[chels127]

First, I should say that I live in a state where MJ is illegal. I no longer smoke it. BUT, when I had my first manic episode ever this spring (and it was a BAD one) at the age of 44, I had been smoking a new batch of weed - like A LOT of it. I ended up in IP for 7 days (so no MJ during that time and none for a couple weeks after that.) When I started PHP progam, I started vaping cannabis (keep in mind, still illegal and didn't know what was in it). Following that I had a few weeks of psychosis and severe paranoia. I stopped vaping and continued to have psychosis for another week or 2. I haven't smoked or vaped it since April. By May, I was no longer manic or psychotic, although I quickly slid into a deep depression within a few weeks - which I still have, going on 4 months and counting. While in IP at the beginning of all this, I was diagnosed BP1. However, my therapist and my nurse practitioner both think it's possible that the whole manic episode could have been caused by the MJ. The NP thinks I may have BP2 instead of BP1 despite the full blown manic episode I had. This is all very difficult for me because I feel I don't have an official diagnosis that I can ACCEPT and move forward with. There's a lingering hope that I don't have BP1, since I'm 44 and never had mania or hypomania in the past (only depression - usually just in winter except for this year) and that I was smoking weed with a very HIGH THC content when the episode happened. Thoughts or knowledge about mania induced by marijuana use? Are my therapist and NP giving me false hope? Thanks ya'll.

[BipolarWolf]

I can relate. Check out some articles by googling " bipolar weed serotonin " there is a lot of research that has been done on this subject.
Basically, you should completely avoid weed, by vape or other. Not good for bipolar.

[saucygirl31]

i ate a lot of edibles once and got manic.

another time I was manic and smoked and I came down from mania.

best avoid.

[fern46]

Piggybacking on what Bipolar Wolf said, I've researched this topic a good bit. Researchers aren't sure if it causes psychosis or if it triggers an underlying issue. Many studies have shown the more you ingest, the more susceptible you are to it so that falls in line with your heavy usage during the period you first experienced psychosis.

The THC works with your seratonin and dopamine systems. Antipsychotic drugs do as well. MJ essentially slows everything down, but your brain eventually compensates. You then become hypersensitive and mania begins. That's the working theory anyway.

My therapist told me almost all of her bipolar patients use MJ. She said she suspects several of them would be fine if they would quit, but that they keep triggering episodes with continued usage. They have no history of mood disorders otherwise and mania set in late in life compared to typical bipolar patients. Your onset at 44 isn't unheard of, but it is later than most.

My advice would be to keep doing what you're doing and leave it alone. It is clear your mind is sensitive to it and it isn't worth risking another episode. My hope for you is that you can stay in remission if you stay clean.

Here's a psychiatrist's take on it.

[Wild Coyote]

HI chels127!

Welcome to the Bipolar Forum at PC!

I do understand the desire to have a final diagnosis so you can accept it and can move forward accordingly. Many of us wait years for the most accurate diagnosis.

The fact that you are 44 years old and have never before had a manic episode does not mean much when it comes to Bipolar illness. Many people have their first episode later in life. Women, especially, can have psychiatric changes as they approach/go through the hormonal changes of peri-menopause and menopause.

As for whether or not the use of marijuana had caused, or had contributed, to your psychosis, it is impossible to know this for sure. Some will argue that the mj had caused the psychosis; yet, how can anyone know for sure? It is possible you'd had a proclivity for BP and the use of the high THC had kindled this proclivity. Yet, this cannot be known for sure, either.

I have seen people admitted to IP, supposedly in a severe psychosis due to mj dusted with PCP. As these patients had cleared up from the exposure to PCP, they'd had an underlying mood disorder. It had turned out they were self-medicating with mj and with mj dusted with PCP in order to alleviate their distress related to their psychiatric illness. The mj and the PCP had caused additional symptoms and difficulties; yet, did not cause their underlying illness(es).

I know a doctor who is very bright. She has 5 siblings who are also extremely bright and are also incredibly successful in politics, scientific research, etc. All 5 of her siblings experienced BP I or BPII in their 40's for the first time. She suspects they have been triggered by use of mj. She is the only sibling who does not smoke mj. Again, even if the mj has triggered the illness(es), it did not cause the illness(es) and omitting the mj has no t cured them. This story has no scientific basis; it is just her observations and her own reasoning based upon what she knows about her siblings, about BP, about the use of mj, etc.

I live with BP II.. I had used mj for pain. I had vaped. I did this for about 6 months and had some very potent strains. I did not become psychotic. I cannot assume I would never become psychotic. I stopped not because of any mental health reason; I had stopped because vaping did not help with pain. (I am in a legal state.)

I know you'd like some clear answers. Again, the truth is: There are not certain answers at this time. The use of mj clouds the ability to come to a clear/certain diagnosis at this time.

You mention you have only experienced depression earlier in your life. This is true of many people diagnosed with BP.

I also want to point out the fact that your episode was in May. It is not unusual for practitioners to take longer than you have waited (to date) to observe further in order to reach the diagnosis which is closest to the truth for their client.

It seems like your practitioners are telling you that you have either a BP I or a BP II diagnosis? I imagine they will sort this out relatively soon.

Should you become labeled with either diagnosis, these are "spectrum" disorders and there is no guarantee that your experience of either version of BP will be just like anyone else"s experience.

How do you feel the delay in exact diagnosis is holding you back?

We all do whatever we can manage to do, despite the label given to us.
I believe you can move forward in your life by doing the same. Do not let any diagnosis define you and/or dictate anything in your life. Always "move forward" in life in whatever way is manageable for you.

Again, welcome!
I hope to see you around!

[Wild Coyote]

I just want to let you know where I am coming from. I am not against the use of mj. Every psychiatrist I have known has not only been fine with the use of mj in their patients, they have actually suggested it. I am told by them that they sometimes ask a patient to withhold mj use for a variety of reasons. I had always been very much against the use of mj, especially when psychiatric issues were involved. In attending many of the educational seminars put on by the state and by the local teaching hospital, I have changed my stance on this.

Every medical specialist I have seen knows of my psychiatric diagnoses (and the history). Every one of them, and there are many, have strongly (and repeatedly) suggested I use mj , stating it is much safer than are medications. They each, too, have shifted in their understandings and in their recommendations to their patients.

I do not know if this is the best approach for everyone. It is definitely the way medicine is going where I live.
My doctors are strongly in favor of discovering individual responses to mj use and making individual decisions accordingly.

I do think it makes sense that mj use can confuse both the practitioners and the clients when trying to make an accurate diagnosis.
I also agree that using mj might, in some cases, make treating mental illness more difficult. However, I do not think it is harmful to everyone with a psych illness.

Just my own stance on the use of mj.

[neverending]

I took one puff in college and went psychotic!

However from teen years on my basic diagnosis was major depressive disorder.

My first manic episode was when I was 61 and my diagnosis is BP1.

However looking back through my life I probably was bipolar with mixed episodes.

I was also BPD so there might have been confusion there too. Psychiatry is a lot more advanced now than when I began this merry go round.

[bpcyclist]

Your story is typical, in my opinion, of why it is often so difficult to accurately make a bipolar-spectrum diagnosis today. For example, based solely on your initial episode, you would not qualify under the current DSM for any diagnosis other than a drug-induced psychosis, I do not believe. But then it lingered and then, later, with no marijuana in your system, you had a depressive episode. Is this part of the original thing, is it evidence of bp2, or do you really have bp1? Very hard to tease out.

I went through a very similar situation and one of the things I did that helped clarify things was to write out a detailed life chart. When you see it on paper, it sometimes becomes a bit clearer. Maybe read about life charts and see if that is something that interests you or not. In my case, we stopped all my meds while I was in the hospital. I do not recommend this. I had a massive mixed episode months later and the diagnosis was confirmed. Sometimes, it takes time.

I live in a state with legalized marijuana which is also an absolutely gigantic producer of the product. It is everywhere. In my town, I would say it is considered common knowledge that weed may cause psychosis in some persons. This is just accepted as fact here. FWIW.

[tecomsin]

I also had my first manic episode at 44 when I was put on an antidepressant for the 1st time in my life. I was also consuming cannabis and was diagnosed with BP 1.

The only way to tell what is going on for sure is to refrain from using cannabis and wait and see if you ever go manic or psychotic again.

In my case I continued intermittently to use cannabis and had subsequent episodes while on it. Now I take an antipsychotic every day and haven't gone psychotic since even though I continue to use cannabis.

However, I am chronically depressed.

[chels127]

Originally Posted by tecomsin

I also had my first manic episode at 44 when I was put on an antidepressant for the 1st time in my life. I was also consuming cannabis and was diagnosed with BP 1.

The only way to tell what is going on for sure is to refrain from using cannabis and wait and see if you ever go manic or psychotic again.

In my case I continued intermittently to use cannabis and had subsequent episodes while on it. Now I take an antipsychotic every day and haven't gone psychotic since even though I continue to use cannabis.

However, I am chronically depressed.

@tecomsin I'm sorry you're chronically depressed. My depression has been absolutely crushing for the last 4 months. I wouldn't wish these feelings on anyone. How long has it been since you were last psychotic if you don't mind me asking?

[tecomsin]

Hi chels127,

I was last psychotic 2 years ago exactly. It was a very bad psychosis and I ended up in trouble with the law. After that I decided to stay on a small dose of an antipsychotic every day. I take Rexulti. Olanzapine works too but it raises my blood sugar. I only take a small dose of Olanzapine if I am having trouble sleeping, and I keep faithful track of sleep with my fitbit. So far this has kept me out of any trouble with an unstable mind slipping into psychosis.

I am sorry for you too that you are also suffering depression. It helps to reach out. I tend to isolate myself and not even post much or read here when I am quite depressed because i tend to find a lot of things that other people are going through triggering, but it is nice when PC is here for the times when I do feel like reaching out.

[daladico]

Marijuana CAN induce mania and/or psychosis in individuals who are susceptible to it (according to research). Personally, I’ve had several times in which marijuana has made me “manic” short term, just until the marijuana wears off. There was one time that I felt manic and paranoid for a week after using marijuana. I no longer use it, as the cons outweigh the pros for me