Manic Depression and Anti-Depressants - some experiences and some questions

[Liberian12]

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.

[chrysanthemum]

Hi Liberian and Welcome to the Boards ,

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.

[Liberian12]

Thanks for the welcome Chrysanthemem .

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 .

[StarCat]

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!

[Liberian12]

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 ).