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how can you tell if its mania/bp related

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umm, minds a buzz. where to start telling story. i stopped taking any serious form of medication back in sept. of last year, after a month or two on prozac, and a dosage increase up to 40 mg + a week of inactivity following a temp job, drove me through the roof. irritable, restless, etc. i don't know what it was exactly (my doc suspected prozac's slight effect on norepinephrine, or maybe i'm the one who first suspected that) but i stopped taking it, and everything fell back down to normal. was depressed as hell for the next two months, and by the end of november my graves disease (my doctor stopped my meds back in july) had raised my thyroid levels way way out of control, and so i was ordered to undergo radioactive iodine to destroy my throid the next week. at that point i was just kinda toxic anxious, from all the thyroid hormones in my symptom, and looked forward to any kind of relief. (not knowing then it was pretty much a death knell for the normal mental functioning i had gotten use too)

fast forward though december, january, february . . . still feeling like crap. irritable, anxious. then a slow cool down, and sense of well being and almost contentment beginning of march, then . . . feeling like crap in april because my thyroid was DEAD DEAD DEAD, deader than a doorknob and the replacement synthroid dose didn't do shit, and i had to ask for cytomel again and again, just to be able to function.

still hypothyroid now , but a little 'better'. not back to what i was used to be. but beginning of may i had just screeched to a halt. was so uber stressed out, hadn't taken any med, had finally started to see my pdoc again, and upon my new therapists urging, i decided to be a good boy and start taking medicine again, and regularly (not subject to my 'emotional decisions' as my therapist called them) tried anafranil, but being hypothyroid it was too much. low blood pressure, couldn't go up. a while later tried cymbalta . . . made me sleepy finally after a couple of weeks of not noticing anything, and then really irritable and anxious too, although it did seem to be doing something for my depression. just couldnt' stay awake enough during the day. tried paxil for a month starting back in july when i went up to chicago for a couple of weeks. nothing, just made me feel flat and depressed. then my doc (mostly due to my suggestion since it seems to have worked so well for my mother) said we could try zoloft. first week, 50 mg (again out of town in the midwest) felt a little bit better, like i could actually tolerate this one. second week, came back to az, really depressed again, feeling like 50 mg ain't cutting it, so i decided this past weekend to start going up, and taking 75 mg. WEEKEND FROM HELL my mom was out of town, so i had the house to myself. which was pretty cool up until saturday, when i just got crazy from all the mess and all the usual depressing aspects that this house usually makes me feel, and also i think because of allergic reactions or something triggering pain and general discomfort. really thought i was gonna lose it. gonna kill myself, blow up, break more shit in the house. rode it out just barely to monday, where i still felt like crap crap crap.

woke up this morning, still under the influence of 'the crap' but then had a kind of low key lackadaisical morning (not stressed out or anything, kinda lazy but okay) then got stressed out again as i finally decided to call about this medical bill, and felt a surge of anger again, but enough that i could control and talk to my mom about since it usually involves the same reoccuring issue, and i felt i was able to express myself pretty well. and now, early afternoon, just had a little little bit of coca cola but . . . [bouncing off the walls]

right now i really think i feel 'manic'. and that could be of a variety of factors. some caffeine this morning (although not really any amount out of the ordinary), my move to take all my cytomel (T3 thyroid drug) all in the morning per my endocrinologists instruction, or just a latent inner craziness brought about by a bump up of my serotonin levels. i really can't say. i felt like CRAP the last three days. just utter dreck, ready to kill myself, and now . . . happy happy happy bouncy. just for a brief period of time so far. but i really don't know what brought this all on. (the unbearable lightness of being? ;) ~ ) i'm not sure if its something i should just ride out and wait until i see my pdoc next week, so i have more personal data experience to report, or let him know right away because this could change my therapy regimen. i really can't judge if this is anything different than the serotonin high briefly experienced while we're changing meds, or something new and completely different. it feels completely different, but maybe just because i've been depressed for so long . . . ?

the only other consideration i'm thinking of (outside of my old therapist suspecting i have some kind of weird manic trait undescribed) is the moderator of my ocd group telling me that i sound kidn of like her husband who has bipolar, but his two moods that he moves from are depression to anger. and that definitely could describe me the past year or so. but the tiny ocd devils are always there to jab my mind with their pitchforks too. so i definitely don't think i have something other than ocd, just something weird maybe underneath it.

i dunno. i've typed all this rapid machine gun fire style, which i haven't been able to do in . . . oh i don't know, forever! i'll let you all be the judge. am i even a little weirder underneath than i thought i was. (and NO i am not calling any subclass of MI or BP weird! i just always figured i was plain vanilla ocd and utter depression, but now i feel like i've definitely bounced something loose that changes my whole perspective on myself) so umm yeah. i could maybe crosspost this to the bp thread if i was technologically gifted and knew what i was doing, or maybe some cb angel could do that for me . . .?

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I'm on 75 mg of Zoloft and can no longer tolerate ANY caffeine--I used to drink 6-10 cups a day, plus Red Bulls (this has been brutal!).

I tried a coffee one day last week and it made me very speedy--similar to when I took epinepherine-type drugs for asthma attacks. It also sent my anxiety through the roof.

Good luck figuring it out.

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thanks skeksi (wow . . . 6-10 cups, really?)

i know zoloft is the one ssri known for its slight dopamine affinity, so that could explain some of it. but i don't think i had that much coffee, and my 'high' felt more like a serotonin high than a dopamine high.

lucky for me anyways , all my energy ebbs out of me by the late afternoon, despite what my dumb endocrinologist says that taking all my cytomel in the morning will not effect me, so my 'manic' state didn't last very long. just a slow roll back down into the ditch that is depression and anger. i'm guessing here it was a combination of the cytomel and the caffeine all hitting me at the right time, and me feeling good for a change. i think now being without a thyroid, i never really have enough energy when i want it, and this was maybe one of those rare rare times when i did. but taking away the limiting reagent of energy still doesn't seem to explain how i was suddenly so talkative, and could type a mile a minute etc. . . and i still can switch into anger and stress in a flash. . . so, i have no idea. i guess i'll have to wait another week and run it by my doc.

has anyone heard of that though before, BP where the two states are depression and anger? i guess this belongs more on the bp forum

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BP states can come in any flavor of euphoria and dysphoria.

There's euphoric mania/hypomania, which is what I think you typified mania with. But let's not miss dysphoric mania/hypomania (aka "mixed state"), which generally presents with irritability, anger, and general symptoms of silicovaginosis.

I have no idea where to you should go with meds from here, perhaps it'd be a wise idea to speak with your pdoc about cutting off most of your Zoloft dose and perhaps adding Lamictal (an antidepressant+mood stabilizer that quickly put an end to my dysphoric hypomania states).

Of course, I need 400mg Lamictal, some good norepinephrine action from Cymbalta, 200-400mg Provigil, and amounts of coffee that would put skeksi to shame... just to make it through the first half of the morning. ;)

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