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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by fionamck on May 8, 2006, at 7:52:36
I was diagnosed with bipolar II in June 05 and my psychiatrist put me on Epilim, raising the dose steadily from 200mg to 600mg. I am also taking Effexor - increasing steadily until my current dose of 225mg. I had previously been taking just Lexapro (20mg) for clinical depression for about 2 years, but noticed my depression getting worse and increased mood swings. I keep a mood chart and each time I have increased the Effexor, my mood goes up to 'happy/optimistic' for a day or two (once I actually hit 'exhilarated', which was an achievement after 4 years of black depression!), then it drops slowly down again and my cycles (rapid: up and down in a day, usually) move only through the range of 'okay/content' to 'depressed/uncommunicative', increasingly 'suicidal' and then back up to 'okay'. I have been counting 'okay' days and have averaged only 10 days a month since June when my mood has hit the 'okay' and stayed there for 24 hours without a drop down again. The rest have been in the grey to black zone. This is not the way I want the rest of my life to be: 10 okay days a month and the rest hideous. I am puzzled as to why I have been diagnosed bipolar II when I don't get the elation or mania. I do, however, suffer extreme irritability at regular intervals, and sometimes rage over tiny things. These generally don't coincide with the 'happy' days, though. I actually only hit 'happy'/'optimistic' for about three days a month (and these are generally isolated 12-24 hour periods, not 3 days together). Does this sound like bipolar II to anyone out there? My psychiatrist is insistent it is. My therapist is treating me for Borderline Personality Disorder, which is a diagnosis I got from a different psychiatrist when I sought a second opinion. She works closely with my psychiatrist, though, and seems to think he is doing the right thing. The mood swings have become more rapid over the last month and my depression has dropped right down to the depths. I have begun to self-harm again, too, about 3 times this month so far (May). I am sick and tired of taking expensive medicine with makes me: sweat excessively, sleep too much, makes my nose run and my hands shake, gives me constipation, wrecks my orgasms, makes it a task and a half to lose the weight that I suspect the Lexapro helped me to gain, and at the end of all of that, it does not seem to be working. My psychiatrist's response has been to ask me to cut down on the stress levels at work, but that I cannot do without changing job, and as I work abroad and need sponsorship (and love my job), I cannot do. My partner is not earning enough to support me if I can't get work. He then suggested increasing the Epilim, rather than the Effexor. I am loath to do this because each time we have increased the Epilim it seems to have cut down the high moods, and I have few enough of those as it is (when I say 'high mood', I mean feeling happy, I don't mean psychosis or mania or doing risky things). He says that is okay because it also reduces my low moods, but I don't think it does, significantly. I also really, really, really don't want to increase a drug that causes weight gain (at the moment I think the weight loss aspect of the Effexor is balancing that out); one of my key issues is low self-esteem and body image and that would be the last straw. What I want is to increase the antidepressant and stop these black days of total despair. Does anyone have any advice or thoughts? I would really appreciate any comments. I'm losing faith in the whole drug thing, really, but have tried everything else I can think of. Have also tried, with no real results: Zoloft, Sertraline, Paroxetine, Lexapro. Thanks.
Posted by crystee on May 8, 2006, at 11:34:02
In reply to Bipolar II? Just what is this??, posted by fionamck on May 8, 2006, at 7:52:36
I feel basically the same as you do...I haven't been given a number to go after my bipolar but on my second opinion I was also dx'd borderline personality disorder. I have tried with no real results: zoloft, paxil, prozac, lithium, depakote, lexapro, tegretol, remeron, elavil (which helped me quit drinking but that was about it), abilify (helped with the rages but made muscles way too stiff to function), risperdal (made me lactate so it was discontinued but was helping with the rages I think), and Effexor, which made me psychotic.
I agree with you, they don't need to take away the few good days we have. I assume your med besides Effexor is a mood stabilizer ( I haven't heard of it, sorry) Someone else on here recommended Topomax to me for mood stabilization and weight loss so I am gonna give it a go. I think I am gonna try to combine it with Wellbutrin (which makes me really angry by itself but with a mood stabilizer it should actually help me get some energy to get outta bed on the black days I think. Let me know what happens.
Posted by stickywicket on May 8, 2006, at 11:50:21
In reply to Bipolar II? Just what is this??, posted by fionamck on May 8, 2006, at 7:52:36
Your post could've been written by me. I've been diagnosed either Bipolar II or Bipolar NOS (not otherwise specified - when they don't really know what flavor of bipolar it is). I'm on 500mg Depakote, 150mg Wellbutrin and just upped my Cymbalta from 60 to 90mg. I have periods of hypomania (the happy, euphoric kind) for as long as 1 1/2 months then it abruptly ends and I'm depressed but not horribly depressed. But the the hypomania was so wonderful that the change makes me feel worse than if I'd just been ok and not hypomanic. Do you know what I mean?
If the increased Cymbalta doesn't work to lift me back to hypomania or just ok, then my pdoc will increase the Wellbutrin.
I wish you luck. Be well.
Posted by CEK on May 8, 2006, at 12:04:44
In reply to Re: Bipolar II? Just what is this?? » fionamck, posted by crystee on May 8, 2006, at 11:34:02
Fionamck, you and I are just alike. It was strange to read your post because that is exactly what life is like for me. My mood swings are all over the place but I never have a real "manic" episode. I've been diagnosed with just major depression for 6 years and was taking just AD's. The depression never got better, only the irritation. The mood swings got worse though and I occaisionally would have a day or couple of hours where I just felt elated. My skin would just crawl it felt so good. I felt like I could go back to school, lose weight and accomplish all of my goals that seemed out of reach in my darkest depression. Usually within 5-12 hours later I was back to wanting to kill myself. I have every personal trait of borderline personality disorder but whenever I mention it to a doctor they just dismiss it saying that many diagnosed coincide with each other. I have not responded to any of the AD's and can not take anti psychotics because of bad side effects. We're trying mood stablizers right now and it's a slow go. My pdoc doesn't want me on ANY AD, he says they will only make my cycling worse. I too love the occaisional "elated" feeling and feel bitter at the doctors for wanting to take that away from me. I now am left emotionless after 6 days of 1000mg of Depakote. They say if you leave those "hypomania" times alone and not treat them with your currant depression, as time goes by and your illness worsens, the hypo will turn into full fledged mania which can be pretty bad. Have you go on the internet and try to research bipolar and it's symptoms? I've looked up all I can. I want to know for sure what's going on. That's how I found out about BPD. How are you making it living this way? Are you working? No one knew I had a problem until I cracked in January. I hid it from all but my family which didn't take me seriously. I'm not working now because of the severety of my illness and it is no better. Just because you quit your job doesn't mean all will be solved and you'll feel fine. My husband thought this and woke up to find out I was just as bad. It's not just aggrivation, it's an illness that needs to be treated, not avoided and run from. That's what I did, and now here I am. Good luck when you find your "fix" and let me know what it is so I might be able to try it. Love, CEK P.S. My diagnosed now is Bipolar 2 with mixed episodes with rapid cycling and GAD.
Posted by Phillipa on May 8, 2006, at 19:19:26
In reply to Re: Bipolar II? Just what is this??, posted by CEK on May 8, 2006, at 12:04:44
Have you tried trileptal? Love Phillipa
Posted by fionamck on May 9, 2006, at 8:33:28
In reply to Re: Bipolar II? Just what is this?? » CEK, posted by Phillipa on May 8, 2006, at 19:19:26
Thanks so much for all your support and suggestions. I have been doing some research into the drugs you mention (Wellbutrin - worried about seizures, though W + Effexor seems to be recommended by a few people; Topamax - though concerned about the eye pressure side effect (weight loss sounds good, though...); Trileptal - this sounds positive; Cymbalta - possible, though there seem to be a lot of side effects listed). I am seeing my therapist tomorrow (she used to be a psychiatric nurse so she knows something about the drugs)- I'll see what she says; can't afford to see the psych until pay day at the end of the month.
So tired of spending my time researching all this when I'm trying to keep a job down and I am paying a fortune for a psychiatrist; he's got more damn energy than I have, too!!
Still, I suppose that's life, and you all seem to have had a hell of a time with it, too. It's such a relief to hear that your stories are similar to mine; I was almost feeling like a fraud as I appear to have bipolar II but no mania, so how can that be bipolar and am I just making it up etc etc.
I hope you all manage to stay well and happy, and thanks so much again for all your support!Incidentally, re the cost (bug bear of mine, although I know all the stuff about one's health being more important etc etc; it just further adds to my rage and frustration that it's eating a huge chunk out of my salary each month. Has anyone managed to get this covered by medical insurance? I'm not in the US and my company has taken out insurance for us with a company that covers 500 pounds a year for 'psych treatment' (I'm paying 429 a month for fees, drugs and counselling, so this figure is laughable), but unlimited for 'prescription drugs' and 'consultants' fees'. They should, therefore, cover all but the counselling under the 'drugs' and 'fees', shouldn't they? I am anticipating a fuss, though, as they have contacted my psych for a treatment plan and I have a feeling they are going to include the drugs and fees under psychiatric treatment and so just allow me the 500 a year. I just don't have the energy to fight them on this, but it is criminal. I almost didn't want to submit a claim because I felt that if they refused to cover it, I would become so apoplectic with rage (anger being a particular issue of mine) that it would do me more damage than good. Has anyone had success with claiming? I know insurance companies are all different, but it would be nice to hear that someone somewhere has got it sussed!
Thanks a lot.
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