[notALICE]

I take two medications for Bipolar Disorder - Gabapentin (300mg twice a day & Klonopin 0.5 twice a day). Sometimes my speech is slower, especially if I'm in a depressive phase, which I seem to be in now. Although slower speech (not slurred) had been observed prior to the Bipolar medication, when I was on antidepressants, along with confusion & memory loss before my diagnosis, and perhaps before any meds at all.

I am getting out of a manic stage, where my speech was rapid. (No sleep, agitation, spending sprees, classic manic symptoms).

I now seem to be coming "down" from that manic state. No longer confused, sleeping better, memory improved but I'm leaning towards isolation, sadness & depression. Yesterday I was asked if I was drunk on a phone conversation. Very sensitive subject to me as I got sober 5 years ago and it's something I can feel good about. (I suffer from extreme low self esteem).

Later in the day I got mad at my son (for a very valid reason) and he said, "You're on drugs". Yes, that's true - meds prescribed and I take them as prescribed. (He has BP1, and I found out he's not taking his mood stabilizer as directed).

I hate being doubted. It cuts me to the core. Drugs were never my issue, I self medicated with alcohol. My beverage of choice now - coffee. Period. I guess my feelings are very hurt & I'm offended. I'm trying everything to get "better" and instead of support from my family I get accusations. I also tend to be hypersensitive.

Anyone else have similar experiences, and how do you deal with them?

Thanks in advance!

[catsrhelm]

Speech irregularities just seem part of the illness to me. Then again I had to attend speech therapy when I was a girl. I had lost my hearing, and then regained it. So, I still have speech issues. For me what works is slowing my thinking down when possible. I can't do that when I am manic.

Sorry about what your son is doing. Mine is autistic too, and just started on Ritilin. I have to give him his morning dose with decongestant syrup to make it go down easier. (Plus he gets allergies.) I have to pack Trix yogurt in his backpack for his lunchtime dose.

So, would a hug help?

Yes, notALICE, I understand the slowing down of thought and of walking, too. It's part of the depressive cycle; I'm sorry you're having it, but we'll talk about that in a minute.

The sensitivity is part of being bipolar, in my view. I was born with a sensitivity
that is unusual, probably as you were, too. It's a lifelong process to come to grips with it, so don't feel alone or upset. It will get better as you grow older provided you take the right "cocktail" of meds and get pro-active in your care.

The antidepressants and some good exercise help with the depression. Since you no longer use alcohol, you're on a road to real lifestyle improvement, but you need to watch for certain other things. I've been told that people who have alcoholism often drink coffee when they are not drinking alcohol. Please give it up if it causes you any symptoms at all. (My psychiatrist told me that it makes bipolar illness worse. Another one has suggested that, in the sensitive person, it should be removed.) Removing anything containing caffeine is a very big help in improving depression.

Some doctors now believe that alcoholism is an extreme allergy; it is distilled from grains (for many forms), and another doctor has written that bipolar patients have an extreme allergy to grains.

It is being borne out now by research that a product of gluten breakdown in digestion produces exorphins which act on the opiate receptors in the brain causing addiction and cravings after 2 -3-hour intervals. (Please read Dr. David Williams' new book called Wheat Belly to learn so much more about all this new information.) Frequently, foods that we are allergic to are ones that we are addicted to.

That's a lot to take in, I agree, but it's with the best intentions that I want to
alert you to those two things. The caffeine and the wheat should be removed from your diet if you really expect to moderate the shifts in mood and decrease the symptoms of bipolar illness. Did you know that many psychotropic medications contain an antihistamine-like product in them?

Sugar is another one that bears close examination. It has no nutritional value; it causes strong mood shifts and it is addictive.

The manic state is a little different because I have experienced only hypomanic
states in the past. For them, I simply squeeze 2 lemons into 8 oz of water and drink it. If I haven't calmed down in 4 hours, I repeat the process. That usually gets feelings in good order for some of us.

I know it sounds foolish, but the lemon (which is a citric food and very acidic) is actually digested as having a very high alkaline ash (or residue). Lemon juice does one excellent job of relieving acidity caused by medication ash and a generally acidic condition of fluids and tissues of the body. (This is quite different from the ph value of the system; that's maintained by the brain and varies only in minuscule amounts.)

Stress is a major builder of acid; it causes stomach acid to increase. A second
problem is sleep interruption. That's a subject for another time, but the "lemon
thing" will help with that, too, because it calms the irritability that high acid levels cause.

These things really help some of us if we apply them on occasion when we really are having a difficult time.

Regarding the slowing down of thought, the anti-depressants will help and changing your diet will help, too. Exercise that you can do while sitting in a chair will help alleviate some of that. Otherwise, reducing stress, getting your proper sleep schedule regulated, and eating good, nutritious food are the biggest helps I know to suggest.

I hope you feel much better very soon. It's spring here, and, of course, spring
and fall seasons may provoke mood shifts for many with bipolar illness, so be
alert to that as a possibility. As long as you're conscous of the causes, you might be able to really be pro-active in alleviating the symptoms.

[Victoria'smom]

I talk like I'm drunk when manic because I'm trying to slow down for others. I just flat out refuse to talk when depressed.

[ultramar]

Originally Posted by notALICE

I take two medications for Bipolar Disorder - Gabapentin (300mg twice a day & Klonopin 0.5 twice a day). Sometimes my speech is slower, especially if I'm in a depressive phase, which I seem to be in now. Although slower speech (not slurred) had been observed prior to the Bipolar medication, when I was on antidepressants, along with confusion & memory loss before my diagnosis, and perhaps before any meds at all.

I am getting out of a manic stage, where my speech was rapid. (No sleep, agitation, spending sprees, classic manic symptoms).

I now seem to be coming "down" from that manic state. No longer confused, sleeping better, memory improved but I'm leaning towards isolation, sadness & depression. Yesterday I was asked if I was drunk on a phone conversation. Very sensitive subject to me as I got sober 5 years ago and it's something I can feel good about. (I suffer from extreme low self esteem).

Later in the day I got mad at my son (for a very valid reason) and he said, "You're on drugs". Yes, that's true - meds prescribed and I take them as prescribed. (He has BP1, and I found out he's not taking his mood stabilizer as directed).

I hate being doubted. It cuts me to the core. Drugs were never my issue, I self medicated with alcohol. My beverage of choice now - coffee. Period. I guess my feelings are very hurt & I'm offended. I'm trying everything to get "better" and instead of support from my family I get accusations. I also tend to be hypersensitive.

Anyone else have similar experiences, and how do you deal with them?

Thanks in advance!

Very interesting that you're on Gabapentin for bipolar, I've only ever heard it used for seizure disorders and chronic nerve pain disorders. Have you tried other meds that didn't work? I'm curious, is this is a new med now in the bipolar arsenal? What has your pdoc said about it?

That said, I took it once for a nerve pain condition and it made me positively narcoleptic -and I was very slow in every way. Maybe it's a side effect of the Gabapentin? Have you noticed if it started getting worse soon after starting that med?

Have you been evaluated by a neurologist concerning the confusion, memory loss, slurred speech? I don't know, that might be a good idea to rule out other causes other than mood and meds.

So it could be medication side effects, depression, neurological, or any number of things. Have you talked to your pdoc about this? Good luck, I'm sorry you're feeling so badly right now.

[notALICE]

When I was depressed my speech would be occasionally slow, but never slurred, but then i got a high pressure job, and started having other symptoms. I thought I was having symptoms of extreme stress, my son had been committed twice in less than a month for suicidal thoughts, my husband is a merchant marine & out to sea for long periods, so I went to my primary physician. My symptoms at that time: anger, insomnia, anxiety. He diagnosed me with Major Depressive Disorder - put me on Lexepro & Trazadone for sleep. Over a period of months my symptoms became worse & worse. Extremely manic, thoughts too fast for actions, no short term memory, impulsive, irritable, not sleeping for days...When I told complained about this several times he upped the antidepressant dosage - until I was in Acute Mania.

Then he diagnosed me with Bipolar (never said I or Ii). He put me on Lamictal. A week layer I got a rash. Then I suggested anti seizure meds, and he added Klonopin for anxiety. Gabapentin is an anti seizure med, and also used to treat neuropathic pain. I actually took it back in 1997 for back pain/fracture for a short period when it was relatively new on the market.

But you're correct: Gabapentin has been prescribed in the mental health context. Numerous trials show that it is not effective alone as a mood-stabilizing treatment for bipolar disorder and so has no therapeutic advantage in having fewer side-effects over better established bipolar drugs such as lithium and valproic acid. Gabapentin is useful in the treatment of anxiety associated with bipolar disorder, but has limited usefulness in disorders such as social anxiety disorder and obsessive-compulsive disorder, in treatment-resistant depression, and for insomnia.

Sigh. I've had bipolar symptoms my entire life, but always associated mania with euphoria, which is rarely my case. I get manic & hypo manic confused. I have more depressed periods.

When all the confusion started my first thought was stroke, but I did have tests done by my cardiologist. (I have super high cholesterol, high blood pressure).

My Pdoc remains my primary care taker. A major blow was to discover my health insurance does not cover mental health. My son was diagnosed with Bipolar a week before me, after having opposite effects to antidepressants. He was put on Lamictal & also got a rash. He was then put on Trileptal, and Adderall which seems to be a better choice based on studies.

I go back in next week. The great news is my insomnia is better, memory better, concentration better but still suffer from anxiety, anger. The relief just sleeping 7-8 hours a night has done wonders. I'm just slower than usual, but at least not manic...much. After taking Gabapentin & Klonipin my speech went from rapid to occasionally slow (and its not slow all the time). But I think I am slipping into depression now

Which I think is common after acute mania???

[ultramar]

Originally Posted by notALICE

When I was depressed my speech would be occasionally slow, but never slurred, but then i got a high pressure job, and started having other symptoms. I thought I was having symptoms of extreme stress, my son had been committed twice in less than a month for suicidal thoughts, my husband is a merchant marine & out to sea for long periods, so I went to my primary physician. My symptoms at that time: anger, insomnia, anxiety. He diagnosed me with Major Depressive Disorder - put me on Lexepro & Trazadone for sleep. Over a period of months my symptoms became worse & worse. Extremely manic, thoughts too fast for actions, no short term memory, impulsive, irritable, not sleeping for days...When I told complained about this several times he upped the antidepressant dosage - until I was in Acute Mania.

Then he diagnosed me with Bipolar (never said I or Ii). He put me on Lamictal. A week layer I got a rash. Then I suggested anti seizure meds, and he added Klonopin for anxiety. Gabapentin is an anti seizure med, and also used to treat neuropathic pain. I actually took it back in 1997 for back pain/fracture for a short period when it was relatively new on the market.

But you're correct: Gabapentin has been prescribed in the mental health context. Numerous trials show that it is not effective alone as a mood-stabilizing treatment for bipolar disorder and so has no therapeutic advantage in having fewer side-effects over better established bipolar drugs such as lithium and valproic acid. Gabapentin is useful in the treatment of anxiety associated with bipolar disorder, but has limited usefulness in disorders such as social anxiety disorder and obsessive-compulsive disorder, in treatment-resistant depression, and for insomnia.

Sigh. I've had bipolar symptoms my entire life, but always associated mania with euphoria, which is rarely my case. I get manic & hypo manic confused. I have more depressed periods.

When all the confusion started my first thought was stroke, but I did have tests done by my cardiologist. (I have super high cholesterol, high blood pressure).

My Pdoc remains my primary care taker. A major blow was to discover my health insurance does not cover mental health. My son was diagnosed with Bipolar a week before me, after having opposite effects to antidepressants. He was put on Lamictal & also got a rash. He was then put on Trileptal, and Adderall which seems to be a better choice based on studies.

I go back in next week. The great news is my insomnia is better, memory better, concentration better but still suffer from anxiety, anger. The relief just sleeping 7-8 hours a night has done wonders. I'm just slower than usual, but at least not manic...much. After taking Gabapentin & Klonipin my speech went from rapid to occasionally slow (and its not slow all the time). But I think I am slipping into depression now

Which I think is common after acute mania???

Hi notALICE,

This is so complex, I think you really need to be evaluated and treated by a psychiatrist! What's going on with your insurance, if you don't mind me asking? I think there's a federal law now stating that insurance has to cover mental health care. If your PCP gives you an official referral, is there any way insurance could cover it? Or maybe if you could pay for just one visit, get an evaluation and treatment plan, and then ask your PCP to carry out the treatment plan recommended by the psychiatrist.

[ultramar]

But you're correct: Gabapentin has been prescribed in the mental health context. Numerous trials show that it is not effective alone as a mood-stabilizing treatment for bipolar disorder and so has no therapeutic advantage in having fewer side-effects over better established bipolar drugs such as lithium and valproic acid. Gabapentin is useful in the treatment of anxiety associated with bipolar disorder, but has limited usefulness in disorders such as social anxiety disorder and obsessive-compulsive disorder, in treatment-resistant depression, and for insomnia.

Given the above, I don't understand why your PCP prescribed it. Can you ask him for a different mood stabilizer?

[Moreta]

I slur my speech sometimes, especially when I'm trying to talk fast. Thanks Lamictal. My husband makes fun of me, so I just try to laugh it off. Most of the time I try to talk slower than usual so it doesn't happen.

I took Gabapentin as a mood stabilizer before. Then I stopped taking it and went crazy. I'm getting ready to start taking it again though for my back.