes that it's my fault and I should be able to control it, it's all just because I'm immature........

Sometimes I want to stop taking medication (sometimes it's simply because it causes fights with my boyfriend)......but really I'm much better off with it, and even he notices it. I do have highs and lows....some days I feel manic and can't sit still and feel my mind racing and some days I feel this insane rage and have fleeting suicidal ideation...I'm still inclined to break stuff (mostly my cell phone), but I don't yell at my coworkers anymore ......the highs and lows aren't as extreme as they were and at least I don't hear voices.

I agree it is progressive. Looking back I experience my first mania when I was twelve which caused some pretty risky behavior....I was free of depression until much later I didn't have another noticable depression until I was about 18, and I only recently realized my "funks" were actually depression. I didn't realize that my impulsivity and recklessness were caused by mania......and amazingly enough I managed to get through college and establish a career, even before I was diagnosed.

It was really my sister that made me realize that I had it too, only mine isn't nearly as severe as hers can be, but I wonder if I hadn't started treating it if it would have gotten that bad....

Scattered
08-08-07, 12:34 PM
Whew! I don't know all that you have been reading, but it sounds very complex, and much more complicated than I like things to be. I do have ADHD after all :D..I personally go by the DSM-IV-R criteria, because this is what doctors are currently provided with for use in diagnosis.A number of places have researchers and practioneers bantering about that SAD, PMDD, and medication induced mania may fall on the low end of the bipolar spectrum. Harvard professor and co author of Driven to Distraction, John Ratey in Shadow Syndromes says, "Unforunately, individuals who belong to the less dangeous categories of bipolar disorder are at risk of becoming severely manic-depressive in time. Fully one-third of cyclothymics -- a milder form of the disorder still 00 will eventually come to qualify for a diagnosis of bipolar I. Even people who suffer winter or summer depressions may in the worst-case scenario, become manic-depressive as their brains react to years of repeated depressions followed by repeated elations. (Many experts believe that seasonal affective disorder is in fact a form of mild manic depression, and some have suggested that postpartum depression - as distinct from postpartum blues -- also reveals a bipolar tendency or vulnerability.)

You make a good point that its best to stick with the DSM IV-R categories for now. My question was a real question. Believe it or not I'm just thinking outloud, not trying to push an anti medication view. As someone who has experienced SAD, PMDD, and postpartum depression where exactly medication to prevent progressing to a more serious diagnosis becomes important is of more than just academic interest to me.




It is my understanding and I just researched this yesterday, so my memory is as good as it can be given ADHD impairments, that cyclothmia is recognized and considered to be very mild, although I am pretty sure that due to the progressive nature of BP spectrum disorders, it might be a prudent idea to medicate at this point.
I wonder -- if only 1/3 of cyclothmics progress to Bipolar I -- perhaps other treatments besides medication might be enough to prevent the progression -- I don't know this for a fact -- I'm just thinking out loud again.
You are very cool for admitting this, ya know that? Thanks! I am definately very scared of medication based on my experience and am definately looking for any other way to treat whatever ails me. A movement disorder may not sound like a big deal, but the one I developed on a stimulent/SSRI combo physically hurt and the constant motion of my jaw about drove me to distraction and nothing helped! It's still not fully gone -- stress or ADD meds, and caffeine can still trigger it. Imagine what bipolar meds would do to it.:eek: I know and am very grateful that not everybody is as sensitive as I am to medication, but many people over time do develop these problems. If the alternative is a full blown mania -- well sometime life is incredibly unfair and you have to take the lesser evil, but if there is a good chance you're going to stay in a milder category. Well, anyway, maybe you see were I'm coming from and aren't getting to annoyed with me.


OK I need you explain this. I have a problem with this every single time I see it stated, with regards to the stimulants I take and the current medication cocktail I take for BPII. You see...I do not seem to have side effects at all. None that I would take any note of anyway. Certainly some of my medications are sedating, they are meant to be, so that situation does not qualify as a side effect. I am really happy your meds don't have problematic side effects for you -- that is awesome! As far as stating that all medication have side effects, I'm just quoting Dr. Hallowell and just about every other doctor I've ever hear discuss the topic of medication. Believe me, when the problem is severe enough, mild (or even severe) side effects may make the most sense. I can assure that is definately the case with my migraine medication.


I'm with Hope on this one, Scatt. When life becomes unmanageable through any other means, then you medicate and you do not balk at that. To do any less in my opinion is just asking for trouble...and that trouble very well might be of a serious nature, indeed.

I know I remember reading, somewhere, at some time, that of all the people who succeed at committing suicide, BPs topped the list. Darn if I can remember where that came from now, though! But that does present a frightening possibility, and a perspective that some people with BP really, really need to take into consideration.I agree. Although I have occasionally wondered if a straight jacket would actually be worse than constant tics -- I guess it would depend on how long I had to be in it. Actually, being a mom I'd probably have to buck up and take the meds, but I don't know how much quality of life I'd have after than with my particular vulnerabilities.
This is all wonderful news...exactly how does it apply to BP though? I understand the bits about brain shrinkage and so forth...but I do not suffer from depression UNLESS its part of a BP cycle. Again, I only have depression as part of a cycle and I honestly believe that BP depression is a horse of a different color when compared to say chronic major unipolar.

Actually, Kay Jameson the author of one of the definitive texts on bipolar disorder and herself a Bipolar I, states in her book An Unquiet Mind that it is not at all clear that unipolar and bipolar depression are different conditions, but rather a spectrum. Since depression is obviously part of the bipolar condition, and since exercise helps reverse the brain shrinkage caused by depression, it is very important for bipolar individuals. This isn't just my opinion, I've read a lot on bipolar sights and from bipolar experts on the importance of exercise -- usually in addition to medication, not instead of medication.
And I wonder if the action of Omega III fatty acids that resembles lithium resembles it to what extent? Because I believe that what I need is something that is known to stabilize mood disorders quite well. I prefer "known to work" as opposed to "helpful" but that's just me.I don't know the answer to that one. I'm not suggesting that it replace lithium for some taking it. Part of the idea of kindling in how depression or bipolar gets worse with repeated ups and down suggests that treating these at with exercise and Omega III at the mild stage may help prevent or slow progression to a more serious stage.

I know sometimes, even intentionally, I come across in the teacher mode, but right now I really am only trying to understand and figure out the best approach to all this -- I'm not trying to discourage anyone from treating their bipolar disorder, whatever kind they have. These questions are for me -- and the responses have been helpful and given me a lot to think about. Occasionally I show up just for myself and ask the questions that are really on my mind.

Thanks,
Scattered

justhope
08-08-07, 12:54 PM
Oh ladies....this is getting entirely too good...and I have to step away..I am starving..dang it....

I'll BE BACK....


Sky! nice to see you made your way over....I sent you a PM...invite..I know CF asked you to join us...

I would love to chat with you more...gotta go stuff my face first....and if I can skate out of a meeting or 2 early....I will get back..before leaving work..if not I am hitting this tonight...for sure...ladies..

Sky...Welcome to the Cycling Club! :)

Crazy~Feet
08-08-07, 01:09 PM
You make a good point that its best to stick with the DSM IV-R categories for now. My question was a real question. Believe it or not I'm just thinking outloud, not trying to push an anti medication view. As someone who has experienced SAD, PMDD, and postpartum depression where exactly medication to prevent progressing to a more serious diagnosis becomes important is of more than just academic interest to me.Oh of course I believe you when you say you are just thinking out loud...why wouldn't I? :)

I can see where you might be concerned about this issue. I am familiar with SAD, although its not in my profile of lovely DXes (oooooh the pretty colors!). I hear that PMDD is really brutal, just terrible to go through...and now that I think about it? That hormone-induced sudden change in emotional pitch and an inability to regulate mood does sound a lot like...something very similar to my experience with BP. Seriously, that's something I need to think about, and probably get all hyped over and research about...:D.

I wonder -- if only 1/3 of cyclothmics progress to Bipolar I -- perhaps other treatments besides medication might be enough to prevent the progression -- I don't know this for a fact -- I'm just thinking out loud again. Thinking out loud is cool, it all good. I have a unique perspective because I have BP and so naturally I think that even 1/3 is too much of a risk. Who knows though? I would have to see a study with meds vs alternatives over a period of many years to make a decision about it. Certainly its not outside the realm of possibility.

Imagine what bipolar meds would do to it.:eek: I know and am very grateful that not everybody is as sensitive as I am to medication, but many people over time do develop these problems. If the alternative is a full blown mania -- well sometime life is incredibly unfair and you have to take the lesser evil, but if there is a good chance you're going to stay in a milder category. Well, anyway, maybe you see were I'm coming from and aren't getting to annoyed with me.
And I am very sorry that you are so sensitive to medications :( thats got to be very troublesome. I wouldn't really know what BP meds would do for you or how you might respond to them. They are quite different from SSRIs and stimulants though.

Most mood stabilizers (not all of course) these days are anti-seizure medications at lower doses than an epileptic might need. Another common med in the combo is some type of atypical antipsychotic. With tics you seriously do not wanna truck with any type of AP as far as I can tell, because there is a slight risk of extrapyramidal effects.

I do hear though that treatment resistant depression sometimes responds to certain mood stabilizers, the Lamictal I take being one of them.

And of course you are not annoying me, silly! I am just really blunt and inclined to think aloud too. I did say that discussion was welcome, right? :)

I know sometimes, even intentionally, I come across in the teacher mode, but right now I really am only trying to understand and figure out the best approach to all this -- I'm not trying to discourage anyone from treating their bipolar disorder, whatever kind they have. These questions are for me -- and the responses have been helpful and given me a lot to think about. Occasionally I show up just for myself and ask the questions that are really on my mind.
Pfft you can come across any way you want to around here. I am so glad to see you again that you could probably tapdance on my head right now and I wouldn't mind ;). You do what you have to do, for you, and you are welcome to think aloud all you need to.

Crazy~Feet
08-08-07, 02:16 PM
I often wonder if my little sister had been medicated early on, she may not have gotten so bad later in life. She was clearly bipolar as a child. She was extremely hard to deal with.....She would cycle rapidly and if you happened to set her off (which was very easy) there would be a trail of destruction in her path, that was time consuming and sometimes expensive to clean up.......no one noticed that there was anything wrong with her until she downed a bottle of tylenol when she was 16....then she was in an out of the hospital for the next 7 years.....and only recently seems to be stabilized and getting her life together.One of my daughters is DXed with pediatric BPII and I have a great fear of her possibly progressing into BPI. I watch her symptoms more than she knows ;). She has not yet progressed from the pediatric form to the adult form, as far as I can tell. So she would exhibit a lot of irritability, a lot of sleep disturbances...and pressured speaking like you would not believe! Geez, thinking back on that makes me breathe a big sigh of relief that we got her onto some meds that actually halted this symptom, because man! She didn't mean it and she could not help it...but sometimes you would just want to cover your ears and scream for mercy. Poor kid knew it too :(.

I am really glad we caught her BP so young. Stories like your sister's are so sad and also scary. There is no turning back from that stage of the illness :(.

Now I wonder if I had been treating the bipolar disorder at it's onset (right around puberty) I might have saved myself a lot of money and I wouldn't have behaved so recklessly and gotten into so much trouble when I was younger.
I totally get where you are coming from Sky. Of course I had no clue that I had BP or ADHD...they kept on telling me that I was depressed :mad:. What a waste of years!

My boyfriend is actually against me taking medication, and he has no understanding od the disorder and doesn't care to learn about it. He argees that I'm "crazy," but he believes that it's my fault and I should be able to control it, it's all just because I'm immature........ And does this collection of attitudes in him make you angry? If not, kindly allow me to get angry for you :mad: because its making me angry anyway! Man this type of thing burns me up every time I see it.

In my not-so-humble opinion, a person has no need to speak to things that they know absolutely nothing about. Believing something is true and correct is not the same as KNOWING that something is true and correct. I do not discuss the finer points of quantum physics with people, because I know nothing about it. If it were something pertinent to my life, like a mood disorder in my SO would be inclined to be? I would darn skippy learn about it, and right quick. And if I were disinclined to research the issue, I would not presume to offer advice. How arrogant! Ugh! :mad:

Well I did say it was making me angry ahead of time :o...

It reminds me somewhat of my DH. He claims that he does not have "time" to learn about BP and that he has learned enough about ADHD :rolleyes: for now...yet he has "time" to spend 4 hours playing a video game THAT HE HAS ALREADY BEATEN SEVERAL TIMES, and about 5 more hours to spend at his cousin's playing cards...what's wrong with this picture??

Recently, though, he admitted to me that a lot of the terminology was hard for him to understand, made him feel stupid and that he was having difficulty learning that way. Oh well. I need to give him a break on that I suppose. Not everybody learns the way I do, which is to research constantly until I have practically reached the end of the www. and I learn quite well by reading.


And at least he seldom if ever tells me what I ought or ought not to do regarding meds and DXes! He knows when he is licked and I have it over on him in spades in that regard. If he is not willing to find a way to learn that he can absorb and understand? Then, as he quickly learned, I expect him to STFU about it. Period. I am not at all tolerant of things like that!!

OK enough ranting...that felt good though. :D

Sky81
08-08-07, 03:23 PM
I really get sick of hearing him tell me to stop being a baby and to grow up already, and to stop trying to be perfect....

I've been with him for twelve years and he's seen my ups and downs. He's seen my sister in a full blown manic psychosis, and was able to calm her down and convice her that she wasn't talking to dead people and that they weren't out to get her and that she really didn't need to go to the cemetary to see her ex-boyfriends dead brother......he's actually good with her when she's manic......but he still thinks that neither of us have anything wrong with us, and he thinks things like ADD and bipolar disorder are made up so pharmaceutical companies can sell pills.....

For everything I love about him....that is the one thing that really bugs me. If I try to tell him about dopamine and serotonin, he tells me to shut up because he doesn't understand that stuff.......grrrr.......

Crazygirl79
08-08-07, 10:42 PM
Hi Crazy~Feet.

Yes I know you like me!! and I like you too!!

I've had many dud psychs in my past and I haven't been helped much by them at all, misdiagnosed with different disorders, put on all kinds of medications etc etc and like you I've fired them too!

I usually have a bad time on medication as the side affects seem to hit me really hard and they seem worse than the conditions themselves.

I have racing thoughts, mood swings which are quiet noticable by others, I tend to do things which are out of character when in certain moods, I often entertain suicidal thoughts which I don't understand because they come at anytime and since I've dealt with this since the age of 11 with very little help (The Australian mental health system leaves a lot to be desired) I usually divert my attention elsewhere so I don't think about my state and I try to ignore stuff which is really hard at times.

I'm NOT implying that you're "doped" up to the eyeballs just because you have BP, however I have a friend with Bipolar whose you may as well call the walking dead...all thanks to her psychs who think putting her on this medication which does nothing more than send her to sleep with very little chance of functioning, I'm not sure how the States handle the medication situation but in Australia the doctors are far too "pill happy"

I hope this explains something and no offense was intended with any of my comments.

Selena
Selena, you know that I like you, right? I do have to speak my own mind, however, you ought to know by now that I would do so, ok?

That's very sad. I love my current psych, he has been a lifesaver for me and for Space. I also have had rotten psychs...and I fired them ;). I stay informed and knowledgeable because its MY treatment, ya know?


Ok...then I am quite curious as to just how you take care of it then? Since we do not know whether you do, in fact, have BP, we really cannot say what the deal is. Maybe you are able to "take care of things" simply because the issue is not BP at all. Other issues can cause mood swings, after all. BP has a definite pattern to it that other types of mood swings lack.


I have got to say that my first gut response to this is resentment. Do you honestly think that I am "doped up to the eyeballs"?? I wonder what makes you believe that BP treatment means "doped up" in the first place?

It is, of course your choice to do what you will, I will not deny that.

Crazy~Feet
08-09-07, 01:19 AM
Hi Crazy~Feet.

Yes I know you like me!! and I like you too!!

I've had many dud psychs in my past and I haven't been helped much by them at all, misdiagnosed with different disorders, put on all kinds of medications etc etc and like you I've fired them too!

I usually have a bad time on medication as the side affects seem to hit me really hard and they seem worse than the conditions themselves.

I have racing thoughts, mood swings which are quiet noticable by others, I tend to do things which are out of character when in certain moods, I often entertain suicidal thoughts which I don't understand because they come at anytime and since I've dealt with this since the age of 11 with very little help (The Australian mental health system leaves a lot to be desired) I usually divert my attention elsewhere so I don't think about my state and I try to ignore stuff which is really hard at times.

I'm NOT implying that you're "doped" up to the eyeballs just because you have BP, however I have a friend with Bipolar whose you may as well call the walking dead...all thanks to her psychs who think putting her on this medication which does nothing more than send her to sleep with very little chance of functioning, I'm not sure how the States handle the medication situation but in Australia the doctors are far too "pill happy"

I hope this explains something and no offense was intended with any of my comments.

SelenaI keep forgetting that you are in Australia and I have heard plenty about how your medical systems leave much to be desired :(...sorry girl!

Here, if you are lucky and get a doc who understands BP spectrum disorders ;) we then medicate to stability and then stop. We have a lot of options...and from what I have gathered, you have a lot less options than we do. I am really, really sorry about your friend! There is no need to drug a BP into a stupor. That must be terrible to witness and I now understand your fear that this may happen to you as well.

Well anytime you care to discuss it with us on any level...we'll be here. :)

I imagine the cycling would be hard to blot out and ignore...I cannot personally imagine even attempting that! :faint:

meadd823
08-09-07, 05:14 AM
I am happy the partial from my recent coarse served to open up a decent discussion . . . . . I saw the response rate and a PM from CF and figured it was a death threat. . . . high response rates in a rapid manner often indicates a thread in conflict. Moderators love it when you post one of those in their area. . . . :o

I am glad this one turned out the way it did I was happy to find a hearty discussion and not a mud slinging party . . . or a closed thread.


I hope this explains something and no offense was intended with any of my comments.


Your initial post was rather hmmmm irritable sounding . . . . I was simply going to say it is your life, your brain your decision {which has nothing to do with my personahood is I have no need to be angry} It is also your consequences. . . .

Well I expended all my energy in my last post to sky I have do=ne the rough draft to this one but I am afraid I shall have to edit and post it tomorrow.




I do wish to leave some thing to Sky81 if she is still bothering to "speak to me" I have posted this in non-ADDer section and the relationship area but I think you need the information as much as any one else does . . . ..


Boundaries (http://www.ybrt.org/bounder.html)

I am hoping CF had given general ADD a good once over because I didn't spend much time in there tonight. Due to some some anxiety I did not sleep last night and it is 4:00 am night two and I am not bi-polar {I don't think because I am about to drop dead in front of my computer} so I am flicking it off right after I hit the submit button here. . . .if I wake up refreshed in four hours when I am supposed to go to work I will be back screaming at myself. . . .. I can't afford another "thing"

Dyslexic insomnia- :D

Crazygirl79
08-09-07, 07:24 AM
Hi Crazy Feet

It's ok...yes the Australian mental health system in particular is pathetic and suicides and homelessness is quiet high, I will say I've never ever been homeless or without money...I have enough survival skills and determination to make sure of that!

I've even considered migrating to another country in order to get better treatment (Sensory Integration Disorder is barely recognised in Australia let alone treated and it's very poorly understood which leads me to entertain thoughts of migrating) but finances and getting a decent paying job are needed first!!

My friend Trish whom I've known for 15 years since I was 12 started out with the diagnosis of ADHD and ODD but that later changed to Bipolar when she was 17 and at first the condition seemed manageable and she was still what people would consider fairly "normal" but as she got older she became more and more sick (she also has substance abuse issues which worsen the Bipolar and she got into that to self medicate) and the doctors just put her on every mood stabiliser and anti psychotic offered in Australia but they didn't offer any rehabilitation programs for the Bipolar or the substance abuse issues, there are support groups but they are of no use to her...my situation is far more manageable than Trish's and I'll be damned if I end up like that when are other better options than being drugged up to the eyeballs with every pill available!!

I'll give you a perfect example of how pathetic the Australian mental health system is...I was 16 when I took an overdose, Mum took me to hospital and I was let out the next day still with dangerous drugs in my system and I only spoke to a psych for 5 to 10 minutes before leaving the hospital, not only that I had to wait 6 *****ing weeks before I saw my regular psych and all he could suggest was increasing my dosage of the very drug (Prozac) that caused the adverse affects in the first place, at other times I've asked to be hospitalised due to severe depression and because I don't have the psychosis part I was told to go home and not worry about things...on one occasion I replied "Do I have to have a *****ing noose around my *****ing neck to get help?"...this didn't work either, another occasion I asked my mother to call the police and tell them I threatened her with a knife (which I didn't do at all) just so I could get help..she refused not because she didn't want to help me but because she knew it'd stuff my life up.

Yes it is extremely hard to blot out and ignore cycling but it's the only choice I have and it's a learnt response since they rarely treated children with mood disorder and issues in the 80's and 90's here at home and the only "real" treatment I got was for my ADHD but that didn't fix the sensory or mood issues at all!

Thanks again

Selena
I keep forgetting that you are in Australia and I have heard plenty about how your medical systems leave much to be desired :(...sorry girl!

Here, if you are lucky and get a doc who understands BP spectrum disorders ;) we then medicate to stability and then stop. We have a lot of options...and from what I have gathered, you have a lot less options than we do. I am really, really sorry about your friend! There is no need to drug a BP into a stupor. That must be terrible to witness and I now understand your fear that this may happen to you as well.

Well anytime you care to discuss it with us on any level...we'll be here. :)

I imagine the cycling would be hard to blot out and ignore...I cannot personally imagine even attempting that! :faint:

Crazy~Feet
08-20-07, 10:23 AM
Hi folks! We have a few new members to the Cycling Team, so I decided this needed to move its way up again, so that they get a chance to see it and reply if they want to. :)

And does anybody who has already posted have any more they'd like to say? If you do, please go for it! I loved this discussion and would like to see it continue if there is anything left to say. :)

unstableAngel
03-29-17, 05:12 AM
. If I flipped over into BPI and became psychotic...would I know that, before I possibly did something tragic and irreversible?i
Unfortunately..no. When you are psychotic you aren't aware that your feelings/beliefs aren't complete fact! Perception is reality. I've had a few minor episodes, 1 included a suicide attempt. It's not til you come back to reality that you become aware, in my case "i'm told" as i generally forget most of it, that your beliefs were not based in "reality". I liken it to being posessed as my behavior, thoughts & actions are NOT ME! I cannot relate to that person...as if it were someone else. But take care of yourself, stay on meds, sleep well etc. will go a long way in keeping your BP from getting worse. :):faint: