Posted by Larry Hoover on December 3, 2003, at 7:56:40
In reply to Help! Calling Rapid Cyclers and other Bipolars!, posted by Mr. Scott on December 1, 2003, at 21:25:19
> Yikes! I've been at this so long now. I'm 29 and first noticed becoming depressed around age 15. Prior to that I was a wild animal, always in trouble and very precocious for my age (setting fires, collecting weapons, reading dirty magazines, and drinking booze by 6th grade). There were two competing diagnoses for me at the time. ADHD and bipolar disorder. I went with ADHD and I got tricyclics for many years and then Prozac. On he tricyclics I believe I was rapidly cycling, but not with manias that were totally off the wall. Mostly I was dysphoric but i thought I was just still depressed! After the Prozac I went kind of nuts with drugs and impulsiveness. I'm personally still not sure if it was hypomania or some of the dopamine shunting effects of SSRI's including but not limited to akathesia and that frontal lobotomy syndrome often seen in patients on SSRI's. Because now I can't even touch Lexapro or Zoloft or Prozac without severe muscle pains and stiffness and agitation not to mention the apathy and complacency. Anyways I've had my ups and downs post college particularly with drugs and alcohol. I have that kicked for today, but now I'm wondering what to do with my black and mercurial moods. My illness is very subtle. The most obvious symptom is depression (often severe), but tonight my doc said he believes I have rapid cycling. Why then is he continuing to give me Effexor. Shouldn't that make everything worse? Tonight he tells me to try the Effexor again with Cogentin, and if that doesn't work to try Serzone. I came home in a really bad bad mood (I mean suicidal as we discussed ECT)and I took .5mg klonopin, 300mg of trileptal (neither of which I am currently prescribed), and i feel better. Not Great mind you, but better.
I'm a slight bit confused....
In the above, you do not ever mention mood-stabiliziers, yet you have access to trileptal...
The way I conceive of things, there are often two distinct processes in treating bipolar individuals, mood stabilization, and mood adjustment. The latter is my concept, but the first would be via lithium, valproate, carbamazapine et al, whereas the second would likely involve antidepressants and/or atypical antipsychotics and/or benzodiazepines.
There is one mood stabilizer that is emerging as the dominant treatment for rapid-cycling bipolars, and those with mixed states and similar (I think that might be a valid descriptor for your black moods)....lamotrigine (Lamictal).
Lithium also has a very powerful effect on suicidal ideation. Fish oil does too.
> What do I do? I've known this doc for over 2 years and he still can't give me the straight answer I'm looking for. He says he's fumbling in the dark just like I am. I need a caring type, but also someone I can have total confidence in. I've made 3 other contacts tonight reaching out to the supposed best hospitals in Chicago.
There's nothing wrong with getting a second opinion, or third or fourth.....you deserve adequate care.
> I feel so bad about having lost so much to my illness ranging from relationships to jobs. I have been nasty to my family at times and have worried them sick. I've been less than kind, but never outright evil. I'm not a bad guy, I just have a bad illness and its affected my ability to make the right choices at times.
>
> I hope some of you can help lead me to peace in this world by sharing your experiences and thats all I'm asking for. I have a lot of knowledge I will try to give back to this community rather than just taking all the time. I don't want to hurt my mother by leaving this world earlier than her and I'm scared I might have to.
>
> I feel like crying which I have not been able to do in over 10 years.Crying is a good thing.
If you're scared, go to a hospital. Go inpatient. Get looked after.
I'm praying for you.
Lar
poster:Larry Hoover
thread:285727
URL: http://www.dr-bob.org/babble/20031202/msgs/286161.html