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Bipolar disorder vs. panic disorder: any insight?

Posted by grapebubblegum on May 4, 2001, at 9:52:40

There is so much information from so many insightful people on this board that I have no idea where to start, so I am soliciting information from all of you.

To make it a very short story: For years I have received diagnoses of depression although I've never felt "depressed" although I have had a sporadic but severe problem with disabling panic attacks. These attacks can be dormant for years at a time but when the conditions are right, they re-emerge and bring me to my knees, wishing I had not lived to feel the episode. I am never suicidal... I'm just illustrating the fact that these attacks are SEVERE and difficult to derail, even with doses of klonopin so strong I can barely walk, talk or see. Generally with or without going to the E.R., (last time I went they gave me so much ativan injected into my hip that I could barely remember the next few days) the attacks end in sleep and after a period of days or weeks of keeping them at bay with low doses of klonopin (or something similar) and a new regimen of SSRIs, I get back into my panic-attack free routine for months or years before they come back. Like most people, I would prefer not to take meds on an ongoing basis, so I taper off the klonopin really fast (I really only use it in dire emergencies) and eventually decide to also taper off the SSRIs, for a variety of reasons including sexual dysfunction and others. Then, if conditions are favorable, I can go med-free for months or years basically asymptomatic (ok, I guess I do notice some depression and ocd THOUGHT patterns that are on the border of what people can manage on their own but I generally do pretty well) until the next crash.)

I read recently that "bipolar disorder is the new fashionable diagnosis" and I am reluctant to try on new diagnoses for myself anyway. But I have to say that my father was a card-carrying bipolar for many years including several hospitalizations and intensive management that enabled him to live well. My son who is only 5 has just been diagnosed with the same, although the pdoc admits he was going largely on family history in making that diagnosis. When I take those tests for mania I always fail, and I hate to get into the question of "sub-manic syndrome" type symptoms because it seems so close to normal behavior.

It seems like we know a lot about panic disorder now but does anyone know how it really ties in with depression and bipolar disorder? It is obviously tied in with depression because the SSRIs that relieve depression symptoms also provide pretty good protection against panic attacks, I have noticed, and also against o-c thought patterns. Can anyone shed some further light on this for me? And of course I am wondering, with all the bipolar diagnoses in my family, if I am suffering from something that could be better treated with a mood stabilizer rather than the regimen I described above. I have started to notice lately that I feel like I am really flying high before it all comes crashing down. What I mean by that is: (and this is embarrassing but we're here to support one another) changes that wouldn't be seen as extreme except in relation to my "normal self," i.e., a little more sexual interest and impulsivity than normal, an urge to shoplift something out of anger at the incompetent store clerks that I did suppress, but still... not like me... you get the idea. Often times personal conflicts also get more heated up than normal and then some little straw breaks my back and, like I said, with all conditions being right, that little wave of weirdness passes over me and the panic attack begins to set in, everything falls apart until I am a barely-functioning, barely-not-in-the-hospital walking wounded, whereby the cycle starts all over again as I recover from the panic attack, start back on SSRI's, take them for months before feeling that I don't need them, etc. etc. etc. I really REALLY don't want to take them forever because I have a great relationship with someone I love and SSRIs just cripple me sexually. I am also a creative person and I feel that my zest for life is just turned down a few notches too low while on meds. I am on Paxil now, 20 mg per day and things are under control after just about three weeks since my last panic attack. Yet I'm already thinking... "I don't want to take this stuff..."

(sorry, I tried to make it short. ;) )




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