PAWS vs. Bi-Polar?
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Join Date: Nov 2013
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PAWS vs. Bi-Polar?
I have recently been diagnosed as bi-polar and my psych doc wants to put me on meds (buspar, lamotigine and wellbrutrin).
However I have also recently stopped drinking (approaching 3 months) -- and am concerned that this may be PAWS instead of bi-polar (and am reluctant to take and/or become reliant on such serious meds if not needed).
Prior to quitting drinking (about 5 months ago) I was put on Celebrex for six weeks for anxiety/depression -- it was a nightmare and caused huge mood swings, inability to sleep, etc. Hence referral from my family doc to a psych doc and the current diagnosis.
Does my reaction to Celebrex confirm bi-polar (and therefore not PAWS)?
I have drank heavily on a daily basis for over ten years -- and didn't notice any mood swings apart from (1) needing a drink to take the edge off at the end of the day, or (2) needing a coffee to get going.
I am meeting with my psych doc Monday and am trying to decide how hard to push back on the meds (or not).
Any insights?
However I have also recently stopped drinking (approaching 3 months) -- and am concerned that this may be PAWS instead of bi-polar (and am reluctant to take and/or become reliant on such serious meds if not needed).
Prior to quitting drinking (about 5 months ago) I was put on Celebrex for six weeks for anxiety/depression -- it was a nightmare and caused huge mood swings, inability to sleep, etc. Hence referral from my family doc to a psych doc and the current diagnosis.
Does my reaction to Celebrex confirm bi-polar (and therefore not PAWS)?
I have drank heavily on a daily basis for over ten years -- and didn't notice any mood swings apart from (1) needing a drink to take the edge off at the end of the day, or (2) needing a coffee to get going.
I am meeting with my psych doc Monday and am trying to decide how hard to push back on the meds (or not).
Any insights?
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Join Date: Dec 2011
Location: CA
Posts: 40
Full disclosure: I am a bipolar alcoholic (still drinking). I think you mean Celexa (not Celebrex). Celexa is a SSRI antidepressant.
Most pdocs want you off the alcohol so they can give you a clear diagnosis. Are you no longer on any meds and experiencing symptoms? If so, you need to be direct and honest with your pdoc about what to expect withdrawal wise to see if you can both reach a mutual decision regarding you care med-wise.
I denied my bipolar diagnosis as being related to raging hormones (I'm perimenopausal) and my thyroid, but ultimately, every time I go off my bipolar meds I become a raging maniac. Some people get the happy high, but not me, I become very angry and impulsive.
I wish you luck in whatever you decide...ultimately the decision is up to you, as you are the one who has to be sold on taking the medications.
Most pdocs want you off the alcohol so they can give you a clear diagnosis. Are you no longer on any meds and experiencing symptoms? If so, you need to be direct and honest with your pdoc about what to expect withdrawal wise to see if you can both reach a mutual decision regarding you care med-wise.
I denied my bipolar diagnosis as being related to raging hormones (I'm perimenopausal) and my thyroid, but ultimately, every time I go off my bipolar meds I become a raging maniac. Some people get the happy high, but not me, I become very angry and impulsive.
I wish you luck in whatever you decide...ultimately the decision is up to you, as you are the one who has to be sold on taking the medications.
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Join Date: Jan 2011
Posts: 1,126
For sure, alcoholism masks mental disorders. I would ask yourself if your doctor has given you a solid bi-polar diagnosis.
I am no doctor, and please don't misconstrue this as medical advice, but it is my layman's understanding is that bipolar implies extreme mood swings, periods of mania followed by deep depression.
Then again, there is hypo-mania, a lesser elevation of mania followed my low depression.
Then again, a few decades ago, that would describe someone who is moody.
I am wary of doctor's who prescribe a medication which creates a side effect of agitation or anxiety or depression and than says that the medication has revealed a underlying mental disorder -- bipolar, which calls for new medication.
How long have you been under this psychiatrist's care? Did the doctor make the diagnosis after a few minutes? after several hours of treatment?
Perhaps you cold research bipolar symptoms yourself and see if you meet the criteria, and then read what others with bipolar have to say about the medication.
I'm not suggesting you be your own doctor, but rather a better informed consumer of psychiatric care.
I am no doctor, and please don't misconstrue this as medical advice, but it is my layman's understanding is that bipolar implies extreme mood swings, periods of mania followed by deep depression.
Then again, there is hypo-mania, a lesser elevation of mania followed my low depression.
Then again, a few decades ago, that would describe someone who is moody.
I am wary of doctor's who prescribe a medication which creates a side effect of agitation or anxiety or depression and than says that the medication has revealed a underlying mental disorder -- bipolar, which calls for new medication.
How long have you been under this psychiatrist's care? Did the doctor make the diagnosis after a few minutes? after several hours of treatment?
Perhaps you cold research bipolar symptoms yourself and see if you meet the criteria, and then read what others with bipolar have to say about the medication.
I'm not suggesting you be your own doctor, but rather a better informed consumer of psychiatric care.
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Thread Starter
Join Date: Nov 2013
Posts: 2
Thank you everyone for your responses...
Sorry... your are right... not celebrex... it was CIPRALEX (aka escitalopram/lexapro)...
Monday will be my third session with the psych doc... and not currently on any meds...
Symptoms "fit" bipolar since my bad reaction to cipralex (big time mania, rage episodes as never before experienced) and to a lessor extent since quitting drinking (moody and feeling uncharacteristically "fragile"/emotional)... but really hard to say prior to then given amount/frequency of alcohol and caffeine...
When drinking, I become more friendly/animated/outgoing -- and then at a certain point get tired -- NOT aggressive/angry/reckless...
"External drivers" were also present for the anxiety/depression which led to the cipralex... so hard to say extent bipolar may or may not have played...
So there is some uncertainty in my mind that it is the right diagnosis (that I can be diagnosed before being sober longer)...
At the same time, I also want to get back to functional (if not "normal) sooner versus later...
Hence confusion...
Sorry... your are right... not celebrex... it was CIPRALEX (aka escitalopram/lexapro)...
Monday will be my third session with the psych doc... and not currently on any meds...
Symptoms "fit" bipolar since my bad reaction to cipralex (big time mania, rage episodes as never before experienced) and to a lessor extent since quitting drinking (moody and feeling uncharacteristically "fragile"/emotional)... but really hard to say prior to then given amount/frequency of alcohol and caffeine...
When drinking, I become more friendly/animated/outgoing -- and then at a certain point get tired -- NOT aggressive/angry/reckless...
"External drivers" were also present for the anxiety/depression which led to the cipralex... so hard to say extent bipolar may or may not have played...
So there is some uncertainty in my mind that it is the right diagnosis (that I can be diagnosed before being sober longer)...
At the same time, I also want to get back to functional (if not "normal) sooner versus later...
Hence confusion...
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Join Date: Nov 2013
Posts: 1
Informed Consent
egbdf12345,
I believe that you are right to focus on your recovery from alcohol use. I've always found it better to deal with one medical problem at a time, whenever circumstances allow. Psychiatrists are not supposed to make diagnoses when there are other drug-related factors that could explain the symptoms.
Additionally, there are several things people should know before making any decisions about psychiatric treatment for bipolar.
1) CIPRALEX as an SSRI can cause a switch into mania (search for 'SSRI mania' in google). A lot of doctors will claim that the SSRI 'uncovered a pre-existing case of bipolar'. Since researchers estimate that at least 30% of people who have never before experienced mania and who are exposed to an SSRI will eventually experience mania, perhaps these drugs are creating 'bipolar' where it never existed before. Doesn't it make more sense to first try treating a (potentially) drug induced mania by withdrawing the SSRI (slowly, over a period of at least 6 months), than by adding more drugs? If that doesn't work, one can always resort to other drugs later.
2) One cannot just 'try' these drugs. Indeed, many people say that withdrawal from these drugs can be more difficult that withdrawal from many street drugs, including coke and meth which are both psychoactive. Some people think that taking the drug according to a doctor's prescription will save them from drug dependence, but there are no guarantees (just talk to people who are hooked on pain meds). If you do decide to try any of these psychoactive drugs temporarily, please quit them very slowly to save yourself from their nasty withdrawal symptoms (search "Psychiatric drug withdrawal 101" in google).
3) There are a host of side-effects with these drugs that many doctors refuse to discuss. Their reasoning seems to be that if people knew about the severity and frequency of the side-effects, they wouldn't take them. Hmm... (pause for thought). It's best to be informed about side-effects from sources other than the drug company wanting to sell it to you. Specifically the federal government has a side-effect reporting system, and much of that data (including drug interactions) is available at rxisk.org
What is my interest in making this list? These are the things that I wish someone had told me before I agreed to be treated by a psychiatrist for bipolar. I believe that these disclosures are necessary before there can be any legitimate informed consent.
No matter what you decide, I wish you the best.
I believe that you are right to focus on your recovery from alcohol use. I've always found it better to deal with one medical problem at a time, whenever circumstances allow. Psychiatrists are not supposed to make diagnoses when there are other drug-related factors that could explain the symptoms.
Additionally, there are several things people should know before making any decisions about psychiatric treatment for bipolar.
1) CIPRALEX as an SSRI can cause a switch into mania (search for 'SSRI mania' in google). A lot of doctors will claim that the SSRI 'uncovered a pre-existing case of bipolar'. Since researchers estimate that at least 30% of people who have never before experienced mania and who are exposed to an SSRI will eventually experience mania, perhaps these drugs are creating 'bipolar' where it never existed before. Doesn't it make more sense to first try treating a (potentially) drug induced mania by withdrawing the SSRI (slowly, over a period of at least 6 months), than by adding more drugs? If that doesn't work, one can always resort to other drugs later.
2) One cannot just 'try' these drugs. Indeed, many people say that withdrawal from these drugs can be more difficult that withdrawal from many street drugs, including coke and meth which are both psychoactive. Some people think that taking the drug according to a doctor's prescription will save them from drug dependence, but there are no guarantees (just talk to people who are hooked on pain meds). If you do decide to try any of these psychoactive drugs temporarily, please quit them very slowly to save yourself from their nasty withdrawal symptoms (search "Psychiatric drug withdrawal 101" in google).
3) There are a host of side-effects with these drugs that many doctors refuse to discuss. Their reasoning seems to be that if people knew about the severity and frequency of the side-effects, they wouldn't take them. Hmm... (pause for thought). It's best to be informed about side-effects from sources other than the drug company wanting to sell it to you. Specifically the federal government has a side-effect reporting system, and much of that data (including drug interactions) is available at rxisk.org
What is my interest in making this list? These are the things that I wish someone had told me before I agreed to be treated by a psychiatrist for bipolar. I believe that these disclosures are necessary before there can be any legitimate informed consent.
No matter what you decide, I wish you the best.
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