Bi-polar and depression.

[LovesAlluNeed]

I wanted to share my story on dealing with bi-polar. Here's the short version:

Diagnosed bi-polar when I was about 17, from a doctor who knew me for no more than about 5 minutes, I started out on Depakote and Risperdal. I gained about 60 pounds from them over the course of about 1 year, also developing severe cystic acne (which my current doc thinks has nothing to do with med's) which 10 years later still plagues me. I tried everything; Abilify, Geodon, Paxil, Effexor, Lamictal, and currently I take Wellbutrin and Seroquel. I am sure there is more that I can't remember.

Anyways, only recently have I discovered that the past 10 years of my life have been a complete blur. I have not really "felt" much of anything, which I guess is the goal of medication when you are bi-polar. No highs, no lows. I have aced that. Additionally, I have never felt true anger OR true love... I feel very detached from people and experiences. That's not the way I want to live the rest of my life... when I think of what the word "living" means I think of having joy, love, sadness, and everything else inbetween. To go through the rest of my days feeling numb and flat is not for me. I believe that all of the med's have certainly played a huge role in this. I think many people feel as if they are over-medicated. America is over-medicated. I am certainly not a doctor by any means, BUT, I do know how I feel. It's normal to be happy, and it's normal to be sad. That's what life is all about.

I am slowly as can be tapering off of my current med's (with my doctor's help) to see what life is all about again. He in no way encouraged it, but he is always willing to help me do what I want to do.

Some people ask "What is normal?" Normal to me is feeling things, and having the right to be happy and sad when you should.

Does anyone else agree with me on this? I am fortunate enough to have a supportive family, doctors, and friends which always helps as well.

Just some thoughts, to see what others think.

[Astro]

Originally Posted by LovesAlluNeed

Some people ask "What is normal?" Normal to me is feeling things, and having the right to be happy and sad when you should.

Does anyone else agree with me on this? I am fortunate enough to have a supportive family, doctors, and friends which always helps as well.

Just some thoughts, to see what others think.

Thank you for your share Loves, this is the first post I've read of yours (I'm a little slow lately. Lol) so let me also give you a belated welcome to SR.

I really don't have much experience with BP, but I've taken Paxil and EffexorXR, part of your share struck me as eerily familiar, namely these things:

I discovered that the past 10 years of my life have been a complete blur. I have not really "felt" much of anything, which I guess is the goal of medication when you are bi-polar. No highs, no lows. I have aced that. Additionally, I have never felt true anger OR true love... I feel very detached from people and experiences. That's not the way I want to live the rest of my life... when I think of what the word "living" means I think of having joy, love, sadness, and everything else inbetween. To go through the rest of my days feeling numb and flat is not for me.

For the short time I took my meds (1 year) at least half that time I felt like I lived in a fog, the best way I've heard it described is "cobwebs in the brain". Each function or effort, whether it was brushing my teeth or shaving in the morning, or trying to go through my duties at work, meant focusing any remaining energy and clarity I had left on the task at hand. I felt ashamed, embarassed, and mostly afraid. My fear was that I couldn't be a complete father to my children, or a good employee.

There was one experience in particular that signified the beginning of my return to "normal". One of my brothers suggested that I sit outside at a cafe and enjoy the fresh air and sunshine. Until that time I'd mostly isolated at home. I remember sitting at that coffee shop, and feeling so warm in the sunlight, the cold and darkness were washing away. People smiled at me, and I wasn't too afraid to smile back. I became a fresh air junkie after that, riding my bike, taking walks, and going every day to that coffee shop. Those cobwebs didn't just magically disappear, but they slowly lessened. 7 months later I tapered off the Effexor, I haven't taken anything since then.

I wish you the best in tapering off, and hope your path to "normal" is a peaceful experience. Please keep talking to your doctor, do this safely, and keep us updated on how you're doing.

[nandm]

The medications used to treat bipolar are not designed to numb the person. The goal of medication therapy is to normalize and stabilize the nervous system to allow it to work as it was designed.

Some information on mood stabilizers:

At this moment in medical history, successful bipolar treatment has to be grounded in medications. You will want to find out the medications that are available and understand their different advantages, so that you can discuss them with your doctor and help choose the ones that suit you best. ......

MOOD STABILIZERS
Most of the medications that have been proven to help bipolar disorder belong to this class of medications called "mood Stabilizers." Mood stabilizers reduce all bipolar symptoms by working directly on the brain cells that cause bipolar disorder, and they are the only bipolar treatment known to prevent manic or depressed episodes from occurring. Mood stabilizers stop the flow of unnecessary thoughts, help to remove the mental "fog", and clear the mind. They reduce distractibility and thus improve attention. Mood stabilizers can control mood, minimize anxiety, and agitation, and decrease the frequency and severity of angry episodes. Mood stabilizers allow your nervous system to function the way it was meant to so that you can become your most natural self.

What do mood stabilizers do in the brain?
All the medication in this class stabilize parts of the brain cell membranes (sodium channels) to keep brain cells firing at the normal rhythm. There is also some scientific evidence that carbamazepine, valproate, and lithium salt can help protect and/or grow new, healthy brain cells in adults. Moood stabilizers, especially carbamazepine, are often used after brain injury as part of the recovery process. The full implications of these findings are not yet appreciated.

How do you decide the optimal dose of bipolar medication?
I try to encourage a good working relationship with my patients where we both participate equally in making decisions. We discuss our progress and where we want the treatments to go and we make decisions accordingly. Often, patients can recognize the problems that bipolar disorder causes them and want to help raise their own medication dose to the optimum level. For patients who have not yet learned to recognize their disease symptoms, I make the lion's share of the decisions at first and try to draw them into the treatment as soon as possible.

The Bipolar Handbook Wes Burgess, M.D., Ph.D.

I have found that partnering with my psych doc helps me to achieve the best results from medication for me. I in no way seek to be numb. I spent 20 years numbing myself with alcohol. I did experience some numbness with a mood stabilizers but spoke with my psych doc and the medication was changed. Problem solved, no more numbness. This is my experience.

I do understand no longer wanting to feel numb. I think that most bipolar seek to find that place between numbness and insanity. I wish you the best with your decision and do hope you find that place.

[jurneyman]

Hi Nandm, I have been on lamictal since around the first of the year, and have had no problems, in your post I didn't see a reference to it as a mood stabilizer. Yesterday I triggered an old fear with something similar, and I overreacted with anger and anxiety, I wrote my way through it on another thread, but that reaction got my attention. Does the good Dr. Burgess have anything to say about it. Or have you had any personal experience with it. I am not asking for advice, but someone else's experience might help.

[evmdimples]

Loves, of your original post, this is what sticks out (and bothers me): "Diagnosed bi-polar... from a doctor who knew me for no more than about 5 minutes." And then nandm's post about meds not supposed to numb you, raises some red flags. Be aware that doctors can misdiagnose.

I was involved with someone who presented some strange behaviors from the start. In the beginning, she was on Lexapro (slept a lot, seemed to be emotionally void... flat as you say, etc.) 6 mos. into the relationship she decided to quit the Lexapro, slowly at first and then suddenly, cold turkey. (She also expressed not wanting to go through life "numb.") Unfortunately, that's when everything started to fall apart. After a few more months of craziness, I realized it wasn't me... so I gathered the facts/symptoms, etc., did my own research and came up with Borderline Personality Disorder, which can co-occur with bi-polar, depression, OCD, etc. When I confronted her, she said she'd been told she might have Bipolar (she does have OCD). More research on my part tells me that Lexapro is contraindicated for bipolars. (I think she was taking it for depression?) Based on my experiences with her, I still believe she is mainly BPD. From what I've researched, BPD can often be mis-diagnosed as Bipolar. Treatments are different but if people present with both or more illnesses they need to be monitored carefully.

I guess the main point I want to make is that doctors make mistakes and misdiagnose and the patients pay dearly for those mistakes, sometimes for years. If the original diagnosis was made 5 mins. after dr. met you... have you been re-evaluated since then? I'm sure you know all this, but here goes anyways: patients need to take an active role in their wellness program: educate themselves about these illnesses and learn about the different management methods that exist; actively co-partner with their primary healthcare provider to figure out what works (what doesn't) and what will improve the quality of their lives. And if like you say, there are supportive family members/partners, enlist them to assist in pinpointing behaviors that patients may not even be aware of (GF did many things she wasn't aware of), and also enlist them to help the patient in the management process.

I'm stepping off the soap box now! (I hope I haven't offended anyone, this is just something near and dear to my heart as it affects not only the person with the illness, but those who love them. Maybe my new career can be patient advocate.)

Take care of yourself.
elena

[nandm]

Originally Posted by jurneyman

Hi Nandm, I have been on lamictal since around the first of the year, and have had no problems, in your post I didn't see a reference to it as a mood stabilizer. Yesterday I triggered an old fear with something similar, and I overreacted with anger and anxiety, I wrote my way through it on another thread, but that reaction got my attention. Does the good Dr. Burgess have anything to say about it. Or have you had any personal experience with it. I am not asking for advice, but someone else's experience might help.

I am also on Lamictal. Stress can cause bipolar symptoms to get worse. There is a thread titled "Interesting bipolar facts" I will post the Lithium information on that this evening. The information in that thread comes from the book by Dr. Burgess. I don't want to highjack this thread.

[jurneyman]

I didn't mean to hijack your thread, my personal question to Nandm was posted here by
mistake instead of the one on Bi-Polor.

[gmc]

Hi, I am also on Lamictal.

I actually did a lot of research on the net before I went in and was fully expecting him to tell me I am bipolar ( I had 6 yrs of cycles that I tried to manage myself that progressively got worse). Of course, I went in the middle of a depression / low cycle and I knewww that I would come out of it eventually and thinking life was great.

So, when he told me he wanted to put me on a mood stabilizer and an anti-depressant, I told him I would take the mood stabilizer to soften the crash I knew was coming but I would not take the anti-depressant because I knew I would feel like life was awesome after I crashed.

He thought this was fine and I have been on Lamictal for 6 years. It changed my life. Managing bipolar for me is a combo of my Lamictal, my diet, exercise, and monitoring my sleep. I also take constant inventory about where i am at and how I feel so I can take steps if I feel down - like making sure I get sleep if ive not slept much, being extra careful with my diet, low-intensity exercise for a release but not exhausting myself.

The point of this long email is 1) Like has already been said, Lamictal is a mood stabilizer, not an anti-depressant and 2) Medication is only one part of handling your mental needs.

Good luck!
Gabby

[Isaiah]

I think that the surge in psychiatrics is due to the way modern life is set up. I don't think that we're just better at diagnosing people, or that people are over-diagnosed. As psychiatric care is becoming a norm, I think it's just a reaction to the type of world we're living in. "Normal" is just becoming harder and harder for someone with a mental disorder.