[MisterUnderstood]

Okay, so I currently see a psychiatrist once a month and a therapist once a week (although I've only seen him once, in early June, as he's gone on vacation until early July) and I've been going to the psychiatrist since a little after I was hospitalized on the 26th of June last year, but none of them seem to understand me. My mother just calls me a hypochondriac and yells at me when I'm miserable and snap at her, and my psychiatrist has given me at least 5 diagnoses and then taken them all back. He's told me I have bipolar tendencies (I had a bad reaction to Lexapro, my first antidepressant and got extremely violent), obsessive tendencies (I worry frequently about what medications will help me or not), borderline tendencies (I have frequent mood swings, but I personally would attribute it to Bipolar II with atypical tendencies, seeing as I have hypomanic episodes), depressive tendencies (I was hospitalized with a deep cut on my wrist in June), and socially anxious/generally anxious, and the hospital (after seeing me for 15 minutes total over the course of a week), diagnosed me as Bipolar I and severely depressed, but I've never been fully manic. I currently take Wellbutrin SR 100 mg twice a day and Vistaril PRN for my anxiety, and I've been on up to 40 mg of Lexapro a day, 3600 mg of Neurontin a day, 3000 mg of Trileptal twice a day, and I was on Zyprexa (up to 10 mg) until I gained 35 pounds in three weeks. I apologize for the length of this message, but does anyone here have any of the symptoms I have? Mood swings, eating too much, sleeping too much, hypomanic episodes, and anger outbursts, etc. and if so, what was your diagnosis? Because I really want to come up with an idea of my diagnosis, but my psychiatrist just laughs and tells me I'm pretty much nothing and it's all just in my head :/ Thank you!

[A Red Panda]

Hypomania or mania means that you have bipolar. But, if you've self-diagnosed yourself with hypomania then take that with a grain of salt.

Try talking to another psychiatrist if you do not trust this one. A lot of psychiatrists seem to be over-eager to give someone a diagnosis (I'm basing this mostly off readings on this forum!) so the fact that yours isn't? I'd find that to be a positive thing, even though I understand your frustration about wanting to know what's going on with you! And saying that it's all just in your head is flat out rude and unprofessional. Unless the psychiatrist has diagnosed you with hypochondria.

Self-diagnosing though... doesn't do much more than stress you out!

As to your symptoms:

Mood swings - for me, my general mood will remain stable for weeks. I do not cycle from depression to anger to super happy within minutes or hours. My day-to-day mood changes are "normal" although they're influenced by what episode I'm in if I am in one.

Eating too much - sometimes when depressed as a bad coping mechanism.

Sleeping too much - sometimes when depressed

Angry outbursts - never. I can become a bit snappy if I'm in an irritable depression/hypomania, but it's never full out anger and never really an outburst.

[Victoria'smom]

I think you should get a second opinion.

[MisterUnderstood]

Well, I went to see him in Early Juneish and I told him that I was having up and down's and I'd really like something to help, so I suggested Topamax, which would also help offset the weight gain from Zyprexa. He just laughed at me and told me I didn't need it and that I should stop suggesting drugs, even though when I suggested Zoloft and Lamictal, he told me they would probably work for me, since Zoloft worked well for my dad. But then he changed his mind and said I didn't need anything. Is that bad or..? And I should add, being underage, I can understand his skepticism in prescribing things, but 1) He went behind my back, talked to my mother, and cancelled the Zoloft without even telling me and 2) He straight up lies to me and says that he's not allowed to prescribe controlled substances to minors, even though I told him Xanax works absolute wonders for my anxiety and agitation. Is that maybe a sign that he's a less-than-good psychiatrist or am I maybe just biased against him? Thanks guys

[~Christina]

Get a second opinion but keep in mind that your being a minor will allow your Pdoc to talk to your parents and there are in fact reasons why benzios are not given to minors.

3600 mg is a gigantic dose of neurontin ... Even most neurologist are hesitant to put anyone of that high of a dose .

It takes a good Pdoc to actually diagnose a teenager with Bipolar as hormones and such play a big part in mood swings and such

I wish you luck and welcome to PC

[Victoria'smom]

Please get a child psychiatrist until you're 21. While your waiting go to an endocrinologist to get your hormones looked at. My son is being treated for ADHD, PDD Nos with bipolar medication and adhd meds Its made very clear he has bipolar but his psychiatrist does not to give him that label until he requires hospitalization.

Its good your doctor is not comfortable with giving controlled substances. It also depends on where you live and your insurance how many hoops he has to go throw to prescribe a controlled substance.

[sarahblue]

It doesn't sound as though your psychiatrist is treating you with much respect. I would definitely consider finding another pdoc.

Many medications that help adults may not be as helpful in minors, and may make situations worse. I would hope that any pdoc you see would definitely use caution when prescribing medications.

From what I've read, having such a strong reaction to Lexapro like the one you described can indicate bipolar I or II. I reacted like that when I was first put on Prozac. It wasn't fun.

With regards to sharing information with your parents, you are right to feel violated. While the laws say that this is allowed so long as you are a minor under their care, I think that a caring mental health professional should work with you and your parents to form guidelines as to when sharing becomes necessary, and otherwise, the professional should keep your confidence.

I hope things get better for you. Adolescence is hard enough without having to deal with mental illness.

Also, do you have a therapist?

[MisterUnderstood]

I know 3600 mg was a very high dose, but aside from the cognitive issues, Neurontin was actually a godsend and really did a number on my mood swings. And he is an adolescent psychiatrist so don't worry about that And I do have a therapist. However, my original one (who worked right next door to my psychiatrist) was too expensive ($225/week and not covered by insurance) so I've switched to another one (unfortunately). But he's out of town for now and doesn't come back until around July 2nd.

[Flummixed]

My doctor has never really pinned an official diagnosis on me either. Although he has said he leans more towards bipolar than anything else. So that's what he's treating me for and so far at least it is helping. Part of what is helping me is that the medication I am on dulls my emotions. Some people might not like that but I have never been able to deal with my emotions correctly so for me it's a relief to have very dulled emotions. Less outbursts that way. That's probably a whole other story though Good luck though and I hope things get better for you real soon.

[MisterUnderstood]

My doctor basically refuses to diagnose me and my last visit, after my mother went back in to get something she left, I hear her go, "Do you think he really needs medication?" And he just laughed and went "No, I don't think so." And then another time after I'd begged him for something to stop the mood swings and the outbursts, when he was in there with her, he goes, "This isn't gonna stop. He's gonna keep wanting more." Which basically he called me a druggie and a faker. And since I'm underage, and my mother looooves that he won't write a prescription and constantly agrees with her, I'm not allowed to switch psychiatrists, even though it's not under insurance and she doesn't even pay for it (My grandmother does). So now basically all of my family is telling me there's nothing wrong and I'm just so tired of all of them. I know that if I really feel like I'm not getting the care I need, I can call DCF or CPS and have them take custody to give consent for it, but that's an extremely drastic step and I really don't wanna start a war so.. And by the way, since I'm on a rant, my mother will tell my doctor that she "was in a massive car accident" and she "didn't need drugs to deal with it" so why should I? But the only way she deals with her stress is by smoking pot, but she'll say that's okay because it's "natural" and "just a plant." Ugh I'm sorry. I don't mean to sound ungrateful for all of your advice. I appreciate it, everyone

[Flummixed]

That really stinks I'm sorry. I wish I could say it gets easier when you're an adult but at least when you are finally 18 your parents won't have any say in what goes on in your care. My mother also feels that there is nothing seriously wrong with me. My father on the other hand is really supportive so that's nice. Like I said I hope things get better for you. Try to hang in there.

[MisterUnderstood]

That's true, I suppose. But 18 seems like forever when I keep snapping at people and going up and down and basically being called a liar and a druggie. And tbh, even then, my mother's probably still gonna try and control me because for a while, I'll have to use her insurance, so she'll do what she always does. Lord it over me that "I pay for this and so I get a say and it's MY insurance and if I don't want you to have something, then you're not gonna." I mean, I'm almost 17 so... I know a lot of other states have "mature minor" doctrines but Florida doesn't so I'm stuck I guess. I could probably get him to put me back on Neurontin, but I hated the way it made me stupid so I guess I'll just have to deal with my Wellbutrin (which also may be another reason I'm so angry).

[sarahblue]

Ugh, I hate it when therapists go on vacations. There was a very funny Bill Murray movie in the 90s called "What About Bob!" about a therapist that goes on vacation, and his patient follows him, and the therapist's family basically adopts the patient, much to the therapist's dismay. I always joke about that movie when my therps tell me they're taking a vacation.

Don't get involved with DCS or whatever it's called in Florida, if you can help it. This is a ****** state for support services, and I greatly fear that you would get lost and entangled in the system.

I know that you feel kind of powerless now, but there are a lot of things that are in your control. You can benefit your mood by taking care of yourself physically: exercising, eating healthy, getting regular sleep. As much as you possibly can.

Also engaging in social activities may seem hard, but it can also be very healing and get you out from under your mom. If you don't have friends you can hang out with, consider joining a basketball team at the local gym, or something similar that interests you. You could also volunteer. There are so many opportunities for volunteering in any community, and you would meet lots of good folks. Also, if you're thinking of going to college, it looks great on your application

Another suggestion I have is trying to find group therapy. Looking back on all the therapists I've had, I think groups helped me more than individual therapy has. Being around folks in similar situations is really reassuring that you are not alone.

Take good care.

[MisterUnderstood]

I was actually interested in group therapy a little while ago, but a lot of the bipolar support groups are for adults, and I'm not sure about how friendly they'd be to adolescents. I was offered group therapy as an outpatient at the hospital (which actually today is 1 year to the day since I was hospitalized), but it was about 50 minutes away and the commute would've been hard on my mother. But if I could find a close group therapy, I would definitely be interested in trying They had group therapy with a social worker up at West Palm, and it made me feel like I fit in, but most of the people there were dealing with substance abuse issues, while I had never tried a thing besides Xanax/Valium. It's nice to hear that group therapy helped you, and I actually think it would be good for me. Don't get out of the house much, to be honest. Thank you, everyone!!

[FaithlessCat]

The only advice i have .... and tbh the most important piece of advice .... get a new pdoc ... now !!

[SirIsaacNippington]

Did you know that the makers of Neurontin were prosecuted for pressuring doctors to prescribe for bipolar when it has absolutely NO effect on it, and was not approved for it? They had to pay a huge fine.

All the studies eventually showed no benefit for bipolar disorder.

Just saying.

[sarahblue]

Hey, MisterUnderstood, how are things going? Just checking in.

[MisterUnderstood]

I wouldn't doubt it. Tbh it did actually help with the anxiety and a little bit of the instability, but then again, that might've just been because I was so out of it and not there that I didn't even notice. I'm still stressed out like crazy, but I just got switched from 100 mg Wellbutrin SR twice a day to 150 mg of Wellbutrin XL once a day. It's supposed to keep me more level, but personally, I've noticed I'm miserable and I sleep too much now :/ I wanna up it to 300 mg but at the same time, I'm sick of how it makes me angry and I wanna try something less activating, like Paxil or Trazodone. I'd give an antipsychotic a whirl, but it seems like dopamine/norepinephrine is my issue and I need more so.. And the only other option is a stimulant like Ritalin which is out of the question for my stupid doctor. He wouldn't even let me try Provigil after I told him I was depressed and I was barely able to stay up. So as much as I'd love to say it's all better, I think I've gone from hypomania to depression and now I sleep like 15 hours a day and just lie in bed. Life's a ball

[Curiosity77]

Dopamine/norepinephrine is a way to consider the problem, but it is more complicated than simply not enough of these neurotransmitter. They have different effects in different areas of the brain, and the different antipsychotics each have varying effects by working on different channels. So there are multiple dopamine tracts and types of receptors for example, which is what makes the various APs different from each other. It's not possible from a clinical interview with a pdoc to pinpoint exactly where the problem is, the science is not that advanced, so it gets described to us in laymans terms as a deficiency in dopamine etc, when it is actually more complicated. You might be deficient in some areas, normal in some areas, or excessive in some areas. Think of it like an out of tune instrument. So, my point is that taking an AP can work as an antidepressant, not just to prevent mania, because the problem and the mechanism of action are complex and not well understood scientifically. So it may be worth giving it a try, even if your problem is more depression than mania.

I hope that helps.

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[MisterUnderstood]

If you don't mind my asking.. I noticed that you're on Mirapex from you signature. I know that that's a dopamine agonist, and so I've done a little bit of research on it. Does it seem to work for you? I know that Wikipedia said it's supposed to be good for bipolar depression, but it was only one study, and Wikipedia is all great in theory, but it doesn't necessarily mean that it's true for a lot of people. So does it help you much? And is it more activating or sedating? Because as much as I like being sedated and calm, Wellbutrin and its stimulant effects have done so-so for my depression and actually really helped with my social anxiety, which leads me to assume it may just be a side effect of my depressed mood. Or that the issue was that I'm very socially withdrawn and it lets me be outgoing. I know Wellbutrin is infamous for being horrible for people with anxiety, but it's been good to me so far. Although I have noticed this XL doesn't make me feel as activated as the SR did.

[Curiosity77]

I take mirapex to prevent weight gain from antipsychotics. I don't totally understand the mechanism of action for how that works, and it's an off label use, but i've been on a few different APs with mirapex and haven't gained any weight. So it may be working, or i may not have gained anyway, but i don't want to take the risk of stopping it to find out. I don't think it's doing anything for my depression though, but i guess that's possible. I'm on wellbutrin and i have a lot of anxiety too, but i still find it's a good drug for me. I think it's ok in anxiety, it just won't necessarily reduce anxiety like an SSRI would. But i won't take SSRIs or SNRIs. Zoloft made me manic, and effexor made me gain 30 lbs and i was still depressed. Wellbutrin seems like the safest option, in combo with lamotrigine for depression. I think saphris also helps my anxiety quite a bit, and every time i try to reduce the dose i get depressed, so it must be working as an antidepressant for me too. It's so hard to know which drug in the cocktail is doing what. Ideally i'd like to be on lamotrigine as monotherapy, but i don't know if that's a realistic goal. I hate being on so many meds, but i suppose it's better than the alternative.

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[MisterUnderstood]

I wish my doctor had known about Mirapex before he put me on Zyprexa and joked that I apparently "said I wanted to gain a little weight." I gained 35 pounds in three weeks I've heard a lot of good things about Saphris, but I honestly have no clue about anything about it. And Wellbutrin actually helps my anxiety, and I think it's the reason I've lost the little weight that I have. But I just switched to XL and I think my weight is starting to climb up slightly again. Zoloft may be a good option, but I also have to balance it against Paxil because Paxil's more sedating so it might help with the anxiety & agitation. And I would've tried Effexor with my Wellbutrin, but my doctor said it might spike my blood pressure. Even on just Wellbutrin, I went to give blood about a month ago, and they rejected me because my pulse was at 117 and my blood pressure was 139/85. Which isn't too high for me, actually, but since they're both activating, I guess I could see it leading to trouble. Another question… How does Seroquel PRN work out? I have Vistaril to use as a PRN med, but it's pretty much useless, and he won't allow me on Xanax or Klonopin. I know at low doses it's very sedating, so that might actually be a benefit, if only to help me relax and not flip out. I wanted to try using my Zyprexa like that, which probably would've averted the weight gain, but he said it couldn't.

[Curiosity77]

That sucks about the Zyprexa weight gain. I started mirapex the same day as i started zyprexa, and my weight stayed normal, so i kept the mirapex with seroquel and saphris. Saphris is a pretty good med for me. It's an atypical antipsychotic, also indicated as a mood stabilizer. I find my emotions a little flat on it, but i'm not totally depressed or getting hypomanic either. I'm mostly pretty euthymic when i take it as directed. I tried reducing the dose, skipping doses, trying to come off of it on my own a few times in the past year, and it hasn't worked out well. So consequently i was quite depressed for a few months in the winter and spring. I'm mostly compliant now, and doing better. It's sedating, so it helps me with sleep. I have the seroquel prn for sleep and anxiety. I rarely take it, and it doesn't work very well for me. Clonazepam and zopiclone work much better for me, but my work does random drug testing, and those meds would make me test positive, so i can't take them. Seroquel is my best option, but i take maybe once or twice a month. The saphris is usually enough.

Saphris is supposed to be weight neutral, but i don't want to give up my mirapex just in case.

There are so many med combos, and they effect all of us differently, so if seems like a lot of trial and error. I hate being on any AP, but i seem to need it, so it is what it is. My pdoc suggested switching from saphris to latuda, but i don't want to risk making any changes in case it makes me worse. This combo works fairly well for me.

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[MisterUnderstood]

Hm.. I should check out Saphris some more. I wanna say that I have an appointment either July 8th or July 9th. Probably the 9th. I have a therapist appointment on the 2nd and the 8th or something. I have it on my calendar, but I can't be bothered to go check. I know he's just gonna give me the same lines, so really, I don't know why I bother with him anymore. It's just 30 minutes of him essentially saying that I'm a druggie and I'm just trying to manipulate people into doing what I want It's just such a pain to even go to him, and I'd switch in a heartbeat. But of course, my mother loves that he won't help, basically. And my new therapist said that "drugs aren't the answer." One visit and she's already in love with him too. Personally, I find him a little too casual for my taste, but I guess I'll give it a shot. I try to explain to my pdoc that I need something to help me stay calm until I can work out my issue with a therapist, but I swear, the only language the man hears is cash. Someone suggested that I take another try on SSRIs, but my mother is paranoid for some reason. Wouldn't even let me take 25 mg of Zoloft. She already wants me off my Wellbutrin, but I tell her that I need to be on it at least a year to truly see a benefit. Then she just tells me how meds are bad and ugh. It's like a broken record. But I guess I can see the generation gap, tbh. I'm all for medications, but she's against them. And my grandmother's even worse. She's paranoid because of the whole SJS issue for Lamictal and I guess she had a friend on Wellbutrin, and to this day, she still has seizures, even after almost 10 years. And my mother, being as stubborn as she is, will tell me "Oh, well they're just online. What do they know?" But I was actually thinking about trying Seroquel daily, but I don't wanna have it interfere with the dopamine reuptake with my Wellbutrin. I know that Saphris and Seroquel share that same dopamine antagonism, but your Saphris still keeps you fairly level, so I would assume that it isn't strong enough to really cancel out the Wellbutrin. But I don't think Saphris is generic yet, so I'll see about the Seroquel. He'll probably just laugh at me and I'll get ticked off, as usual. I'm sorry for asking 20 questions about every med you're on haha. Just curious to see how it affects people

[Curiosity77]

Saphris and wellbutrin work together to have an antidepressant effect, while not inducing mania for me. It's not a matter of one canceling the other out. I think the interaction of the neurotransmitter systems is more complicated that that. But you are right that Saphris isn't generic yet, so if your insurance doesn't cover it than it will probably be expensive. I hope you find the right combo that helps, but IMO meds only do part of the job, the rest of the healing comes from psychotherapy and healthy lifestyle choices. So it's good that you are open to meds because they can really help, but there is no magic bullet. It sounds like you know a lot about the meds, so hopefully your family and your pdoc will take your wishes into account. I'm happy to answer any more questions if I can, because I've been on a lot of different meds, and I also prescribe psych meds frequently because I am a nurse practitioner. I hope that helps.