HELP- diagnosed with agitated depression/unipolar depression/akathesia..

Wow.. it's been so long since my last post. I am usually in the Bipolar area because up until a few months ago I was under the impression that i had Bipolar I.

A little back story: Between the years 2008-2011, I suffered severe manic/psychotic episodes and was hospitalized 4 times for them. I was diagnosed with BP1 my first visit to the ER in 2008, and was prescribed an arsenal of meds to help me stabilize. I was also using a lot of drugs and drinking heavy amounts of alcohol on the weekends (I was in my first year of University). In 2009, I was diagnosed with BPD ontop of my BP1 diagnosis. Then in 2010, the psych ward doctors became convinced that I was schizophrenic. The specialist I was referred too didn't agree in any way, he just told me that I was "severely depressed". There was a couple reservations I have always had about my diagnoses , the main ones being my drug use at the time (I have been clean from drugs/alcohol since Dec 2011, and subsequently episode free), and the fact that my episodes appeared to be textbook mania/psychosis.. however, what I was experiencing inside wasn't typical manic thoughts. Also, every time I ended up bringing myself to the hospital (which is not typical in full blown mania).

Anyways, long story short.. the professionals in my life, after following me for a long time, rejected all my previous diagnoses at the end of last year, calling my episodes "drug induced psychosis". We then made a very difficult decision for me to go off my medications, which I am on the tail end of doing now. I've been on so many meds the past 6 years. This decision was one of the hardest in my life because it was the first time in 6 years that I was told that the medications may not be necessary anymore. The transition has been very positive so far, apart from some sleep issues, which I'm told not to worry about as long as I get some sleep. I'm now almost off my third and last mood stabilizer (also the one I have been on the longest), have been off my antipsychotic for about 6 months, and have been off of my other mood stabilizer for about 2 months.

Yesterday, I was thrown a curve ball by my psych (who I've been seeing every week for almost 4 years) - he says that he's been doing a lot of research about my episodes and that he strongly believes that my episodes were a result of "agitated depression/unipolar depression/akathesia" (which was drug induced, rather than organic)

I was just as confused as you might be right now (lol). I had NO idea what that was.. and I thought I knew every type of depression in the book! Anyways, he went on for a long time about it and I took some notes. Here's some of what I got:

-Can be chronic or organic, can also be drug induced (symptoms of organic would be consistent)*
*can be induced by anti-depression/psychotropic meds as well as narcotics
-extremely persistant
-activated angry depression
-inner dialogue: self-hatred
-can involve pacing, hand ringing, moving
-often involves a short fuse- most confusing aspect of it
-thought process is the key aspect in diagnosing this condition
-volatile
-off and on
-person must manage stress levels, or they can have an episode (of severe mania/psychosis)
-episodes can occur as a result of stress and/or anger and/or growing stress level and demand
-episodes involve depressive internal thinking and severe anger
*hallmarks of episodes* = negative inner dialogue but on the outside the person appears enraged, and can even act happy (but this is difficult to sustain). Rebellious angry attitude. When peaking: heightened anti-authority. If attached to someone (ex: relationship), can become very clingy.
-alcohol/drug use is common
-self-hatred, coming into stress, feelings of impending failure, drug use peaks, lots of anger = cumulative effect can result in an episode
-typically checks themselves into hospital, only place they feel safe. Often though process is that of "go get help, go somewhere"

Anyways, I hope I didn't bore anyone too much.. I would just like ANY feedback from anyone. What now? I'm just so unbelievably lost. Any words will help me.

Thanks for listening.

I suspect the professionals in your life are waiting to see how you respond to being clean and off meds for a while before giving you any kind of a new diagnosis if any. You are extremely lucky to have such good doctors who aren't content to just keep on with the drugs & label.

I have the BPII diagnosis but now that I've been off anti depressants for years and I have never again had a manic episode but the doctors here do not want to deal with changing it. They just decided to just downgrade it to BPII even though I started out with a PTSD/major depression diagnosis and did not get manic until after they put me on the antidepressants. After starting the antidepressants my life became hell with multiple hospitalizations and the label BPI. A couple of years ago I was given trazadone for sleep, they didn't tell me it was an antidepressant even though I had told them I could not take any antidepressants. I ended back up in the hospital, where they tried to put me on mutiple psych drugs. It was only the intervention of my T that got me out without getting put back onto that crazy drug merry go round.

I'd say your doctors are real professionals and not to worry too much about a label. You are who you always have been, just free of drugs and meds.

What drugs were you doing?
How much were you doing?
Have you stayed clean since Dec. 2011?

I did alot of meth before I got clean and sober in 1995. I had Post Acute Meth Induced Withdrawal Syndrome. They didn't know much about it at the time. It kicked in two weeks after I got sober. It lasted over a year. They diagnosed me with BP1 and I took tegretol, effexor, and halidol. the halidol was only for a year until I got over the psycosis. I finally convinced my pdoc that I was not BP1 and that is was from the drugs and he took me off of tegretol. I have never had a manic episode before or since.

Meth totally mimics BP and the withdrawal can a long time. It can take years to get brain chemistry back to normal. Some people never recover.

Thank you it sounds like you have a pretty awesome T!! If only everyone could be so fortunate..

Wow, clean since 1995.. that is AMAZING!!

I wasn't using meth. I was smoking a lot (7-10 grams) of pot/"poppers" a day, and doing a lot of hallucinogens, and drinking tons. My friday night (drink wise) would be about a 14-26 oz of liquor BEFORE the bar (I was a 125 lb girl at the time). I can remember eating mushrooms out of a bag like it was popcorn for 3 days straight before one of my episodes..

Once they put me on clonazepam and risperidone I became heavily addicted to those as well. Every medication they put me on that I could "feel" something, I abused it. It just became a huge drug cocktail mess..

And yes, I have been clean since Dec 16th, 2011.

Very good for you.

Hmmm it is usually coke and meth that cause those kinds of things. Maybe the hallucinogens. I don't think drinking would do it even if it was alot. Must have been the shrooms and hallucinogens. The pot wouldn't do it.

It sure is a mixed up bag when drugs and alcohol are involved along with psych meds. The longer you are clean the better they will be able to diagnose you. If AD's make you manic that would suggest BP. Keep at it and stay away from the benzo's.

Have you stayed clean on your own or with AA/NA?

NA.. I fluctuated between the two for the first little bit, but I ended up connecting more with the NA fellowship where I am from.

However, if I travel to the states/anywhere else (I'm from Canada) and need a meeting, I don't discriminate lol

Good for you.

And what are poppers? Synthetic?

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Pot with tobacco underneath in a bong, gives you a very crazy feeling (head rush mainly). Called a popper because it makes a "pop" sound when its pulled..

Awful stuff.

This may be all drug induced in all honesty. You may not even be "crazy" at all, but simply had a bad reaction to something you took. I know that all these years later, that seems almost unfathomable but trust me it's possible. Who knows, you may not even be "mentally ill" but are simply suffering the effects of a drug that you took a long while back. Sometimes when people take drugs (especially large amounts of them) they have long term effects with regard to mental health. What did you take exactly? What effects did you have to what you took? If this is all drug induced, it changes the whole picture of how you can go about solving this issue. If it is, I cannot guarantee that you will fully return to your old self (in fact I think you will come out of this a changed person) but you may have a better chance of recovery

Eating mushrooms out of the bag like its popcorn is a good way to lose it. To take them like that for 3 days straight seems like a near certain way to induce some sort of "episode" in almost anyone. That's just asking for trouble.

Like I mentioned earlier I had meth induced post acute withdrawal syndrome that lasted over a year. They tagged me BP1. They did not know much about PAWS back then. 1995.

Yesterday I started looking for research on it for someone else and it seems they still do not know much about it. No big studies by NIMH or universities. I was very surprised by this.

Staying clean and sober is the best thing you can do. It can take years to heal your brain from heavy drug use.