Hi all,
Something I'm struggling with lately is the feeling that my bipolar illness is becoming more aggressive. I wasn't diagnosed until I was 43, before then I was probably more of a cyclothymic, I was able to manage things even though I got depressed off and on, it was never deep enough that I felt I needed to see a dr. I raised a family, lived the nomadic military lifestyle for over 20 years, I even went back to school and got my teacher's license and did better in school that time than I ever did in my early years. I got sick the last year of school, beginning with mania and had my depressive breakdown the second week of student teaching. Its been downhill since then. I am now 50, I haven't seen the inside of a classroom in 3 years, each year I seem to cycle more, the dr needs to add more meds and now my anxiety issues are becoming almost as serious as the bipolar because they fuel the episodes...what might be ordinarily a mild episode with my mood stabilizers on board becomes amplified by anxiety. We're treating the bipolar with an antipsychotic and two mood stabilizers, the depression and anxiety with an antidepressant and anti anxiety med, the adhd with another antidepressant because I can't take a stimulant.
I've been looking up the cognitive issues, executive function issues and I know I am not working with the brain I had in my twenties and thirties, not even up to mid forty. It kind of sucks to be honest. Anyway, I was wondering if there were any other folks out here who feel like their bipolar is progressing or becoming more aggressive as they get older? I'm not sure I articulated this feeling to my tdoc the other day very well. Just thought I'd look for answers amongst my fellow bp'ers.

[BipolaRNurse]

Oh, sweetie, you are singing my song!!

Like you, I wasn't diagnosed until comparatively late in life (age 53), when a series of stresses basically tipped me over. I've probably been bipolar since childhood, but it was subthreshold for a good portion of my life and only really "woke up" about 3 or 4 years ago.

And it came on with a VENGEANCE. My diagnosis went from BP-NOS to BP 2 to BP 1 after a series of manic episodes dispelled whatever doubts my pdoc had in the beginning. I fought it tooth and nails until late this spring, when we finally found the right combination of meds; and other than a breakthrough manic episode in July and another uptick in my AP, I've been very stable (even though my life is going to hell in the proverbial handbasket right now). My main concern right now is whether my current med regimen will hold me for awhile, or if I'll need continual upwards adjustments until I max out and then need even MORE meds.

Cognitively, I used to be very bright and prided myself on my intellectualism; now I'm having to retire from nursing a decade early because I can't remember stuff, can't retain new information, can't concentrate, can't help getting distracted. I don't trust myself to hold a patient's life in my shaky little hands anymore. I too have serious anxiety issues, just like my mother and sister developed in THEIR mid-50s, and that doesn't help.

I feel ya, emomom! Hope it helps to know you're not alone.

[zbmom]

Is there anyway you are premenopausal or menopausal? I've heard that can massively intensify bp. Hormones are hell. I've heard things calm down a lot once all that is over.

Thanks! Oh and yes, the start of perimenopause I think was one of the triggers for the full blown bipolar to come out. I'm still not out of it either, grrr. I can't wait for it to be over and hopefully some kind of stability...I asked one of my pdocs how I was supposed to figure out what was perimenopause and what was my bipolar...he just waved my lamictal rx at me and smiled. I didn't keep that dr btw.

[BipolaRNurse]

I don't know. I was postmenopausal by several years when it all hit the fan, but I'm sure BP didn't make perimenopause any easier (on my family, either!).

It hasn't really been studied for later in life ladies, just puberty and childbirth hormonal onsets, as far as I've been able to tell. But it would make sense to show up at this time too. BUT ya never know. Drs don't know for sure where it comes from, what causes it so it could be something we ate for all we know. I"m teasing, I know its got genetic markers and physical properties in the brain. I also had some difficult family issues going on at the same time too, my first trip to find help for depression and anxiety was two years before my manic episode occurred.

[99 FAIRIES]

I had gotten to the point where I was full blown manic every month during "my" time. I had to go on the depo shot and still have some hypomania around that time of the month. I also had post partum psychosis after my daughter was born. And then was diagnosed with bipolar shortly after that. So ya... I believe hormones play a big role in bipolar disorder.

[Phoenix_1]

I wasn't diagnosed until 2007, when I was 53. In 1987 I was diagnosed with clinical depression (now called major depressive disorder). And I don't think my bp is any better than it was when I was 15, although I have less good feeling highly productive hypomanias now, and more irritable ones and mixed episodes.
My OCD has improved and my GAD has gotten worse.

[Skittles56]

Well first...

Holy pharmacy! That's a lot of meds. As an aside, if you are getting along with the Saphris, you are the first person I've heard of that can.

I hear ya on the anxiety part. The only time I used to have anxiety was when I had to fly somewhere. I could usually handle that with a couple of shots of Wild Turkey. Now, my anxiety can last for half a day or more, mostly for no reason. And when I say anxiety, I mean the kind that has me mostly non-functional. In a bizarre way, I get depressed because I am anxious about getting depressed. I usually try to suffer through it because I don't want to start relying on Klonopin to get me through the day.

I posted this before, but my doctor said that bipolar "ages," meaning that it gets more pronounced the older you get. I am 56, and I had mine pretty well under control until 4 years ago when I completely went off the reservation. I have to agree with him. Over the last four years, my ups and downs have become decidedly more pronounced.

Being a male, I can't really comment on the menopause thing.

Thanks for the input everyone! That's something else I noticed too, my moods tend to be mixed now instead of a more pronounced one or other and the mania side now is irritable and unpleasant where the year I got diagnosed I was up and happy and laughed a lot. Not saying I want to be manic, just that I notice a difference in how they are presenting. My dx wa in 06, I was manic again in 10 and that was the first time it morphed into mixed before morphing into depression with tons of anxiety, that was my first hospitalization, I came close this past spring but managed to keep out with the help of my drs and husband. But this spring there was no happy mania in the beginning like earlier. It just started out high energy, a little irritable then wham, anxiety hit.Once we managed the anxiety level I had started the down swing so had to work to pull me back up. Its such a balancing act and forever teetering you know?

Oh about the saphris, I was doing well on it but began to show signs of tardive dyskinesthesia (sp?) So went off for 3 months, my pdoc blames the seroquel I had been on previously but wanted to take me off AP anyway. Most miserable 3 months and it was over last years holiday season, could not sleep no matter what other med we tried (trileptal, lunesta, ambien), I actually took an ambien and stayed up 8 more hours reading a book. I couldn't get my head to shut up. The first night I went back on saphris I went right to sleep and didn't wake til around 10 I think. It was heaven. We've cut back my dose because I'm still dozing off on the couch in the morning but to be honest I'm thinking it might be the topomax I take in the morning. She gave me that for weight though I'm not losing any. Not gaining either so there's a plus. Anyway, I haven't had any reason to come off saphris. Now if it wasn't black cherry flavor there might be a problem, that regular crap is some nasty stuff.

[dragonfly2]

I have also heard that menopause can be hell on bipolar. I'm only 43, so not quite there yet, but not looking forward to it at all. I'm already on disability, so the next step would be spending months in the hospital like I had to after my children were born. Hopefully we can prepare for it better and head problems off before they get out of control.

What I am seeing now though are the cognitive problems. I used to be able to juggle everything with no problem. Work, kids' schedules, finances, housework, all of it. Now I'm having memory problems, having trouble understanding things I've read without having to reread them, trouble organizing my thoughts into a coherent conversation, messing up the checkbook...it's horrible.

As for mood changes, my manias are also becoming more mixed. I've also seen a shift in the depressions to more severe physical symptoms, mostly fatigue. My depressions used to be emotionally painful. Now they're bordering on catatonic - can't move, can't speak, thoughts down to a crawl at best. Not sure where they'll go from here. Hopefully it will be a while before I find out.

[Phoenix_1]

Perimenopause was a relatively (and deceptively) happy time for me, but really chaotic. I was still undiagnosed as bp and was on celexa, clonazepam, and trazadone. I spent money like water (no wonder I was happy ). I got into financial trouble and couldn't handle the mortgage on the 1/4 section of land I owned, so I escaped by selling the acreage, buying a store, and eventually went bankrupt.

I was 42, perimenopause was beginning, I began my second teenagehood again, chaperoning my kids to concerts got me into bands which led to fansites which led to friendships which led to an online affair and a $1000 ticket to England to meet my True Love. I was definitely happy until it ended and everything crashed, I had a breakdown and eventually got my diagnosis. Never mind I was a middle aged mother of two, married for 20 yrs when it all happened. That was my crazy year. But I was happy. Oh. I got caught before I left the country thank goodness. It was truly an awful mess.