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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Fionamck on June 25, 2005, at 11:31:51
Can anyone shed any light, please?
I've just been diagnosed by one psychiatrist with bipolar 2 and, when I got a second opinion, I was diagnosed with borderline personality disorder. My therapist doesn't think it's bipolar 2, but the first psych is quite insistent that it is.
I've read all I can find on bipolar 2 and borderline and now I am really confused. I was diagnosed with 'clinical depression' 9 years ago and have been having depressive episodes roughly every 1.5 to 2 years since. I have taken paroxetine, sertraline, zoloft over the years and have now been on lexapro for about a year and a half. I began cutting myself about a year and a half ago (although I had done it occasionally in the past) and began keeping a mood diary five months ago as I noticed mood swings.
Now, the mood never really goes above 'optimistic' (and we're talking 'yes, I believe I can enjoy life' rather than 'yes, I believe I can fly'-type optimism), but the swings are quite sharp: up and down to almost bottom (but not as low as before the lexapro) within a couple of days and back, sometimes within a day.
I don't seem to get the increased energy (there are times when I am more focussed and on the ball, and I have a reputation for getting lots of work done at work, but this seems normal to me). At no time do I really feel buzzing or need less sleep. Most of the time I feel drained and find it very, very hard to get up in the morning or do anything that I don't have to do. Now and again I have days/parts of days when I feel as if I am underwater, distant, and cannot focus on anything, and times when I fidget and feel as if I have ants running round in my head - in the sense that I can't concentrate and I almost have to shake the fizziness out of my head (sorry, I can't think of a word for it).
I have the deep fear of abandonment associated with borderline, yet I often have a deep need to be alone and quiet and so am not 'clingy', together with the flashes of very intense irritation and anger (although I control this reasonably well) and lack of willpower over spending (but we're not talking real debt here) and eating. But I don't seem to have the unstable and erratic relationships.
Basically, I really don't know which I am and I cannot afford to go for a third opinion (perhaps I would get a completely new diagnosis if I did, just to keep me entertained...); this whole thing is costing me a fortune. The bipolar psych said that my not responding well to the lexapro (or indeed the other antidepressants in the past) suggests that it is not unipolar depression. Plausible, I suppose.
Both psychs recommended Epilim - controlled release -(I believe this is called Depakote in the States?)and the bipolar psych is quite firm that I need to take it. It's only 200mg and he says it will stay low, but I really, really don't want to take another drug. The weight gain side effect I have read about is a real issue for me (very closely linked to my mood), as is the sleepiness (I need to be wide awake at work)and the worry that the drug will be increased and then increased and then increased...
This is a long, long post and I apologise, but I am drained from doing research on this and feel I am getting nowhere, and I wondered if any of this rings any bells for anyone/anyone has had a similar experience and/or taken Epilim at all.
Please get in touch if any of this makes any sense to you!
Posted by bbug on June 25, 2005, at 20:35:45
In reply to Bipolar 2?, posted by Fionamck on June 24, 2005, at 10:11:47
Hi. Sounds tough. You are trying so hard to understand what is going on with you... ouch.
I am wondering if your question is whether you have bipolar or not... or whether you should take the meds?
And you say that you don't have enough money to see another doctor...
So to me it sounds like if you want to feel better you take the meds... both doctors suggest regardless of which is right for diagnosis... Is it probably one or the other? And the treatment is the same?
Have you talked with your doctor about your weight issue? Maybe you could give the med a try... and agree to reconsider if you gain some set amount (say 10lbs? I don't know)...That way you will have given the doctor a heads up about what weight "risk" you can handle... and STILL have a chance to be feeling better...
Not everyone has all side effects... maybe give it a chance.
I don't have personal experience with this med... so maybe take what I have to say with a grain of salt.
At any rate, good luck. It sounds like you are feeling pretty bad... I hope that you improve...
bbug
Posted by stresser on June 25, 2005, at 21:30:17
In reply to Re: Bipolar 2?, posted by bbug on June 25, 2005, at 20:35:45
I read the post, and I and my daughter are Bipolar II.(genetic) She has a bit of Borderline, and I can relate to EVERYTHING you are posting. At one time, I have felt what you are feeling, and she has too. It's draining, and I know that you feel as if you don't know what's wrong with you. I am to the point that it really doesn't matter, just as long as I have the correct medication to be happy and get my life back! Finding out what meds work, are by trial and error. My daughter tried many different medications, and has found four that work for her. I found a combination that works for me, right away! Try to be calm, and start with a mood stabilizer. I take Topomax, and my daughter takes Trileptal and Topomax. We both take an anti-depressant (Zoloft/me & Wellbutrin/her)
I don't remember what meds you said you are taking. Let me know how you are doing, and just remember that it takes time. It gets better. -L
Posted by Fionamck on June 25, 2005, at 23:53:43
In reply to Re: Bipolar 2?, posted by stresser on June 25, 2005, at 21:30:17
> I read the post, and I and my daughter are Bipolar II.(genetic) She has a bit of Borderline, and I can relate to EVERYTHING you are posting. At one time, I have felt what you are feeling, and she has too. It's draining, and I know that you feel as if you don't know what's wrong with you. I am to the point that it really doesn't matter, just as long as I have the correct medication to be happy and get my life back! Finding out what meds work, are by trial and error. My daughter tried many different medications, and has found four that work for her. I found a combination that works for me, right away! Try to be calm, and start with a mood stabilizer. I take Topomax, and my daughter takes Trileptal and Topomax. We both take an anti-depressant (Zoloft/me & Wellbutrin/her)
>
> I don't remember what meds you said you are taking. Let me know how you are doing, and just remember that it takes time. It gets better. -L
Thanks very much to both you and bbug for your response. I think you're right; I have to swallow my belligerence and take the medicine with a review after a month or so. I have raised the weight issue but both psychiatrists said that a mood stabiliser might actually make it easier for me to prepare sensible meals and get some exercise (at the moment I have zero energy or motivation for it). At the time, I took that as sales pitch for the medicine (need to work on losing some cynicism...), but perhaps they have a point.It's a relief to know that other people have felt the same, although it's not a good thing, obviously! Glad you and your daughter are doing okay on the meds. Perhaps I have some bipolar and some borderline. like your daughter. At the end of the day, I don't suppose it much matters what name you give it so long as you can find a way to deal with whatever it is. I've read bits about Topamax; wonder why my psych didn't suggest it. I'll look into this further. Does it cause weight gain?
I'm also trying fish oil and thinking of taking my holiday in the summer instead of using it to catch up on masters studies, as I had intended. That may do me some good, too.
Keep in touch, and thanks again.
Posted by bbug on June 26, 2005, at 20:48:52
In reply to Re: Bipolar 2?, posted by Fionamck on June 25, 2005, at 23:53:43
Fionamck,
Hang in there. I haven't a name for what my meds are for either. But I try to work with them to feel better.
One thing that I did... kinda blackmail myself to exercise? I started taking my daughter to the gym a couple of times a week. She really loves to go so that keeps me to the schedule.
And I love my gym... it has electronic machines... so the person before me may be lifting 100lbs... but sets up the machine and looks just like I do when I set up to lift 10!
No competition... just some exercise.And I walk SLOWLY on the treadmill...
But everytime I come home I am feeling better than I did when I went... everytime. It is amazing. And I guess the little bit of lifting weights is helping me to burn calories too.
Maybe you could blackmail yourself too? Silly sounding idea, I know.
BBug
Posted by Fionamck on June 26, 2005, at 22:54:18
In reply to Re: Bipolar 2?, posted by bbug on June 26, 2005, at 20:48:52
Bbug,
Thanks. It's not a silly-sounding idea at all, and I'll give it a try. What IS silly, really, is that I have an exercise bike and weights at home. The exercise bike is usually used as an extra surface for my boyfriend to dump books and papers on. When I was feeling okay, I used to work out every day in front of the television. Now it seems too much effort. What I can do, re your idea, is blackmail myself by saying that I get to watch a really good film every night, or every other night - so long as I am active while I am watching. That may work.
Glad the exercise makes you feel better.
Cheers,
FionamckFionamck,
>
> Hang in there. I haven't a name for what my meds are for either. But I try to work with them to feel better.
>
> One thing that I did... kinda blackmail myself to exercise? I started taking my daughter to the gym a couple of times a week. She really loves to go so that keeps me to the schedule.
>
> And I love my gym... it has electronic machines... so the person before me may be lifting 100lbs... but sets up the machine and looks just like I do when I set up to lift 10!
> No competition... just some exercise.
>
> And I walk SLOWLY on the treadmill...
>
> But everytime I come home I am feeling better than I did when I went... everytime. It is amazing. And I guess the little bit of lifting weights is helping me to burn calories too.
>
> Maybe you could blackmail yourself too? Silly sounding idea, I know.
>
> BBug
Posted by stresser on June 28, 2005, at 13:18:48
In reply to Re: Bipolar 2?, posted by Fionamck on June 26, 2005, at 22:54:18
Topomax does not make us gain weight. In fact; in can have the opposite effect on some people, and can make them lose weight. Some peole lose quite a bit, and really like the medication because of that reason. I think most pdocs stay away from it because it's not used as a "first choice". My daughter was dealing with a binge eating disorder, and she was put on it alone because she didn't want to gain weight. The doctore added Trileptal two months ago, and that has been weight neutral also. Some people are freightend of Topomax, but it hasn't had a negative effect on either of us. She is taking 300mg, and it has caused her hair to fall out in the shower. (that is the only issue)
Now...about working out that body! I don't think there is anything that can make you feel better about yourself than doing just that. Cardio is very important, and if you aren't doing any at all, 30 minutes per day, three or four days per week is great! Resistance training twice a week to start out would also be great, and then work up to three times per week. The more muscle you have, the faster your metabolism burns fat. You will start feeling better about yourself on the inside, as well as the outside. You will be proud of yourself! Hand in there, I know you can!-L
Posted by fionamck on June 30, 2005, at 23:45:27
In reply to Re: Bipolar 2?, posted by stresser on June 28, 2005, at 13:18:48
Stresser,
Many thanks for the info and the advice about the exercise (I WILL do it, today). I've got some good DVDs to watch while I cycle/weight train (I get bored very easily...).
My therapist said that I should not take anything that speeds up my metabolism (Topomax??), for some reason. I started taking the Epilim. So far okay; a bit sleepy.
Thanks,
Fionamck
> Topomax does not make us gain weight. In fact; in can have the opposite effect on some people, and can make them lose weight. Some peole lose quite a bit, and really like the medication because of that reason. I think most pdocs stay away from it because it's not used as a "first choice". My daughter was dealing with a binge eating disorder, and she was put on it alone because she didn't want to gain weight. The doctore added Trileptal two months ago, and that has been weight neutral also. Some people are freightend of Topomax, but it hasn't had a negative effect on either of us. She is taking 300mg, and it has caused her hair to fall out in the shower. (that is the only issue)
>
> Now...about working out that body! I don't think there is anything that can make you feel better about yourself than doing just that. Cardio is very important, and if you aren't doing any at all, 30 minutes per day, three or four days per week is great! Resistance training twice a week to start out would also be great, and then work up to three times per week. The more muscle you have, the faster your metabolism burns fat. You will start feeling better about yourself on the inside, as well as the outside. You will be proud of yourself! Hand in there, I know you can!-L
Posted by stresser on July 1, 2005, at 23:01:17
In reply to Re: Bipolar 2?, posted by fionamck on June 30, 2005, at 23:45:27
Does your doctor say that Topomax speeds up metabolism? My doctor didn't say anything about that, and that makes me a bit concerned. -L
Posted by fionamck on July 4, 2005, at 0:29:25
In reply to Re: Bipolar 2?, posted by stresser on July 1, 2005, at 23:01:17
Dear Stresser,
I have done a quick search on Google and the only thing I can find is your earlier thread on Psychobabble:
http://www.dr-bob.org/babble/20041223/
I can find no link between Topamax and increase in metabolism and so I am inclined to think that it may have been either a throwaway remark from my therapist or an assumption (if a drug makes you gain weight, they often put it down to a lowering of metabolism, and so it makes sense to assume that if it makes you lose weight, it might be due to an increased metabolism). Either way, it looks inconclusive.
I wouldn't worry about it. Speak to your psychiatrist; if you are happy on the drug, then stick with it.
Sorry to have caused you any concern, and hope your psych can put your mind at rest.
> Does your doctor say that Topomax speeds up metabolism? My doctor didn't say anything about that, and that makes me a bit concerned. -L
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