Jump to content
CrazyBoards.org

BP Type 3


Guest BOYD

Recommended Posts

I think I'm BP3. It's my own dx. If true is the Lexapro a good med to keep things in check. What do I do if I feel like I could be cycling to a hypomania state of mind. I do feel good but not really F'ING GOOD. I just don't know a course of action if this feeling is building which may or may not be the case. Plus this cable internet cable is slow as "cold molasses" and I feel like calling them up and telling someone off!

Link to comment
Share on other sites

First off, while you may very well be BPIII, you shouldn't take any action based on a self dx.  That being said, if you are feeling hypomanic and you think it is being caused by Lexapro, call your pdoc (you do have a pdoc don't you?) and share your concerns with him.  Yours is not an uncommon reaction. 

Link to comment
Share on other sites

I just did some "research" thanks to Jerod.  You'll find info on lexapro at crazymeds.us/lexapro.  I only checked out the first couple lines and saw that it's an SSRI antidepressant that is used for bipolar depression, but not as a mood stabilizer.

If you have a form of BP, it's likely that being on an AD alone is a bit like holding paper a few inches over a fire.  Not so good an idea.  If you do suspect you have BP disorder, get thee to a pdoc and tell him the symptoms you think indicate BP, as well as any other symptoms you have.  Only a pdoc can do the diagnosis; it's just impossible to self-diagnose which condition is causing symptoms.

Of course, don't stop the lexapro unless the pdoc tells you to.  Don't rely on a GP.  Really.

Link to comment
Share on other sites

Guest Llamanator

What you do is call a pdoc.

If you have a history of hypomania or mania with ADs, taking ANY or without a mood stabilizer isn't such a good idea. Or without a pdoc prescribing.

Especially with, you know, sudden, dramatic mood changes months into treatment. Especially considering how any form of hypomania or mania fries your brain.

Having a family history of BP doesn't help.

If you think you're cyclothymic (BP III), or any other flavor of MI involving an abnormally elevated mood, you really need to be talking to a pdoc. Like, yesterday.

It's a pdoc's call, but given what you've been doing on the boards recently, no, I don't think Lexapro's a good idea by itself.

Mimi

Link to comment
Share on other sites

Isn't Bipolar III rapid or ultradian cycling? If so, Lexapro isn't a good option for this.

I took Lexapro at the time when my family doctor was prescribing my meds. Although he knew I was bipolar, he was pushing antidepressants for a while.

I took Lexapro twice. On 2nd trial, it made me manic as hell. I was wired all the time, excited, and euphoric. Then before I knew it, it turned to dysphoric mania and I was acting bitter towards others and pitching arguments. At the climax, I had a manic attack where I drove recklessly on someone's parking lot after someone said something to me, and I also went back and acted like an a$$hole. Next night, I got verbally abusive with the people who were involved.

So based on that experience, Lexapro is not recommended for your case. I would go with anticonvulsants. Your mood disorder case is most likely caused by a Glutamate/GABA imbalance rather than Serotonin.

Link to comment
Share on other sites

Guest Llamanator

I'm taking any BP numbers beyond II (NON-DSM numbers; kiddies, your pdocs likely won't recognize them, and the insurance companies sure as hell won't) from the first post of this thread:

http://www.crazyboards.org/index.php?showtopic=28

Ultradian/rapid-cycling/seasonal patterns/turns green are all modifiers of the base BP condition. Ultradian isn't official, either. Your local library likely has a copy of the actual DSM-IV, if you're wondering how the modification works.

I took Lexapro. It made me completely fucking insane and miserable until the doc saw fit to take me off of it. Other people do okay who are dxed BP. With mood stabilizers.

It's fucking impossible to tell which neurotransmitter is responsible for what, considering I've only seen serotonergic drugs mentioned. What the hell happened to norepinephrine and dopamine? GABA and glutamate aren't responsible for everything mood-wise. Mood stabilizers also hit other things. That's something a pdoc could tell, or brain scans might be able to tell, or more drug trials might be able to tell, but we don't have enough information, do we?

No, we don't.

Meh.

As we don't know what other meds Boyd's been on, we can't have any idea of what might be the problem with what.

Oh, yeah.

Hypomania is not okay. It eats your brain.

Bite me.

Mimi

Link to comment
Share on other sites

It's fucking impossible to tell which neurotransmitter is responsible for what, considering I've only seen serotonergic drugs mentioned. What the hell happened to norepinephrine and dopamine? GABA and glutamate aren't responsible for everything mood-wise. Mood stabilizers also hit other things. That's something a pdoc could tell, or brain scans might be able to tell, or more drug trials might be able to tell, but we don't have enough information, do we?

No, we don't.

Meh.

So true, so true.  This is a very interesting article about the effects of bipolar in the brain:  Interview with researcher Husseini Manji, of NIMH.  The following snip is particularly relevant to this discussion:

In almost every field of medicine-diabetes, cancer, endocrine research, etc. -- most of the research is moving inside the cell. What the chemical does inside the cell is more important than what it does in the synapse [the space between two neurons]. That shift has been going on for now about a decade. Of all psychiatric diseases, bipolar disorder is the one in which there is the most evidence that the abnormalities are primarily inside the cells. If you measure serotonin, norepinephrine, or dopamine [different neurotransmitters], you do find abnormalities, but more of the abnormality is likely inside the cell -- after the neurotransmitter binds. I can't tell you precisely which of the molecules are the problem -- we have clues but we don't know yet. It is how the cell reacts to the neurotransmitter which is more important than the neurotransmitter itself. And that is where the mood stabilizer seems to work. We think that is one reason why mood stabilizers are effective in bipolar disorder. When you treat with antidepressants, you treat far away from where the problem is, because antidepressants affect neurotransmitter levels and action out in the synapse. If the machinery within the cell is all working fine in a patient, then the antidepressant will have the expected effect. The antidepressant starts to have its effect way outside the cell and lots of things have to change en route before you can turn on the gene in the cell nucleus to achieve the desired effect. If the inner cell signaling machinery is not working fine (and we believe that in bipolar patients, that is where the fundamental problem is), then it is possible you can mess with a neurotransmitter all you want, but it won't be able to convey its information to the cell nucleus and turn on and off the gene that will make the difference.

In some cases, correcting that intracellular signaling abnormality is enough to restore mood stability. {suggesting perhaps Lexapro would suffice in a few cases}  In others, you restore the function of the signaling pathway in the cell back to normal, but find you still need some "oomph" to turn on the pathway after it is restored. An antidepressant can do that, so you see benefits -- but only after you have given the mood stabilizer a chance to fix the internal cell signaling problem first; otherwise you run the serious risk of overshooting and triggering manic episodes.

Link to comment
Share on other sites

I'm taking any BP numbers beyond II (NON-DSM numbers; kiddies, your pdocs likely won't recognize them, and the insurance companies sure as hell won't) from the first post of this thread:

http://www.crazyboards.org/index.php?showtopic=28

Ultradian/rapid-cycling/seasonal patterns/turns green are all modifiers of the base BP condition. Ultradian isn't official, either. Your local library likely has a copy of the actual DSM-IV, if you're wondering how the modification works.

I think if there's ultra rapid cycling or ultradian cycling, they may call it bipolar-NOS or not otherwise specified. I believe that's what my doctor classifies me as. There's no telling if I ever fit BP I or II. I definitely never have or had delusions/psychotic symptoms in my episodes before.

I took Lexapro. It made me completely fucking insane and miserable until the doc saw fit to take me off of it. Other people do okay who are dxed BP. With mood stabilizers.
For me, it was intensified when it was mixed with Geodon. I was taking those two by themselves together while I was waiting for Topamax to get to therapeutic level.

It's fucking impossible to tell which neurotransmitter is responsible for what, considering I've only seen serotonergic drugs mentioned. What the hell happened to norepinephrine and dopamine? GABA and glutamate aren't responsible for everything mood-wise. Mood stabilizers also hit other things. That's something a pdoc could tell, or brain scans might be able to tell, or more drug trials might be able to tell, but we don't have enough information, do we?

No, we don't.

Based on the functions of each neurotransmitters, the common hypotheses are that each subtype of depression is based on a subset of symptoms:

Black depression with suicidal tendencies, anxiety, insomnia, agitation are based on:

Low serotonin, maybe low GABA

Psychotic depression:

Low serotonin, high dopamine

Lethargic depression, low motivation, empty feeling, world looks gray, carb cravings, mental retardation

Low dopamine and norepinephrine

Bipolar [spectrum], cyclical depression, anxiety

Low GABA, high glutamate, possible high dopa/norep

Different meds are out there to target each individual subtype.

Some of this is based on Dr. Carver's website found here:

http://www.enotalone.com/article/4119.html

Link to comment
Share on other sites

"bipolar III" is cyclothymia.

And itll take, like, an actual doctor to figure out where the issue lies, apart from the DUH factor that an antidepressant without a mood stabilizer with ANY form of bipolar is shooooooopid.

Kassiane

<{POST_SNAPBACK}>

Here's one thing that got me over 1 1/2 years ago  ;) . My family doctor who was prescribing my meds at the time was pushing antidepressants even when I wasn't at high enough doses of mood stabilizers to stabilize things. He started me right on 20mg of Lexapro with 40mg of Geodon (once a day at night) when I was just starting on Topamax ot 25mg which was going to take a while to get to therapeutic level. He said Geodon and Lexapro synergized well. But. you know, Geodon + SSRI = Mania City.

Because his initial Topamax target was only 100mg, I most likely wasn't going to get much mood stabilation at that dose anyway and was probably going to need to titrated higher as I was going to be using it as my only mood stabilizer at the time.

So, basically I was going to be on an antidepressant by itself for around a month before Topamax would start doing something. As a result, I got into the Mania City on Lexapro + Geodon which led to a manic attack. Due to that, he increased my Topamax too fast right from 100mg to 200mg (smart move!). It abated the mania fast but at the cost of mucho side fx and cognitive dysfunction. Lowering Lexapro, punting Geodon, and titrating slowly on Topamax would've been better idea.

Link to comment
Share on other sites

My family doc hasn't been prescribing my meds since over a year ago.

I have a good pdoc now who prescribes my meds. He definitely knows what he's doing. With bipolars, he's very conservative about anti-depressants and makes sure mood stabilizers are at good dose levels before starting the AD's if they're needed. He tries to use lowest doses of AD's as possible.

And with meds, he's all for slow titration.

Link to comment
Share on other sites

Here's one thing that got me over 1 1/2 years ago  ;) . My family doctor who was prescribing my meds at the time was pushing antidepressants even when I wasn't at high enough doses of mood stabilizers to stabilize things. He started me right on 20mg of Lexapro with 40mg of Geodon (once a day at night) when I was just starting on Topamax ot 25mg which was going to take a while to get to therapeutic level. He said Geodon and Lexapro synergized well. But. you know, Geodon + SSRI = Mania City.

<{POST_SNAPBACK}>

My family doc gave me Lexapro cuz he thought I was just depressed.  10mg was enough to wig me the fuck out.  I can only imagine how wigged you were.

It would be hard to get into a BPIII dx but not out of the picture. BP I & BPII are not possibly me. I just battling GAD & DEPRESSION.

Is that coming from a pdoc? 

Link to comment
Share on other sites

THANKS GUY- I reposted way up top. I don't think BP is my issue. I only had one true hypomanic episode & that was 1.5 years ago. At that time I was hit with a real time stressful event which which became a pure obs. OCD. This was the cause for the depression.

which was multiplied by GAD. One year later I did rebound into another depression also due  to that ongoing situation. It would be hard to get into a BPIII dx but not out of the picture. BP I & BPII are not possibly me. I just battling GAD & DEPRESSION.

That is all well and good. But, "Holy Blathering M adness [also known as bipolar], Batman."

You are a post-a-holic.  Which is fine- I'm not saying don't post, I encourage you to do so.  However, if you look through this board in particular, you will likely find some of the longest posts of the forum here. and the most posts.  and the most redundant posts.  and the most posts where there is quoting of quotes that have been quoted. [with the exclusion of the springer board, in which every day is ''anything can happen day'']

That in itself isn't a large indicator of anything...  but it does tell me that you have an interesting brain, and could benefit from a pdoc.

So I hope you haven't given up that idea.

Also, you have mentioned some interesting reactions to meds.  It seems like you are out of your GP's area of expertise- most mentally interesting people are.

''Just depression'' and ''just anxiety'' are fairly complex- and you don't need someone who is unexperienced messing you up with innapropriate meds.

I seem to be getting alot of stuff out of my head with this site.
Yes. But you also got a lot of feedback from people.

I was just thinking that perhaps posting has helped me break away from the bonds of the mentality I was in. I always thought therapy was a bunch of shit to tell you the truth but I was absolutey wrong. It's a crutch of sorts but sometimes you need a crutch to get you where you want to go.

<{POST_SNAPBACK}>

The thing about therapy- it is a long term process.

Holy whoa. 

Good Idea: going to a psychiatrist with proper training for management of your psychiatric conditions.

Bad Idea:Going to your general practitioner, who does not have the training, and therefore can not  form an educated  opinion regarding what the drug reps say when they make office visits.  [eek]

I think you are on the right track, questioning what is actually going on with you- keep going and see the proper doctor.

[as people in this thread have said- hypomania is not good. nor are bizarre reactions to meds. in my experience, ocurrences of either of these often indicate there will be more]

~navy~

p.s.  re: ''Blathering Madness"-  this post is has some mild traits.

Link to comment
Share on other sites

Hi Boyd,

I'm gonna throw another chip on the pile.  You need to see a Pdoc. GP's good intentions not withstanding, self diagnosing, guessing and worrying aren't doing you any good, obviously.

BPIII or what would get coded as BP-NOS (not otherwise specified) for insurance purposes, is a low depressed condition. It isn't wild swings, rages or "Only one true hypomanic" inicident. Also, hypomanic doesn't require feeling euphoric or even good.  It can just be an expansive driven mood, even irritated or agitated. I just read a report of a large study 3 years ago that found that BPII'ers are depressed 52% of the time and hypomanic or mixed only 3% of the time.  Averages, of course.    Anyway, I've got a BPII tag and have only had 1, count 'em, 1 hypomanic incident in 44 years. I could get by until last year when the depression and anxiety laid me low. I managed to talk my way out the problems the hypo incident caused.   

You need to get to a Pdoc.  A specialist in MI conditions.  Preferably one who is familiar with BP conditions. My amateur experience tells me that a mood stabilizer is the next logical trial.

Be better, stop waisting time,  see a Pdoc.

A.M.

Link to comment
Share on other sites

Yep, I'm seeing all kinds of folks saying they have GAD and that kind of thing and when they talk about symptoms, they sound an awful lot like me untreated or me on ADs.  Anxiety/chronic worrying "leading to depression" sounds like there could be BP going on.

I don't have panic attacks or chronic generalized anxiety any more.  At all.  I used to think that pervasive fear was my main problem.  Turns out it was hypomania.  I just never associated all my other symptoms with BP.

Again, don't get stuck on BPIII or "definitely not BPI or II."  You are not able to diagnose yourself.  You don't know what is symptoms and what is you. It's simply impossible, no matter how bright or "up" you are.  It can not be done.

And treatment won't take away the WHEEE of Utah powder.  Don't worry.  It will just keep you from getting all compulsive and dangerous about it.  This is from someone who has learned the difference between having fun on the hill (good) and getting high on the edge of self-destruction (dangerous).  Hey--I'm not an adenaline junkie anymore.  I just enjoy myself.  Calculated risk-taking is good, learning what my boundaries are is good.  Crazed foaming-at-the-mouth, ruining knees & shoulders, skiing on blown ankles, climbing with torn cartilege in my shoulders--now that was just stupid.

Repeat after me:  Stop thinking so much and trust a pdoc.  Stop thinking too much and trust a pdoc.  Stop thinking too much and trust a pdoc.  OK?

Link to comment
Share on other sites

Why, thank you, AM.  I took it off for a while because I worried that someone might be offended--since we're all so attached to our ideas--but then I said screw it, if nothing else I need to remember it myself.

I think I picked it up from a bumper sticker.  It's the quote of the year for me.

Link to comment
Share on other sites

Guest PinkToo2grrl

just to kinda chime in ... back in the day when psych profs were taught that the way to determine BP was to try lithium, and if it did not produce results there was no BP, they did just that with me.  I spend the next 10 years with a depression dx, going on and off various anti-depressants, with some to no luck to outright worsening of symptoms (prozac, i realize now, induced hypomania - the pdoc said it was impossible for the drug to make me feel worse -- so i fired her).  About 8 years ago they started talking about agitated depression, and then flavors of anxiety issues and borderline PD, at which point we added some xanex.

The last 6 months or so my pdoc has been murmuring about the new thinking on the BP "spectrum", and trying a mood stabilizer.

Looks like she is on to something.  I was having a hypomanic PMS from hell, and adding depakote seems to have helped in several days.

I asked the pdoc, no way this could work that fast, and she said for some stuff, no, it takes longer, but for what you're experienceing, yes, it could help this quickly.

depression, anxiety, BP-III/NOS --- yeah a professional is going to be the one to help you tweeze this out.  And it could take some time. 

Over 18 years of treatment I had to switch pdocs a lot because of insurance and relocation.  Then there is the ongoing studies, the new meds.  It's a process.

I think I might finally be where I need to be.  Pdoc always asked me, every session "do you have racing thoughts"  me: "no."  But, since the depakote, my brain is so quiet, I guess i did have them after all, but I had had them so long, I had gotten used to them.  But, she kept asking, and followed her intuition, and training, and the mood stabilizer was the thing that did the trick.

So far so good.  Good luck on your journey!  Hope ya find what works for you.

Link to comment
Share on other sites

Archived

This topic is now archived and is closed to further replies.

×
×
  • Create New...