[SoScorpio]

Back in October I went to my primary doctor and got on Wellbutrin, because I anticipated I would go through a bout of depression in winter. I was right. I was seeing a counselor but stopped so I would have money to get in some results-oriented therapy.
For three months I took the Wellbutrin at night, because that's always when I've taken my pills. Wasn't until a few weeks ago that I learned I should be taking it in the morning. I've been doing that, but it's not going well. I'm still depressed most days that I have to work, and my lack of symptoms at home makes my boyfriend think I'm just lazy or don't like my job, even though I do. A couple days after I started taking the pills in the morning, I had some mania-like symptoms in the morning and early afternoon. One day it felt like I had way too much caffeine, which I'm sensitive to, and almost gave me a panic attack. A little later the same day, I started giggling at the absurdity of feeling both happy and anxious, and couldn't stop laughing for a while.

A while back I finally dealt with my insurance to find out which psychiatrists are in our network. As it turns out, only psychiatrists attached to the hospital from which the insurance comes. My mom works there and I'm on her insurance, but I turn 26 this November and will lose it then. I did a search on the insurance site for any psychiatrists in network within 20 miles of me. I read every page of the results and literally came up with only three that are not associated with the hospital: an Autism center, a brain injury center, and one private practice woman who apparently got driven out of town by the hospital, because all of her phone numbers were disconnected. So I buckled down and called the outpatient psychiatry department. I was hopeful, the website said they do comprehensive psychological testing, pharmacological guidance, and "evidence-based" therapies. It even said most appointments could be made within two weeks.
Well THAT was BS. I called and they didn't have an opening until March 3rd. They told me to try to get an appointment somewhere else if I could, but they'd put me down for that date in case I couldn't find anyone. The receptionist even said that most people were having trouble finding anyone else. With thousands of people depending on the hospital for crappy HMO insurance, I'm not surprised.

But what do I do now? There's no one else I can go to. I'm kinda thinking I should change medications, or add one, or change the dosage, but I'm not really sure I should go back to my general practitioner for that. It feels like she'd just be making a shot in the dark. Should I just keep taking the Wellbutrin? Maybe taking it at the wrong time set me back a lot and it will take another three months taking it in the morning before I'll know if it works?

All I know is, I'm tired of crying on my way to work, of counting the minutes until I can go home, of dreading every second that I have to spend interacting with people. I don't know if I can wait over seven weeks.
I don't know what to do.

Sorry you're going through all this.

Honestly, psychiatrists are mostly taking a shot in the dark when they first prescribe. I would definitely make an appt. with your GP as soon as you can. Don't keep yourself in a miserable state. Also, you don't want to risk going into crisis waiting airing for March.

Sorry to hear about this SoScorpio! It sounds scary that you almost became manic. Since some antidepressants may turn people into bipolar, I think the best you can do is to go back to your GP and tell. (I tried to read about your medication, but wasn't able to find out if it is among those that can lead to medication induced Bipolar Disorder, That is Bipolar III). Please go back to your GP. Doctors, even psychiatrist, do "try and see if it works" when trying to help. If the medication doesn't work as intended they need feedback.

Wish you good luck!

[SoScorpio]

Hold up. Are you saying some meds can cause longterm bipolar, as in it continues even when you stop the medication? I have never heard of this. A doctor did once prescribe me something he said would cause mania if I WAS bipolar, but no one ever thought I was. I don't remember which medication it was.
I'm not finding much on drug-induced bipolar, only manic episodes and the articles don't specify if the mania continues after quitting the medication. If that is what you mean, can you link me an article?

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[little turtle]

Originally Posted by SoScorpio

Hold up. Are you saying some meds can cause longterm bipolar, as in it continues even when you stop the medication? I have never heard of this. A doctor did once prescribe me something he said would cause mania if I WAS bipolar, but no one ever thought I was. I don't remember which medication it was.
I'm not finding much on drug-induced bipolar, only manic episodes and the articles don't specify if the mania continues after quitting the medication. If that is what you mean, can you link me an article?

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this could be very important to find this out...I will look also... at mad in America site...

Sorry if I frightened you, SoScorpio. That was not my intension. The most important is to understand that doctors need feedback from their patients, even if they are professors, to find the right medication or combo of medication that really helps. Trust your doctor, but tell him/her how the medication worked on you, so he/she can adjust them to the unique person that is you. Ask how long you are to use a medication before you can expect to feel better and ask for when to contact the doctor again. If your GP doesen't know that some people can get "bipolar symptoms" by using some types of antidepressants, I would have found myself a new one if I were you.

Bipolar III is not an official diagnose, but it is known that some people become manic or manic-like if they doesn't respond well to some antidepressants (usually SSRI).

An article from PsychCentral about "Bipolar III":
Antidepressant-Induced Mania Similar to Bipolar Disorder | Psych Central News

Hope the article makes the topic more clear to you!

[Mountainbard]

Originally Posted by SoScorpio

Hold up. Are you saying some meds can cause longterm bipolar, as in it continues even when you stop the medication? I have never heard of this. A doctor did once prescribe me something he said would cause mania if I WAS bipolar, but no one ever thought I was. I don't remember which medication it was.
I'm not finding much on drug-induced bipolar, only manic episodes and the articles don't specify if the mania continues after quitting the medication. If that is what you mean, can you link me an article?

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I've never heard of a med causing bipolar, but SSRI's or SNRI's taken alone will bring on a hypo/manic episode. It's happened to me three times-- before I was correctly diagnosed.

[SoScorpio]

Interesting...
This is why I wonder how often you have to have mania, or how bad it is or how long it lasts, to be considered bipolar. Seeing as I've been on most of the SSRIs that are out there and not suffered any extended mania, I doubt I'm bipolar.

But the fact does remain that I experienced mania before I was ever on an SSRI. I can only remember one instance of it, so that doesn't really seem like enough. But one morning when I was around 12 or 13, I awoke to an upbeat, optimistic pop song playing on my clock radio, and I felt like the world was a different place. Everything seemed more vivid. I felt unaccountably happy, and told my mom I wanted to buy a sewing machine and make all my own clothes. I don't remember what else I did, but I do remember that was when I learned what mania was, because my mom was alarmed by my behavior and called it manic.
I hadn't been on any antidepressants yet, but if I remember right, I was prescribed Xanax before this time. I think they had me taking it every day at night, and during the day as needed. Very bad idea, but not sure if that could cause mania.

Other than that one isolated time, I think I have only experienced mania-like symptoms on medication. What happened to me last week was definitely not just "being in a good mood" as my boyfriend suggested. I know when I'm happy, and that was not happy, it was more like a demented, uncontrollable giddiness.
However, it happened three days in a row and not again. A couple mornings I thought I could feel some slight stimulating effects. Like the other day I heard something stressful an hour or two after taking my pill, and my reaction was a little exaggerated. Palms sweating, heart racing, and I was at home, which is usually enough to quell my anxiety.
Nothing else though. I'm hoping they were temporary side effects, but I'm still waiting on a call back from the nurse advice line at my doctor to tell me if I should be concerned about the side-effects, and if I need to get in right away to change my medication.

Is there a public depression or mental illness support group that meets in your area? It can be very helpful to get together with others and discuss experiences of symptoms, medications, side effects, recoveries, relapses, whatever. Empathy and support, like 12 step meetings without the 12 steps. There's a pretty good one here but I'm not well enough to drive myself and I don't want to impose on my wife to drive me.

SoScprpio, may be what matters here is that the medication hasn't helped to reduce your depression. If it is changed with another now, you may expect 2 - 6 weeks before it works. On your first post on the thread you related your depression to the winter. In 6 weeks from now it soon will become Marc, the time when winter-depressions usually disappear. May be it's not worth to try another medication? If you are not manic now, perhaps the best is to stay at Wellbutrin until you can have a proper screen by specialists. I wouldn't have used so much time thinking about if you are bipolar (manic) if I were you. I would have let the specialists set the diagnosis either it is unipolar or bipolar depression and then tried to be in an active transaction with the specialists (have good communication). Please remember that what your mother called manic doesn't have to be what is clinically manic.

In many cases the meds aren't expected to do the job with depression alone. Often a combination of therapy and medication are meant to be the «working force» that together will bring about a relief in symptoms. In therapy you are expected to cooperate, that is doing your part of the work as you sure know. Since you have to wait ca three month there isn't so much you can do now other then to try the best way you can to cooperate with yourself (not get stuck in thoughts about what it is rather then to try to live the best way you can with your symptoms).

Here is an article from «HelpGuideOrg» about how to try to cope with depression:
Dealing with Depression: Self-Help and Coping Tips to Overcome Depression

I very much agree with Lefty the Salesman about that it can be wise to try to find a support group near you. If you cannot find anyone, an alternative could be to try to find one on-line if that is possible. Another option is to continue to "talk" here at psychcnetral.

[little turtle]

dear sos---what do you think is causing your mood problems...

[SoScorpio]

Originally Posted by little turtle

dear sos---what do you think is causing your mood problems...

I don't know. SAD probably, but I haven't been to a psychiatrist in years, so I can only guess at that. I have a long history of anxiety, and intermittent depression since my dad died 10 years ago. I have a genetic defect in the MTHFR gene which can cause B vitamin deficiency, so that may be part of it.
Sometimes I think it's just bad luck in being a Scorpio, we're drawn to the darker aspects of life and have a harder time seeing the light, hence my username.

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[little turtle]

Originally Posted by SoScorpio

I don't know. SAD probably, but I haven't been to a psychiatrist in years, so I can only guess at that. I have a long history of anxiety, and intermittent depression since my dad died 10 years ago. I have a genetic defect in the MTHFR gene which can cause B vitamin deficiency, so that may be part of it.
Sometimes I think it's just bad luck in being a Scorpio, we're drawn to the darker aspects of life and have a harder time seeing the light, hence my username.

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have you ever used light therapy......

[SoScorpio]

No, the lights cost more than I can justify spending. I'm barely at home anyway to use it, except on my days off when I don't feel as bad anyway. Plus I actually get a decent amount of sunlight at work. The storefront is all windows and I sit about 20 feet away. Does it only count if I'm actually outside?

In any case my boyfriend will never believe it's a valid treatment until a doctor says so -- my doctor, not just endorsements which he will say is just money-grabbing. We live like we're married, our finances are intertwined and we don't make purchases like that unless we both agree.

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SoScorpio - I just checked craigslist under For Sale, type is "sad light" and several light therapy lamps were posted for $60 or less.

Also, suggested to someone else to check into SAM-e and 5-HTP.

Are you to taking sublingual Vit B complex? I've heard of the MTHFR variant. Many people find with that variant that the Cyanocobalamin form of B12 doesn't work, but the methylcobalamin form does.

[SoScorpio]

Looks like my B complex has the cyanocobalamin. It has a lot of stuff including folic acid and an herbal blend.

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"Looks like my B complex has the cyanocobalamin. It has a lot of stuff including folic acid and an herbal blend."

You may want to consider finding the methylated forms of folate and B12 (see cut-and-paste below). I have read that this helps many with the MTHFR mutation. The mutation can inhibit the methylation of folate and cyanocobalamin, so many with MTHFR mutation do not get the benefit when taking the common forms.

MTHFR Treatment: The Complete Guide
MTHFR Treatment
The treatment of MTHFR mutations is often a two-pronged approach. First, supplemental methylfolate and methylcobalamin directly address dysfunction in methylation pathways. Second, it is important to adopt appropriate lifestyle habits to down-regulate epigenetic expression of MTHFR mutations.

Supplements
The two most common supplements used to treat MTHFR mutations are methylfolate and methylcobalamin, both of which are methylated forms of B vitamins. The forms of these B vitamins found in typical multivitamins and supplements are not methylated. It is important to choose methylated forms to ensure adequate absorption and utilization.

[SoScorpio]

That's really good to know, thanks.

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