[NowhereUSA]

i'm not very well-versed in bipolar and i had some questions.

for the last five years i've been in treatment for MDD and GAD. i've been on a ton of ADs and nothing has worked in the least bit (more than once i end up with higher anxiety and insomnia, very frustrating).

i talked with my t about the possibility of bipolar but i don't have mania. what i do have are periods where my energy is up and my mood is better, but it's not above 'normal' (make sense?). i used to chalk it up to maybe my depression was cycling except as i started to think about it, it didn't make sense. my 'ups' only last a few weeks (they're a gradual incline) and then i go back down into the depths of my horrible, suicidal depression.

during my ups i get really energetic. i'll wake up early and scrub the kitchen and then do laundry and i'll get a TON done in a day and this is usually when i join things (like i sold pampered chef for a while a few years ago but after i came down off my up, i was like wtf? and i lumbered through until i had an excuse to stop). Last Christmas i went on a baking spree even though my oldest was really sick, i kept up with him and the house and the cooking. i don't even like to bake and i baked like five different things for a straight week.

because they fall into the realm of 'normal' for most people i think, and i'm not being reckless or causing myself harm, i've never thought about it.

my t says it wouldn't hurt to talk to my pdoc about a mood stabilizer. we did try lamictal and lithium years ago but in low doses and they didn't do anything.

i thought i'd ask here if what if what i was experiencing was in the realm of possibility? obvs, i need my pdoc and t to diagnose but if i knew what to ask my pdoc or what meds are out there or something... maybe that would be helpful.

i'm just desperate for something to work

[loophole]

Many people who aren't bipolar are on some form of a mood stabilizer. . Sorry not much help but you don't have to be bipolar to get specific meds. ..

[pawn78]

it sounds like mild mania, maybe. Bipolar disorder type 2 is usually mostly depression with hypomania also (milder mania). Bipolar disorder type 1 has depressive episodes, hypomanic episodes and outrageous MANIC episodes.

[NowhereUSA]

sure, i guess it couldn't hurt to try a mood stabilizer w/o being bipolar. i guess i was also just wondering if there was a chance my diagnosis was off.

my t mentioned hypomania. i should google that.

[TheatreKid]

Before I was diagnosed bipolar, they thought I might have atypical depression, which is a type of depression that brightens temporarily in reaction to events. This can also exist along with bipolar disorder. After a lot of hard to miss symptoms, I was rediagnosed with bipolar I.

Atypical depression - Wikipedia, the free encyclopedia

[ozzy1313]

My hypomania is how you described. I always thought it was just the up and down cycle of depression. I was diagnosed BP2 last year and have doing well with lamictal.
In my "up" state I start new projects (I manically did art for almost a year), make impulsive decissions, etc. These things are not really bad things, but they are different from my baseline state.

[NowhereUSA]

Originally Posted by TheatreKid

Before I was diagnosed bipolar, they thought I might have atypical depression, which is a type of depression that brightens temporarily in reaction to events. This can also exist along with bipolar disorder. After a lot of hard to miss symptoms, I was rediagnosed with bipolar I.

Atypical depression - Wikipedia, the free encyclopedia

yeah. this is how i thought i might have been too. i do have some of these symptoms. what made me wonder this time was i realized i was feeling "better" (not great, but not suicidal, and i was feeling more energetic) for a length of time and i couldn't point back to a trigger event. and then as i thought about it, i realized that this was something i can remember experiencing since i was a teen.

Originally Posted by ozzy1313

My hypomania is how you described. I always thought it was just the up and down cycle of depression. I was diagnosed BP2 last year and have doing well with lamictal.
In my "up" state I start new projects (I manically did art for almost a year), make impulsive decissions, etc. These things are not really bad things, but they are different from my baseline state.

i always start up new projects too nothing huge and i've learned over the years to be really, really careful about it, but i still end up signing up for things and then wondering how the heck i'm going to complete them later on. i hate flaking out but this last year... yeah i flaked out on a lot because i wasn't careful. like you they aren't bad things and to an outsider, i would look relatively normal, just more peppy than usual, but to me they don't fit.

[A Red Panda]

It could be hypomania.

I get a mild hypomania; if my baseline wasn't so low as a standard I'm not sure if I'd notice it. As it is, my baseline is pretty low so I notice the mood increase. I pay more attentiont to energy and sleep levels.

[vans1974]

Originally Posted by NowhereUSA

i'm not very well-versed in bipolar and i had some questions.

for the last five years i've been in treatment for MDD and GAD. i've been on a ton of ADs and nothing has worked in the least bit (more than once i end up with higher anxiety and insomnia, very frustrating).

i talked with my t about the possibility of bipolar but i don't have mania. what i do have are periods where my energy is up and my mood is better, but it's not above 'normal' (make sense?). i used to chalk it up to maybe my depression was cycling except as i started to think about it, it didn't make sense. my 'ups' only last a few weeks (they're a gradual incline) and then i go back down into the depths of my horrible, suicidal depression.

during my ups i get really energetic. i'll wake up early and scrub the kitchen and then do laundry and i'll get a TON done in a day and this is usually when i join things (like i sold pampered chef for a while a few years ago but after i came down off my up, i was like wtf? and i lumbered through until i had an excuse to stop). Last Christmas i went on a baking spree even though my oldest was really sick, i kept up with him and the house and the cooking. i don't even like to bake and i baked like five different things for a straight week.

because they fall into the realm of 'normal' for most people i think, and i'm not being reckless or causing myself harm, i've never thought about it.

my t says it wouldn't hurt to talk to my pdoc about a mood stabilizer. we did try lamictal and lithium years ago but in low doses and they didn't do anything.

i thought i'd ask here if what if what i was experiencing was in the realm of possibility? obvs, i need my pdoc and t to diagnose but if i knew what to ask my pdoc or what meds are out there or something... maybe that would be helpful.

i'm just desperate for something to work

Sorry to hear, I like when the pdocs just treat the symptoms you're experiencing. If you MDD, Cymbalta's proven to probably be the best AD, and it also is approved to GAD. For me it's all about finding the right dose! Cymbalta also typically doesn't poop out. If you're bipolar I'd suggest an AAP, like Latuda, instead of an anti-convulsant, like Lamictal, or both together. I find though, the AAPs are much more effective for treating daily mood swings! Best of luck...and obviously it's crucial in finding a good pdoc.

[Victoria'smom]

Your ups and response to them is why a lot of bipolar get misdiognosed. Full blown mania rarely looks like TV mania, expecailly to the one that is going through it. I think hypomania is only associated with bipolar spectrum.

[Alokin]

I would not get hung up on the label.....few people fit perfectly into a dx just like few people react similarly to rx.

[archipelago]

A tricky one. And we can't really say because we don't really know enough. Two other diagnoses are possible as well. Dysthymia, which is mainly depressive, but has some lifting of mood and is chronic. There is also Cyclothymic, where hypomanic and depressive symptoms occur but do not meet full criteria. In your case, it does sound like you meet criteria for depression though so that one seems like it could be rules out.

For depression I have tried many meds and am currently finding Wellbutrin to be working. (I'm also taking Provigil which is really the thing that is making the difference but it is very difficult to get approval for.) I have taken things like Lamictal and have been fine with that. While it is true that you don't have to be bipolar to try other meds, it is true that once diagnosed with bipolar, certain meds will be considered off limits so I would pay some attention to how this turns out.

[NowhereUSA]

Originally Posted by A Red Panda

It could be hypomania.

I get a mild hypomania; if my baseline wasn't so low as a standard I'm not sure if I'd notice it. As it is, my baseline is pretty low so I notice the mood increase. I pay more attentiont to energy and sleep levels.

i have a really low baseline. i should try to track energy/sleep levels. i've noticed the last few weeks i've had more trouble sleeping than usual but it's also hard to track because i have some meds for sleeping that i take :-/

Originally Posted by vans1974

Sorry to hear, I like when the pdocs just treat the symptoms you're experiencing. If you MDD, Cymbalta's proven to probably be the best AD, and it also is approved to GAD. For me it's all about finding the right dose! Cymbalta also typically doesn't poop out. If you're bipolar I'd suggest an AAP, like Latuda, instead of an anti-convulsant, like Lamictal, or both together. I find though, the AAPs are much more effective for treating daily mood swings! Best of luck...and obviously it's crucial in finding a good pdoc.

hmm. y'know, of all the meds we've tried, i don't think my doc has ever given me cymbalta. which is weird given the depression and the GAD :P i might ask about that and latuda when i see him.

Originally Posted by Miguel'smom

Your ups and response to them is why a lot of bipolar get misdiognosed. Full blown mania rarely looks like TV mania, expecailly to the one that is going through it. I think hypomania is only associated with bipolar spectrum.

yeah. that's why i've never thought about it. because i imagine what i see on tv (or what i saw in the hospital the one time i was there).

Originally Posted by Alokin

I would not get hung up on the label.....few people fit perfectly into a dx just like few people react similarly to rx.

oh, i'm not. i'm just trying to figure things out. part of the 'label' too is that my H and i are talking about moving and to some extent a label can be easier to get someone up to speed with lol. but no, i'm not stressing, just wondering right now.

Originally Posted by archipelago

A tricky one. And we can't really say because we don't really know enough. Two other diagnoses are possible as well. Dysthymia, which is mainly depressive, but has some lifting of mood and is chronic. There is also Cyclothymic, where hypomanic and depressive symptoms occur but do not meet full criteria. In your case, it does sound like you meet criteria for depression though so that one seems like it could be rules out.

For depression I have tried many meds and am currently finding Wellbutrin to be working. (I'm also taking Provigil which is really the thing that is making the difference but it is very difficult to get approval for.) I have taken things like Lamictal and have been fine with that. While it is true that you don't have to be bipolar to try other meds, it is true that once diagnosed with bipolar, certain meds will be considered off limits so I would pay some attention to how this turns out.

wellbutrin gives me horrible insomnia and makes me jittery - they've tried to give it to me twice now :P

i'm curious, what meds become 'off limits'? outside of generalities, i'm not really familiar with bipolar. i've googled but that's about it.

[archipelago]

Many will not give anti-depressants to people with bipolar for fear of inducing a manic or hypomanic episode, which they seem to fear more than depression. And they will consider other medications, such as anti-psychotics to help with mood which isn't as common with depression that isn't bipolar. So it does change the range of meds people consider. I have found Lexapro to be pretty good in the past. My depression of late has been with severe fatigue so I needed something more activating and the Wellbutrin is working, but I was concerned at first that it would increase anxiety or make me feel wired. I got lucky.

[A Red Panda]

Antidepressants, SSRIs in particular, like Zoloft, are often not given to people with bipolar because there is a risk of them trigger a hypo/manic episode.

I started on just an antidepressants and went into my most straight up hypomanic episode I've ever had. I've now added a mood stabilizer (lamotrigine/Lamictal) and have reintroduced the Zoloft - which isn't conventional but it is what I was willing to do. It seems to help, but it's not the common combination.

[NowhereUSA]

Originally Posted by archipelago

Many will not give anti-depressants to people with bipolar for fear of inducing a manic or hypomanic episode, which they seem to fear more than depression. And they will consider other medications, such as anti-psychotics to help with mood which isn't as common with depression that isn't bipolar. So it does change the range of meds people consider. I have found Lexapro to be pretty good in the past. My depression of late has been with severe fatigue so I needed something more activating and the Wellbutrin is working, but I was concerned at first that it would increase anxiety or make me feel wired. I got lucky.

Lexapro was another that didn't do anything for me. honestly, i'm rather sick of the ssri's because almost every time i get them, i end up an insomniac. prozac made me jittery. wellbutrin gave me insomnia. i also got insomnia with several others as well. they tend to increase my anxiety or do nothing at all.

my pdoc is decent and my t works in the same clinic and has gone to bat for me more times than i can count. i'm not overly worried about what he'll do as i've got a good support team.

Originally Posted by A Red Panda

Antidepressants, SSRIs in particular, like Zoloft, are often not given to people with bipolar because there is a risk of them trigger a hypo/manic episode.

I started on just an antidepressants and went into my most straight up hypomanic episode I've ever had. I've now added a mood stabilizer (lamotrigine/Lamictal) and have reintroduced the Zoloft - which isn't conventional but it is what I was willing to do. It seems to help, but it's not the common combination.

ugh. zoloft. i had a terrible reaction to that one too i think it made me suicidal (my friend says i was going down when i was taking it but after i started taking it and it was kicking in, she said it was like someone put a brick on the accelerator and i spiraled down faster).

well. even if it's not bipolar, i'm willing to give anything a go. i can't function like this anymore! i hate only intermittently having a few decent weeks and then going back to the dark pit.

[ozzy1313]

Originally Posted by NowhereUSA

Lexapro was another that didn't do anything for me. honestly, i'm rather sick of the ssri's because almost every time i get them, i end up an insomniac. prozac made me jittery. wellbutrin gave me insomnia. i also got insomnia with several others as well. they tend to increase my anxiety or do nothing at all.

Wellbutrin would also give me insomnia. I now take it when I wake up and again at noon (the xr version gave me headaches). Pdoc then gave me xanax at night to combat the wellbutrin and help me relax enough to sleep.

[archipelago]

Some people find Lamictal helpful. It is activating but not too much depending on the dose. It has helped me in the past and I tolerated it well. What is helping the most and has in the past is Provigil, an atypical stimulant used mainly for sleep disorders. I also have anxiety and some insomnia but I seem to not be affected by the Provigil (or the Wellbutrin). Unfortunately it is outrageously expensive and not easy to get approved. Besides it may be too activating if you are sensitive in terms of insomnia.

[NowhereUSA]

Originally Posted by archipelago

Some people find Lamictal helpful. It is activating but not too much depending on the dose. It has helped me in the past and I tolerated it well. What is helping the most and has in the past is Provigil, an atypical stimulant used mainly for sleep disorders. I also have anxiety and some insomnia but I seem to not be affected by the Provigil (or the Wellbutrin). Unfortunately it is outrageously expensive and not easy to get approved. Besides it may be too activating if you are sensitive in terms of insomnia.

thanks. I was thinking about asking him about trying lamictal again. idk. we'll see. i just want something to work - whatever that maybe.

[r010159]

There is at least one notable doctor that believes bipolar can exist without (hypo)mania. The treatment would be thar same. The patient would respond too MS.

Sent from my iPhone using Tapatalk

[Trippin2.0]

Originally Posted by r010159

There is at least one notable doctor that believes bipolar can exist without (hypo)mania. The treatment would be thar same. The patient would respond too MS.

Sent from my iPhone using Tapatalk

I'm honestly curious, in such a case, what would the Bi part of the Polar be then?

Or is there a different "opposite" to depression that I'm unaware of?

NB. I used inverted commas for the word opposite because many of us don't get euphoric or the euphoria becomes dysphoric after some time.

[pondbc]

Originally Posted by archipelago

Many will not give anti-depressants to people with bipolar for fear of inducing a manic or hypomanic episode, which they seem to fear more than depression. And they will consider other medications, such as anti-psychotics to help with mood which isn't as common with depression that isn't bipolar. So it does change the range of meds people consider. I have found Lexapro to be pretty good in the past. My depression of late has been with severe fatigue so I needed something more activating and the Wellbutrin is working, but I was concerned at first that it would increase anxiety or make me feel wired. I got lucky.

Archipelago, if you don't mind my asking, how much Wellbutrin do you take to give you energy?

[Tucson]

Originally Posted by Trippin2.0

I'm honestly curious, in such a case, what would the Bi part of the Polar be then?

Or is there a different "opposite" to depression that I'm unaware of?

NB. I used inverted commas for the word opposite because many of us don't get euphoric or the euphoria becomes dysphoric after some time.

I need to find more info on this. I think it was in one of his books that I read, but he also has published allot of papers in psychiatric journals. He sees Bipolar as a spectrum illness starting with Bipolar I, Bipolar II, Bipolar NOS, and so forth. I think he says that some forms of episodic depression can be considered mood swings that can be treated the same way that the mood swings of Bipolar are treated. Maybe he refers to this type of depression as an equivalent to what he calls Bipolar Depression.

S Nassir Ghaemi, MD | Sackler

He is internationally recognized in his areas of interest. If you want, I will try to find exactly how he referred to this type of mood swing. It is part of his book on Bipolar illness which is a terrific book. I can actually understand what he writes. Interesting fellow.

PS: My old handle was r010159.

[StayinAlive]

Your up periods do sound like my hypomania, too. My diagnosis is cyclothymic disorder, which is like a step down from bipolar II. Your symptoms sound somewhat like mine. Don't know if that helps. Like many people, it took many years for me to get a correct diagnosis. It is worth pursuing.

Good luck!

[NowhereUSA]

thanks everyone. i see my pdoc on the 23rd. i might ask him about just giving MS a try. it can't really hurt since nothing seems to be working.

i'm also headed downward too so, at least i had this conversation with my t and he can keep an eye on things and how i'm doing.