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Re: frustration with treatment, diagnosis and meds

Posted by Elizabeth on December 15, 1998, at 20:36:49

In reply to frustration with treatment, diagnosis and meds, posted by Elizabeth on December 15, 1998, at 11:06:18

Hi there. :-) (Thanks for switching to Liza, BTW; there is also someone who is not me who has posted as elizabeth-with-a-lowercase-e!).

I think it is _very_ possible that you are bipolar or that medications have been giving you manic reactions. Feeling hyper shortly after starting antidepressants may be a sign of this. It might be something to talk to your doctor about.

The increased suicidal urges could be signs of a "mixed state" - where the antidepressants cause mania but you are also still depressed at the same time. (Supposedly the worst feeling in the world.)

(I am not bipolar exactly but I have had manic episodes on antidepressants too. Tricyclics seem to be the most likely to do this, while Wellbutrin and MAOIs are least likely.)

Tegretol is an anticonvulsant that can prevent seizures, manic episodes, and rages (these may be a type of seizure too BTW), and also may (with long-term treatment) cause depressions to occur less frequently. It can be combined safely with most antidepressants. There are other, newer anticonvulsants that may have the same benefits (Lamictal, Neurontin, Topamax) with less sedation and without the need for blood tests. Depakote is another anticonvulsant that is known to be effective for bipolar disorder and also may help with the panic attacks.

As far as panic goes: I suffer from panic disorder too. Unless the panic attacks are related to some specific stimulus (like a phobia or certain interpersonal situations, thoughts, etc.), cognitive therapy is limited in what it can do. The best strategy for panic disorder with agoraphobia is to find a medication that will stop the panic attacks and then use CBT to unlearn the agoraphobia.

Regardless of whether you call it a personality disorder, mood disorder, or anxiety disorder, unstable moods are really hard to deal with. I think it's smart of you to avoid alcohol, and it shows you have a lot of will power and determination to get better.

I'm not sure which personality disorders you were diagnosed with ("mixed personality disorder" means that you have features of more than one) but I agree that this tends to be an excuse for giving incomplete treatment or even being downright nasty. I don't think that personality disorders are exactly mood disorders but most of them seem to be exacerbations of mood or anxiety disorders. (For example, almost everyone diagnosed with borderline personality disorder (which I think is the most common one) also has a mood disorder.)

I sympathize with your complaints about the way patients are treated by clinicians! I get a lot of weird looks for being well-informed.

Anyway I hope this helps. Take care, and stick around.




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