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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by sk85 on May 3, 2011, at 15:14:19
I've had few episodes in my life when starting or discontinuing antidepressants I become very highly productive and "hyper". It is difficult to describe precisely but it feels like my mind is working 150%, I'm very enthusiastic about almost everything, I have flight of ideas (usually very creative, but then again I'm bit artistic to begin with), I tend to feel like I could take on the world...but all this is colored by background anxiety and sometimes irritability. This lasts couple of weeks and then subsides.
Now my doctor thinks only people who have underlying bipolar illness get these "symptoms" on antidepressants and I tend to disagree. First, I don't operate like this when I'm off meds: most of the time I tend to be bit slow and sluggish and generally low on energy. I have no relatives with bipolar. And third, the effect seems to fade out usually, only to reappear perhaps when life circumstances provoke anxious thoughts or I've accomplished something great.And foruth during "these" episodes my sleep isn't usually disrupted.
My theory is that I don't have bipolar but just weak "brakes" that would normally function just enough, only to stop temporarily working when on meds which then manifests in hypomania-like state. If my doctor is right and I'm wrong then I should perhaps consider a different diagnosis for myself (which currently is depression with OCD)? Or is this BS and it's normal for meds to do this? And I probably don't have bipolar? I do have to say that I've had relatively little success with antidepressants alone, they work great for depression, but poorly for anxiety and compulsiveness. I'm confused.-Ikaros
Posted by mellow on May 3, 2011, at 15:45:43
In reply to Is this a bipolar myth or not?, posted by sk85 on May 3, 2011, at 15:14:19
Your situation and symptoms would probably get different opinions from different doctors. It is certainly normal for AD's to trigger manic episodes. Some believe this means there is underlying manic depressive illness. It certainly indicates that AD's aren't safe to use in your case. Therefore operating from a bipolar diagnosis may be more efficient when trying to get your med mix right because you could look to the mood stabilizers rather than AD'S.
While the traditional mood stabilizer of choice is lithium my doctor has the theory that people who favor depression do better on anti convulsant mood stabilizers such as lamictal, tegretol, tompirmate, trileptal,etc.
I wouldn't worry so much about the diagnosis as much as having a doctor you are comfortable with. If you answer the doc's questions honestly and let him/her use their knowledge from working with thousands of patients you might find the perfect mix. Although you may have a crummy doctor and end up just getting really doped up. That happened to me at first and luckily I found a better doc.
I was diagnosed in 2006 and I had a episode this February where I finally decided maybe there was something behind the whole bipolar thing and I finally surrendered to the meds. It's taken this long to actually get a good mix going, because I never fully bought into the treatment. Don't let hang ups about "being bipolar" keep you from the life you deserve. You are more than a diagnosis scribbled on a chart in a filing cabinet. If you don't like your doc get a new one and comply with the treatments they prescribe regardless if they tell you that you are bipolar are not.
That's the best advice I can give as someone who has been fighting this thing for almost 5 years diagnosed and my whole life before that. Best of luck.
mellow
Posted by Phillipa on May 3, 2011, at 19:20:32
In reply to Re: Is this a bipolar myth or not? » sk85, posted by mellow on May 3, 2011, at 15:45:43
I had this happen only once when on 250mg of luvox regular. I still was taking ativan I think but for the first time in my life could get up early and create things. Asked the pdoc if could be hypomanic. She at the time said no I just didn't know what it felt like to feel good. Only lasted two weeks. Phillipa
Posted by desolationrower on May 3, 2011, at 20:57:04
In reply to Is this a bipolar myth or not?, posted by sk85 on May 3, 2011, at 15:14:19
I really haven't seen much research into whether people who have 'drug-induced bipolar' respond differently (more like unipolar or bipolar dxed people). If a drug is working currently i wouldn't switch based on this
-d/r
Posted by SLS on May 3, 2011, at 23:07:40
In reply to Re: Is this a bipolar myth or not?, posted by desolationrower on May 3, 2011, at 20:57:04
> I really haven't seen much research into whether people who have 'drug-induced bipolar' respond differently (more like unipolar or bipolar dxed people). If a drug is working currently i wouldn't switch based on this
>
> -d/rAbrupt discontinuation of some antidepressants can produce a mood-lift, but not always hypomania or hypomania. This phenomenon is thought to occur more often with TCA and MAOI. Abrupt discontinuation of these drugs can also trigger mania in vulnerable individuals. Whether or not this indicates a bipolar diathesis has been the subject of debate. I think Linkadge is of the opinion that this occurrence is not necessarily an indicator of a bipolar spectrum disorder. I tend to believe that it is.
It would be great if people who experience antidepressant-discontinuation induced mania would chime in.
- Scott
Posted by desolationrower on May 3, 2011, at 23:32:19
In reply to Re: Is this a bipolar myth or not? » desolationrower, posted by SLS on May 3, 2011, at 23:07:40
> > I really haven't seen much research into whether people who have 'drug-induced bipolar' respond differently (more like unipolar or bipolar dxed people). If a drug is working currently i wouldn't switch based on this
> >
> > -d/r
>
> Abrupt discontinuation of some antidepressants can produce a mood-lift, but not always hypomania or hypomania. This phenomenon is thought to occur more often with TCA and MAOI. Abrupt discontinuation of these drugs can also trigger mania in vulnerable individuals. Whether or not this indicates a bipolar diathesis has been the subject of debate. I think Linkadge is of the opinion that this occurrence is not necessarily an indicator of a bipolar spectrum disorder. I tend to believe that it is.
>
> It would be great if people who experience antidepressant-discontinuation induced mania would chime in.
>
>
> - ScottYeah i just don't feel like i have seen any real investigation into it, and don't have enough personal experience either. I did feel pretty happy the first few days off of sertraline, but that drug had made me feel worse.
-d/r
Posted by Phillipa on May 4, 2011, at 19:18:36
In reply to Re: Is this a bipolar myth or not?, posted by desolationrower on May 3, 2011, at 23:32:19
But they all made me feel worse minus the luvox strange? Phillipa
Posted by 49er on May 5, 2011, at 5:18:50
In reply to Is this a bipolar myth or not?, posted by sk85 on May 3, 2011, at 15:14:19
>Now my doctor thinks only people who have underlying bipolar illness get these "symptoms" on antidepressants and I tend to disagree. First, I don't operate like this when I'm off meds: most of the time I tend to be bit slow and sluggish and generally low on energy. I have no relatives with bipolar. And third, the effect seems to fade out usually, only to reappear perhaps when life circumstances provoke anxious thoughts or I've accomplished something great.And foruth during "these" episodes my sleep isn't usually disrupted.
> My theory is that I don't have bipolar but just weak "brakes" that would normally function just enough, only to stop temporarily working when on meds which then manifests in hypomania-like state. If my doctor is right and I'm wrong then I should perhaps consider a different diagnosis for myself (which currently is depression with OCD)? Or is this BS and it's normal for meds to do this? And I probably don't have bipolar? I do have to say that I've had relatively little success with antidepressants alone, they work great for depression, but poorly for anxiety and compulsiveness. I'm confused.
>According to Joseph Glenmullen, a psychiatrist who is not antimeds, bipolar disorder can't be diagnosed on a med reaction. It should be based on the patient's history that occurred independently of being placed on any med.
Astonishingly, in Anatomy of an Epidemic, I forgot the exact ratio, but only aproximately 2 people out of 16, were diagnosed in this manner. Everyone else was diagnosed on a med reaction.
Fortunately, my former psychiatrist, seemed to be one of few doctors who refused to diagnose me with BP based on my bad reactions to ADs. He felt there was no reason to diagnose me with it and I totally agreed.
49er
Posted by creepy on May 13, 2011, at 14:49:11
In reply to Is this a bipolar myth or not?, posted by sk85 on May 3, 2011, at 15:14:19
discontinuation symptoms from SSRIs can include hypomania. I have personally had this happen also.
I suspect it could be a big chunk of the reason people go off their meds, feel tons better for a week or so then crash and burn.
Keep a close eye on your mood and make sure that youre not heading for a depressive episode. It may start with some mixed stuff like irritability or rushing around. At least thats how I experience it.
This is the end of the thread.
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