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Bipolar as a spectrum-- general thoughts and inquiry.


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You are hanging on by a thread?? That does not sound good.

I am not sure whether it matters if you have a DX for BP 2, or MDD, or Mood Disorder NOS.

What matters is treatment for your symptoms.

Has your doctor tried mood stabilizers?

You want to try and make outpatient work? What is going on with you which makes you consider inpatient?

What symptoms do you have that your Wellbutrin is not treating?

And, if your brain is bipolarish, then treatment of ADHD without stabilzing moods can be an issue.

Your post sounds so reasonalbe and together.....but then your last paragraph implies serious problems.

Extreme irritability and agitation? That could be treated in a number of ways including Depakote, Lamictal, and Seroquel.

Plus lots of other ways. I think you need a very honest conversation with your psychiatrist and if he does not GET IT

then you need a NEW Psychiatrist.

take care, Ladybug

these are just my opinions.....

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There's always bipolar nos, its just a fact of life that mental illness can't be categorically filed into neat little diagnoses. I don't experience hypomania, but maybe you fall in the "fast cycling" range. I don't really know, bipolar confuses the hell out of me (ironically the one I apparently have).

First of all i haven't had good reactions to any form of ADs and from what I hear this happens to a lot of people. What you should be doing is treating with a mood stabilizer as a base so you can gauge what needs to change on a level playing field. There are AD's out there that help for bipolar (quite a few) but I can't help you there.

Ahh. bpladybugs post just popped up, I'm gonna go ahead and bow to the maestro and move along. ^_^

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Treatment-resistant MDD is often treated with mood stabilizers, and I'm surprised that you aren't on one. The diagnosis isn't as important as the treatment, and if you are getting the right treatment, it doesn't matter what the diagnosis turns out to be. I have treatment resistant MDD. It has been suggested that I might have some unusual form of bipolar because no AD works for me, but a mood stabilizer does (and possibly an AAP). I frankly don't care. I just want to feel better.

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This links to the DSM5 working group on bipolar. It will give you an idea what they are considering for the disorder. For example, the period of hypomania is shortened. Also look at depression. The "specifiers" are the spectrum part as far as I can tell. They cross over.

endless ramblings about psychology and mental illness

Is why we are here. :)

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I like the idea of bipolar being a spectrum, because it's really just a tool for getting people the right drugs.

For you, I am surprised you aren't on a mood stabilizer. Being on a mood stabilizer has really helped me, even though I didn't get a change in diagnosis until a few months ago. I sort of feel like I would have been better sooner if there was a mood stabilizer introduced sooner. Definitely ask your doctor about it though!

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I too personally agree (and see) that BP falls on a far wider spectrum than current dx. Again, the best way to tell would be to try some BP drugs and see if they help you, in my opinion.

I do consider failure on many ADs to be a strong indicator, honestly.

Anna

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I also agree that the diagnosis isn't the real key to fixing all your problems - it's the treatment that matters. I would definitely ask your doctor about something along the lines of a mood stabilizer or atypical antipsychotic to see if they help your symptoms. But that's between you and your doctors.

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I was scared to try more mood stabilizers or AAP's until I had tried more AD's, but I really have nothing to lose by giving them a go...and literally everything to gain.

I'm not sure why you'd be scared to try other classes of drugs besides ADs? Lamicatal has been a life-saver for me, and I'm sorry previous pdocs didn't consider a BP II dx for me because now I will always wonder if I stayed ill more than I had to....

Hope you find something that gets you symptom-free.

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Agreed, other drugs can be scary. It can be overwhelming to consider a new dx, spectrum, or class of drugs.

However, I have found, after being on MOST BP drugs, they aren't scary. I've had good and bad experiences with them, and over time have developed a workable med regimen.

I am scared of SSRIs, like crazy, my doc put me on them about 7 months ago, now I'm on like 10 meds to freaking function and manage health side effects. It's probably going to take a year or so to restabilize. Now THAT is fucking scary to me.

Find the right class. It really rocks.

Anna

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