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Suspecting that I am bipolar II...


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As far back as I can remember, I've had depressive and manic episodes which I can today describe as hypomania. I've just discovered recently, in the last few weeks, that I've been like this since childhood. It got me thinking that I always were bipolar to some degree, most probably bipolar II.

I've had highs (manic symptoms) and lows (depressive symptoms) but I've also had mid-long periods without clear mania or depression, stable even, but it never lasted. I still have those today, but I'm on medication for depression and mood swings, which actually helped without my knowing, my irregular manic episodes. The more I think about it and remember, I can now sum this up to :

Mania :

I was hyperactive; running everywhere or when alone literally laughing out loud for no reason or jumping around and singing super loud; lessened need to sleep and waking up energized; trying to coax life into everyone and actually bugging them; talking fast and almost uncontrollably with a racing thoughts but managed to used that excitability to make people laugh; was very quick to reply to everyone usually with humor, making people laugh and and others awed because it amazed them; feeling invicible and capable of doing anything even risky ventures, sustaining a great amount of pain; very strong minded and getting really angry at people because they were "incapable" of doing something with efficiency but I, on the opther hand, could do it with ease; always thinking that I'm superior and that no one knew or understood my incredible value and intelligence; having sexual urges to masturbate multiple times in a day (even when in a relationship) and watching porn all over the place; I was super competitve and got angry if I lost, knowing that it was impossible so I made sure to win the next time even if I had to cheat (I was sure no one would catch me... wrong!); I did everything super fast (and still do) which is great for my bosses (I can do the job of 2 people and still find time to relax at work); I kept looking for gratification and popularity and trying to amaze them with feats that they could not do (which were not really that hard). I always tried/try to make people laugh, ALL the time

Depressive : I felt lonely and miserable, not wanting to see anyone and stay by myself; people trying to get me moving rarely achieved their goal and if I had a task to do it'd be difficult just to get up and I did it backwards; I got angry at people telling me that I was lazy or unproductive or negative; I was melancolic looking out the window at the "happy" world and my friends playing not too far; wiching to be able to do more but acutely knowing that I was not able to; wanting to sleep 12 hours a day; wanting to become the king of couch potatoes; I was negative and wanted to show it to everyone and when someone finally noticed I'd try to make them also feel miserable, which I would manage at a psychological level, poking at their sensibility; I got jealous for nothing ... anyway, at least I wasn't suicidal, but did appear later in my life but I never acted upon it and probably never will.

I remember when a best friend of mine made me realized (rather harshly) that I was really getting on everyone's nerve and that they had "enough" of it. I remember this precise moment when I realized what I was doing and how it affected people around me. Ever since, I've been keenly aware of when I was hitting the mania button, thinking to myself "am I saying too much?", "am I bothering someone?", trying and trying again to stop talking all the time and be hyperactive. It even got me in trouble at some work places. I've done sports and worked in a McDonalds to evacuate all that extra energy and it actually worked well. I' ve stayed 6 years in a McDonald's, I was really enjoying it and no one understood why I liked this job that much and why I was so good at it.

I write alot and never, ever had the blank page syndrome. My imagination is extremelly fertile, to a point that no one can follow my lead. I can imagine or visualize almost anything or any situation. It helped on my creative personnaly but made me more miserable in my depressive episodes, imagining alot of things that weren't really happening or will not happen, seeing the worst in all situations (no hallucinations though).

Well, that's about it. I went to the doc 1 year and a half ago and got prescribed Wellbutrin (I would not touch a SSRI even with a stick) for general anxiety, mood swings (anger instant bursts) and generalized depressive episodes. I never imagined that I might have been bipolar or even what mania is.

The wellbutrin got everything under control. I have fewer manic episodes but still have some once in a while, getting wired while my girlfriend laughs at me for all the silly things I can say. I get much less depressive episodes, which is very good; no more wanting to break my relationship and abandon my kids, all this without a trace of remorse, get angry for nothing, literally throwing things on the wall. Accusing my girlfriend injustly just to anger her or hurt her. Making a scene when she "discovered" that I had spent money on bad things even if our finance was low. And the list goes on and on. At least the manic episodes, everything is beautiful and loving !

Today, with all the information I found on the Internet, here and compared it to my past, I am suspecting but at the same time am pretty sure that I am bipolar II.

Should I tell my doc even if the wellbutrin helps already ?

Should I talk to my girlfriend about it ? Even my family ? Does this really help ?

God, this is a long post, I just couldn't stop writing after I've started... thank you all of you who had the patience to read it all.

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Wellbutrin wouldn't really help with manic episodes, so if wellbutrin has ameliorated what you're describing as manic episodes, they're likely something else. But, by all means you should raise this with your pdoc. How well he or she can treat you depends largely on how clear a picture he or she has of what's going on with you.

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Im all for the least amount of medication that does the job. But Id bounce it off a pdoc anyhow. At least do some mood logging for a few months to make sure nothings going on.

Wellbutrin seems to be one of the ADs least likely to make bipolar worse. Ive gone into mixed states on some SSRIs but wellbutrin has no side effects except anxiety.

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Maybe you can just print off your first post to give to your pdoc? You can explain that you don't know if they're definitely "manic" things or not (see the note that wellbutrin wouldn't really take care of it if it were), but that they're enough hypomanic-like that you were concerned. Or just that they were enough noticeable and disturbing that you wanted to mention them.

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This is coming completely out of my asshole and take it as such: If Wellbutrin helped your "manic" symptoms, you might look into ADHD or something like that instead. Where Wellbutrin will not ameliorate manic symptoms, in some cases it can help symptoms more related to ADHD. But the two disorders don't really present the same, so that's a long shot.

With that said, no one is going to be able to diagnose you better than a good psychiatrist. Reading things on the internet doesn't always translate to what the symptoms are in real life. Bring what you wrote to your psychiatrist.

You may not get a clear diagnosis for a very long time, but this is a start.

Agreed. Seek a pdoc.

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Thanks for the advices, I will indeed talk about it to my pdoc, I have an apointment in half an hour.

Concerning the Wellbutrin and the manic episodes, I've talked with my girlfriend last night for about 4 hours. We went through all that has happened to our couple in over 9 years and went through my memories prior to our relationship. There are numerous occasions where I clearly acted manic and depressive. My mood swings that got me to the pdoc the first were actually a side effect of my various highs and lows. The fact is, since I started Wellbutrin, I got rid of almost all depressive episodes, which got me in a lot of trouble emotionally and endegenred my relationship and my actual family life. But I also consider that it did help with the manic episodes. More control, no more overspending and lying about it, or seeing things through my eyes where everything works in an almost magical way and that, being the center of the universe, I will be THE one who will benefit from those revelations or truths. I used to get so egocentric, not caring about others... leaving for my pdoc office.

------

I just came back from seeing my pdoc (had a apointment at 10:15 this morning).

I went with my girlfriend and I explained everything I could remember and how it affected me and how I felt, and my girlfriend explained all that she's seen in the last 9 years and all that she had coped for and the horrors of our extreme up-and-down relationship. She also explained that my ups made everything oh so good with me... but it always eventually crashed. Answering lots of questions, it finally made it more clear for everyone of where all those episodes came from. My pdoc mentionned ADHD but the thing is, I never ever had attention deficit, I'm actually a pretty focused guy and am very quick to understand and remember. She ruled out ADHD. She then goes for cyclothymia but with the effects that my ups and downs had on my life and the people around me, she sided more for bipolar II, but not necessarily excluding cyclothymia. My episodes are somewhat rapid (could go for a couple of days or weeks, but very rarely in months) so she finally diagnosed rapid-cycling bipolar II and kept a side note for the cyclothymia.

I finally said that the Wellbutrin definitely helped me for the depressive episodes but I also said that I still have some manic symptoms but they seemed lessened. She actually confirmed that Wellbutrin is an excellent med for depressive symptoms AND manic episodes. She explained how some meds actually precipited manic episodes while Wellbutrin can actually be given to stop a mania from happening. She's really up to date on research and medication. She said that there are alot of studies and research going on for bipolar, ADHD and other neurological sicknesses, and that some conclusions might now link ADHD to bipolar disorders and the neurotransmitter roles in all of this. She explained how and when bipolar can be identified and it can take years to diagnosed it, etc... well, it took me around 20 years to finally understand what was going on with me. I've seen a couple of docs back in the day, but nothing was ever diagnosed like that.

I've read about bipolar people on Wellbutrin and enhanced mania, which I do believe to be true and authentic, but following my pdoc explanation and confirmation, I, in my case, can now say that Wellbutrin is helping me on all fronts.

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I havent heard anything about that either.. in fact Ive heard a bunch of stories about wellbutrin pushing people into mixed states (some SSRIs do that to me). Maybe what your doc meant is that its less likely to cause increased cycling? In any case its probably good to keep seeing this doc for awhile so they can get a feel for whether you remain reasonably stable over time.

Mood stabilizers arent fun stuff but they will help to keep the kindling and mood issues in check. If you can cope without taking them and without the illness becoming worse, why not? Wellbutrin doesnt have much in the way of long term health effects like many AEDs do. Its tough on your liver I think thats about it.

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When my pdoc told me that Wellbutrin helps with depression as well as mania, I myself thought that it sounded weird, espacially with comments I've seen around and such. I evidently won't contradict her, but I will ask her (by email) what she is referring to for the wellbutrin-mania axis ? Most probably a study ?

She goes to alot of medical seminars where they get the latest news in the medical field, she might have gotten her info there. She's been our family physician for almost 5 years and for me as a psychiatrist (she has a speciality in it) for the last 2 years, and she normally is always right or at least, she looks around to make sure she is. She has her own office here and it's a private office, so to keep having patients around, she does general and psychiatry mixed together, depending on the patient needs. Anyhow...

Since what you're calling your manic episodes are somewhat atypical (lasting only a few days at times), she may be waiting to see what happens and if you have one.

I checked it out around and there are rapid cycling bipolar and hyper (even hyper hyper) rapid cycling bipolar, and there's cyclothymia which specifies rapid cycling onset and offset. I also read around that there are as many cycling particularities as there is bipolar people. So who knows ? I'll let my pdoc decide where I stand and since the med she prescribed is working wonderfully, I just have no answer for the atypicalarity (is that even a word?? lol). As for the waiting options, she said that she has noted everything and will now have a fresh startpoint if ever the Wellbutrin fails or if I need a side treatment eventually. We'll see where this gets me, but my guess is that I probably won't have any med update for a long time, at least, I hope so.

Again, thanks for the replies, I find your comments very helpful to make sense of it all in my head.

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I just wanted to add that I've been told by *two* of the professionals I've seen that Wellbutrin has been shown to have mood stabilizing effects. For psych issues, I took nothing but Wellbutrin (XL, 300mg) for quite some time and from my own anecdotal experience, this seems to be the case. (Had previously taken lamictal, but stopped because it was giving me severe head pain.)

I also tend to have a brain that reacts differently to drugs than the majority of the population, so maybe this just happens to a small percentage of people with strange brain chemistry?

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Thanks for the add-in information Anodyne Oblivion, it seems that some physicians out there have the same opinion concerning Wellbutrin.

I've been having lots of manic symptoms in the last month and they increased this week. They actually did because of the extreme excitation I'm in since I finally was able to put my finger on what was happening to me (and for the last 20 years!!) and that, through this "discovery", I was able to share so much with my girlfriend. I just want to do 8 things at the same time and spend my days buying stuff uncontrollably (mtg cards, food, lottery tickets, going nuts in walmart...) its hard but my g/f is my own private angel and she always brings me back on my feet. And on the other hand, she enjoys the increased energy in the bedroom :D

No answer from my pdoc yet. Will wait a week before bugging her about it again.

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True Dianthus, I agree. That's why I want a comeback from my pdoc on what evidence she has to back this up.

Logically, in my own opinion, I would say that Wellbutrin is not a good mood stabilizer for bipolar people, or unipolar manic ones. My guess is that it might be so for the unipolar depressed people, just gets them more leveled and less depressed, not sure that it can send them into reversed manic episodes. But again, that's only my two cents.

Personally, if Wellbutrin keeps getting me, as it's been doing for the last 18 months, on a "controllable" manic without any major depressive breakdowns, for me, it's a relationship/life saver.

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If someone reads this, I finally had my answer from my pdoc:

As of this afternoon, she just came back from a psychiatry conference, to better answer my questions, she spoke with the lecturer about the wellbutrin-mania axis. His answer was that no one really knows why some people enter a manic episode on antidepressants. He continues saying the Wellbutrin is weaker than the other antidepressants and that might explain why it has a tendency to cause less med-induced manias, he also says that, in his opinion, med-induced manias are extremely rare. Another hypothesis in favor of the Wellbutrin is that it involves dopamine and not serotonine (which he didn't specified but guessing is that SSRI's might cause more manias than Wellbutrin).

Mind you, I'm French Canadian and I translated my pdoc email as best I can, so it might have slight wording innacuracy, but on the whole, I think it's an ok translation.

See ya

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I think the norepinephrine is the problem. I just read about this. I was curious because I had to go in the hospital when Wellbutrin put me in a mixed state. Then I started Geodon last week, and by Sunday, felt the exact same way. I googled it, and found some stuff about patients having higher levels of norepinephrine when in mixed states. I suppose you need to be susceptible or something, since it doesn't happen to everyone who takes it. Definitely doesn't stabilize the mood, but good for anxiety, depression and ADHD, I suppose.

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Wellbutrin helps me, and doesnt drive me into mixed states.. I think my previous experience with mixed states was the fault of SSRIs. The only drawback to wellbutrin that I can find, is that its effects poop out over time. Im on yet another retrial of it and its like taking a sugar pill. I may ask the doc for an NRI in its place. Too bad there isnt anything else quite like it..

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If someone reads this, I finally had my answer from my pdoc:

As of this afternoon, she just came back from a psychiatry conference, to better answer my questions, she spoke with the lecturer about the wellbutrin-mania axis. His answer was that no one really knows why some people enter a manic episode on antidepressants. He continues saying the Wellbutrin is weaker than the other antidepressants and that might explain why it has a tendency to cause less med-induced manias, he also says that, in his opinion, med-induced manias are extremely rare. Another hypothesis in favor of the Wellbutrin is that it involves dopamine and not serotonine (which he didn't specified but guessing is that SSRI's might cause more manias than Wellbutrin).

Mind you, I'm French Canadian and I translated my pdoc email as best I can, so it might have slight wording innacuracy, but on the whole, I think it's an ok translation.

See ya

From this I get that Wellbutrin may be less likely to elicit mania, but nothing about its actually functioning as a mood stabilizer.

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  • 2 weeks later...

If someone reads this, I finally had my answer from my pdoc:

As of this afternoon, she just came back from a psychiatry conference, to better answer my questions, she spoke with the lecturer about the wellbutrin-mania axis. His answer was that no one really knows why some people enter a manic episode on antidepressants. He continues saying the Wellbutrin is weaker than the other antidepressants and that might explain why it has a tendency to cause less med-induced manias, he also says that, in his opinion, med-induced manias are extremely rare. Another hypothesis in favor of the Wellbutrin is that it involves dopamine and not serotonine (which he didn't specified but guessing is that SSRI's might cause more manias than Wellbutrin).

Mind you, I'm French Canadian and I translated my pdoc email as best I can, so it might have slight wording innacuracy, but on the whole, I think it's an ok translation.

See ya

From this I get that Wellbutrin may be less likely to elicit mania, but nothing about its actually functioning as a mood stabilizer.

Exactly SachaSue. I think today that all of those meds, antidepressants and mood stabilizers, have a chance of helping/stabilize our moods (whatever your mood axis is), but on the other hand. they all have a chance of f***ing you up. Many of us end up in a trial and error stability quest with those meds and with the indispensible help of our pdoc.

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If someone reads this, I finally had my answer from my pdoc:

As of this afternoon, she just came back from a psychiatry conference, to better answer my questions, she spoke with the lecturer about the wellbutrin-mania axis. His answer was that no one really knows why some people enter a manic episode on antidepressants. He continues saying the Wellbutrin is weaker than the other antidepressants and that might explain why it has a tendency to cause less med-induced manias, he also says that, in his opinion, med-induced manias are extremely rare. Another hypothesis in favor of the Wellbutrin is that it involves dopamine and not serotonine (which he didn't specified but guessing is that SSRI's might cause more manias than Wellbutrin).

Mind you, I'm French Canadian and I translated my pdoc email as best I can, so it might have slight wording innacuracy, but on the whole, I think it's an ok translation.

See ya

From this I get that Wellbutrin may be less likely to elicit mania, but nothing about its actually functioning as a mood stabilizer.

Exactly SachaSue. I think today that all of those meds, antidepressants and mood stabilizers, have a chance of helping/stabilize our moods (whatever your mood axis is), but on the other hand. they all have a chance of f***ing you up. Many of us end up in a trial and error stability quest with those meds and with the indispensible help of our pdoc.

No. Antidepressants don't have mood stabilizing properties. They work only against depression. They will not be effective against mania, and may well exacerbate it.

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If someone reads this, I finally had my answer from my pdoc:

As of this afternoon, she just came back from a psychiatry conference, to better answer my questions, she spoke with the lecturer about the wellbutrin-mania axis. His answer was that no one really knows why some people enter a manic episode on antidepressants. He continues saying the Wellbutrin is weaker than the other antidepressants and that might explain why it has a tendency to cause less med-induced manias, he also says that, in his opinion, med-induced manias are extremely rare. Another hypothesis in favor of the Wellbutrin is that it involves dopamine and not serotonine (which he didn't specified but guessing is that SSRI's might cause more manias than Wellbutrin).

Mind you, I'm French Canadian and I translated my pdoc email as best I can, so it might have slight wording innacuracy, but on the whole, I think it's an ok translation.

See ya

From this I get that Wellbutrin may be less likely to elicit mania, but nothing about its actually functioning as a mood stabilizer.

Exactly SachaSue. I think today that all of those meds, antidepressants and mood stabilizers, have a chance of helping/stabilize our moods (whatever your mood axis is), but on the other hand. they all have a chance of f***ing you up. Many of us end up in a trial and error stability quest with those meds and with the indispensible help of our pdoc.

No. Antidepressants don't have mood stabilizing properties. They work only against depression. They will not be effective against mania, and may well exacerbate it.

I stand corrected. I was surfing away alone on the ocean there, not looking around if I was stil ok or not.

Just read this: seems some studies concluded that co-administrating an antidepressant (wellbutrin or paxil vs placebo) with a working mood stabilizer in bipolar disorder does not necessarily have any added benefit. Even the emergence of a manic episode during the study on both antidepressant were the same as placebo: all three had 10% of people turning manic. Damn, this is a complicated disorder.

http://www.sciencedaily.com/releases/2007/03/070329075342.htm

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