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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Leighwit on May 14, 2002, at 10:49:55
Someone here wrote recently about irritable and dysphoric moods as part of the bi-polar spectrum even without any episodes of mania whatsoever. They also linked a site titled "Dr. Ivan's Depression Central" and I cannot find the post using the site search engine. (I must be doing something wrong).
In any case, if you're recognizing this as the author I'm referring to, please respond, so I can thank you again.
I saw my Pdoc yesterday, and she agreed that I should try Lamictal, and that it's possible I am not unipolar. !!! She didn't actually give me a new diagnosis yet, but talked about why I might meet the criteria for a cyclothymic (I'm not sure that was the word she used -- sounded like it) type. She also said that since nothing across the board had worked in terms of AD meds, perhaps a mood-stabilizer had been needed all along.
I guess she's waiting to see if the Lamictal works, and if it does then she'd "backwards-engineer" the diagnosis. At this point, given the dismal performance of everything else that's been tried, it sounds like that's as good a diagnostic tool as anything else (process of drug elimination?)
I'll start tomorrow. I can't believe the many ADs I've taken for over a decade might have been excaserbating my condition instead of treating it. On the other hand, I'll be greatful if this works.
Speaking of gratitude, thanks to everyone who responded to my posts about Wellbutrin and irritability and questions about the Bi-Polar Spectrum. I had no idea that someone without any mania should think/look outside of the box in terms of their unipolar depression diagnosis. I had been using a number of erroneous assumptions in deciding to just "grin and bear it" year in, and year out.
Lamictal might not be the answer. But at least I'm asking new questions and have been told by a Pdoc that they are valid questions. If it weren't for this site, I wouldn't be asking any of them.
Thanks again,
Laurie
Posted by JaneB on May 14, 2002, at 12:02:26
In reply to New Questions=New Diagnosis In Progress=Thanks, posted by Leighwit on May 14, 2002, at 10:49:55
Just curious. Has your pdoc suggested trying any other mood stabilizers first, ex. depakote or lithium? I am beginning to think that I need one and wondered what to expect from my pdoc? Thanks,
JaneB
Posted by MomO3 on May 14, 2002, at 16:24:55
In reply to New Questions=New Diagnosis In Progress=Thanks, posted by Leighwit on May 14, 2002, at 10:49:55
I have read some really scary things about Lamictal. Please do a search and read some of the posts about that drug.
Posted by Leighwit on May 14, 2002, at 18:18:30
In reply to Re: New Questions=New Diagnosis In Progress=Thanks, posted by MomO3 on May 14, 2002, at 16:24:55
> I have read some really scary things about Lamictal. Please do a search and read some of the posts about that drug.
I did. That's the very reason I asked my Pdoc about it. She said it was quite easily tolerated, but warned about the precautions for liver problems and the rash symptoms. Is that what you are referring to?
Posted by JohnX2 on May 14, 2002, at 18:31:22
In reply to New Questions=New Diagnosis In Progress=Thanks, posted by Leighwit on May 14, 2002, at 10:49:55
> Someone here wrote recently about irritable and dysphoric moods as part of the bi-polar spectrum even without any episodes of mania whatsoever. They also linked a site titled "Dr. Ivan's Depression Central" and I cannot find the post using the site search engine. (I must be doing something wrong).
>
> In any case, if you're recognizing this as the author I'm referring to, please respond, so I can thank you again.
>
> I saw my Pdoc yesterday, and she agreed that I should try Lamictal, and that it's possible I am not unipolar. !!! She didn't actually give me a new diagnosis yet, but talked about why I might meet the criteria for a cyclothymic (I'm not sure that was the word she used -- sounded like it) type. She also said that since nothing across the board had worked in terms of AD meds, perhaps a mood-stabilizer had been needed all along.
>
> I guess she's waiting to see if the Lamictal works, and if it does then she'd "backwards-engineer" the diagnosis. At this point, given the dismal performance of everything else that's been tried, it sounds like that's as good a diagnostic tool as anything else (process of drug elimination?)
>
> I'll start tomorrow. I can't believe the many ADs I've taken for over a decade might have been excaserbating my condition instead of treating it. On the other hand, I'll be greatful if this works.
>
> Speaking of gratitude, thanks to everyone who responded to my posts about Wellbutrin and irritability and questions about the Bi-Polar Spectrum. I had no idea that someone without any mania should think/look outside of the box in terms of their unipolar depression diagnosis. I had been using a number of erroneous assumptions in deciding to just "grin and bear it" year in, and year out.
>
> Lamictal might not be the answer. But at least I'm asking new questions and have been told by a Pdoc that they are valid questions. If it weren't for this site, I wouldn't be asking any of them.
>
> Thanks again,
> LaurieLamictal has one of the more notable antidepressant effects
of the mood stabilizer and is generally good for cycling.
Dosing into the medicine is a little time consuming to
avoid the itchy skin or rash, but a lot of people report
few side effects once they are on a maintanance dose of
the medicine. Of all the medicines I've taken (which is
like almost all of them), Lamictal has had the fewest
side effects. After taken a zillion ADs, lamictal was the
first medicine to help with my depression and not poop-out
and stabilize me. A lot of people also take AD's with Lamictal.
Your results may vary as always.Depakote is good for cycling too but generally has less/or no
antidepressant effect (more of an antimanic agent).
There usually are adjunctive medicines with Depakote.
Depakote may be better in some situations if you feel irritable.Lamictal is more likely to be mildly stimulating than
Depakote.Good Luck,
John
Posted by Leighwit on May 14, 2002, at 19:32:13
In reply to Re: New Questions=New Diagnosis In Progress=Thanks » Leighwit, posted by JohnX2 on May 14, 2002, at 18:31:22
>
> Lamictal has one of the more notable antidepressant effects
> of the mood stabilizer and is generally good for cycling.Thanks for the info, John. Re your comment about cycling, I've read many Lamictal-related posts that mention cycling. Since I don't have any mania I wouldn't guess I have a cycular condition.
I must admit, however, that the more I read about the bi-polar "spectrum" the more confused I'm getting. I don't for example, understand what people refer to when they use the word hypomania. Is that merely referring to an "extended or exaggerated mood" or is it always an elevated mood? Can one be manic in an irritable or angry sense?
I don't think I have any cycles per se'. I'm irritable (as an adjunct to the depression symptoms of lethargy and disinterested melancholy/hopelessness) and anxious to the point of distraction rather regularly. Some days are worse than others, but I don't see a pattern of episodes.
I've been complaining about it the past year as a side effect of Wellbutrin, thinking I should stop WB or start taking Xanax, which didn't appeal to me. Then I started reading posts here from people who had the same overall condition (depression plus irritabilty and/or anxiety) and were finding out that they were not unipolar and neeeded some sort of mood stabilizer in order to treat the irritability. I also read that ADs can make such people worse and can excaserbate their actual condition.
Are there always cycles to bi-polar conditions? Are manias always "elevated" moods?
I wonder-
Laurie
Posted by JohnX2 on May 14, 2002, at 22:22:59
In reply to Re: New Questions=New Diagnosis In Progress=Thanks » JohnX2, posted by Leighwit on May 14, 2002, at 19:32:13
> >
> > Lamictal has one of the more notable antidepressant effects
> > of the mood stabilizer and is generally good for cycling.
>
> Thanks for the info, John. Re your comment about cycling, I've read many Lamictal-related posts that mention cycling. Since I don't have any mania I wouldn't guess I have a cycular condition.
>
> I must admit, however, that the more I read about the bi-polar "spectrum" the more confused I'm getting. I don't for example, understand what people refer to when they use the word hypomania. Is that merely referring to an "extended or exaggerated mood" or is it always an elevated mood? Can one be manic in an irritable or angry sense?
>
> I don't think I have any cycles per se'. I'm irritable (as an adjunct to the depression symptoms of lethargy and disinterested melancholy/hopelessness) and anxious to the point of distraction rather regularly. Some days are worse than others, but I don't see a pattern of episodes.
>
> I've been complaining about it the past year as a side effect of Wellbutrin, thinking I should stop WB or start taking Xanax, which didn't appeal to me. Then I started reading posts here from people who had the same overall condition (depression plus irritabilty and/or anxiety) and were finding out that they were not unipolar and neeeded some sort of mood stabilizer in order to treat the irritability. I also read that ADs can make such people worse and can excaserbate their actual condition.
>
> Are there always cycles to bi-polar conditions? Are manias always "elevated" moods?
>
> I wonder-
> LaurieLaurie,
Usually there are cycles to bipolar, call them mood swings.
Some people have very long cycles though.Its possible to be hypomanic and not euphoric (maybe even depressed).
In fact this is a more difficult condition to diagnose. Some people call
it "dysphoric hypomania". There are also "mixed states" with symptoms
of both depression and hypomania at the same time.Usually you may feel at least agitated, maybe have psychomotor
agitation (can't sit still), disctracted easily, think fast and
in tangents, maybe feel hostile or angry.Sometimes if the other classes of medicines don't work out, then
you are right, switching to a new class like mood stabilizer might
be a good bet. Process of elimination is useful.Good luck with the Lamictal. Another mood stabilizer that a lot
of people use secondarily is Neurontin. You may add this to your
cocktail to help with agitation and anxiety. Other people really
like Klonopin (It does have mood stabilizer properties).Take Care,
John
Posted by Leighwit on May 15, 2002, at 10:09:02
In reply to Re: New Questions=New Diagnosis In Progress=Thanks » Leighwit, posted by JohnX2 on May 14, 2002, at 22:22:59
Posted by polarbear206 on May 15, 2002, at 12:13:59
In reply to New Questions=New Diagnosis In Progress=Thanks, posted by Leighwit on May 14, 2002, at 10:49:55
> Someone here wrote recently about irritable and dysphoric moods as part of the bi-polar spectrum even without any episodes of mania whatsoever. They also linked a site titled "Dr. Ivan's Depression Central" and I cannot find the post using the site search engine. (I must be doing something wrong).
>
> In any case, if you're recognizing this as the author I'm referring to, please respond, so I can thank you again.
>
> I saw my Pdoc yesterday, and she agreed that I should try Lamictal, and that it's possible I am not unipolar. !!! She didn't actually give me a new diagnosis yet, but talked about why I might meet the criteria for a cyclothymic (I'm not sure that was the word she used -- sounded like it) type. She also said that since nothing across the board had worked in terms of AD meds, perhaps a mood-stabilizer had been needed all along.
>
> I guess she's waiting to see if the Lamictal works, and if it does then she'd "backwards-engineer" the diagnosis. At this point, given the dismal performance of everything else that's been tried, it sounds like that's as good a diagnostic tool as anything else (process of drug elimination?)
>
> I'll start tomorrow. I can't believe the many ADs I've taken for over a decade might have been excaserbating my condition instead of treating it. On the other hand, I'll be greatful if this works.
>
> Speaking of gratitude, thanks to everyone who responded to my posts about Wellbutrin and irritability and questions about the Bi-Polar Spectrum. I had no idea that someone without any mania should think/look outside of the box in terms of their unipolar depression diagnosis. I had been using a number of erroneous assumptions in deciding to just "grin and bear it" year in, and year out.
>
> Lamictal might not be the answer. But at least I'm asking new questions and have been told by a Pdoc that they are valid questions. If it weren't for this site, I wouldn't be asking any of them.
>
> Thanks again,
> LaurieHi again Laurie! Here is the web address.
http://www.psycom.net/depression.central.html
I'm not very computer savvy, so I might of goofed when I gave you this address. I'm glad you took my advice and asked your pdoc about trying Lamictal. Keep me posted with your progress. I might of suggested this in this post to you last time, a great book to read is "Why Your Depression Isn't getting better",by Michael R. Bartos M.D. You can order it through amazon.com. There is a FAQ sheet on Lamictal in the web site above. Good Luck, Laura.
Posted by Leighwit on May 15, 2002, at 14:11:16
In reply to Re: New Questions=New Diagnosis In Progress=Laurie, posted by polarbear206 on May 15, 2002, at 12:13:59
Laura! It's you! I'm so happy to see that you've responded. I cannot believe I forgot your name and couldn't find the post that helped me so much.
The website address was fine and that site was very helpful ~ thanks so much. I printed 18 pages of it and took it with me to the Pdoc appointment where we discussed all of this and decided to try Lamictal in addition to the Wellbutrin dosage I've been taking for a couple of years. God knows I've tried all of the ADs. Hopefully, a mood stabilizer will make a difference. I may not be a perfect round peg in the square hole (diagnosis-wise), but that doesn't mean it won't work (or so I've been told).
You hadn't mentioned the book before, though. I'll have to track it down; the title is certainly intriguing. Thanks again Laura!
Laurie
> Hi again Laurie! Here is the web address.
> http://www.psycom.net/depression.central.html
> I'm not very computer savvy, so I might of goofed when I gave you this address. I'm glad you took my advice and asked your pdoc about trying Lamictal. Keep me posted with your progress. I might of suggested this in this post to you last time, a great book to read is "Why Your Depression Isn't getting better",by Michael R. Bartos M.D. You can order it through amazon.com. There is a FAQ sheet on Lamictal in the web site above. Good Luck, Laura.
Posted by polarbear206 on May 15, 2002, at 20:45:12
In reply to Re: New Questions=New Diagnosis In Progress=Laurie » polarbear206, posted by Leighwit on May 15, 2002, at 14:11:16
> Laura! It's you! I'm so happy to see that you've responded. I cannot believe I forgot your name and couldn't find the post that helped me so much.
>
> The website address was fine and that site was very helpful ~ thanks so much. I printed 18 pages of it and took it with me to the Pdoc appointment where we discussed all of this and decided to try Lamictal in addition to the Wellbutrin dosage I've been taking for a couple of years. God knows I've tried all of the ADs. Hopefully, a mood stabilizer will make a difference. I may not be a perfect round peg in the square hole (diagnosis-wise), but that doesn't mean it won't work (or so I've been told).
>
> You hadn't mentioned the book before, though. I'll have to track it down; the title is certainly intriguing. Thanks again Laura!
>
> Laurie
>
> > Hi again Laurie! Here is the web address.
> > http://www.psycom.net/depression.central.html
> > I'm not very computer savvy, so I might of goofed when I gave you this address. I'm glad you took my advice and asked your pdoc about trying Lamictal. Keep me posted with your progress. I might of suggested this in this post to you last time, a great book to read is "Why Your Depression Isn't getting better",by Michael R. Bartos M.D. You can order it through amazon.com. There is a FAQ sheet on Lamictal in the web site above. Good Luck, Laura.
Laurie,
Here is another page from PsycEducation.org.
Bipolar II: Mood Swings without "Manic" episodes
http://psycheducation.com/depression/OO_intro.html
keep me updated! Good luck, Laura.
This is the end of the thread.
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