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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by rabble_rouser on November 18, 2005, at 14:13:53
Dear Dr Bob,
I have posted here before on some of the boards. I have been at various levels of depression since I can remember, way back into childhood (I'm 27 now). I have always thought I suffered from unipolar depression, and whenever anyone mentioned bipolar I was always "oh, thats not me at all". And I never looked into it.
In the last week however I have gone from the absolute depths two thursday's ago, almost suicidal, to thinking I am all-powerful and destined for greatness on Tuesday. Suddenly everything was falling into place and I could do no wrong. Today I just feel awful and like giving up. This got me thinking - there have been rare islands like this in the past. Normally, I am depressed, finding it very difficult to form and keep relationships. I am irritable, have low energy and poor concentration etc etc. I always bought what medics told me - I am depressed.
But there were things that didn't fit the standard depression equation. Excessive interest in sex, devoting hours at a time to porn (my ex girlfriend also could not cope with my endless need for sex). Saying inappropriate things (not necessarily sexual) but not understanding what was wrong. Occasional, rare moments where I became everything I've ever wanted to be - eloquent, clear, entertaining, charming and attractive. Boundless energy and desire to start up huge, world-beating projects. Sometimes I talk so fast and my brain goes so quickly people cannot follow me. But as soon as it had come it will go, and I would be back to being unable to communicate with people, social anxiety, poor communication skills but the endless need for closeness and attention. I also go through phases of spending without thought and find it enormously hard to get organised.
I also looked up the profile for bipolarity in children - most notably the separation anxiety and hypersexuality at an early age (8-10), and it described my childhood perfectly. My mother agreed with me, and I have taken online tests (which I got my mum to fill in with me in mind) and come out clearly in the bipolar spectrum.
I have been on Effexor in the past, and it again made me everything I've always wanted to be - it felt amazing, and its abou the only thing that can do that. But whilst on it I also went too far on a number of occasions - my confidence was just enormous. From what I read, this is a typical bipolar response to Effexor.
I have an appointment to see a psychiatrist soon, and I have suffered for so long I just want to finally find a way out. What do I say to him / her? Its so confusing, and I feel like I will have to fight to get any treatment - I am from the UK and NHS treatment is so hard to get unless you are literally suicidal in front of them.
Can this be treated without drugs? My company drug-test randomly and it could have devastating effects.
Thank you for reading
Ross
Posted by alexandra_k on November 18, 2005, at 19:25:16
In reply to I think I'm bipolar - what can I do?, posted by rabble_rouser on November 18, 2005, at 14:13:53
hey there.
sounds like... effexor isn't working out so well.
if i were you... i'd tell the p-doc about your suspicion of manic episodes.it might be worth trying a mood stabiliser (such as tegretol or epilim) instead of the effexor.
i wouldn't stop taking the effexor all at once though. some people have fairly nasty withdrawals off of that stuff and most people find it much nicer to taper it down slowly...
i'd imagine that you'd have to do that before starting on a mood stabiliser.
some people with depression (or low mood in conjunction with another disorder like a personality disorder or dysthymia or something like that).. well some people with depression find more benefit to taking a mood stabiliser than to taking an anti-depressant anyways.
so... it might be worth a shot.
Posted by Dr. Bob on November 19, 2005, at 20:07:45
In reply to I think I'm bipolar - what can I do?, posted by rabble_rouser on November 18, 2005, at 14:13:53
> I have an appointment to see a psychiatrist soon, and I have suffered for so long I just want to finally find a way out. What do I say to him / her?
>
> Can this be treated without drugs? My company drug-test randomly and it could have devastating effects.Sorry, my role here is just administrative. But others will have lots of good advice. Good luck with your appointment!
Bob
Posted by alexandra_k on November 20, 2005, at 6:43:40
In reply to I think I'm bipolar - what can I do?, posted by rabble_rouser on November 18, 2005, at 14:13:53
hey. sorry... i missed the random drug test thing...
what drugs do they test for in the random drug test thing???
i ask because... to the best of my knowledge... it is fairly expensive to test for different sorts of substances. and... a specific test is required to test for most substances. so... they will only find substances they are actually looking for... a few different varieties of illegal drugs i suppose.
i'm really not sure that anti-depressants / mood stabilisers would show up in that kind of drug screen. i would say... that it would be worth asking about that over on the substance board and / or the main babble board.
with respect to alternative treatments...
yeah, there surely are some.
you might find a benefit to talking to a therapist.
you might also find benefit to some alternative medications (some people do and the alternatives board would be a good place to ask about that).
Posted by rabble_rouser on November 20, 2005, at 15:30:24
In reply to Re: I think I'm bipolar - what can I do?, posted by alexandra_k on November 20, 2005, at 6:43:40
Hi,
Thanks both to Dr Bob and alexandra k for your replies.
You are right, its very expensive to do testing, but the company I work for is one of the richest companies on earth and can do what they want!Unfortunately, my employer has also it written into their safety charter that anyone who has ever been depressed, has ever taken or is taking an antidepressant, is precluded from certain activites. You'd think I was in the military but its something much more normal, they're just draconian when it comes to these things. That means that yes, they specifically test for antidepressants. If they showed up, it would have a massive impact on my career (as if any condition I have wasn't enough to fight with in the first place).
I will give the substances board a shout, though I don't think there is any way around these tests- they seem pretty exhaustive.
Thank you for your thoughts.
Ross
Posted by 10derHeart on November 20, 2005, at 16:33:38
In reply to Re: I think I'm bipolar - what can I do?, posted by rabble_rouser on November 20, 2005, at 15:30:24
Gosh, Ross, that IS draconian! I mean....to be fair I suppose I'd have to toally hear their side of things....what's the rationale...based on what data...but it *sounds* as if it may well be an outmoded "policy" based on faulty assumptions or something...
Guess I'm just quite surprised as I WAS in the military for over 20 years, and with the limited exception for maybe (I'm not 100% sure of this) terribly sensitive jobs involving certain weapons systems and/or intel, being on an AD brings with it NO restrictions on you at all. Slowly but surely, the DoD seems to be coming around to current thinking of treating mental disorders like any other ailment....but it's been a long process with still a ways to go to remove all traces of stigma.
Sorry you're in such a predicament - must be very stressful. My best to you.
Posted by alexandra_k on November 20, 2005, at 17:11:11
In reply to Re: I think I'm bipolar - what can I do?, posted by rabble_rouser on November 20, 2005, at 15:30:24
> You are right, its very expensive to do testing, but the company I work for is one of the richest companies on earth and can do what they want!
hmm. that complicates things slightly ;-)
> Unfortunately, my employer has also it written into their safety charter that anyone who has ever been depressed, has ever taken or is taking an antidepressant, is precluded from certain activites.
okay then... do they have something specific against depression (is that the only condition they name) or are there other conditions as well? my thought is... do they mention bi-polar? how about 'brief adjustment disorder'? do they have the policies against ALL psychiatric conditions or just some specified ones?
My thought here is that... there are sympathetic p-docs out there. to a fairly large extent diagnosis can indeed be a 'matter of interpretation'. if there is a condition (that is similar enough) that they don't have policies against you MIGHT be able to find a sympathetic p-doc to diagnose you with something else and say you were misdiagnosed before. maybe. maybe. maybe you function too highly to even get a current diagnosis at all ;-)
>That means that yes, they specifically test for antidepressants. If they showed up, it would have a massive impact on my career (as if any condition I have wasn't enough to fight with in the first place).
hmm. i don't think they last all that long in your system... maybe... one month or something like that. there are different varieties. do they test for them all? how about mood stabilisers? can you get any info on precisely what they do test for? that might help your p-doc if you would like to give medication another try. oh... how about dysthymia? do they mention that? because anti-depressants are given for more conditions than just depression.
alternatively...
can you afford yourself a lawyer?
the trouble with corporations is that they have a little too much money...
but...
this sounds like discrimination on the basis of mental illness to me.
which is unlawful.
sigh.
there seems to be a lot of that going around...
Posted by rabble_rouser on November 23, 2005, at 15:32:23
In reply to Re: I think I'm bipolar - what can I do? » rabble_rouser, posted by alexandra_k on November 20, 2005, at 17:11:11
Hi 10derHeart and alexandra_k,
wow, thankyou so much for your replies - highly informative and insightful. I was amazed to hear that the US military does not discriminate against antidepressants. I actually work in the offshore oil industry which is one of the most safety-conscious fields on earth, following major disasters such as Piper Alpha and Texas City. This thinking filters down into everything and is often reactive.
They have a substance abuse policy which covers class A's, B's and alcohol, but, I presume because of one or two (perhaps litigous) incidents in the past have also shoved antiD's in there too. I always found my thinking was clearer and brighter when I was on Effexor before (I'm not on it right now - i stopped when i took this job and have felt the decline ever since) but the UK medical community always errs on the side of extreme caution - this is why so many drugs that you can get OTC in the states are not even available on prescription here.
I see what you are saying about interpretation. The documents I have seen mention 'mental illness and / or depression', and debar persons who are on or who have ever taken antidpepressants or psychotropic medications. As you rightly lean towards at the end of your post, alexandra, this reflects a general lack of understanding acceptance by people as a whole anyway. That used to hurt, but to me its just human nature now.
You make another good point - that of high functioning. That seems to be part of my problem. Privately, I experience a great deal of pain and identify with bipolar II symptoms. But i've been like this from a little boy - so I've learned to cover certain feelings and behaviours in certain settings where I know they have caused a problem in the past. So when I see doctors or psychiatrists, who I perceive as authority figures, my neediness tends to kick in and I try to present as 'normal' as I see it. I find it hard to be emotionally expressive and can't put that pain 'out there'. Sometimes I see them when I'm on an up - and they think theres nothing wrong at all, just that I talk a bit too much. Consequently they say things like "oh we'll soon have you feeling better" or acting like "hey this guys a fake" - and all the time the pain, confusion and anger is burning under the surface.
I'm more frustrated right now because I know effexor works and can't take it, unless I drop an amazing career opportunity. It will feel like I've let my illness beat me again, after so many years of fighting it, whatever the hell it is.
Sorry to sound defeatist today, just feeling a little that way!
Thanks
Ross
This is the end of the thread.
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