Greetings,

(27 year old male) I've had manic depression since I was around 17 years old. I wasn't diagnosed until I was 20 and at that time, I was diagnosed with straight depression, not manic depression. So, I was put on Zoloft.

Big mistake. I was manic for about six weeks. I started a foolish affair with my brother-in-law's sister that had all sorts of bad ramifications. I went to the doctor and was taken off the zoloft. At this point I was diagnosed as being manic depressed.

Six years later, I was extremely depressed after an abusive relationship (unfortunately, it can happen both ways). It was so bad, I asked the doctor about anti-depressants again, and he suggested Paxil. I went on it, and it was a nightmare. I went into rapid-cycling, with extreme highs and lows oscillating in about six hour periods, and in some of the lows became self-destructive (I have the scars to prove it). To be frank, I'm lucky I'm not dead.

I talked to my doctor about what happened, and he suggested I may have been suffering from post-traumatic stress after the abuse I suffered. The paxil with the adrenaline and the manic depression caused this rapid cycling. I went off the medication, and slowly reverted to normal.

I had to leave school during all of this (I'm a Phd. student) and went back in January. In going back, my disease manifested itself quite differently, partly because I was back at the same school with the person who had abused me. My mania manifested itself as anger rather than euphoria, and when I wasn't manic, I was depressed most of the time. I hid myself in my room and did my work for the term.

I talked to the doctor, and he suggested Epival. It has really helped with the anger and occasional euphoria, but it has had little effect on the depression. He'd like to try me out on another family of anti-depressants (the one that helps cure smoking - I'm sorry, but the name slips my mind), since the Epival has left the depression intact. He feels that the Epival will prevent me from becoming manic again.

I'm very very worried about this, as both my experiences with anti-depressants have been horrible. I also am not sure whether I am free from the mania. I find I have about one or two angry episodes a week (as opposed to daily) and a euphoric one about every two weeks. I also am afraid I am not free from the PTSD, as I had another related nightmare a few days ago, and they seem to crop up about every month or so. The one a few days ago was actually the worst yet.

I don't want to get into more trouble with mania, especially now that it is manifesting itself as anger. I also don't want to go back into rapid-cycling, as I don't want to hurt myself and can't afford to take another medical leave. But I'm so depressed all the time and I find it almost impossible to enjoy anything. I just want to lie in bed, and I hate this feeling.

I'm wondering what experience other people with manic depression or PTSD have had with anti-depressants, and whether people have found any that don't induce mania. If I had some names of some medications I could suggest them to my doctor. Right now, I'm totally stuck. I can't stop being depressed but I'm afraid to take any anti-depressants.

Thanks.

Hi Liberian and Welcome to the Boards http://www.healthboards.com/ubb/wave.gif,

You have had a very frustrating time trying to get the right treatment, but you are on the right track.

Have you discussed your reservations about AD's with your doctor? S/he should be aware of any concerns you have, as well as past experiences with medication.

As for the mood swings, are you aware that you can have cognitive behavioural therapy as well as medication? This would help you enormously particularly when it comes to dealing with anger. Relaxation techniques can also help. Both of these techniques help you exercise greater control over your moods, and therefore help you feel much more stable.

Quite often, people with manic depresssion tend to reach a stage where they feel hopeless in dealing with or controlling the mood swings, but that is not the case.

I would discuss the possibility of working on these things with your doctor, and if s/he is not responsive, go and see a counselor or psychologist who teaches these techniques. It would be well worth your while.

Best wishes,
Chrys. http://www.healthboards.com/ubb/smile.gif

Thanks for the welcome Chrysanthemem http://www.healthboards.com/ubb/smile.gif.

I've talked to my doctor about my concerns about AD's and he's worried, too. He was the same doctor I had during the paxil incident (not for the zoloft, though). Right now, I'm waiting on the epival to see if it diminishes the mania more than it already has. So far, it's been promising, but not perfect.

I've tried some of the relaxation techniques for when I'm euphoric/angry, but it's so bad I literally can't sit still. Perhaps it is worth doing some more research on this, though.

I guess I'm scared on some level. I so want the mania to go away so I can go on anti-depressants again, but it just won't. If not, I'm basically stuck again http://www.healthboards.com/ubb/frown.gif.

Hi Liberian,

I am manic-depressive also, although I have type 2 and therefore I don't get the full manic episodes... But I have had similar experiences with anti-depressants. I've found that any of the "happy-pills" (the medications that try to boost the chemicals in your brain that will make you "happy") will make me rapid-cycle. I think this is probably a trend with most people who have manic-depression. I have had better results with medicines whose primary function is not to cure depression, such as anti-convulsants. So trying a med that helps people quit smoking might work (but you might want to make sure it doesn't have caffeine, adrenaline, etc. in it since that might make you manic).

You could ask your doctor about exploring mood-levellers or anti-convulsants. I'm currently on Keppra (it's a new epilepsy medication), and I've also been on Lamictal (but that gave me an odd twitch in my neck) in the anti-convulsant category. Everyone is different, so what works for me might not work for you. But there are lots of new medicines, and new approaches being taken to treat manic-depression. Just hang in and you'll find the right meds.

Good luck!

Thanks Starcat. I'll ask my doctor about those drugs. What I'm taking now, Epival, also started as an anti-convulsant. The problem with it is it mainly treats mania and has little effect on depression. Have you found that either Keppra or Lamictal have had effects on the depression itself? I'd really like to find a mood stabiliser that affects both depression and mania, so I don't have to take any more dangerous "happy pills" (I like that term http://www.healthboards.com/ubb/smile.gif).

Hi Liberian and welcome to the board. I think the anti-depressant you are referring to that helps with quitting smoking is Wellbutrin. I am currently taking it for depression. It is the only anti-depressant that I know of that does not cause a decreased libido.

Have you ever tried lithium? That is a very common treatment in the US for Bipolar (manic-depression). If not, you may want to discuss this with your doctor.

Regarding other antidepressants, nyx posted great information in another post entitled "Question" - posted by dreamer. I have cut and pasted it here for your convenience.

nyx wrote:

"There are a few different types of anti-depressant, poissibly more than i know of, but these are the ones i do know of :

serotonin reuptake inhibitors include: Fluoxetine (Prozac), Sertraline (Zoloft), Paroxetine (Paxil), Fluvoxamine (Luvox), Venlafaxine (Effexor), and Citalopram (Celexa).

monoamine oxidase inhibitors include: Phenelzine (Nardil), and Tranylcypromine (Parnate).

tricyclic antidepressants include: Amitriptyline (Elavil), Clomipramine (Anafranil), Imipramine (Tofranil), and Nortriptyline (Pamelor).

atypical antidepressants include: Bupropion (Wellbutrin), Nefazodone (Serzone), Trazodone (Desyrel), and Mirtazapine (Remeron).

Hope that helped some...maybe you could talk to a dr. about it?

------------------
~ nyx girl ~"

Thanks, Witherss, that's exactly what I was looking for in terms of a list. I noticed that Zoloft and Paxil were in the same list, which may explain how I had problems with both of them.

Yes, it was Wellbutrin. Heh - I'm trying to quit smoking as well, so maybe it'll be a side effect http://www.healthboards.com/ubb/smile.gif. I see it's in another list, and worth talking to my doctor about, as that's a really worth considering.

On the bright side, I haven't had any symptoms of mania in over a week, so maybe the Epival is really working. I'll give it another couple weeks before I consider even going near another anti-depressant, though.

Anyway, I've got a doctor's appointment next week to check the bloodwork from the Epival, and I'll talk to the doctor then. I'll let you know how it goes.

Hi again,

For me, the Keppra has had an effect on stabilizing the depression. I'm sure everyone is different, but I had to go off it recently for 2 weeks, and I definitely noticed a change for the worse. But you know, I was on Wellbutrin too at one time, and it did not work well for me at all. So now that you're "armed and dangerous" with all this info, talk to your doc and I hope you find the right stuff.

Good luck!

hi,
for 8 years they thought i had depression until 2 years ago i had a nervous breakdown and no medicine would help. It took 1 1/2 years for them to say you have bipolar II. Most tricyclic antidepressants make you manic as well as SSRI, i am not too sure about MAOI. The only medicine that helped me is Lamictal. Tricyclic made me very manic. I used SSRI the first 8 years and it didn't seem to affect me but your bipolar worsens over time. There are other medicines such as lithium, depakote, Lamictal...and topomax. What I am doing now is mediciating every day for the past 6 months and workin gon my issues and I have been able to reduce my medicine significantly. I am not saying not to take medicine just seek other alternative solutions as well. Most depression is anger turned inwards...you have to do something with your anger...you need to express it..even in meditation you can lash out at someone or something..we just bottle up our emotions and something we do not know what to do with them goodluck!

Hey there Liberian,

The first thought that springs to my mind after reading your post is that you should change your doctor. From what you say he or she appears to know little about treating bi polar and even less about suitable drugs. I would seek a doc who knows both, more than likely a psychiatrist would be best.

In simple terms bi polar should be treated with both an anti depressant and a mood stabiliser such as lithium although there are many others. In conjunction with this you should see your doc probably once a week to monitor your moods as well as your reaction to whatever drugs are prescribed.

Until now you seem to have been given inadequate medical support in my opinion. Even when you in between periods of mania you should be monitored for early warning signs etc to try and prevent recurrences.

Remember that it should not be your role to suggest drugs to your doc. If they need this info from you they are the wrong person to help you.

Hope this helps

Best

So Low

HI Liberian! You sure have been put through the proverbial wringer! I think its wonderful that you are so involved in your own recovery and know what works for you, as so many just take for granted that their Doc knows whats best. I have a question. Is your doctor a Psychiatrist? Your story sounds so much like mine when I was being treated by my family doctor. At one point she took me straight off paxil and put me on wellbutrin. I about lost my mind, while I was driving! and it scared her to the point of finally telling me that she could no longer treat me. LOng story short, my new Psychiatrist, more knowlegeable with meds, brought my symptoms under control in a short time and I am stable. I suffered for so long trying this med and that med. Much longer than needed because my doctor with all good intentions, simply wasnt qualified to treat bipolar disorder. I also suffered from PTSD and it was a long journey back.....alot of therapy, guided meditation.....alot of positive affirmations......letter writings and burnings......alot of self love and self nurturing. HOw about an abuse support group? You are a very intelligent man LIberian. Keep searching for what it is you need and most of all, have you forgiven yourself for your own indiscretion? For a long time I would not allow myself the joy of healing because I felt I deserved to suffer for the wrongs I had done to others. Hey, we're human. We make mistakes. We need to forgive ourselves and promise ourselves to not repeat those mistakes and move on. Its a simple concept. Not easy....but simple.

------------------
ULTREYA! Moving forward with courage

Hi Liberian,
I'm so sorry to hear you've had such a hard time getting 'it right.' Unfortunately, alot of us have been to many docs and on many meds....trying to 'get it right.'
I certainly can't 'one-up' anyone on advice or info so I'll just say 'welcome,' http://www.healthboards.com/ubb/wave.gif and hope you will keep us posted on how you're getting along.
Take Care,
leppi

Hi everyone. I just have a little something to share. I am not manic but i do know a lot about what is going on in the antidepressant world. Right now i am currently a member of a suit against the makers of the antidepressant PAXIL. This drug has done so much harm to me and others that i can't stress to you how much i hate it. Sure the serotonin levels in paxil and other anti's will help you at first and will seem like your best friend at first. UNTIL you first try to wean your way off them. You see that's when hell on earth starts to kick in and all the problems you had before taking this medication have doubled maybe even tripled. WITHDRAWS EVERYONE I AM TALKING OF THE WITHDRAWS AND ADDICTIONS. Zaps in the brain and body, muscle tension nausea, disoriented, fatique, dizzy, anger, tight chest, difficulty breathing, hoplessness, suicide attempts,helplessness, outrage on self and others. These are just some of the things i have experienced with PAXIL and most have experienced with other antidepressants. This is real and it isn't going away. If you are experiencing worse problems on or while getting off paxil it's not all in your head. These are the reality of the antidepressants we think are going to help us (especially paxil). If you are on or are thinking of going on this drug please don't. I have had too many lost friends over this drug. If you need any information (research or such) please let me know.
You all already have enough problems to deal with as it is. You don't need a medication that is going to sugar coat everything at first then distroy you at the end.
take care all and big hugs

okay, i am bipolar and i have to say..poo to your doctor he should know better...many bipolars can not take tricyclic or ssri because they make you manic...you have 2 examples of being manic...hence, no more tricyclic or ssri.....stop them...i was diagnosed with depression for 6 years then have my first manic attack...and docs didn;t knwo what the heck it was and tried tricyclic and alot of other heavy mends..i am currnetly on lamictal 300mg and seroquel 400mg to sleep....the lamictal is an anticonvulsant....but i caution you if you decide to try lamictal is can give you a life-threatening rash IF you raise the dosage to fast...and by the way...if you doc decided to go up any more than 25 mg ever 3 weeks do not listen to him...my rn went very slowly and i didn;t get anything...i have hear dozens of horror stories about people's doctors giving them 50mg for 1 week then 50mg increase.....research the drug on the internet...also if you are on depakote and lamictal it is very easy to get the rash...there is also neurotin...

Everyone is right about tricyclic drugs such as amitrytiline. I am on amitryptiline for depression and I am going into a manic phase, where I have more energy to lift weights everyday and I am not talking just lifting 10 lbs, and I am very talkative. before I was on amitryptiline I was not sociable at all. I am really loud and laughing alot. Well I had some manic episodes even before I was diagnosed as having depression. About 7 years ago, I was so bad that I was going on trip after trip even though I was on welfare. I had horrible spending habits and still have bad spending habits even though my money is controlled by my group home staff. I am now on handicap benefits. I get $30.00 a week to spend, and that is gone within a day. I see my psychiatrist on Thursday.
It sounds like you do have a mixture of PTSD and manic depression. It sounds like everytime you face someone who has caused you alot of stress in your life that you go into a manic phase. Maybe ask your doctor about starting you on lithium along with an antidepressant to get you going. If the antidepressant is not working for your depressed phase, ask to try an antipsychotic along with lithium.

Just thought I would share that my son had a severe violent reaction to paxil errupting in the necessity to dextox at age 8 for 5 weeks in a psychiatric hospital, but was able to tolerate serzone very well.-meme

Hi,
I am new to this board, and after reading your thread, I new that I must respond, and introduce myself to everyone here. January '00, I was diagnosed with, 'severe-major-depression', by a top phsycho-pharmocologist, in New York City. I was originally treated with, Paxil. I felt as if the top of my head was literally going to pop-off. Color's, sound's, intensified, movement's surreal, digital, distorted, psychotic,...way out there in, 'deamland'. Immediatley, my doctor took me off, Paxil, and prescribed, Zoloft. Once again, I experienced a much-similar effect as with the, Paxil. The best way that I can describe the feeling, the experience, I felt without sounding, 'writerly, poetic, intellectual', is hallucinagenic, LSD, Mescaline, (this not a feeling that you want to walk around with at all time). My last course of treatment was medication(s), Celexa, later, Celexa/Buspar cocktail. Again, making me feel like a lunatic, madman... My doctor did not seem to be concerned with any of the side-effect's that I was experiencing from medication, went-on to prescribe, Revia, an opiate-blocker, used at the time for not only heroin/opiate addiction, but alcohol addiction.
At this time, needlesstosay, I am not seeing a m.d., or am I taking any medication for depression. I am beginning to discover, (except) the realization that I am probably, Bi-Polar. My mood swings are very quick-paced, hallucinagenic, wild, usually ending in abrupt darkness, where I feel hopeless. It is now 'mid November. The day's are getting shorter, it is cold here in New England, the, 'holiday season', just'round the corner. I am afraid, lethargic. Is there a connection? Is it a sign? That these side-effect's that I experienced with SSRI's, that I might be Bi-Polar? Leland

[~~Elysium9, it is not permissable to post or request personal contact details. Please ensure you are familiar with the HealthBaords guidelines.~~ Thanks, Minerva]

[This message has been edited by minerva (edited 11-09-2002).]

400MG of Wellbutrin regular relase has basicly ended my taste for cigars which I would only have one a day, damn it works great but took away my one pleasure, but you have to make tradeoffs

I have been FINALLY diaganosed with Bi-Polar and after a failed marriage and nearly wrecking the one i am in now.... I have been on many meds with no results... lithuim absolutley made me ill.. I am now on Depakote ER.. it is for seizures, migranes and Manic Depressive, i also take Efforx XR and xanax as needed...I feel i am on an even keel now... You might want to suggest Depakote to ur doctor... Best of luck...

Diane :)

Hi There,

I had similar problems when I was first put on prozac, and mis-diagnosed with depression. I went into my first manic state, and was still not diagnosed, but bounced from one ad to another. It wasn't until years later, (and many destructive episodes that nearly tore my family apart) that I was finally diagnosed bp. I was kept on an ad, and added a mood stabilizer - seroquel, which worked well for me at the time. I also have ptsd as a secondary disorder.

At the time I was put on the seroquel, I was having panic attacks, and night-terrors, and the seroquel was a godsend, I finally slept through the night without waking my husband and children up with blood-curdling screams.

But then about 8 months later, I slipped back into depression, I think the seroquel was the wrong med for me to be on for a long-term basis. So I was switched to trileptal. And that was pretty bad at first, I was rapid-cycling like crazy. Eventually, I evened out, and then got depressed again. So now my doctor has me back on the prozac, along with the triliptal, and wellbutrin, and sometimes for sleep, I still use the seroquel.

My doctor lets me kind of tweak my meds, and use what I think I need depending on how I feel. If I'm really down, I will take extra ad, and if I'm feeling manic, I will take more trileptal (its a anti-seisure med) and seroquel. I'm doing pretty well with this combination for now, but I expect to have to change after a few months, whatever I'm taking tends to lose effectiveness.

Hope that helps!!

~~heather~~