Posted by missinglynx on March 3, 2001, at 11:55:31
In reply to A BIPOLAR (II) EXPERT *PLEASE* (longish), posted by JahL on March 3, 2001, at 10:31:22
> The background: I have unremitting life-long depression characterized by DYSPHORIA, IRRITABILITY, ANXIETY & suicidality. 20+ meds has had little impact. Extensive interpersonal, group & cognitive-behavioural therapy (in both public & private settings) achieved nothing & was not a little insulting towards my intelligence. Systemized common sense. I taught myself everything therapy has to offer (me) by age 11.
>
> Anyway I am not confident in my current dx (dysthymia+double depr.) & am pondering a possible BIPOLAR II DX. During my years of mistreatment I have noticed the following:
>
> 1/ First ever AD (Paxil) brought about the fabled miracle cure overnight. Over the next month my mood swung wildly (RAPID CYCLING?) btwn agitated depression & (never b4 experienced) euthymia. When this petered out, the introduction of Prozac brought about another short period of euthymia.
>
> 2/ The above remissions/relapses were induced by a circadian 'switch' (would wake up cured or relapsed-no inbtwn).
>
> 3/ Sub-therapeutic doses of Paxil & Celexa brought about hypomania (8 days of).
>
> 4/ All these events were precipitated by a REDUCTION in dose (v strong correlation).
>
> 5/ Every mood stabilzer (Zyprexa, Risperdal, VPA, Lamotrigine) save Lithium (indicated for classic BP I) has quickly eliminated suicidal ideation.
>
> Also to be considered:
>
> 1/ *V* strong family history of this disorder.
>
> 2/ Have been diagnosed Social Phobic + ADD (high Bipolar co-morbidity)
>
> 3/ No mood reactivity.
>
> 4/ Have never related to depression per se, or to those suffering. No problems with self-esteem, tearfulness etc. Cannot understand illogical depressive thought constructs. My symptoms are akin to schiz. neg. symptoms; dysphoria.
>
> I am not so much depressed as wholly dysfunctional.
>
> 5/ I have a volatile temper.
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> 6/ Have always been considered intellectually 'gifted'
>
> 7/ THE CLINCHER: started on Lamotrigine 25 mgs 10 days ago & already my derealisation has improved, my intellectual powers are returning & well I feel a little *hypomanic* (last night posted as much as I have in my whole PB 'career'!) This is a v low dose to be feeling such effects!
>
> Well, do I have a case for possible BP II dx, or have I already answered my own question?
> Or is this stretching the BP spectrum too far?
> (Sorry 4 length of ths; wanted to get my facts straight)
>
> All replies gratefully received (& may be used in my next pdoc meet)
> ta,
> Jah.
Hey hows it going Jah...yea you do seem like a brain,, hey Ive enjoyed your postings lately. Why do you consider this a bad "sign". The following advice is not advice,since you seem more evolved on Treatment then me. And your British LOL and I dont argue with the British (rule # 87 in my handbook) In my case I get aggatated when Im depressed, akin to angry internal dialogue. I think why does this person dress so stupidly, why are they so "cute" acting, why do they have alot of money.... etc. Anyhow I asked my Psychiatrist about Lithium for this type of mood reaction He said "do you know the side effects of Lithium. Alot of people have alot worse reactions to them then the SSRIs " NOt wanting to create "bad Blood" I sort of dropped it. Anyhow He was semiopen to trying Tranxene and I can say its GOOD... No nightmare side effects...People here take Klonipin with their SSRIs this is sort of the same principle > By the way what are you taking right now.? Didnt you say you couldnt get any creative therapy cuz the MDs in London are not allowed or unwilling to try innovative treatments? How do you like the Lamotrigine... Is it a keeper? anyhow I hope you solve this real quick,,, I know how stressful it is ! Take care
poster:missinglynx
thread:55442
URL: http://www.dr-bob.org/babble/20010302/msgs/55451.html