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Dr. Gershon: Meltdowns and bipolar

Posted by Dinah on November 5, 2002, at 23:39:12

Dr. Gershon, I really enjoyed your presentation. I especially enjoyed the new information on the genetic links between bipolar and schizophrenia and other mental illnesses.

My pdoc has me somewhere on the bipolar spectrum - cyclothymia or perhaps Bipolar II. But my question is about my periodic meltdowns. They happen every couple of months and last for about a week, sometimes less. I guess I can best describe those as discrete periods of depression with agitation, anger, or extreme fear. It is not always associated with insomnia, sometimes I sleep way too much during them. There is usually a trigger, although it may well be something I ordinarily would not be upset about or that at least I would not react to so strongly. It just doesn't feel like me at all, it seems more like aliens have taken over my body. I do understand while it is happening that I am behaving unreasonably, but I can't seem to stop. I do things like self injure, or rock in the closet, and am quite difficult interpersonally. I am enormously embarassed afterwards.

There are very convincing psychological (non-biological) explanations for what is happening. In that case medications would not be of much use and therapy would be indicated. But I'm wondering if there are equally convincing biological explanations for what is happening. I realize you can't speak directly to my situation. But does what I'm describing fit in with a bipolar spectrum illness? My pdoc is suggesting adding a low dose of Risperdal to my Depakote and Klonopin, and I'm reluctant to do so if the causes are psychological rather than biological.

Sorry for the length of my post. And thank you for giving your time to this board.





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