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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by bee on October 19, 2000, at 11:40:35
Is there such a thing as mild manic-depressive? I have been on medication for 9-10 years for depression. Currently (and mostly) elavil. I have had no luck with the SSRIs; made me to agitated, insomnia, aggressiveness. Have also tried augmenting my elavil with another tricyclic in the hopes of lowering my dose of elavil to get away from the cravings and weight gain. When augmenting, especially with ludiomil, I felt really funny. Tingling/buzzing at the base of my neck on left side and felt like I was going to convulse or have a seizure. So, now, I'm back on elavil.
I have been asked before if I have ever had the highs and lows of mania. I said no but I'm starting to wonder if I have. My husband, one day recently, mentioned that maybe I am manic. He's noticed that I get pretty low, not suicidal, but nothing pleases me and everything is awful, no motivation, look at the bad side of everything. Then the next day or so, I want to redo the kitchen floor or get new countertops, etc... I seem to flip back and forth between these emotions.
How do you know if you are manic-depressive? Do you try the MAOIs and see if they work? Is there a good one of this class for insomnia and no weight gain? I can't take any of the stimulating types of drugs. Any thoughts?
bee
Posted by Ted on October 19, 2000, at 14:27:46
In reply to Mild manic-depressive?, posted by bee on October 19, 2000, at 11:40:35
> Is there such a thing as mild manic-depressive?
Sure is. It is called "Bipolar-II Disorder" and it is fairly common. Bipolar disorder has no firm boundaries for positive diagnosis. There is a continual range of symptoms from "normal" to "severe". The way you sound doesn't indicate any real problem to me. The one thing to really be careful of is doing reckless, dangerous, or destructive things while (hypo-)manic, including overspending money, sexual indiscretions, reckless driving, etc. Often the individual does not even recognise the problem. Trust your husband to help identify your moodswings. I was oblivious until I went completely out of control and my wife took me to the hospital. Saved my life AND marriage.
Good luck
Ted
Posted by noa on October 19, 2000, at 15:11:17
In reply to Mild manic-depressive?, posted by bee on October 19, 2000, at 11:40:35
As Ted said, there are mild forms of BP disorder, and some people have hypomanias triggered by antideppressants. If the fluctuations in moods is a problem, then a mood stabilizer might be something to consider. In any event, sometimes mood stabilizers have good antidepressant effects anyway.
Ted's point about the effects of the relative highs is a good one. Are they leading to lapses in judgment or self-defeating actions?
Also, I have found, for myself, that it is hard to tell if the relative highs are hypomanias or just a sort of exhiliration at getting one's head above water, ie, a relief from chronic depressed feelings. I have felt at times a certain pressure to make up for lost time and others here have said similar things.
Perhaps keeping a mood journal will help. For some women, the fluctuations are related to hormonal fluctuations. Plus, there might be other factors that are affecting the variation, and keeping a journal might help you detect any patterns.
Posted by laural on October 19, 2000, at 16:15:27
In reply to Re: Mild manic-depressive?, posted by noa on October 19, 2000, at 15:11:17
hi--
i agree mostly with the above 2 people--i'm bipolar myself--just one thing though. if you think these highs are not really you be careful because as the brain deteriorates from lack of medicine (depakote, lithium, etc) your symptoms will probably get worse if you are bipolar, to the point where you may resist meds because they take away your euphoria or do begin to lose judgement or at worse case (and i think this is long time untreated) you fail to respond to medicine anymore. the earlier you get treated the better, laural
Posted by coral on October 19, 2000, at 17:53:37
In reply to Mild manic-depressive?, posted by bee on October 19, 2000, at 11:40:35
Talk about timing. I, too, thought that I might've developed manic-depression. I'm on the healing side of my second depressive episode (depression free for five years), and one day would be great, plenty of energy, positive outlook, the next day, I'd be a lump curled up on the couch. I finally began stringing more positive than negative days together but the ups and downs felt just like a rollercoaster, or that there were two of me; on the positive days, I couldn't imagine what had caused me to be so down before, and on the bad days, I couldn't believe that the woman who had been productive, accomplishing a great deal and smiling the day before was actually me. During my first depressive episode, I healed in little, tiny baby steps. This one is like a tennis match. I researched the bi-polar websites and found that I didn't match the criteria. I also checked it out with my psychologist who assured me that I was not bi-polar, and since this depression wasn't nearly as severe as the first, that my pattern of healing was "normal" or, at least, understandable.
My therapist also suggested that since I'm so angry about getting depressed again that I might be pushing myself too hard on the days when I'm feeling great and simply wearing myself out which leads to the dark days.
Funny, too, about meds. I can't take Elavil because it enrages me, and the other tri's don't work at all, but Zoloft works wonderfully.
For me, my fears were unfounded, but I think you do need to check it out thoroughly. Good luck!
Posted by Cindy W on October 19, 2000, at 21:41:39
In reply to Re: Mild manic-depressive?, posted by coral on October 19, 2000, at 17:53:37
> Talk about timing. I, too, thought that I might've developed manic-depression. I'm on the healing side of my second depressive episode (depression free for five years), and one day would be great, plenty of energy, positive outlook, the next day, I'd be a lump curled up on the couch. I finally began stringing more positive than negative days together but the ups and downs felt just like a rollercoaster, or that there were two of me; on the positive days, I couldn't imagine what had caused me to be so down before, and on the bad days, I couldn't believe that the woman who had been productive, accomplishing a great deal and smiling the day before was actually me. During my first depressive episode, I healed in little, tiny baby steps. This one is like a tennis match. I researched the bi-polar websites and found that I didn't match the criteria. I also checked it out with my psychologist who assured me that I was not bi-polar, and since this depression wasn't nearly as severe as the first, that my pattern of healing was "normal" or, at least, understandable.
>
> My therapist also suggested that since I'm so angry about getting depressed again that I might be pushing myself too hard on the days when I'm feeling great and simply wearing myself out which leads to the dark days.
>
> Funny, too, about meds. I can't take Elavil because it enrages me, and the other tri's don't work at all, but Zoloft works wonderfully.
>
> For me, my fears were unfounded, but I think you do need to check it out thoroughly. Good luck!
Bee, Ted, Noa, Laural, and Coral, I could relate to what each of you wrote. I'm starting to wonder if my overspending during visits to thrift stores and used bookstores is hypomania. Like you, I have depressive slumps; then I start overspending, driving too fast, overextending myself (doing more in a day than I can really comfortably do), and talk rapidly, according to people who've recently given me feedback about this. Will talk to my pdoc about this next Monday. What meds have you found effective as mood-stabilizers for hypomania? I love the exhilaration, but can't keep spending more than I make each month (my house is full of stuff already, to the point I could use a storage locker so I can walk through the house again!). Thanks!
Posted by laural on October 20, 2000, at 8:01:56
In reply to Re: Mild manic-depressive?, posted by Cindy W on October 19, 2000, at 21:41:39
> Bee, Ted, Noa, Laural, and Coral, I could relate to what each of you wrote. I'm starting to wonder if my overspending during visits to thrift stores and used bookstores is hypomania. Like you, I have depressive slumps; then I start overspending, driving too fast, overextending myself (doing more in a day than I can really comfortably do), and talk rapidly, according to people who've recently given me feedback about this. Will talk to my pdoc about this next Monday. What meds have you found effective as mood-stabilizers for hypomania? I love the exhilaration, but can't keep spending more than I make each month (my house is full of stuff already, to the point I could use a storage locker so I can walk through the house again!). Thanks!hi--
it sounds like you ARE hypomanic. i used to drive so stupidly when i was younger and thought everyone who yelled at me to slow down were weak, i would laugh at them, not realizing that i was risking their lives as well as my own and other cars--but that of course isn't all, the fast talking, spending, hyperactivity to the point of desperation sounds classic--do you get enough sleep and does your judgement lessen at this time, you may not realize the latter but a lot of times you're not acting as rationally as you may think. a word of advice, try really hard not to make decisions when you feel this way : ) as for meds, i think they would probably give you depakote first, though i really don't know but i thought that dep. was the most popular mood stabilizer until i came to this site. but my bipolar sounds like yours only i have additional psychosese (sp?) granted i don't want to diagnose you--but with dep. you should not even bother with the generic form (valproic acid) it hurts your tummy like crazy Since i've never tried anything else, i don't have anything else to say (other than) i've been "stable" mania-wise for about 2 years now other than the manic episode i had about a month or two ago. i don't know why i had this episode, stress?, so i'll let you know. once on dep. (if) getting it out of your system takes only a week or less, i think, because i notice things right away. also, it might make you sleepy and i think if youre taking ADs you might have to up them to be as effective. laural
Posted by Cindy W on October 20, 2000, at 9:37:12
In reply to Re: Mild manic-depressive? to Cindy W, posted by laural on October 20, 2000, at 8:01:56
>
> > Bee, Ted, Noa, Laural, and Coral, I could relate to what each of you wrote. I'm starting to wonder if my overspending during visits to thrift stores and used bookstores is hypomania. Like you, I have depressive slumps; then I start overspending, driving too fast, overextending myself (doing more in a day than I can really comfortably do), and talk rapidly, according to people who've recently given me feedback about this. Will talk to my pdoc about this next Monday. What meds have you found effective as mood-stabilizers for hypomania? I love the exhilaration, but can't keep spending more than I make each month (my house is full of stuff already, to the point I could use a storage locker so I can walk through the house again!). Thanks!
>
> hi--
>
> it sounds like you ARE hypomanic. i used to drive so stupidly when i was younger and thought everyone who yelled at me to slow down were weak, i would laugh at them, not realizing that i was risking their lives as well as my own and other cars--but that of course isn't all, the fast talking, spending, hyperactivity to the point of desperation sounds classic--do you get enough sleep and does your judgement lessen at this time, you may not realize the latter but a lot of times you're not acting as rationally as you may think. a word of advice, try really hard not to make decisions when you feel this way : ) as for meds, i think they would probably give you depakote first, though i really don't know but i thought that dep. was the most popular mood stabilizer until i came to this site. but my bipolar sounds like yours only i have additional psychosese (sp?) granted i don't want to diagnose you--but with dep. you should not even bother with the generic form (valproic acid) it hurts your tummy like crazy Since i've never tried anything else, i don't have anything else to say (other than) i've been "stable" mania-wise for about 2 years now other than the manic episode i had about a month or two ago. i don't know why i had this episode, stress?, so i'll let you know. once on dep. (if) getting it out of your system takes only a week or less, i think, because i notice things right away. also, it might make you sleepy and i think if youre taking ADs you might have to up them to be as effective. lauralLaural, I'm glad to hear things are going well for you now. Will talk to my pdoc about mood stabilizers on Monday.--Cindy W
Posted by Ted on October 20, 2000, at 14:38:58
In reply to Re: Mild manic-depressive? to Cindy W, posted by Cindy W on October 20, 2000, at 9:37:12
Cindy,
I agree with Laural -- you *definitely* sound at least mildly hypomanic if not pushing typical mania itself. Not to be afraid: It is treatable in most people. Like Laural, I also take depakote (500 mg bid) to keep the hypomanias under control and zoloft+wellbutrin to handle the depressions. FINALLY I am feeling pretty good. If you read Laural's intro in the Psycho-Social Babble group, you can tell she speaks from lots of experience.
Not to scare you or anything, but some things to keep in mind about depakote: It will make you very sleepy and lethargic at first. It *will* go away, so grin and bear it. :-) Also, it is hepatotoxic (toxic to the liver) and there are *LOTS* of drug interactions, many serious. If you have to take this, I highly recommend that you go to Abbott Labs' website and read about it (www.abbott.com then search for depakote) or look it up in the PDR. Lastly, because of the liver toxicity, you will have to get blood tests done regularly to both make sure your liver is doing OK and to make sure the valproate level is correct. My pdoc had me get blood tests every 3-4 weeks for several months, then every 8-10 weeks; now I have them done only every 3-4 months. AVOID alcohol when on this stuff. Good luck.
Take care of yourself; you sound like my twin with your symptoms. Let us know what happens after your monday appt.
Ted
Posted by Cindy W on October 20, 2000, at 22:19:29
In reply to Re: Mild manic-depressive? to Cindy W, posted by Ted on October 20, 2000, at 14:38:58
> Cindy,
>
> I agree with Laural -- you *definitely* sound at least mildly hypomanic if not pushing typical mania itself. Not to be afraid: It is treatable in most people. Like Laural, I also take depakote (500 mg bid) to keep the hypomanias under control and zoloft+wellbutrin to handle the depressions. FINALLY I am feeling pretty good. If you read Laural's intro in the Psycho-Social Babble group, you can tell she speaks from lots of experience.
>
> Not to scare you or anything, but some things to keep in mind about depakote: It will make you very sleepy and lethargic at first. It *will* go away, so grin and bear it. :-) Also, it is hepatotoxic (toxic to the liver) and there are *LOTS* of drug interactions, many serious. If you have to take this, I highly recommend that you go to Abbott Labs' website and read about it (www.abbott.com then search for depakote) or look it up in the PDR. Lastly, because of the liver toxicity, you will have to get blood tests done regularly to both make sure your liver is doing OK and to make sure the valproate level is correct. My pdoc had me get blood tests every 3-4 weeks for several months, then every 8-10 weeks; now I have them done only every 3-4 months. AVOID alcohol when on this stuff. Good luck.
>
> Take care of yourself; you sound like my twin with your symptoms. Let us know what happens after your monday appt.
>
> TedTed, thank you for your post! Will talk about options Monday with my pdoc. Am not sure he'll think I'm hypomanic (but my friends, who include a psychologist and social worker, have suggested they see me as hypomanic lately. And I've been overspending like crazy and feel unusually good.--Cindy W
Posted by bee on October 20, 2000, at 22:56:30
In reply to Re: Mild manic-depressive? to Cindy W, posted by Cindy W on October 20, 2000, at 22:19:29
Wow, interesting reading! I went to my family doc. on Thurs. and she did not feel comfortable about me trying anything new until I meet with a psych. doc. She said to up my elavil dose as I am starting the fall downfall. So I've upped my dose by 10 (as you can tell, I hate to take higher doses cuz the weight comes on after this!).
I will be going to a psych. doc. on Monday. At least I will be going in knowing quite a bit about what drugs work for me. I have not tried the MAOIs as a washout period is needed and this is the wrong time of year for me to try this. Years ago, this pdoc had suggested maybe augmenting elavil with lithium but back then, I did not think I was manic. I have a cousin and great aunt who are manic but I did not think I fit into their category. Know I'm not sure.
At least I have this board to get info and feedback now. Thanks everyone for your replies.
bee
Posted by Tori on October 21, 2000, at 9:25:26
In reply to Mild manic-depressive?, posted by bee on October 19, 2000, at 11:40:35
I have been depressed/had major depressive episodes since I was 18 years old (I clearly remembering waking up one morning and feeling exhausted and having a dreaded feeling about the future -- just out of the blue!!!).
I'm 26 now and after being hospitalized in March for a suicide attempt the psych dx me with bipolar aff disorder (have no idea what type it is).
What I was doing was:
hating the world
driving aggressively
extremely, extremely agitated, irrritable, annoyed
if not above, then extremely depressed, suicidal
lethargic, atypical, treatment resistantAfter he put me on lamctal 300 mg a day the aggressive driving and irritability, etc. lowered or almost stopped (I still get pissed off ... see now, the difference is BEFORE if somebody cut me off I would chase them down the road, then DWELL on it for the rest of the day; now I get annoyed, give them the finger, then go on my merry way, not taking it with me for the rest of the day).
I'm also on parnate 40 mg a day for about five weeks now and on the fourth day the extreme suicidal thoughts/ideations (spelling?) disappeared.
I never really know if I am bipolar, even thoughI have been dx with it. All I know is that when I went through withdrawal to start the parnate (washout period) I went COMPLETELY MANIC, crying one moment, irritable the next, giddy, then wanting sex (boyfriend wasn't complaining,LOL), made a huge purchase on sears.ca one night of about 1000.00 (returned most of it - does that classify as being manic???).
I guess I'm confused. I also want to get my thyroid re-checked and show my GP the articles that have been posted here. I still suffer from lethargy, gained FIFTEEN POUNDS in the two weeks I was going through withdrawal and the weight is not coming off; I am too tired to exercise, I am not hungry during the day......?????? I just don't feel like I am being treated effectively.
:-) Tori
Posted by Noa on October 21, 2000, at 13:49:11
In reply to Re: Mild manic-depressive? (me?) » bee, posted by Tori on October 21, 2000, at 9:25:26
good luck with the thyroid tests. Keep us posted on the results.
"leave no stone unturned"
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