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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 164 to 188 of 479. Go back in thread:
Posted by McPac on July 19, 2002, at 22:56:58
In reply to Re: Remeron poop out - Jill » Essence, posted by BarbaraCat on July 19, 2002, at 21:48:15
BarbaraCat/Anybody: I would GREATLY appreciate any and all feedback to this request:
Could anybody who has Bipolar Disorder please state clearly what the "manic" phase of Bipolar Disorder is like? One doctor of mine years ago diagnosed me with Bipolar. Others did not. The one that did said he did "because lithium is what worked for me". I just read online recently a presentation by a shrink that said that this is NOT a valid reason to automatically diagnose someone with a specific diagnosis. He said that just because a medicine works for someone that that doesn't automatically mean that that is their diagnosis. In other words, just because the lithium helped that doesn't prove that I am Bipolar. I also told my doctor that said that, right at that time, that other meds had also worked..for example, an antidepressant that I took a couple of years earlier had also worked very well. So how could he be so sure I was bipolar just because the lithium worked???????He didn't want to talk about it anymore. He never cared to answer patient's questions. Your typical arrogant-as-hell, pompous, know-it-all shrink. Anyway, for the last 20 friggin' years I have never had another doctor conclusively come to a conclusion. So I'm asking you all here: EXACTLY what the hell does this manic phase get like? I would think that it would have to get really bad if it was something that you could be hospitalized for. It should be TERRIBLE if it's such a terrible thing. I think I only have the "hypomanic" part, because when I get "overly" happy it doesn't seem terrible at all! I know I have the terrible depression "lows". But, WHAT is this manic phase all about? Any and all replies greatly appreciated because I just want to know if I have that "manic" phase or not. Thanks!
Posted by McPac on July 19, 2002, at 23:05:30
In reply to Re: Remeron poop out - Jill » Essence, posted by BarbaraCat on July 19, 2002, at 21:48:15
Barbara said: "Any increase (in antidepressants) would send me into severe panic disorder, sleeplessness, wiredness which would eventually wear off until the next poop cycle. This is a fairly common symptom of Bipolar, but I didn't know that until just a few months ago."
>>>>>>Increases in my anti-d's NEVER caused any bad reaction to me...does that mean anything (like maybe I don't have Bipolar)? Do you have ANY link that says that type of quote BarbaraCat or anyone?
Posted by McPac on July 19, 2002, at 23:13:26
In reply to Remeron and weight gain, posted by LyndaK on July 19, 2002, at 0:41:38
LyndaK wrote "My weight hasn't budged even though I'm starting to get my waistline back. I wish I understood the physiology of the stuff. I've wondered if it's a combination of having an appetite (I had no appetite when I was on Zoloft) and lowered metabolism."
>>>>>>>Lynda, I read once that one likely hypothesis was that many of the anti-d's lowered the body's metabolism. NOT just that a person's metabolism was lowered because they didn't eat as much, felt more tired, laid around more, etc., BUT that the meds actually lowered the body's metabolism in a specific way. It was stated as very likely but at that time not totally proven. You could always try to find a guy that likes the extra "cushion".
Posted by Jill on July 19, 2002, at 23:50:25
In reply to LyndaK, posted by McPac on July 19, 2002, at 23:13:26
Lynda,
My pdoc (very reputable, in a well-established practice in a large city) explained that the weight gain from Remeron is due to increased histamine caused by the drug (the benefits of histamine include antianxiety, ease of sleep, calm...but also increase appetite).
Some pdocs prescribe Zantac to lower the histamine (just in the stomach) to help counteract this side effect. I tried it for awhile, but I actually found it increased my heartburn (weird, eh...it was almost like a rebound effect for me).
Anyway, he also said that, in his practice, he's seen this drug cause weight gain mostly in young, skinny females...versus, say, middle-aged men. Obviously, age and gender must play a role in the response. Interesting.
That said, plain old watching what I eat and exercising works for me. I have gained weight, but I was pretty thin for my body type to begin with...now I look about "average" weight. Same for my sister.
We both feel great, so the extra pounds (I'm 5' 5 1/2...athleticish body...5 years ago started at 135 (size 8) and am now 150 (size 10)...although I'm working at eating better lately...more fruits and veggies and not letting myself eat after I take my meds at night), really are a small price to pay for the calm and happiness I feel (plus no sleep or sexual problems!). Also, I probably would have gained a little even without Remeron...hitting those 30's :)
By the way, thanks to everyone for info on Celexa/pregnancy. With my history of severe depression, my pdoc said I should probably stay on something during the pregnancy. He did say I should try to switch a few months before getting pregnant, so my body would be going through so much at once.
I'm bummed that I'll probably have to switch to an older drug with more data be safer, since Remeron doesn't seem to have pregnancy data. My pdoc also said I may not feel as good on a different drug which only increases serotonin). (Remeron increases noradrenelin, serotonin, and histamine...which really helps me...and many others with depression/anxiety).
Also, I'm disappointed that I'll have to deal (probably) with the sexual and sleep issues again. Especially a bummer because I will actually be trying to get pregnant...hope it's not too much of a drag :).
I took Prozac before (not trying to get pregnant, though) and did well (except for those side effects). I also tried Paxil (made me so sick...diarrhea, major weight loss), and Luvox (bad headaches).
So, I guess Zoloft and Celexa may be the next possibilities. Anyone have any other pregnancy/med stories or suggestions? I need an SSRI type thing for OCD/depression.
Very OCD of me to be worrying about this med thing now...not even married yet (but we're discussing plans)! Ha! Anyway, thanks in advance for all your insight.
Sorry this is so long!
Be well,
Jill
Posted by Jill on July 20, 2002, at 0:08:28
In reply to Re: Remeron and weight gain » BarbaraCat, posted by LyndaK on July 19, 2002, at 15:11:41
p.s. This is important about weight gain/Remeron! (You may already know???).
My doctor explained that there is less weight gain at higher dosages (30mg+). I take 45 mg/night. He moved me up very quickly to that dose when I started the medication (can't remember exactly...within a few weeks, I think...) to that level.
I believe he told me he did that to avoid excessive weight gain and sleepiness (I cry frequently [not enough AD effect for me] and am totally wiped out at only 30mg...my sister had the same experience on Remeron).
I do every few months [with doctor ok] take slightly less than 45 mg/night for a couple nights to help me sleep better (and then bump my dose back up to 45 mg). It seems to increase histamine enough to help counter the noradenelin that seems to build up over time. It's a great way (for me) to keep the sleep thing in check without sleeping pills.
Of course PLEASE check with your pdoc about meds/dosing for you.
Hope this is helpful.
Jill :)
Posted by LyndaK on July 20, 2002, at 0:31:20
In reply to LyndaK, posted by McPac on July 19, 2002, at 23:13:26
Ha Ha Ha. Thanks for the laugh. I already have a guy I've been married to for 17 years. He's got some "extra cushion" himself. I was a little underweight to begin with, so I don't look obese or anything. Just went from a size 6 to size 10. As long as it stabilizes at that I can live with that O.K. :-) Lynda
Posted by LyndaK on July 20, 2002, at 0:50:35
In reply to Re: LyndaK, posted by Jill on July 19, 2002, at 23:50:25
Thanks for your response. I did notice the increased hunger when I first started taking it, and I really had to watch what I ate then. Now that I've been on it a while and up to 45mg per day, I don't notice that ravenous hunger anymore. My hunger/satiation cycle seems more normal, but the weight remains. I really do believe that my metabolism is lower on this drug, so exercising (hopefully increasing my lean body mass) becomes really important. It is encouraging to hear that your weight elevated some but then stabilized. I'm 5'4" and started out at 116 (underweight) and have gone up to 138. I'm 40 years old, so that's probably pretty average, but there's a lot more subcutaneous fat than I'm used to having. But I've ramped up my exercise, even joining a dance class which adds to the fun in my life, and I'm feeling pretty good even though my weight is staying the same.
Thanks again for your response.
Lynda
Posted by BarbaraCat on July 20, 2002, at 0:50:43
In reply to Re: Remeron and weight gain, posted by Jill on July 20, 2002, at 0:08:28
Jill,
Not necessarily true. I'm at 75mg and noticed increased NE effects such as not feeling groggy anymore and increased energy, but unfortunately did NOT lose any weight on a higher dose even with higher activity. Of course, I am 51 and expect to put on some extra at my age, but not like I have in so short a time. - Barbara. > p.s. This is important about weight gain/Remeron! (You may already know???).
>
> My doctor explained that there is less weight gain at higher dosages (30mg+). I take 45 mg/night. He moved me up very quickly to that dose when I started the medication (can't remember exactly...within a few weeks, I think...) to that level.
>
> I believe he told me he did that to avoid excessive weight gain and sleepiness (I cry frequently [not enough AD effect for me] and am totally wiped out at only 30mg...my sister had the same experience on Remeron).
>
> I do every few months [with doctor ok] take slightly less than 45 mg/night for a couple nights to help me sleep better (and then bump my dose back up to 45 mg). It seems to increase histamine enough to help counter the noradenelin that seems to build up over time. It's a great way (for me) to keep the sleep thing in check without sleeping pills.
>
> Of course PLEASE check with your pdoc about meds/dosing for you.
>
> Hope this is helpful.
>
> Jill :)
Posted by BarbaraCat on July 20, 2002, at 1:39:35
In reply to BarbaraCat, posted by McPac on July 19, 2002, at 23:05:30
Notice I said 'fairly' common, not a hard and fast rule. Also, this is how my particular chemistry reacts so don't judge whether or not you're bipolar on someone else's response. There have been numerous articles recently published on how Bipolars can (notice I said 'can') get worse on ADs, although I can't quote from any particular source at the moment. I'll bet if you did a web search (or here in this board) on bipolar+antidepressants or bipolar+SSRI you'll come up with a bunch of hits in which you'll find this pheonomenon. My pdoc is very familiar with it, so you might ask your doctor. It's pretty prevalent knowledge. Even with my earlier statement, on my current Remeron I was able to double it within 2 weeks without any problems. But Remeron is not an SSRI, but an SNRI, acting on different receptor sites that seem implicated in Bipolar disorder. So, Remeron may be a very good AD for bipolars, whereas standard SSRI's are perhaps not so good. Also, I was and still am on lithium when I increased, and I'm sure that made a huge difference. When you start tweaking fine hairs at the receptor sites, one SSRI can be quite different from the next SSRI, even though they're primary action is via serotonin. Rocket science, if you ask me.
Are you the person who asked about what does mania feel like? I couldn't find the thread again and would love to answer whoever wrote it. If that was you, or you're interested in Bipolar I, read Kay Jamison Redfield's book "An Unquiet Mind". She's a psychiatrist who has written very eloquently about her severe Manic Depression and what it feels like to be in a full blown mania. If that was you and you also said your definition of hypomania was just being happy, I can assure you, hypomania is not just being happy. Just being happy is simply that. Hypomania may start out that way but quickly gets more and more urgent or ecstatic and reckless and wired and then spins off into disorganization and frantic behavior and then inevitably ends up in a crash. But then again, that's my version of it. Cyclothymia, on the other hand, is a less severe form of bipolar and is explained by less intense depressions cycling with periods of being 'up', so you may want to do some research there.
I thank God I'm 'only' BP-II and not the very disintegrating BP-1. Since getting rediagnosed it just explains so much for me as to why I was getting weird reactions all this time and why my depressions never felt the same as others. Heck, they're not even the same as other BP-II's because I've also got the very nasty 'mixed-states' form.
If the Bipolar doesn't sit well with you, definitely ask your pdoc for some in-depth diagnostic testing. It's available and very important if you don't think you're on the right med track. If your meds are working for you, then why worry about a label? We can only make a best guess anyway. - Barbara
> Barbara said: "Any increase (in antidepressants) would send me into severe panic disorder, sleeplessness, wiredness which would eventually wear off until the next poop cycle. This is a fairly common symptom of Bipolar, but I didn't know that until just a few months ago."
>
> >>>>>>Increases in my anti-d's NEVER caused any bad reaction to me...does that mean anything (like maybe I don't have Bipolar)? Do you have ANY link that says that type of quote BarbaraCat or anyone?
Posted by BarbaraCat on July 20, 2002, at 1:50:55
In reply to Jill, posted by LyndaK on July 20, 2002, at 0:50:35
FYI, in Europe Remeron is generally started at 30-45mg and levels off at 90mg and even higher. They don't report anywhere near the same problems with grogginess, weight gain, and consider it an energizing AD. I also noticed that I don't crave carbs nearly as much at the higher level. Oh no! now that I'm decreasing I sure hope I don't go through that late night feeding frenzy stage again! I actually went through two quart jars of deli pickles in one week back in those early days. It was like being pregnant.
Having the motivation and desire to dance and move again is wonderful, though, and I will not give that up.
Posted by McPac on July 20, 2002, at 9:18:13
In reply to Re: BarbaraCat » McPac, posted by BarbaraCat on July 20, 2002, at 1:39:35
Barbara wrote "Hypomania may start out that way but quickly gets more and more urgent or ecstatic and reckless and wired and then spins off into disorganization and frantic behavior and then inevitably ends up in a crash."
>>>>>>>>>more and more urgent? ecstatic and reckless..spins off into disorg. and frantic behavior...ends in a "crash"?
Could you be more specific? The "urgent" and "frantic" and "disorg." terms sure sound like feelings that I've gotten many times before. I just want to see exactly how you mean them.
ALSO, you wrote "If the Bipolar doesn't sit well with you, definitely ask your pdoc for some in-depth diagnostic testing. It's available and very important if you don't think you're on the right med track." I don't see a pdoc. I hope that the vast majority of them burn alive. What is this "in depth diagnostic testing" though? That interests me. Thanks! Mike
Posted by McPac on July 20, 2002, at 10:04:07
In reply to Re: BarbaraCat » McPac, posted by BarbaraCat on July 18, 2002, at 23:24:04
BarbCat, do you know much about Lamictal? I have just started to read some on it. I am wondering if Lamictal would do the same positive things for me that lithium does? I've read that Lamictal may have LESS side effects than lithium, so that interests me. Also BarbCat, do most/all of the mood stabilizers pretty much do the same thing? i.e., lithium, Tegretol, Lamictal, etc....what's the difference in what they would do for somebody?
Finally BarbCat, I'd love to hear your opinion on this: I can only take ONE lithium pill EVERY 2 or 3 DAYS and benefit greatly from it. It keeps me much less anxious/nervous, much more calm, etc. I have NEVER heard of anybody benefitting from such a miniscule dosage!!Even when I did take "more" of it, I would only take 1 a DAY, that's it, to feel fine. What do you think? The reasons that I like lithium is because it helps me to feel much more calm and not "frantic", it keeps my temper/anger/agitation away, it mellows me out and keeps that "high-strung" feeling away. In other words, I seem to need it MORE as a "nerve pill" and NOT as an anti-manic pill. Does that sound odd? Thanks!!!
Posted by BarbaraCat on July 20, 2002, at 10:29:14
In reply to BarbaraCat/Anyone, posted by McPac on July 20, 2002, at 10:04:07
Hi Mc,
No that doesn't sound strange at all. Lithium makes some people feel too mellow and dopey. It has a smoothing effect on my nerves. As for Lamictal, we share the same interests and questions. Dr. Ivan Goldberg, who has his own website and is a contributor to this board, highly recommends Lamictal as both a mood stabilizer and an antidepressant. In fact, just recently an article was published (I think it was in Science) that it's a much better drug for the depression end of bipolar disorder. That lithium acts as a good augmentor and potentiator to antidepressants and works better in preventing mania, but Lamictal acts as a good antidepressant in it's own right as well as a mood stabilizer. I'm going to ask my pdoc for it next time. As far as side effects, one in particular is noted in the precautions and worries my doc, and that is if you increase too quickly there's a possibility of a skin rash that can be uncomfortable. Some people also just don't like the way it feels, or it works for a while and then the good ol' poop out. Definitely do a search on this board for Lamictal. It's the best resource for anecdotal stories rather than the scientific research (which many are funded by the same pharmaceutical company that made them - hmmmm).As far as are they all the same/work the same. No, they all seem to work differently by different routes and I couldn't begin to do this topic justice. Here's the website for Dr. Goldberg.
http://www.psycom.net/depression.central.html
Do a search on Lamictal, or mood stabilizers or whatever you want to know (helps to use the exact phrase option). Here's another page with loads of links about depression.
http://stripe.colorado.edu/~judy/depression/
You'll find a lot of good information to start your research. - Barbara
> BarbCat, do you know much about Lamictal? I have just started to read some on it. I am wondering if Lamictal would do the same positive things for me that lithium does? I've read that Lamictal may have LESS side effects than lithium, so that interests me. Also BarbCat, do most/all of the mood stabilizers pretty much do the same thing? i.e., lithium, Tegretol, Lamictal, etc....what's the difference in what they would do for somebody?
> Finally BarbCat, I'd love to hear your opinion on this: I can only take ONE lithium pill EVERY 2 or 3 DAYS and benefit greatly from it. It keeps me much less anxious/nervous, much more calm, etc. I have NEVER heard of anybody benefitting from such a miniscule dosage!!Even when I did take "more" of it, I would only take 1 a DAY, that's it, to feel fine. What do you think? The reasons that I like lithium is because it helps me to feel much more calm and not "frantic", it keeps my temper/anger/agitation away, it mellows me out and keeps that "high-strung" feeling away. In other words, I seem to need it MORE as a "nerve pill" and NOT as an anti-manic pill. Does that sound odd? Thanks!!!
Posted by McPac on July 20, 2002, at 10:58:21
In reply to Mood stabilizers » McPac, posted by BarbaraCat on July 20, 2002, at 10:29:14
BarbaraCat wrote "Some people also just don't like the way it feels, or it works for a while and then the good ol' poop out."
>>>>>>>......just don't like the way it feels? Specifically, what do you mean..what way do these people say it makes them feel?
As for the good ol' "feces out" comment, are you saying that it may lose it's anti-dep. effect? I wouldn't think that it would lose it's "mood stabilizer" effect? Finally, you seem so similar to me in many ways (your specific problems and symptoms), that's why I'm asking you so many questions. Still, the one thing that puzzles me is that I seem to need the lithium or lamictal to be more of a "nerve pill" than an anti-manic agent; in which case, why would I have bipolar/ mania part if I need more of a "nerve pill" type of effect and nothing for "mania"? This stuff gets to f***ing complicated, lol!!!Plus, I've got a dr. appt. on Monday (with a regular "family doctor; I detest shrinks and mental health dr's). BarbCat, I also jotted down yesterday from a site that Lamictal had "relatively benign side-effects" and "significantly more antidep. potency than Lithium" as well. That's why I'm seriously thinking of making the switch, perhaps like you are. Again, please, what specifically are others on Lamictal saying about "not liking the way it feels"? (<is it nervousness/anxiety?) THANK YOU SOO MUCH!!!!!!!!!!!
Posted by Jill on July 20, 2002, at 11:39:53
In reply to Jill, posted by LyndaK on July 20, 2002, at 0:50:35
Lynda,
You know, logically, I can see how Remeron would reduce metabolism. Just from the simple fact that I don't have so much nervous energy anymore...and feel much calmer. I've noticed that many high metabolism people tend to move more than others (like pacing while waiting, bouncing their legs while sitting).
When I was in the midst of OCD anxiety, I talked to friends/family 1000 miles a minute, trying to calm myself down, sometimes exercised obsessively, and also couldn't eat much due to my anxiety/stomach aches. My head (and often body) were often on geared-up, anxious mode. I'm sure I burned many calories this way (although it wasn't pleasant).
I think that the calming effect of this drug probably does "slow things down" and increase hunger. For me, getting my brain to stop swirling and obsessing with worry has been the nice payoff. I'm able to be more patient with myself and others and take time to do things more carefully/deliberately.
Have a great weekend! Thanks for your informative posts!
Jill
Posted by BarbaraCat on July 20, 2002, at 14:30:42
In reply to BarbaraCat, posted by McPac on July 20, 2002, at 10:58:21
Hi Mc,
Probably the best way to find out what others on this board have reported is to do a search here for Lamictal. That's how I got my info. There are a number of posts from people stating that it worked then it stopped, or they felt uncomfortable on it (I didn't notice a pattern on how people felt, different responses all around). I'm actually looking for some positive anecdotal reports as well before I feel totally gung-ho to try it. If we both go on it around the same time it would be great to keep each other and the rest of the folks here informed about our response.About the 'nerve pill' thing. Lithium simply has that kind of effect on some people. It does for me. There are stories about why some of the mineral spring spas make you feel so relaxed is because of the high lithium content in the waters. I stayed at a spa in Mexico where the spa as well as drinking waters were high in Li content and we were all limp as noodles (much more so than other spas I've stayed at) and joking about it.
I certainly don't know all the physiology of the drug, but I do know that it allows the calcium ion pump in cell membranes to work better, allowing better transmission of nerve impulses. It allows better uptake of GABA, an inhibitory, or relaxing neurotransmitter. GABA is what benzos are trying to affect, so lithium and a traditional 'nerve pill' are working with the same stuff, only going about it differently. BTW, other mood stabilizers have similar effects in that they increase the cellular response to GABA. I and others have a similar response to Neurontin (gabapentin) which is yet another mood stabilizer I'm taking for fibromyalgia pain. The thing is, taking a benzo generally delivers more of a chill effect in a quicker time and is the more traditional method for use as a tranquilizer. Also, not everyone has the 'nerve pill' response to lithium and other stabilizers. Some people absolutely hate Lithium - just depends on one's chemistry.
Lithium also has beneficial effects on the brain even in the absence of bipolar. It's recently been in scientific and anti-aging journals as increasing the 'plasticity' of the brain, meaning that new neurons are formed and new dendritic connections are seemingly made allowing for new growth of information and adaptability. Antiaging proponents with NO mood disorders are taking small amounts because of it's reported brain health attributes (alzheimer prevention, memory retention, etc.) There's even a Lithium product sold over the counter as a health food supplement called 'Serenity'-something or other.
I can only answer as much as I'm able with meds I've taken. I can't help much with drugs I'm not experienced with. Do as much online research on these questions of yours as you can. It will definitely empower you during your visits to the doctor. It helps to come with a list. Also, insist on answers from them even if they're trying to rush you. - Barbara
> BarbaraCat wrote "Some people also just don't like the way it feels, or it works for a while and then the good ol' poop out."
>
> >>>>>>>......just don't like the way it feels? Specifically, what do you mean..what way do these people say it makes them feel?
> As for the good ol' "feces out" comment, are you saying that it may lose it's anti-dep. effect? I wouldn't think that it would lose it's "mood stabilizer" effect? Finally, you seem so similar to me in many ways (your specific problems and symptoms), that's why I'm asking you so many questions. Still, the one thing that puzzles me is that I seem to need the lithium or lamictal to be more of a "nerve pill" than an anti-manic agent; in which case, why would I have bipolar/ mania part if I need more of a "nerve pill" type of effect and nothing for "mania"? This stuff gets to f***ing complicated, lol!!!Plus, I've got a dr. appt. on Monday (with a regular "family doctor; I detest shrinks and mental health dr's). BarbCat, I also jotted down yesterday from a site that Lamictal had "relatively benign side-effects" and "significantly more antidep. potency than Lithium" as well. That's why I'm seriously thinking of making the switch, perhaps like you are. Again, please, what specifically are others on Lamictal saying about "not liking the way it feels"? (<is it nervousness/anxiety?) THANK YOU SOO MUCH!!!!!!!!!!!
Posted by BarbaraCat on July 20, 2002, at 15:10:08
In reply to Re: BarbaraCat, posted by McPac on July 20, 2002, at 9:18:13
Mike,
Hypomania to me starts feeling like I have an enormous amount of energy. My brain starts firing more quickly. I can think better and faster and I start to have all kinds of ideas about things. I'm a creative person anyway and have alot of interests (except when I'm in the pits of depression) so this part of the cycle can remain just as it is when I'm feeling inspired. When hypomania kicks in, (not always, but usually when I'm under extra stress it seems) I'll start projects and don't finish them because I'm so easily distracted. I'll start spending money like crazy for arts/crafts tools, or music books, or dance videos. It's like I get an idea in my head and become obsessed with it. The problem is that so many ideas start crowding each other out and all my projects start becoming unfinished piles of stuff all over. My husband becomes very annoyed. I begin to not need sleep and am on a buzzy high. There's a driven quality to it, a compulsiveness, and at the beginning stage it feels so alive and energizing that I don't want to pay heed to the signs. Bipolar I usually just continues from here, careening off into genuine psychoses. Bipolar II's usually hit a wall at this stage and the trajectory begins to fall back to Earth.The lack of sleep usually is what starts the downward spiral for me. There's not much I can do about sleep anyway during a 'high'. I've taken dangerous amounts of sleepers, benzos, and they don't touch it. Even if I do sleep, it's not restful and I begin to feel burnt and frayed. Things start to get a very out of control feeling and overwhelming at this point. My thoughts continue spiraling but they're not fun anymore. Things begin to seem ominous and fearful and I'm totally exhausted after a week or so of frenzied living so I can't defend against these bleak thoughts and worries. I recently ran out of lithium for over a week and sure enough, I started buying whole palletts of plants for the garden, digging up mounds of dirt here and there, not sleeping. Luckily the lithium arrived and I was able to head it off at the pass and prevent a full blown hypomanic/depressive episode.
I have what's known as 'mixed states'. This means that my manic agitation overlays the depression. Most bipolars experience depression as an emptiness, a slowing down heavy dullness with little emotion, just empty. Mine is very different from this, it becomes very terrifying and awful and my frantic frenzy now is living in Edvard Munch's 'The Scream' painting. It's what put me in the hospital.
I had questions about, well, is this really ADD since I get so distracted and overwhelmed? Is it OCD since I get so compulsive and driven? Is it schizophrenia since I become immersed in bizarre frightening alternate realities? It's sure not standard major depression, which is what I've always called it before, because of the 'wired' quality and the fact of the extreme highs and lows. What I finally got confirmed, mainly through this board, is that bipolar MAY have elements of all these disorders, but the fact that it's cyclical as well as the extreme highs inevitably follow with extreme lows is what differentiates it as 'bipolar'. All of these disorders have got elements of all in them which makes it so difficult to target. I also want to say that this crazy state of affairs is not the norm for me at all. I have had long stretches of 'normalcy'. It has seemed, however, that the episodes and cycling were occurring more and more frequently as I got older.
I have not taken the mood disorders test I referred to, but it was discussed in a few posts here on this board a few months ago. You'll have to do a search for them. If you don't have a pdoc then hopefully your regular doc is knowledgable about all these many and confusing facets of mood disorders. It's an amazingly convoluted and fascinating detective story we're all part of. - Barbara
Bi> Barbara wrote "Hypomania may start out that way but quickly gets more and more urgent or ecstatic and reckless and wired and then spins off into disorganization and frantic behavior and then inevitably ends up in a crash."
>
> >>>>>>>>>more and more urgent? ecstatic and reckless..spins off into disorg. and frantic behavior...ends in a "crash"?
> Could you be more specific? The "urgent" and "frantic" and "disorg." terms sure sound like feelings that I've gotten many times before. I just want to see exactly how you mean them.
> ALSO, you wrote "If the Bipolar doesn't sit well with you, definitely ask your pdoc for some in-depth diagnostic testing. It's available and very important if you don't think you're on the right med track." I don't see a pdoc. I hope that the vast majority of them burn alive. What is this "in depth diagnostic testing" though? That interests me. Thanks! Mike
Posted by McPac on July 20, 2002, at 15:55:28
In reply to BP 2 » McPac, posted by BarbaraCat on July 20, 2002, at 15:10:08
"It's an amazingly convoluted and fascinating detective story we're all part of."
>>>>>>>>>It's like trying to put together a 1-million piece jigsaw puzzle, in which the pieces never seem to fit just right!!!
It's so damned incredibly frustrating and tiresome that oftentimes I just say "F*** IT!!!)
You are so good to correspond with. You are very intelligent and insightful. I have a dr's appt. tomorrow. I think I may try to get on Lamictal to replace my lithium with (I haven't been taking it much for awhile anyway..and I need something like it. I hate the stigma of lithium. There isn't a Lamictal-stigma (yet, lol!) since it is a newer medicine and an anti-convulsant. More importantly, it is said to have stronger anti-dep. properties, which is good. Take care!
Posted by BarbaraCat on July 20, 2002, at 16:58:31
In reply to BarbaraCat, posted by McPac on July 20, 2002, at 15:55:28
Good luck, Mike and let us know the outcome of your visit. About the lithium stigma, I say "F*** THEM!!!. Besides, they're probably on it too, or should be! Take care and talk to you soon. - BCat
> "It's an amazingly convoluted and fascinating detective story we're all part of."
>
> >>>>>>>>>It's like trying to put together a 1-million piece jigsaw puzzle, in which the pieces never seem to fit just right!!!
> It's so damned incredibly frustrating and tiresome that oftentimes I just say "F*** IT!!!)
> You are so good to correspond with. You are very intelligent and insightful. I have a dr's appt. tomorrow. I think I may try to get on Lamictal to replace my lithium with (I haven't been taking it much for awhile anyway..and I need something like it. I hate the stigma of lithium. There isn't a Lamictal-stigma (yet, lol!) since it is a newer medicine and an anti-convulsant. More importantly, it is said to have stronger anti-dep. properties, which is good. Take care!
Posted by Shawn. T. on July 20, 2002, at 22:34:19
In reply to Re: BarbaraCat, posted by Jill on July 19, 2002, at 8:02:21
Switching to Celexa to avoid AD effects is a bad idea. Celexa would be much worse than Remeron. Really the best thing for you to do would be to try going off the antidepressants completely for a while. Taking a DHEA supplement would be a really good idea in my opinion (it will help with depression and help your baby). Read the GNC page; they provide a massive number of references, so I would trust their information. I would not trust
anything like Celexa.Check out
http://www.gnc.com/health_notes/Concern/Pregnancy.htmhttp://www4.infotrieve.com/search/databases/detailsNew.asp?artID=26649563
Remeron is a NaSSA by the way; it is a noradrenaline and selective serotonin antidepressant.> I've taken Remeron now for 5 years with no "poop-out." My pdoc told me that Remeron actually is less likely to poop-out than SSRIs. It's not an SSRI, but rather a novel antidepressant in a different class (sorry, name escapes me...tetracyclic?).
>
> Anyway, I don't have bipolar depression, so that may be why my body's reacted differently to it (I have mild-moderate OCD and major depression.)
>
> I feel great on this drug, but my partner and I are discussing marriage/children, so I may have to switch to a more well-know drug during the pregnancy (need to stay on something or get so depressed I can't function). I'm thinking of Celexa??? Any thoughts on that, anyone?
>
> Good luck with the Remeron. I just wanted to put my plug in for it.
>
> Jill :)
Posted by BarbaraCat on July 20, 2002, at 23:59:13
In reply to Re: BarbaraCat » Jill, posted by Shawn. T. on July 20, 2002, at 22:34:19
Hi Shawn,
You consistently provide helpful and illuminating information, so thanks. Thought you'd be interested in the fact that I was tested 2 years ago by a naturopath (a salivary test spread out over 24 hours) for DHEA. It was found to be practically non-existent. My cortisol was also tested and found to be within normal range, which surprised me since I was in extreme stress at that time. I was 49 and in menopause so low DHEA wasn't a surprise, but it was barely registering on the chart. I've been on 25mg. DHEA pills, which is considered high for women in some schools of thought. I also take licorice root elixer to support the adrenals and catalyze the DHEA.I can't say that I feel a huge difference from taking DHEA and plan on getting tested again to see if my levels are up. I'm on estrogen and progesterone natural hormone replacement, but recently got tested for free testosterone, which was on the low side. Since DHEA is a precursor to the sex hormones one would think that taking enough DHEA would positively affect the serum level of those hormones - especially testosterone. Masculinzation in women is one of the purported bad side effects of even a tad bit too much DHEA, so that in itself suggests I need to tweak it upwards. You know, sometimes I wonder whether these nutritional potions we take (a) have any active ingredient in them, (b) get adequately digested and assimilated or are simply pooped out. Heck, I'd even put up with daily shots if I knew I was getting the real deal.
I also have fibromyalgia and was told that low DHEA was a contributing factor. I never saw any studies on it and wonder if you've come across anything like that? - BarbaraCat
Posted by Shawn. T. on July 21, 2002, at 19:29:07
In reply to DHEA » Shawn. T., posted by BarbaraCat on July 20, 2002, at 23:59:13
Yes, DHEA levels are definitely lower in fibromyalgia. The difference between a serious deficiency in DHEA and an excellent level of DHEA for women is a factor of 4 or 5. I really think 50mg/day would be better; I couldn't say for sure though. I don't have any evidence to say 75mg/day would be advisable, so I won't tell you to take that much. I have got to remember to adjust my DHEA recommendations for women; it really does vary a lot from person to person in general though. 25mg/day is probably high for women with normal DHEA levels in those schools of thought. I bet they're not considering someone with your levels of DHEA. I guess you could have your blood levels checked after taking various dosages to find what you need to maintain homeostasis. Fibro+menopause+lots of stress would definitely result in very very low levels of DHEA. I've been waiting to learn more about fibromyalgia until my sister gives in and starts listening to me instead of her doctor. I'll try to see if I can type up some sort of explanation for you to check out sometime in the coming week. It's a lot more complicated than depression, so I'll have to do more reading. I'm pretty sure that Remeron + DHEA + fish oils + a multivitamin would help you out. I usually recommend Remeron for other reasons, but this time, I am thinking of its 5-HT3 antagonist properties. I really need to figure out how
5-HT3 receptors relate to the HPA axis.
I hope you know about the low blood sugar connection to fibromyalgia.http://nootropics.com/5-ht3/index.html
http://www.gnc.com/health_notes/Concern/Fibromyalgia.htm
http://www4.infotrieve.com/search/databases/detailsNew.asp?artID=9955864
Posted by BarbaraCat on July 21, 2002, at 21:10:39
In reply to Re: DHEA » BarbaraCat, posted by Shawn. T. on July 21, 2002, at 19:29:07
Thanks for all the info, Shawn. I'll be spending some enjoyable perusal time with it. I wish I could reciprocate by sending you a great link I found on multiple DHEA studies, but I can't locate it. There were a number of papers that dealt primarily on the difficulty of DHEA's bioavailability when injested. Apparently it doesn't survive the second pass through the liver very well. Alternate delivery methods were discussed including transdermal and injection, with injection coming out on top. This fuels my initial suspicions that DHEA is a great substance but only if assimilated properly. With fibromyalgia I also have digestion problems (I'm taking every known nutrional aid I know of to deal with it), so bioavailability is further compromised.
I am taking Remeron, funny you should mention it. It's been the best AD I've taken but very imperfect. The weight gain issue is a real bummer and I have to exercise this poor hurting body like crazy just to stay on an even keel. I'm trying to get off it and attempt to manage my bipolar-II mixed states brain with lithium and eventually adding lamictal, but this was before your post. If Remeron helps fibro then I don't want to court getting any worse by removing it.
No, I didn't know about the low blood sugar relation to fibro. I don't believe I am, however, but don't trust any standard blood test to tell me so. I'll do some research on it and see if I fit the profile.
Do you know about the hypothyroid connection? Dr. John Lowe, DC, is convinced that either undertreated hypothyroidism or celluar resistance to thyroid hormone is rampant and is THE cause of fibro. I've read his massive tome on the subject "The Metabolic Treatment of Fibromyalgia" and it is very convincing - especially since I'm hypothyroid. He talks in depth about the need for T3 along with T4, and sometimes T3 alone. I take Armour thyroid and just recently doubled the amount, now up to 3 grains. Alot of my pains have dimished and I'm feeling no hyper symptoms at all. The fascinating thing about how all this ties in is DHEA's role in thyroid function!! DHEA seems to be implicated in every metabolic and reproductive process. So the first thing I will be doing is getting an overal DHEA and hormone panel done by my naturopath and then monitoring my levels as I increase the dose. The next big question now is, what about pregnenalone? Preg is the precursor to DHEA, so why is it so unfamiliar? Other than the nootropic literature, I haven't seen any major studies on it such as with DHEA. I'm sure there are yet more precursors to pregnenalone, but the path seems to stop there for right now. It seems to me that precursors are the key to regulating our neuro and biochemistry.
What do you do, BTW? Do you have a practice in nutrition or alternative medicine? Good chatting with you. - Barbara
Posted by McPac on July 22, 2002, at 18:10:35
In reply to DHEA, et al » Shawn. T., posted by BarbaraCat on July 21, 2002, at 21:10:39
BarbaraCat
Well, I'm back from my General Practitioner's office (I hate shrinks, lol) and I JUST began Lamictal!
Hopefully, all will go good.
The plan is: Goodbye Lithium, hello Lamictal!
I am only going to take a very small dose; I have always been very sensitive to most meds.
I took such an incredibly puny dose of Lithium. One pill every 2 or 3 DAYS! I still don't know if I've truly got bipolar or just terrible depression w/ agitation,irritability, anxiety. It just seems like so many bipolars go to such extremes, high and low, and I seem more like a low w/agitation issues. There doesn't seem like a very big difference between what I have and a "clinically depressed" person has. They probably have anxiety, agitation and irritability too; so what's the difference? Sounds like a "play on words" to me, in my case.
Posted by Shawn. T. on July 23, 2002, at 20:59:00
In reply to DHEA, et al » Shawn. T., posted by BarbaraCat on July 21, 2002, at 21:10:39
Thanks for the tips. My sister has give me the go ahead for telling her exactly what medicines to take, so I am going to do a lot more research on this subject than I already have. I'll post something when I'm done reading. Most of my day is spent sitting around and reading about neuropsychopharmacology and biochemistry (I force myself to spend time with friends as well because of what I know about stress). I had a job lined up, but I skipped out on it because it would have bored me silly. I was intent on being a computer scientist, but I eventually got extremely sick of programming (too much stress). I really should get a job, but I think I can turn my knowledge of neuroscience into some sort of money making venture at some point. There really aren't any real opportunities where I am living right now, so I would rather spend some time learning than working. I should note that I have taken college courses in chemistry and other sciences, so I have some background to help me out. I've also been interested in pharmacology, philosophy, sociology, biology, and some psychology for a while.
Shawn
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