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Originally Posted by Gabyunbound
Hi guys!
This was brought up in passing in another thread, and I relate to it so much I wanted to bring it up generally.
Some 25 years ago, I had been diagnosed with depression and anxiety for several years and yet with clear signs of hypomania and mania. It was not until a bout of hypersexuality that my pdoc of the time diagnosed BP (when I had brought it up about a year prior, he had said that people were finding BP under ever rock, in other words, thought it was way over-diagnosed, and therefore didn't apply to me (!!)).
Anyhow, I was first prescribed Lamictal (which helped enormously with depression, but not with hypo/mania). I had been an alcoholic for some 8 years before that. And poof! After the Lamictal kicked in, I just didn't crave alcohol anymore! Since then, I've had the occasional social drink, but that's it.
So has anyone had a similar experience? How prevalent do you think it is to self-treat MI with substances? And how difficult has it been to get your pdocs to understand this?
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Hi Gabyunbound! I read your post earlier this morning, but didn't want to answer until I had a bit more time to.
Just to quickly address some of what you wrote earlier in your post, I think there are some psychiatrists that over diagnose bipolar disorder, and some that under diagnose. Certainly with many young people knowing more about bipolar disorder, there is the chance of them exaggerating their experiences to closely match the bipolar symptom lists. However, at least your psychiatrist now seems sure of your bipolar disorder dx. That's good. Many people never get the right one.
Lamictal is very activating for me, too. It likely has never helped curb my hypomania, and definitely not mania, but it is good for my bipolar depression. I don't think any doctor would call it a strong antimanic, but for many it helps sufficiently enough. At least now you know what's good for your depression. What do you have for your hypomania/mania control?
What came first? The chicken or the egg? Yes, a lot of people have doctors that put alcohol/substance abuse before the mental illness or emphasize the alcohol/substance abuse over the mental illness. It's really a catch-22. Can you become stable while using? Can you become sober or manage alcohol use when symptomatic with bipolar disorder? Ouch! It's tough. Yes, I relate.
Like you wrote, after my bipolar disorder was stabilized enough (and my drinking issues stopped), I no longer had major alcohol cravings and could drink moderately. That doesn't take my history of alcohol abuse away, but I do believe it should remove the word "alcoholic" as a descriptor for me. Honestly, I wonder if the same could be said for my father, but it's just too soon after his detox to safely test those waters. Plus, my father hasn't sought proper support/treatment for his alcohol abuse. Also, he likely has cognitive issues (dementia) that should discourage he ever drink again.
Though I do often have a daily half drink to two, I know that drinking too much can be destabilizing and is not good with my medications. Though I don't believe I am "an alcoholic" I know my drinking could get out of hand, if something triggered it (tragedy in my life, gradual increase in consumption, severe mood instability).
I know that some people just really are prone to addiction. In those cases, they should never drink/take drugs ever again.
In my case, my bipolar disorder was acknowledged as separate from my drinking, and diagnosed at the same time. No one thought drinking caused it. The bipolar disorder was present likely as early as 14 years old in me. I didn't drink way back then. I do think that drinking (or even more so, drug use) can sometimes bring on symptoms that may lead to incorrect psychiatric diagnoses. I've read of many cases where when the abuse stopped, the so-called psychiatric symptoms stopped.