Confused, need confirmation/opinion

Hi all. I've been seeing a Psychiatrist for over 2 months now and here's where I am med-wise:

150mg Zoloft AM
30mg Cymbalta AM
0.5mg Clonazepam AM and PM
*300mg Lithium PM <------ This one just added.

The kicker is that this Psychiatrist does not diagnose, he just treats symptoms (which is fine), but for my own knowledge I'd like to know, is this treatment for Bipolar Disorder (Hypomania in my case I believe because my 'highs' weren't elations, more like restless irritability and wanting to do a bunch of stuff all at the same time, believing I could do anything that needed doing)?

My mother is Bipolar II I'm sure, and my son (10) has just recently been to the Dr. Amen Clinic where the SPECT scans showed ADHD Type 6 which indicates a mood disorder. The Psychiatrist there diagnosed him with Mood Disorder NOS, hesitating calling it Bipolar since my son isn't 16.

Anyway, I know I could outright ask my Psychiatrist but he still could return with "why does it matter" or some such remark. I'm looking for the thoughts and opinions of people who know all about Bipolar Disorder and live with and through it. Thanks so much.

Brian

it seems to be an odd mix of meds for me, unless he plans to up the Li. Do you have insurance or are you self-pay?

Fortunately I have insurance.

Initially I was diagnosed with just Depression for 10 years by my GP, and I was put on Effexor up to 150mg in AM. When things started to fall apart marriage-wise recently, I looked back and saw that the Effexor helped with my Anxieties, but I was an irritable grump a good portion of the time with bouts of 'activation, restlessness, feel like I could accomplish a million things, increased sex drive'. I looked back and it appeared like a pattern or cycle of sorts.

I ended up with a new GP who in December tappered me off the Effexor and started me on Zoloft. He then sent me to the Psychiatrist. The Psychiatrist added the Cymbalta and Clonazepam based on my presentation of Anxiety and Depression. I started daily mood charting and I finally had concrete evidence of a pattern of 'elevation (negatively)' then down. It seemed like every time an antidepressant was increased I became agitated more for several days. 2 weeks ago he dropped the Cymbalta to 30mg and started Lithium at 100mg/1 week then up to 300mg (have been at that for 1 week). I read that with Lithium I need blood work to check to see if I'm at a therapeutic levels, but he made no mention of that. I see him again in 3 weeks.

Brian

I had been given Zoloft and Lithium in the past for manic depression so I would say yes to your question for at least those two I'm not sure about the 0.5mg Clonazepam AM and PM maybe a sleep aide and as for 30mg Cymbalta AM, isn't htat advertised on tv as an additional medication to help depression?

Are these medications helping? I would think that after 2 months you sould be able to notice a difference in your mood swings.

Cymbalta is an anti-depressant, not an add-on to an anti-depressant - an SNRI while Zoloft is SSRI, also an anti-depressant. I would question why you are continuing Zoloft as Cymbalta hits the same neurotransmitter and more.

That's weird. I replied to Hamster-Bamster a couple of hours ago explaining that I've been in treatment for Depression only, but over the course of the past 10 years things have come to the surface that made me think its more than that. I re-evaluated my past and realized that with Bipolar Disorder running in my family with my mother and other relatives, things started to make more sense for me.

Once I ended up with a Psychiatrist two months ago, that was the first time in my 40 years on this planet that I was in the care of a Psychiatrist. He looked at my symptoms at that time and determined Depression with Anxiety. That's why he added Cymbalta to the Zoloft my GP started me on and added Clonazepam for Anxiety as well. I started mood charting daily and for 2 months logged a period of 'elevated' mood but not happy elevated, more aggitated and restless and talkative elevated. Two weeks ago I presented the pattern on the graph I made and with the irritability running constant he added the Lithium 100mg/1 week and I went up to 300mg just 1 week ago. This is why I'm asking what the learned members of this community think about this, as this Psychiatrist just looks at symptoms and won't 'label'. I've believed for awhile that anti-depressants make me irritable or magnify it. 9 years of Effexor did that to me. I believe the Zoloft and Cymbalta are doing the same. I've done the reading where anti-depressants in mood disordered people can bring out the manic side.

Thanks to all of you for reading and offering your thoughts. It means a lot to me.

Brian

Hi Brian!
Yes, this is true.
I am wondering from your posts if these patterns that you have seen have been happening in the 10 years you've been on ADs or did they precede it as well? (I couldn't quite work that out in the reading, but I've been scattered.)
Reason I ask is that, while a manic reaction to ADs can certainly be one of the things that can point to BP, for some people, the manic-y symptoms appear only because of a medication (ie. "substance-induced mood disorder"). In terms of diagnostics, symptoms need to be NOT attributable to a substance or other condition that explains the symptoms in order to count towards a BP dx.

Since this and many other things can cause symptoms that look like BP, it can be tricky to diagnose. Perhaps he is just not prone to coming to a quick conclusion, which is a good thing. The last 10 years have been "influenced" so to speak, so the net needs to be cast wider and further back, and that just takes some time and thought. Sounds like you are looking back, family history and all that, so that is good.