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...if the Lithum is working, does that mean I'm BD


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Five days ago my psychiatrist switched me from Depakote to Lithium.  The Depakoe was suppressing my mood swings, but not doing anything for my urges to cut [and possibly making them worse].  On it, I still had the occational mood dip where I would end up harming myself kinda bad.  I'm also on Paxil CR for depression..

See, I originally started counseling for my drastic mood swings, relationship instabilities, and depression.  My [former] therapist agreed that I met all the requirements for Borderline Personality Disorder, but refused to treat me as a BPD.  She did not really BELIEVE in it.  So when I saw the psychiatrist, he gave me something for depression [Paxil CR].  But soon I noticed I started to loose control- I wasn't as depressed...but I would have these episodes that would last all day where I was COCKY and MEAN.  I would try to physically harm my friends and loose control and go on drug binges.  [i took an excess of 400mg of DXM in Delsym form and got serotoning syndrome and was incapacitated for a week].

So when I was better, I told my doctor about this and he said those who are possibly Bipolar react this way when they take SSRI's alone.  So thus I was put on Depakote.

So back to the present...

for a whole week I have been feeling GREAT.

No dips in my mood, no depressive states, and my urge to cut is pretty much non-existant.

When I last went with my therapist, she mentioned Dissociative Personality disorder and Depression, but we haven't met enought for her to evaluate if I am BD or BPD or not.

I know your diagnosis doesn't really matter...BUT I would just like to know- DOES THIS MEAN I WILL BE ON MEDS THE REST OF MY LIFE??  This is the most "in" myself I've felt in years..

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Hi DoD, welcome.

I'm running late tonite so will be short.

Do you have to take the med for the rest of your life? That is one of the big shockers that we all deal with at the beginning.

One Pdoc writes that his answer to that is to tell his patients "Lets just plan for three months and see how you are doing then."

Don't try to deal with your whole life this week.

Glad that you have felt so great this week.  That is a real gift, especially so early in treatment.  Probably not all weeks will be like that, so try to carry a memory of it as a motivation for what you are working toward.

Again welcome.

A.M.

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To answer your question, to me (I am NOT a medical professional) it sounds like BP. BP shares so many commonalities with BPD that many psychiatrists think that BPD is another manifestation (as if there aren't enough manifestiations!) of BP.

I think it is highly probably you have a form of bipolar disorder. Be prepared to take meds your entire life. Sorry to say. As I said, I am not a medical professional, just another crazy person with lots of experience being crazy. If it makes you feel better, go for it. There could be periods of med-poop-out, periods of med readjustments, periods where you feel like shit and go back to feeling like worse shit. But at least you have a treatment team and some hope now.

Fire whoever told you they don't believe in borderline. They suck.

loon

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There are two types of depression: unipolar and bipolar.  Generically, if you react to antidepressants with symptoms of mania or hypomania, a good psychiatrist will then treat you as if you are bipolar, regardless of whether you are or not.  Sometimes this is called Bipolar III, or med-induced bipolar.  If your reaction to the SSRI Paxil is your typical reaction to SSRIs and other antidepressants, then you are, for all intents and purposes, bipolar.  You should be treated for bipolar for the rest of your life.  Whether this will always involve meds is another discussion.

As for BPD vs. BP, BPD is not depression and therefore not bipolar.  I challenge anyone to produce evidence that BPD is a form of depression.  BP may be comorbid with BPD, but BP may also be comorbid with ADD.  It is hard to distinguish some of the symptoms of ADD with those of BP, but they are two separate illnesses.  The same is true of BP and BPD.

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Purely from a medication standpoint, the fact that Lithium seems to work doesn't indicate Bipolar Disorder.

I may be hugely mistaken, but Lithium works as a mood stabilizer. and should work as a mood stabilizer for anyone. Where the life sentence comes in is those of us with BP will need or moods stabilized for the rest of our life, whereas someone who is dealing with something more episodic may only need that support for a short period of time.

(That was a really long sentence.)

Please, someone jump in if I'm way off base, but I'm just addressing the title of this thread.

No, the fact that Lithium works for you does not mean you are Bipolar.

InfoNut

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Hey!!

I'm fairly ignorant in all this, so i'm just going to tell you my position and how i feel.

My life is crap right now, i've only just started on SSRI's, and i've had the same rage filled incidents, i'm not into cutting - but i've been on drug binges the last couple of weeks, i've done up to 80-120 pills a week.

If you've found something that's helped you feel stable, i really wouldn't worry if you have to be on it for the rest of your life. It you're given a choice of a real crap life, no life, or a life of drugs.... i think i'd take the life on drugs.

It's going to give you more than what you have, and for that price it's worth it.

Justin

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Please, someone jump in if I'm way off base, but I'm just addressing the title of this thread.

No, the fact that Lithium works for you does not mean you are Bipolar.

InfoNut

<{POST_SNAPBACK}>

Correct.  But if the hypomanic reaction to SSRIs is patterned, it indicates BP.  The fact that the mood stabilisers have been successful will likely make them the primary treatment drug and I think that this is a remarkable success story in diagnostics.  Kudos to the physician.

PS. Apparently according to the interknot med-induced BP is BP IV.  Okee dokee.

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You describe that you have "drastic mood swings" which could certainly point you in the BP direction. Also, that reaction to antidepressants is typical. But of course, only a doctor can make that diagnosis.

I was initially diagnosed as Borderline, then when a doctor investigated it a bit more we figured out it's Bipolar. I have classic manias (like when I wake up my parents at 2 am by running around the apartment and jumping, and then run into their room to tell them God is in the room...) so there's not that many other diagnoses to choose from.

Well, back to you. In my opinion, therapists are usually not that great on giving diagnoses. A psychiatric doctor have more experience with that. No, just because Lithium works, it doesn't mean you're bipolar. But it means there's a possibility you and your doctor should look into more.

If you ARE bipolar it's highely likely you will be on meds for the rest of your life. That can be harsh to accept, but I've finally beginning to accept this fact. It's not that bad. It's better than being unstable, isn't it? Side effects can really, really, really suck. But it's all a matter of finding a med that works for you with minimal side effects.

Hope you continue to feel this good! I'm thinking about you.

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just one additional thought...

If you end up feeling much better on the Li and Paxil, try to avoid thinking of the medications as For. The. Rest. Of. Your. Life. It's just another of those daily inconveniences like showering, shaving, brushing your teeth. As you feel better and remain stable, the idea of taking the meds will kind of blend into the background of all the other annoying things you have to do.

The most important thing is how good you're feeling. Congrats on THAT!

Greeny

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What Greeny said!

You described the meds as being very helpful to you. You have energy and balance and feel like yourself. Lithium is probably the most researched and studied mood stabilizer out there. It's been around a long time, and as long as it's properly maintained as far as blood levels, I think it's probably one of the safest to take.

I really like Greenyflower's view on it. It's not some outlandish thing that is going to crimp your whole life if you have to stay on meds. There are ALOT of things you have to do for the rest of your life! You have to shower if you don't want to be smelly, brush your teeth if you don't want to have cavities, and take your meds if you don't want to be crazy. See? As long as they're working for you, it's only a big deal if you make it be a big deal.

Something that may help is to switch focus. Look at all the things you can do now! Look at the way you're feeling and how clearly you're thinking! Personally, I worry more about making sure I CAN BE on my meds for the rest of my life! Good luck getting them away from me without a damn good reason!

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