Quote:
Originally Posted by BirdDancer
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.
|
Thanks for your reply!
To clarify, I was referring to a pdoc I had over 20 years ago. I've since been re-diagnosed 3 times with BP 1. Like you, Lamictal (though I don't find it activating) has not helped with hypo/mania, but a great deal with depression. I also take Abilify.
My feeling is that, in my case, the alcohol was the result of BP (me treating my symptoms), only because, as I say, after taking Lamictal the cravings for alcohol just faded away, and this was after many years of alcoholism. It was amazing. I was very fortunate. No doubt the alcohol also affected my mood and I do think it can be difficult to make MH diagnoses when someone is on substances, but my symptoms were so classic that that moron of a pdoc should have bitten the bullet (he was so afraid of over-diagnosis, he underdiagnosed, at least in my case) and given me the diagnosis, only so that I would finally get the proper treatment.
It took some 16 years of experimenting with meds to finally find the cocktail that works for me, and I've been largely stable ever since (going on 4 years, with one major manic episode in there and another far shorter one, where it was caught right away by my current pdoc and she increased my AP, which worked). Unfortunately, my symptoms started in my early 20's, so this means a lot more time during which I suffered from both depression and hypo/mania. Granted, it wasn't all bad... There were certainly periods of stability and hypomania's that led me to experience things, wondrous things, that I wouldn't have otherwise... Anyway, I'm babbling at this point...