[Chance07]

This is from my Introduction post and it's tough but it's what is happening to me. I'm hoping to get help here as well as from my new doc when I do get to see him.

Hello there, I am Bryan and I am here because I was just recently got diagnosed as having Bipolar Type I with ADD as well. I have been going through a lot with the diagnosis because of everything that has happened in the past few months. Starting from when I was a kid I was diagnosed as having ADHD. I have seen a Psychiatrist since I was a child. I stopped seeing the doctor when I was a teenager because of family issues going through a divorce and everything. For the most part I was good, in some instances I was better than good. Being the oldest child I stepped up to help my mother with the chores and everything around the house. I am one of four kids so my mom had her hands full with raising us, working full time, and going to school to get her degree so that she could provide for us. I kinda went a little overboard with the helping with everything and I ended up trying to be a stand in father to my youngest sister who was six years old when my parents split. I was 13 when this all happened and didn't know any better but I did not need sleep as much and I always had energy for a time. I ended up causing issues for my mother and my step father when he came into the picture a few years later because I always had the good ideas to just do something and he ended up having issues with it. Not long after this I ended up getting really down and moody, not sure what started it but I did. I ended up getting diagnosed with depression at the age of 17 from my PCP. Since my diagnosis I have been on 7 different antidepressants and none of them seemed to work. This went on for a while, years actually, I would get really depressed and then start to feel better then feel like nobody could tell me wrong. I went through almost 20 jobs in a 4 year span. I finally got the job that I currently have and have had it since. I still had manic episodes while having this job but they have been very understanding and I have a very good PCP who makes sure that I never have any issues with my job because he has no problem covering my "issues" as they were called with documentation. This is what gets me the most this past year I went into a deep depressive episode right after Halloween. It got to the point that I ended up not eating and lost just over 30 pounds. Now I am a little overweight but nothing major so thirty pounds was very noticeable. My family started getting extremely worried and convinced me to go see my PCP. He got me on another antidepressant to help with the depression but also asked me if I had been screened for bipolar disorder, I said that I had not and he suggested that I should. The thing about this is that I had seen a new Psychiatrist not but a year and a half before this started. This new Pdoc did not even ask me questions about my mood and just gave me a script for my concerta. After seeing my doc and getting the prescription I started to get more depressed and I stopped taking all of my meds all together. I started to feel a little better about myself and then my family staged an intervention of sorts because they saw what was happening to my body. It took a lot of convincing but they got me back on the meds. I would usually say this was a good thing but, the new antidepressant was not one I had ever taken before, this med caused me to go into my worst manic episode that I have ever had. I ended up talking very fast, not sleeping much if any at all, spending all of my money to the point of going negative in my account, being very promiscuous, and doing crazy random things. My family got me to my pdoc and he thought that I was only hypomanic and gave me a diagnosis of bipolar type II. He put me on Lamictal, but with Lamictal you apparently have to work up to the right dose. He also kept me on the antidepressant that I started taking right before the episode started. It may have worked if it had enough time but after that appointment things got worse, I went and bought everything to go on a camping trip in the middle of January when it was 20 degrees outside with nothing but a simple sleeping bag. I disappeared from everyone and didn't respond to anyone. I believe I was very paranoid that someone was going to come and get me. I ended up going home on my own and acted like nothing was wrong even though I pissed off my family. The next day I was still manic and rambling on at top speed and then I cycled. I ended up lower than I was when I went to the doctor. I was rambling about someone trying to come and take me away and pleaded with my mom to not let them take me. That day I ended up slitting my wrists and trying to down an entire bottle of pills to kill myself. My family tried to stop me and called 911 and they got me to the hospital. I remember being very dazed, when I took the pills I was stopped and only took about 8 of them. It just made me be very dazed and had blurred vision. I was admitted into a psychiatric hospital and was evaluated. The docs there changed my diagnosis to BP type I w/ADD. They were able to explain things to me and the therapist there was able to help me realize what has happened to me my entire life. They took my off of the antidepressant and told me not to take any again because antidepressants can (and in my case have) trigger mania in bipolar patients. I was in for a week and was switched to lithium. Originally I was feeling lethargic and slept a lot but I contributed that to the two and a half weeks with almost no sleep. I was kept out of work for another week to help have time to adjust to the meds and I can say that it is getting some what better. My mood is completely stable for the most part. I have started having tremors and am scatterbrained and can not focus which is crazy because I am on the concerta to help me focus. I have gone back to my pdoc and have decided to find another doc because it is completely apparent that he does not know what he is doing. Told me that its the concerta that can trigger mania not the antidepressants. When I told him that is not what the hospital and almost every website online said he did not say anything just moved on. For my follow up appointment after being in the hospital I was in the room with him for less than 10 minutes before we were done according to him and when I went to check out he was behind me and walked out of the office. I was not even out of the office before he had left for the day. I know that everyone wants to get home after a long day and I know I was his last appointment but to rush it is uncalled for. I am on here to help me understand what it is that I need to find in a doctor. I am searching for one currently but am unsure of what to look for. I could go see the doc that I had in the hospital but his private practice is almost an hour away from me. I have plenty of meds for now but I do not want it to take too long. So I need help and also has anyone else gone through something similar where your disorder wasn't caught until you were an adult?

[Altered Moment]

Antidepressants can definitely trigger mania. I am not sure that means for sure you are Bipolar I. Have you ever had major manic episodes before or since?

If the concerta makes you calm and more focused as opposed to feeling wired then it is working right. If it makes you very wired than maybe you don't need it for ADHD. It should have the opposite effect from getting wired if it works for ADHD.

I would push against the diagnosis of BP I if you don't have a history other than this one antidepressant. That was a pretty bad episode though.

Even BP II the standard would be a mood stabilizer like Lamictal. I like it very much and think it is safe. I would hesitate on the Lithium.

[Altered Moment]

Usually the first major manic episode presents in the teens. That doesn't mean it can't happen for the first time later on.

I had a major manic episode that lasted over a year and had tons of psychosis. Classic Bi Polar I episode. The thing is it was caused by Post Acute Withdrawal from Methamphetamine. I have never had a major one before of since. They tagged me as Bi Polar I for a long time but it wasn't true. I do however get hypomanic a lot.

[Chance07]

Originally Posted by Altered Moment

Antidepressants can definitely trigger mania. I am not sure that means for sure you are Bipolar I. Have you ever had major manic episodes before or since?

If the concerta makes you calm and more focused as opposed to feeling wired then it is working right. If it makes you very wired than maybe you don't need it for ADHD. It should have the opposite effect from getting wired if it works for ADHD.

I would push against the diagnosis of BP I if you don't have a history other than this one antidepressant. That was a pretty bad episode though.

Even BP II the standard would be a mood stabilizer like Lamictal. I like it very much and think it is safe. I would hesitate on the Lithium.

I have had manic episodes in the past. The people that I lived with when I was in my late teens thought that I was just being fun and energetic. I have also had psychotic tendencies when I go manic. I am pretty sure that the diagnosis is right because when I got on the Lithium originally I started to feel better. My original dose was 600 mg/day and was able to adjust fine to it. The doctor tested my Lithium levels and said that they were just below therapeutic levels and that they needed to up the dosage so that I would get to the levels that I needed to be at. I just hate the side effects of the Lithium that I have dealt with and now I'm finding out that weight gain, acne, and possible hair loss can also be side effects its overwhelming to say the least and not something the boasts confidence in continuing to take the medication. The kicker to all of this is that I cannot get into see a pdoc until the end of march which is not good at all.

[Ocean Swimmer]

I understand you'll also need blood work done with Lithium.

[Altered Moment]

That is the problem with Lithium. It works but has side effects and needs blood tests.

Since you are bi polar I I would try the mood stabilizers like Lamictal. That one seems to be effective and have a very clean side effect profile.

I would get a new pdoc. See if he can do some testing on you. Yes I wasn't diagnosed until I was 36. I had my first manic kinda psychotic episode when I was 21 though after I gave birth to my son. My primary drs always said they thought I had bp but I didn't believe them. When I was 36 I went into a bad mania that turned into a psychosis and ended up in the hospital and was diagnosed with bipolar disorder 1 and PTSD. But I also took like 4 different tests in the hospital. After seeing it in black and white I completely believe it now.

I think stay on the lithium. For me I couldn't imagine taking any adhd meds. I'd be completely manic. But I don't have adhd at all. I really think seeing a new pdoc that will take time for you is your best way to go. I do take anti depressants, but only the ssris. The snris make me go mixed. But I also can take them bc I'm on a high dose of a mood stabilizer and a strong anti psychotic. But your manic episode could have been anti depressant induced. I would hope for that and hope you're not bp. It's no fun. Good luck.