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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Mr.Scott on December 20, 2002, at 1:59:06
I have bipolar II, some ADHD, and anxiety spectrum disorders. I'm primarily depressed, but bipolar/temporal lobe seizure tendencies emerge upon taking virtually any antidepressant. These tendencies can get pretty wild and range from increased distractibility to anxiety and agitation to aggression impulsiveness and rage if the wrong combination of stuff is going down (environmental and or chemical). Enough Prozac and Wellbutrin in combination will cause me to go completely mad. I can induce mixed and rapid cycling predictably with these two meds in combo at standard doses. Yet no AD at all and I'm ready to accept my death by my own hand.I can probably 'get by' in this lifetime with a pinch of AD (pretty much any SSRI or Effexor) combined with a benzo. But I worry that I should be hunting for a more legitimate anticonvulsant regimen that will endure, or even ditching the AD's all together and going ALL anticonvulsant in accordance with the latest theories on bipolar. My doctor is light years behind me on this stuff and wants to discuss 'psychology' each week.
I want the perfect anticonvulsant cocktail, not to discuss my dysfunctional family. Where is my logic twisted?
Scott
Posted by Anna Laura on December 20, 2002, at 3:28:58
In reply to Seeking Reassurance, posted by Mr.Scott on December 20, 2002, at 1:59:06
>
> I have bipolar II, some ADHD, and anxiety spectrum disorders. I'm primarily depressed, but bipolar/temporal lobe seizure tendencies emerge upon taking virtually any antidepressant. These tendencies can get pretty wild and range from increased distractibility to anxiety and agitation to aggression impulsiveness and rage if the wrong combination of stuff is going down (environmental and or chemical). Enough Prozac and Wellbutrin in combination will cause me to go completely mad. I can induce mixed and rapid cycling predictably with these two meds in combo at standard doses. Yet no AD at all and I'm ready to accept my death by my own hand.
>
> I can probably 'get by' in this lifetime with a pinch of AD (pretty much any SSRI or Effexor) combined with a benzo. But I worry that I should be hunting for a more legitimate anticonvulsant regimen that will endure, or even ditching the AD's all together and going ALL anticonvulsant in accordance with the latest theories on bipolar. My doctor is light years behind me on this stuff and wants to discuss 'psychology' each week.
>
> I want the perfect anticonvulsant cocktail, not to discuss my dysfunctional family. Where is my logic twisted?
>
> ScottI've got bipolar II also and i think you're absolutely right.
The past or present environment might play role in triggering or worsening some conditions but recovery it's a total different story. It' like having gastric ulcer; your illness might have been caused by a dysfunctional working place or family because of constant stress or pressure but you won't get cured until you find the right meds; you can go through deep changes, learn how to cope with your collegue or with your spouse or family but you will still have gastric ulcer.
Depression is a chemical condition with few exceptions of milder cases which are somehow more reactive and might respond to therapy; I think i can understand your pain ; i personally feel like they're adding more chaos on my already chaotic life; i feel like i'm being blamed for my condition (you know, "you can change your depression if you really want")this is being robbed of one's dignity , and dignity is the only thing i have left.See Bipolars often have an unstable self, which is my case (i don't know wether it fits your case or not); you could be a strong, battling person and still have an unstable self; unstable self is over-sensitive to judgements and interpretations which is what happens in therapy if it's not handled correctly, with deep human understanding and keen insight which is quite rare. If you have un unstable self they could be telling you you've got a blue nose and you wouldn't be able to get rid of this judgement no matter how stupid or impossible it might be; you could spend hours at the mirror looking at your nose thinking "may be they're right i've got a slight fade of blue on my nose". It's the same with personality.
my younger sister, she is a strong young woman, she's a go-and-getter; she lived in Spain for a year to complete her College studies; she's about to graduate right now, she never suffered from depression;
she's a lively and nice young woman; she got involved in social stuff lately teaching italian as second language to Southern Americans immigrants here in Italy; o.K., to cut it short; her friends saw her change and didn't like it so they went like: "You know Marghe, you've got a problem; you won't go out with us on Saturday nights, you won't drink and go to disco clubs as we do, we think you suffer from depression and you're in denial of it"
My poor sister got haunted from that idea and she spent an entire week to get rid of it. She wasn't depressed of course.
The same thing happens with psychotherapy; if you have unstable self issues, which get worse as depression get worse, you'll be haunted by uncorrect interpretations without being able to defend yourself "You should be getting a job that's why you're depressed; you're depressed 'cause you won't take any responsability and so forth" or: "Your apathy and anhedonia it's your mother complex"; well, let me tell you one thing: i learned how to cope with my dysfunctional family and with the guy i'm living with and 'im still depressed; don't get me wrong: psychotherapy might help if it's done in the correct manner: i did it for two years and felt more self-confident, better coping skills and so forth; i liked my psychotherapist a lot i trusted him and so forth but i was depressed still.
I think that lowering your stress levels wether is inner or outer stress might be playing a role in your depression, but it's totally uneffective or insufficient if you won't find the righ med or combo.
Try to be confrontational with your therapist; if you don't manage to do that, no matter how hard you try, dump him 'cause he's going to add more distress to your already distressing condition and you don't need that.I've found valuable information about bipolar II on Dr. Phelps site; he's a decent human being; i wish he was my pdoc! I think it's worth a look:
www.psycheducation.org
blessings
Posted by Ritch on December 20, 2002, at 8:55:42
In reply to Seeking Reassurance, posted by Mr.Scott on December 20, 2002, at 1:59:06
>
> I have bipolar II, some ADHD, and anxiety spectrum disorders. I'm primarily depressed, but bipolar/temporal lobe seizure tendencies emerge upon taking virtually any antidepressant. These tendencies can get pretty wild and range from increased distractibility to anxiety and agitation to aggression impulsiveness and rage if the wrong combination of stuff is going down (environmental and or chemical). Enough Prozac and Wellbutrin in combination will cause me to go completely mad. I can induce mixed and rapid cycling predictably with these two meds in combo at standard doses. Yet no AD at all and I'm ready to accept my death by my own hand.
>
> I can probably 'get by' in this lifetime with a pinch of AD (pretty much any SSRI or Effexor) combined with a benzo. But I worry that I should be hunting for a more legitimate anticonvulsant regimen that will endure, or even ditching the AD's all together and going ALL anticonvulsant in accordance with the latest theories on bipolar. My doctor is light years behind me on this stuff and wants to discuss 'psychology' each week.
>
> I want the perfect anticonvulsant cocktail, not to discuss my dysfunctional family. Where is my logic twisted?
>
> ScottScott, your logic isn't twisted at all. Most pdocs are going to at least make some primary med choices and tweaks to treat your *core symptoms*. If those core symptoms aren't under control it is difficult for any therapy to help. Environmental things can wig me out big time as well. But, without meds those stressors probably would wind up costing me my job or worse. Bipolar is probably the most genetic mental illness around, and if you don't get the meds nailed down reasonably well, therapy is just going to be chasing its tail. The only therapy that has helped me is just the very basic core CBT type things (fundmamental irrational assumptions, ie), and a willingness to "sample" opinions of others about my feelings (to help gauge their objectivity). It sounds like you may need to target a psychopharmacologist first thing and THEN let them refer you into therapy that is going to be the most beneficial given your particular set of probs. BTW, they sound just like mine!-- good luck, Mitch
Posted by Krysti on December 20, 2002, at 13:33:31
In reply to Seeking Reassurance, posted by Mr.Scott on December 20, 2002, at 1:59:06
Hi Mr. Scott,
You're definitely on the right track. When you are bipolar, AD's without a mood stabilizer will most likely cause rapid cycling. Getting on a mood stabilizer is the most important part. Once your cycling is under control, if you are still on the depressed side, your pdoc can then try adding something for the depression. Incidentally, every mood stabilizer I have been on has also taken away my anxiety.
Are there any other pdocs around you that have more experience with bipolar? Finding one who is really knowledgeable about the meds used to treat it will help a lot.
Good luck and keep us posted : )
Krysti
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