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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by sometimesblue on September 24, 2007, at 11:54:41
I have been treated for depression and anxiety for the past few years. I have tried 4 different AD's and none have worked, the longest was a few months.
I'm looking into Bipolar and I think that might be the case with me [though i'm no expert]. So my question is what do i do next? how do i approach this with my doctor? I don't know if it's my paranoya but i feel like if i'm the one that brings it up she'll think i'm a hypochondriach, and she's never considered it i don't think.
Anyway, my major concerns with any meds are:
1. anorgasm
2. energy
3. focus
4. motivation
5. depression
6. anxietySo what meds can i suggest to my doc considering the above concerns?
Can my regular doctor even diagnose me as Bipolar?
I'm soooo confused and i don't know where to start.
Any advice?
-SB
Posted by Phillipa on September 24, 2007, at 11:58:08
In reply to If BIPOLAR, what do i do next??? what meds?, posted by sometimesblue on September 24, 2007, at 11:54:41
You could just say you would like to try a mood stabalizer maybe lamictal or trileptal or if you are anxious maybe zyprexa a lot here say it helps. Good luck. Phillipa
Posted by stargazer2 on September 24, 2007, at 16:45:28
In reply to If BIPOLAR, what do i do next??? what meds?, posted by sometimesblue on September 24, 2007, at 11:54:41
Why do you think you're bipolar? Have you had signs of being bipolar? Your symptoms sound like mine and I wouldn't call myself bipolar even if many AD's have never helped me either.
Have any meds ever helped you? You say you've been on 4 meds for depression. Were they ever given along with another medication to help augment the first med?
You may have treatment resistent depression (TRD) which can be helped, as Phillipa said, with mood stabalizers (Lamictal, Lithium, Depokote) or with antipsychotics (Abilify, Seroquel, Zyprexa, Geodon). This doesn't mean you are bipolar though unless you show symptoms for it, like irritability, insomnia, feeling so good you are invincible. These are manic symptoms. The symptoms vary widely but manic symptoms are usually quite distinctive with an elevated mood and doing things quicker and "better" than everyone else.
Antidepressants can precipitate a manic phase when someone bipolar is taking an AD alone.
Has this ever happened to you?I would ask for meds that can be used in combination with another med and given your history, this should have been tried by now if you say no med has been helpful.
Your doctor is a psychiatrist, right? If not, you should be treated by one, since GP's cannot make the skilled decisions on medications when a case is difficult. GP's typically should only try one or two meds and then refer you to a specialist for more aggressive treatment.
So just tell your doc how you are feeling and tell her that no medications have helped (she should know this)and you're wondering if a combination of medications might be more helpful.
Good luck...
Stargazer
Posted by curiousfish on September 24, 2007, at 19:06:16
In reply to Why bipolar? Do you have bipolar symptoms?, posted by stargazer2 on September 24, 2007, at 16:45:28
in my opinion, i dont think regular docs should be diagnosing bipolar disorder. Ive been diagnosed for about 9 months and I am studying to be a mental health professional.. and i STILL dont understand it. it is more complex than i ever could have believed.
lamictal causes some fatigue, but pretty much satisfies your list. geodon causes more fatigue, but otherwise satisfies your list (all in my experience).
read up on 'bipolar spectrum disorder'..its really interesting. many people dont fall into the clear cut boxes of traditional bipolar.
Posted by Netch on September 24, 2007, at 21:41:28
In reply to If BIPOLAR, what do i do next??? what meds?, posted by sometimesblue on September 24, 2007, at 11:54:41
sometimesblue, you should consider yourself in the bipolar spectrum if your mood shifts or you easily get agitated while depressed.
You need to tell your doctor about the poor effect from ADs, explain about your mood swings and suggest an anticonvulsive treatment like lamictal.
Posted by Phillipa on September 24, 2007, at 21:48:04
In reply to Re: If BIPOLAR, what do i do next??? what meds? » sometimesblue, posted by Netch on September 24, 2007, at 21:41:28
Seriously I don't want a discussion of placebo vs antidepressant but antidepressants don't work for more than about isn't it 30-50% of people? This is off the top of my sick head but why should that make one bipolar if that is the only symtom this doesn't make sense at all to me. Phillipa
Posted by sometimesblue on September 25, 2007, at 8:54:53
In reply to Why bipolar? Do you have bipolar symptoms?, posted by stargazer2 on September 24, 2007, at 16:45:28
> Why do you think you're bipolar? Have you had signs of being bipolar? Your symptoms sound like mine and I wouldn't call myself bipolar even if many AD's have never helped me either.
Honestly, it never occured to me that I was Bipolar. But i read up on it, and i can relate to most of the symptoms of hypomania, especially the quick changes in mood. Also, i have a family history of Bipolar, and what really got me thinking was that when i first got on lexapro and wellbutrin i definately felt a change that's consistant with hypomania. Or maybe the AD just worked at first then pooped out, i really don't know for sure.
> Have any meds ever helped you? You say you've been on 4 meds for depression. Were they ever given along with another medication to help augment the first med?No. they were all given to me by themselves with the exception of wellbutrin which i was supposed to take with lexapro at first, then get off it altogether and i kind of jumped the gun and got off it before i was told to.
> You may have treatment resistent depression (TRD) which can be helped, as Phillipa said, with mood stabalizers (Lamictal, Lithium, Depokote) or with antipsychotics (Abilify, Seroquel, Zyprexa, Geodon). This doesn't mean you are bipolar though unless you show symptoms for it, like irritability, insomnia, feeling so good you are invincible. These are manic symptoms. The symptoms vary widely but manic symptoms are usually quite distinctive with an elevated mood and doing things quicker and "better" than everyone else.
That's just it, i do show all those syptoms [with the exception of insomnia, i usually get very tired all the time]. But i don't think they are to the degree which i read about. I have family members who have been diagnosed as Bipolar and i don't think I'm as bad as them.
> Antidepressants can precipitate a manic phase when someone bipolar is taking an AD alone.
> Has this ever happened to you?Yes. It's like what they describe as hypomania, although I've never had a "grandiose self-image"...in that respect i think i'm pretty grounded. But now the longer i'm on wellbutrin [or any AD for that matter] my mood swings seem to get worse, and i fall into an even deeper depression.
> I would ask for meds that can be used in combination with another med and given your history, this should have been tried by now if you say no med has been helpful.
I have an appontment today to discuss all my options.
> Your doctor is a psychiatrist, right? If not, you should be treated by one, since GP's cannot make the skilled decisions on medications when a case is difficult. GP's typically should only try one or two meds and then refer you to a specialist for more aggressive treatment.No, unfortunaly i don't have mental health coverage, so my GP has been trying her best to help me. I might have to tell her to talk to my insurance company, maybe she can persuade them to allow at least a certain amount of mental health visits since it seems clear that i do need someone more familiar with what's going on with me.
Thanks for your help.
Posted by sometimesblue on September 25, 2007, at 8:58:00
In reply to Re: Why bipolar? Do you have bipolar symptoms?, posted by curiousfish on September 24, 2007, at 19:06:16
I have been reading up on it and that's what's gotten me so confused. I thought i just had major depressive disorder, with some ADD issues. But when i read up on 'soft bipolar' it got me thinking.
i'm so confused.
Posted by sometimesblue on September 25, 2007, at 9:03:10
In reply to Re: If BIPOLAR, what do i do next??? what meds?, posted by Phillipa on September 24, 2007, at 21:48:04
Actually, it isn't the only consideration when diagnosing someone bipolar. There are a bunch of other things to consider like mood changes, a person's highs and lows...it's so complicated. And now with the bipolar spectrum, it's even more complicated because a person [like myself] who never considered BP as a diagnosis finds themselves falling into one of those categories [symptom by symptom].
-SB
Posted by Phil on September 25, 2007, at 9:24:53
In reply to Re: If BIPOLAR, what do i do next??? what meds? » Phillipa, posted by sometimesblue on September 25, 2007, at 9:03:10
If your insurance allows it, see a psychiatrist. They have enough trouble DXing bipolar but with family history they'll be looking for it. It took me 20 years to get the right DX.
A GP's not qualified to deal with it and could easily do more harm than good. I'd say the same for depression. We need the pros for the mind.
I worked with a lady that was on 2 SSRI's that her OBGYN prescribed...not too swift.
Good luck.
Posted by curiousfish on September 25, 2007, at 14:52:02
In reply to Re: Why bipolar? Do you have bipolar symptoms? » curiousfish, posted by sometimesblue on September 25, 2007, at 8:58:00
have you always had ADD symptoms? this happened with me. all of a sudden i just couldnt concentrate on ANYTHING. and flipped from subject to subject and began thinking i was ADHD. and well..signs of that are apparent in childhood, not randomly in adulthood. for me, it was a symptom of hypomania. bipolar is INSANELY confusing. I was diagnosed because a mood stabilizer worked for me. my psych doc didnt know what was wrong with me. she knew i was moody and just tried lamictal as grasping for straws..anything. and well..my symptoms cleared up quite quickly. this is too complex for gp. even now, bipolar and my symptoms doesnt make a lot of sense. you might be bipolar.. you might not be. but it is important that you find out.
Posted by sometimesblue on September 25, 2007, at 15:17:42
In reply to Re: Why bipolar? Do you have bipolar symptoms?, posted by curiousfish on September 25, 2007, at 14:52:02
> have you always had ADD symptoms?
Looking back on it now, knowing what i know: YES.
But back then they just thought i was a day dreamer, or just didn't like ot pay attention, teachers said i was very talkative and that i had to be told quite often to pay attention. The thing is though, that i still did very well in school. Which is why i think they never paid too much mind to it.
Posted by polarbear206 on September 26, 2007, at 9:37:27
In reply to Re: Why bipolar? Do you have bipolar symptoms?, posted by sometimesblue on September 25, 2007, at 15:17:42
> > have you always had ADD symptoms?
>
> Looking back on it now, knowing what i know: YES.
> But back then they just thought i was a day dreamer, or just didn't like ot pay attention, teachers said i was very talkative and that i had to be told quite often to pay attention. The thing is though, that i still did very well in school. Which is why i think they never paid too much mind to it.I went through the exact same thing you describe as above. My teachers also said I was creative and had quite an imagination. The creativity stems from my bipolar I guess.
PB
Posted by sometimesblue on September 26, 2007, at 10:43:05
In reply to Re: Why bipolar? Do you have bipolar symptoms? » sometimesblue, posted by polarbear206 on September 26, 2007, at 9:37:27
YES! Exactly...i was tagged "very creative" as well.
Now, about my meds, my doc added prozac to the wellbutrin. She thinks it will augment the wellbutrin, level out my moods, and perhaps get rid of the side effects.
What do you think?
Posted by polarbear206 on September 26, 2007, at 11:19:14
In reply to NEW MEDS... » polarbear206, posted by sometimesblue on September 26, 2007, at 10:43:05
> YES! Exactly...i was tagged "very creative" as well.
>
> Now, about my meds, my doc added prozac to the wellbutrin. She thinks it will augment the wellbutrin, level out my moods, and perhaps get rid of the side effects.
>
> What do you think?
Wellbutrin is usually used as an add on. IMOP it is a week AD, but works well in combo with other AD's I take it with effexor and Lamictal. Lamictal evens my moods and has been a life savor for me. I have no side effects. Your symptoms are very simular to mine. I have soft bipolar. I don't have any full blown mania. I get alot of energy and can get alot accomplished and don't need as much sleep when I'm like this. I also get insomnia, and take klonopin on occasion. On the downside, I would cycle with extreme fatigue, confusion and concentration problems, irritability, anxiety and depression. My limbs would feel heavy and it would be an effeort to do simple things around the house. Since adding the lamictal I am 100% better!! My bipolar is depression dominated, so I do need to be on an AD. I have SAD also and have exacerbations for a week or so prior to the time change. I suspect you have an undiagnosed underlying bipolar spectrum disorder. For proper medication treatment and diagnosis, you need to see a psychiatrist who specializes in mood disorders. Bipolar can be very tricky to diagnose and can be overlooked. You have to keep the AD dose as low as possible to prevent mood cycling and in combination with a mod stabilizer. Give the Prozac and wellbutrin a try and see what happens.PB
Posted by linkadge on September 28, 2007, at 23:22:45
In reply to Re: NEW MEDS... » sometimesblue, posted by polarbear206 on September 26, 2007, at 11:19:14
Going from antidepressnats to mood stabilizers can be a ROUGH RIDE. I was yanked off antidepressants and thrust onto lithium and AP's in such a way that I have never recovered even almost 5 years later.
Antidepressants can be a roller coaster. You need to know yourself and know whats is the meds.
Simply put, when you're on drugs, you're on drugs.
Linkadge
Posted by sometimesblue on September 29, 2007, at 16:55:14
In reply to Re: NEW MEDS... » sometimesblue, posted by polarbear206 on September 26, 2007, at 11:19:14
Since i've been on wellbutrin [generic] i have had just about all the side effects. The freakiest was hearin voices. That eventually went away, but i;m wondering what it all meant. My doc was very concerned about this as well. but to be honest, my sex life has improved 100% since on wellbutrin...i'm more sexual, and enjoy every bit of it. Unlike the AD's i was on before.
I also had ringing in the ears and my thoughts were unbearably loud. i coundn't stop thinking. But i guess you have to weigh the good with the bad right? I mean, that what this is all about...trial and error.
-SB
Posted by polarbear206 on September 29, 2007, at 20:01:42
In reply to HEARING VOICES?????: » polarbear206, posted by sometimesblue on September 29, 2007, at 16:55:14
> Since i've been on wellbutrin [generic] i have had just about all the side effects. The freakiest was hearin voices. That eventually went away, but i;m wondering what it all meant. My doc was very concerned about this as well. but to be honest, my sex life has improved 100% since on wellbutrin...i'm more sexual, and enjoy every bit of it. Unlike the AD's i was on before.
>
> I also had ringing in the ears and my thoughts were unbearably loud. i coundn't stop thinking. But i guess you have to weigh the good with the bad right? I mean, that what this is all about...trial and error.
>
> -SB
I suggest you keep a detailed mood journal and write down everything you are experiencing.PB
Posted by Maria3667 on October 7, 2007, at 14:38:59
In reply to HEARING VOICES?????: » polarbear206, posted by sometimesblue on September 29, 2007, at 16:55:14
SB,
As Wellbutrin suppossedly increases the levels of dopamine in the brain, it could be you are having 'auditory hallucinations'.
It reminds me of some symptoms schizophrenics sometimes also have. In most schizophrenics the levels of dopamine are raised too. Often these people are sexually very active. Coïncidence with the effects of Wellbutrin, I wonder...?> Since i've been on wellbutrin [generic] i have had just about all the side effects. The freakiest was hearin voices. That eventually went away, but i;m wondering what it all meant. My doc was very concerned about this as well. but to be honest, my sex life has improved 100% since on wellbutrin...i'm more sexual, and enjoy every bit of it. Unlike the AD's i was on before.
>
> I also had ringing in the ears and my thoughts were unbearably loud. i coundn't stop thinking. But i guess you have to weigh the good with the bad right? I mean, that what this is all about...trial and error.
>
> -SB
Posted by sometimesblue on October 8, 2007, at 9:14:09
In reply to Re: HEARING VOICES?????: » sometimesblue, posted by Maria3667 on October 7, 2007, at 14:38:59
I don't know, that makes sense i guess..i'll tell you thi though, i won't give up wellbutrin...and the voices fianlly stopped [thank GOD] since i thought was going crazy for a second there.
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