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Old 04-04-2006, 10:43 AM   #1
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Bipolar I - only one "episode"?

I have a few questions about Bipolar disease that I am hoping someone could provide feedback upon:

I don’t want to get too specific about the details but I should mention some history. Since a really nasty run-in with Accutane in 2000, I have had a pretty dehabilitating mental illness. I combined the prescribed drug with consistent street drugs (mostly marijuana) and just took on almost every possible side effect associated with the drug. I believe to this day that the Accutane took me on a whirlwind of a personality ride that I would have otherwise avoided (at least for the time being). But this can be debated obviously. But what I know today is that I had a crazy manic period during this six month process of intake. I always sort of laugh at it because it was so textbook; the money, the sex, the invincibility, the reckless abandon, etc., I had it all. And I tell everyone about it as if to note that I could never picture myself achieving that before the incident, nor anytime “after” or in the future. I am just not capable of being that person, nor should I have ever been. That’s not to say I didn’t love it... hell if I was that person my entire life I would be on top of the world, a president or professional athlete or something.

But that’s just it, it could never happen like that – my body was operating parallel to my brain but it’s as if it didn’t know (like a car running without any gas). As eluded to, six months “after” this ridiculous high, I crashed and have been burning like a log in the light wind ever since. This was just after coming off all the drugs – Accutane mostly. I couldn’t do street drugs anymore because I couldn’t handle the fear of my sober brain let alone when I was high. I developed insane amounts of paranoia and fear, I worried about everything – albeit no physical hallucinations – I see things in such a strange, terrible concept. The world is dying to me really and everyone is trying to bring me down. My self-esteem is shot, I have panic attacks coupled into complete obsessions. I watch myself and repeat looking at myself deteriorating everyday. Whereas before this, I could motivate… I find myself just feeling worse and worse. I have tried everything in the last three years to fix it as well… I started eating right, I quit smoking or doing any drugs, I have limited alcohol (never get “drunk”), I have tried self-help books, natural therapies (Omega 3, 5HTP, St. John’s Wort, etc,.), and even some exercise. The exercise thing I realize is so key, but I have no energy to even do it. I have tried and I just can’t even do it… it’s the worst thing in the world. Ultimately I give up because my exhaustion is just too high. I feel that my mind is racing the moment I get out of bed. I don’t remember having dreams in my sleep for the last so many years. It is seriously becoming a ridiculous hole I am sub-consciously digging myself.

I have tried so many anti-depressants. All of which have made me slightly happier perhaps, but I have to go off within a month because my mind just races uncontrollably. I have been diagnosed with Bipolar three times but refuse to believe this is what it is. Alas however, for now I have given in – my body can no longer stay a fort. I finally saw a psychiatrist in town (it’s hard to get these in Ontario, Canada) who I trust. He says without a doubt I am Bipolar Type 1 and I should notice a considerable difference in who I am after being treated. But I always perceived Bipolar as being a back and forth type thing. I mean I have never gone back to that state of mind where I felt invincible, and I don’t see myself going back. I have just been depressed ever since. How can that be Bipolar? Or should I continue arguing this point?

I just wish my exhaustion would go away and I could feel at peace with myself. I want to enjoy life again.

Thank you so much or your help,

Matt

 
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Old 04-04-2006, 02:31 PM   #2
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Re: Bipolar I - only one "episode"?

Most people who develop bipolar I disorder genetically and don't have episodes sparked by the use of an illegal substance do tend to cycle, and the longer they are without medication, the worse their manias and depressions get. However, as long as a person has had one manic episode, they are classified as being bipolar I, even if they never have another one. I agree with your doctor- you are a clear-cut case of bipolar III disorder. Bipolar III disorder is the development of bipolar disorder due to the use of an anti-depressant, an organic injury, or an illegal substance. The fact that you have descended into mania with the use of the Accutane and that your mind begins to race and you become, at the very least, hypomanic while using an anti-depressant, there's really no doubt that you do have bipolar I. (The thing about bipolar III is that it only tells a physician or a psychiatrist how you developed the disorder, but every person who's classified as being "bipolar III" will have either bipolar I or bipolar II symptomatology, depending on whether they become full-blown manic, as you did, which initiates a diagnosis of bipolar I.) You may never become full-blown manic again, but since you have already become hypomanic on anti-depressants, you may very well become full-blown manic again. Your doctor/psychiatrist needs to put you on a mood stabilizer (Lithium, Depakote, Tegretol, etc) and/or an atypical anti-psychotic (Zyprexa, Risperdal, Seroquel, etc) right away! People who are bipolar should never be on an anti-depressant alone! Perhaps you will only have depressive episodes from now on, but regardless whether or not this is true, every time you use an anti-depressant without a mood stabilizer to treat your depression, you're chancing that you might become (hypo)manic again, especially since it's already occurred. If you have any more questions, feel free to ask! Good luck, and God bless!
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Old 04-04-2006, 05:42 PM   #3
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Re: Bipolar I - only one "episode"?

Quote:
Originally Posted by GatsbyLuvr1920
Most people who develop bipolar I disorder genetically and don't have episodes sparked by the use of an illegal substance do tend to cycle, and the longer they are without medication, the worse their manias and depressions get. However, as long as a person has had one manic episode, they are classified as being bipolar I, even if they never have another one. I agree with your doctor- you are a clear-cut case of bipolar III disorder. Bipolar III disorder is the development of bipolar disorder due to the use of an anti-depressant, an organic injury, or an illegal substance. The fact that you have descended into mania with the use of the Accutane and that your mind begins to race and you become, at the very least, hypomanic while using an anti-depressant, there's really no doubt that you do have bipolar I. (The thing about bipolar III is that it only tells a physician or a psychiatrist how you developed the disorder, but every person who's classified as being "bipolar III" will have either bipolar I or bipolar II symptomatology, depending on whether they become full-blown manic, as you did, which initiates a diagnosis of bipolar I.) You may never become full-blown manic again, but since you have already become hypomanic on anti-depressants, you may very well become full-blown manic again. Your doctor/psychiatrist needs to put you on a mood stabilizer (Lithium, Depakote, Tegretol, etc) and/or an atypical anti-psychotic (Zyprexa, Risperdal, Seroquel, etc) right away! People who are bipolar should never be on an anti-depressant alone! Perhaps you will only have depressive episodes from now on, but regardless whether or not this is true, every time you use an anti-depressant without a mood stabilizer to treat your depression, you're chancing that you might become (hypo)manic again, especially since it's already occurred. If you have any more questions, feel free to ask! Good luck, and God bless!
-GatsbyLuvr1920-
That was truly an amazing response. I did not realize so much of that information, and the information that I have come to grips with is bang on where I am at.

One question for you Gastby is this:

If I go on a mood stabilizer... can I expect to get all of the symptoms covered? I know you mentioned different drugs - but I suppose what I am saying is, can a mood stabilizer "stabilize" fear and depression along with the racing thoughts? Can a "mood stabilizer" make someone happy or at least douse the depression so I can think for myself?

Thank you so much one again!

 
Old 04-05-2006, 04:22 AM   #4
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Re: Bipolar I - only one "episode"?

Matty- Mood stabilizers are used for the treatment of both manic and depressive episodes, and to prevent future episodes from occurring (Lithium is especially note-worthy for its prevention of both mania AND depression). The only thing that it might not take care of is the intense anxiety/panic. If this is the case, then you'll probably be put on a benzodiazepine (ex. Valium, Klonopin, Xanax, etc.) in addition to the mood stabilizer. Also, some patients need to be on a mood stabilizer and a different anti-depressant, but since you had the classic, euphoric mania, I'll bet that Lithium would be your best choice. Mood stabilizers don't take away happiness or sadness or make someone a zombie without emotions- they simply "even you out" so you still have normal emotions, but they don't turn into the extremes of mania and depression. I don't have bipolar disorder; I have severe OCD, severe panic attacks, GAD, and Asperger's. However, I take Klonopin for my panic attacks and Lamictal (another mood stabilizer) for my mood swings and outbursts associated with my Asperger's, and I've been on Zoloft, Lexapro, and Prozac (which I'm now weaning off) for my OCD, so if you have any questions, feel free to ask! I hope this helped! Write back soon!
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Last edited by GatsbyLuvr1920; 04-05-2006 at 04:24 AM.

 
Old 04-05-2006, 10:49 AM   #5
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Re: Bipolar I - only one "episode"?

Quote:
Originally Posted by GatsbyLuvr1920
Matty- Mood stabilizers are used for the treatment of both manic and depressive episodes, and to prevent future episodes from occurring (Lithium is especially note-worthy for its prevention of both mania AND depression). The only thing that it might not take care of is the intense anxiety/panic. If this is the case, then you'll probably be put on a benzodiazepine (ex. Valium, Klonopin, Xanax, etc.) in addition to the mood stabilizer. Also, some patients need to be on a mood stabilizer and a different anti-depressant, but since you had the classic, euphoric mania, I'll bet that Lithium would be your best choice. Mood stabilizers don't take away happiness or sadness or make someone a zombie without emotions- they simply "even you out" so you still have normal emotions, but they don't turn into the extremes of mania and depression. I don't have bipolar disorder; I have severe OCD, severe panic attacks, GAD, and Asperger's. However, I take Klonopin for my panic attacks and Lamictal (another mood stabilizer) for my mood swings and outbursts associated with my Asperger's, and I've been on Zoloft, Lexapro, and Prozac (which I'm now weaning off) for my OCD, so if you have any questions, feel free to ask! I hope this helped! Write back soon!
-GatsbyLuvr1920-
Hey Gatsby,

Thank you once again.

So I went to see my psychiatrist today... let me give you an interesting run down:

After trying everything else under the sun, I know today that I am a clear cut Bipolar. The high that I went through was one hell of a unique dent in my life and it's been downhill since. I know I can't come out of it without something to fix the Bipolar. My mind races like the Indy 500.

I got into see a solid psychiatrist in the area (which is not easy here in Canada) and he's taking me on as his patient. He's not a pill pusher from what I've been told... and he wanted me to go in a Seroquel vs. Lithium BP trial sponsored by AstraZeneca Canada (maker of Seroquel I believe) because he liked me as a candidate. I was about 4 hours into the trial interview, and I had to be kicked out. We both thought I was a sure bet for the trial, and I think it came to a disappointment for both of us. I am all for contributing anyway I can... but regardless, he didn't seem to care. He politely said that I couldn't go on the trial because of a stipulation saying I could not be "depressed" for over 12 months. I have been "depressed" for about 3 years since my crazy high...

Regardless, he said his motivation was to help me and not to worry about the trial. He gave me a form to get blood work done and will see me in about a week. He has given me Seroquel (50 mg) to take every evening until then. I didn't ask him if he has any plans to change or add next week, but he just said to take this for now because it will help me sleep, it encompasses a lot of the anxiety / fear / paranoia issues I seem to have AND (this is the kicker), he said in the next month, Seroquel should be approved as a recommended mood stabilizer for Bipolar patients. He said from the same study performed last year, that the results were outstanding for Seroquel as a treatment for BP patients.

So while I'm hesitant, and would much rather prefer something like Lithium (which I have researched much about), I can only trust that this man knows a hell of a lot more than I do about what is best for me. I can explain my problems, but I don't know how to fix most of them... God knows I've tried so many things to get to this point.

Thoughts?

Last edited by Matty; 04-05-2006 at 10:57 AM.

 
Old 04-06-2006, 07:49 AM   #6
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Wink Re: Bipolar I - only one "episode"?

Why are you so about Seroquel.

There are other atypical antipsychotics. The latest on the market is "Abilify". Its an atypical antipsychotic but works completely different than any other conventional/atypical antipsychotic.

Do research on Abilify.

 
Old 04-10-2006, 06:44 PM   #7
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Re: Bipolar I - only one "episode"?

Don't be misled to believe a psychiatrist knows a lot more than you do about YOU. It's okay to agree with a doctor and try medications they recommend but remember you need to manage your own health care, doctor's are service providers.

 
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