Posted by Blue Cheer 1 on February 16, 2002, at 8:15:14
In reply to Re: Puzzle » Blue Cheer 1, posted by Ritch on February 16, 2002, at 0:39:30
> > I know. I've never known anyone who was diagnosed as bipolar II. I know that in the lithium clinic where I was treated for 7 years, we were just plain "bipolar." I assumed everyone had at least one manic episode, but then I never asked. All these numbers after the diagnosis don't seem justified.
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> Blue,
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> I have been dx'ed BP since 1979 and I didn't see the differentiation on my charts until the last five years.Hehe, maybe your psychiatrist was anticipating a full-blown episode to happen sooner or later. >
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> > You mean the time? LOL.. Yeah, you're lucky what you experienced didn't happen in the 70's or earlier. Your "agitation" might've been treated with antipsychotics.
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> My 2nd pdoc in 1980 suggested 10mg Valium 3x daily (with my lithium). At the time there was all this furor about benzodiazepines being BAD, and I *refused* it, and wound up a year later taking Thorazine 25mg once daily instead-which was a big mistake.Yeah, I'm hooked on Valium, and I have doubts that I'll ever get off it. Once I did (for about 3 months in 1990), but I was in a sertraline study for depressed lithium patients, and it was unavailable at the end of the 8 weeks. So, I switched to Prozac and made the mistake of resuming Valium when I got Prozac-induced anxiety. I don't like being on it, but it's he** getting off it. I was using 20 mg/day for the past year or so; went down to 15/d two months ago; now down to 12.5 mg/day for one week -- and I feel it.
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> > I was never "mixed" until I had serial high-dose trials of Prozac, Zoloft, Luvox, Paxil, Effexor, Parnate, Deprenyl, etc. - for about 4 years straight (with lithium). Then, when there was no response, the headcase psychiatrist decided to take me off lithium (after 20+ years and no consultation with my primary psychiatrist who'd been prescribing it!). Well, you know the rest of the story... anyway, that's how I became mixed. My present psychiatrist tries to tell me I'm a rapid cycler, too, but I guess he hasn't seen it defined in the DSM yet. :) Actually, he wrote it up in an admissions note when I was going to have ECT (along with about a dozen other lies - all designed to justify me *having* ECT and relieving him of liability in case things went, ahem, "wrong." I'll never forgive him for making up these lies. (He had my wife walk me over to the inpatient unit, and we stopped at the cafeteria where we both read the note. (I never would've bothered except for a parting remark he made: "Of course, if you try to sign out, they'll commit you." That was uncalled for since it was a voluntary admission, and not the kind of send-off one would expect!! He *even included* an e-mail I'd sent him the night before, in which I said I wanted ECT. From the initial consideration and discussion of ECT through the hospitalization (18 days), it was one lie after another. Finally, I refused to sign the informed consent and walked out.
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> Jeez, what a mess! If it wasn't for antidepressants (too high a dose or the wrong one, etc.) I never would have had a serious mixed episode.This "mixed" dx bothers me because I think I really only had one protracted mixed episode. You're in real bad shape, according to strict DSM criteria, if you're mixed. In my case, one doctor sees me as mixed, and the other as depressed - or sometimes a little mixed.
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> > I think so. I've taken every AD ever marketed in the U.S. and some abroad (with the exception of Serzone), and they just weird me out and agitate me. I can't tolerate them at all now. Not until I read this board did I see that I wasn't the only bipolar who'd never responded. The psychiatrist who dragged me through all the AD trials used to say that I "got side effects no one else gets," and that "you get the same ones with every drug." He made it sound as though it were *my* fault I was a non-responder. I'd like to try Dexedrine with Lamictal and Trileptal - if I get in a bad depression again. I just d/cd lithium last night (started on 1/23) because it was somehow making me depressed again. I only wanted it for its neuroprotective/neurotrophic properties, but not at the expense of worsening depression. Plus, it was causing some dyskinesias.
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> Adderall and Neurontin whipped my seasonal bipolar depressions with small dosages. I just got uptight and panicky on the Adderall. Would like to try Neurontin+Provigil instead. Or who knows? Neurontin+Focalin (dexmethylphenidate).Me, too. I've made up my mind. The next drug I'm taking if my depression worsens is a psychostimulant. I don't know how I'll feel using it with two AEDs and Valium, but I'm going to find out. One after another if I have to. I'd never heard of Focalin until I saw it mentioned here not long ago. I used Ritalin in 1975 (with lithium and doxepin - maybe Valium, I forget), and under the counter Dexedrine, methedrine in divided doses - both with lithium and Valium (oh, and beer). :) But I'm off lithium now, and don't drink, so I'll have to see. I don't want plain Ritalin, though (what the VA is willing to give).
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> > Yeah, I side with the "splitters." You're right: just as it was lithium in the 70's that uncovered so many "bipolars" (many of whom dropped out of treatment, I *know*, after discovering that they weren't really bipolar), now I think another generation is getting the BD diagnosis, in part, due to the advent of AEDs. Many psychiatrists "see" what they want to see, especially if they have a lucrative practice treating mood-disordered patients. I've been hospitalized with some people who had no depression or mood elevation, or even a history of mood problems, but when they were assigned to psychiatrists who specialized in mood disorders, they were asked all kinds of questions about mood. Even when they said that's not me, you know, they were pressed.
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> > At least most people with bipolar disorder aren't being misdiagnosed with schizophrenia - like in the 70's and before that. I was depressed on and on for 10 years before getting a bipolar diagnosis. It's not fun going into a VA hospital for 8 months, in a severe depression, and getting dx'd as schizophrenic (sometimes by FMG's who did their residencies in OB-GYN at Bombay U. or somewhere); then getting bombarded with high-dose antipsychotics - which actually *did* make you appear to be withdrawn and schizophrenic. I spent about 3 years, off and on, in a VA hospital, misdiagnosed until a Senior Attending psychiatrist from a real psychiatric hospital happened to come to the VA as head of a university/VA hospital teaching program, and then he saw me get admitted a few times in different mood phases. It was 7 years before I was even treated with an AD - and that was when my *mother* called the treating psychiatrist, and actually had to tell her that she saw me as depressed.
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> > Back then, in retrospect, I think you wouldn't get a manic-depressive dx unless you were maybe an ultra rapid cycler, or had clear-cut manias. I remember only one guy dx'd as manic-depressive (before lithium). You'd see him out on open ward one day, talking a mile-a-minute and multiplying 3-digit numbers in his head, super-personable, and then the next morning you'd wonder where he was -- and he was back on the locked end so bad off he had to be spoon-fed.
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> > Blue
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> My grandmother got *misdiagnosed* with paranoid schizophrenia in the mid-60's and was given ECT. She was manic-depressive just like her father (who was a travelling preacher).That's sad. I hope it helped anyway, if she had it while depressed. A manic travelling preacher sounds interesting. I think hyperthymia, at the least, is a prerequisite for that kind of work. :)
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> Thanks for those personal insights,
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> MitchThanks to you, too.
Blue
poster:Blue Cheer 1
thread:92727
URL: http://www.dr-bob.org/babble/20020215/msgs/94395.html