Posted by SLS on March 14, 2006, at 13:00:10
In reply to Re: Never thought I'd hear this..... » SLS, posted by detroitpistons on March 14, 2006, at 12:00:46
> > I guess you'll know soon what psychological issues remain after the depression goes into remission. Sometimes, depression leaves a real mess in its wake. Therapy can help clean it up after the depression is gone. Sometimes, "issues" mysteriously vanish once the depression is gone. I guess your doctor would like to see you biologically healthy before assessing your psychological health.
> >
> > With depression, things generally are not that simple. I don't think there are very many blanket statements that can be made that covers every person who suffers from it. Let's hope the Lamictal does the trick.
> >
> > Are you bipolar? What other drugs, if any, are you currently taking.
> >
> > Good luck.
> >
> >
> > - Scott
> >
>
> I was recently diagnosed as bipolar II after being on Effexor 225mg. I had an irritable hypomania with a lot of agitation, irritability, racing thoughts, excess energy, etc. I was sort of rapid cycling and a kind of mixed state.
>
> I went down to 150mg of Effexor and started the Lamictal (just went up to 200mg today). The doc wants to wait till I'm fully stabilized to think about taking me off of Effexor.
>
> To be honest, I'm not really sure I'm really bipolar because this hypomanic episode happened while on Effexor. But I did take Effexor once before with awesome results (maybe even some euphoric hypomania, but I can't really remember)and then it pooped out. I then tried Paxil and then Lexapro, with diminishing results.
>
> Late last summer, I started becoming depressed again, and saw the doc but by that time I was really spiralling down. The Effexor succeeded in pulling me up, but then a couple months later the hypomania hit me hard. I guess the fact that my depression is recurring along with the fact that SSRI's don't work for me are soft signs of bipolar, but I'm still not completely convinced of the BPII dx.I, too, have experienced mania only while taking antidepressants. That seems to be enough to qualify one as having a bipolar-spectrum disorder. For the most part, I would agree with this diagnosis.
200mg seems to be the "sweet spot" for Lamictal when it is used to treat bipolar depression. For me, Lamictal by itself is not sufficient to treat depression. It does seem to be used more often as an augmenting agent than as monotherapy. However, there have been a few postings here on Psycho-Babble by people for whom Lamictal was sufficient to bring them into remission. Interindividual biologies are so varied as to produce many different responses to the same medication. It is still difficult to predict how any one person will react to any one treatment.
I am not one who believes that psychotherapy is necessary simply because one describes themselves as being depressed, especially if the depression is part of a bipolar diathesis. Some perfectly healthy people are struck with brain disorders in the absence of psychopathology.
I suspect that you have been in psychotherapy long enough to have identified specific issues that need attention - if any do indeed exist. For me, I have used psychotherapy from time to time to help me deal with the effects that bipolar depression has had on my life. It has helped provide me with some tools to "undo" the damage that the biological depression has caused and continues to inflict. I seem to have very few issues that are independent of bipolar disorder. For these, I have used pschotherapy as a precision tool. However, I do believe that issues can be resolved, and not be vortices of perpetual therapeutic need. It has been my experience that during times of remission, I have not had a need for psychotherapy. I pretty much just get up, brush myself off, and start walking and talking. I have fun.
It might be interesting for you to identify your psychological issues and describe them to your doctor. Perhaps he will conclude that you should go for psychotherapy. Perhaps not. Either way, you will have provided him with detail that he didn't have before from which to draw more informed conclusions as to how to approach your recovery from depression and maintenance of mental hygeine.
If I were a doctor, I would never resolve to never tell anyone that they don't need psychotherapy. Some people don't.
:-)
- Scott
poster:SLS
thread:620137
URL: http://www.dr-bob.org/babble/20060310/msgs/620217.html