[Greenspark]

So up until a couple of weeks ago I was feeling great--the most psychologically stable I've ever been in my life, and happy and (mostly) free of anxiety. It was mostly the result of having been on 100 mg of sertraline and 20 mg of ziprasidone a day. I was originally diagnosed with dysthymia and GAD, although I personally feel that my anxiety symptoms are actually OCD. While this was all under good control this past year and a half of or so, about two weeks ago I started having strong breakthrough anxiety and major mood swings--I'd be having a panic attack one minute and then the next be incredibly irritable and want to fly off the handle at the drop of the hat, then go into a crying jag. This is very unlike me... I rarely have the feelings of wanting to yell at loved ones or smash things (luckily I have good control over my behavior). It was really scaring me, so I went to see my psychiatrist again, and she revisited the possibility I could be bipolar again. She thought that before because I display mood reactivity and can feel happy temporarily due to good circumstances, and the fact that my depression and anxiety tend to come and go in cycles--sometimes my anxiety bothers me much more than my depression, and vice versa. So, she gave me carbamazapine as a mood stabilizer because I got a major rash from lamotrigine before. I feel calmer since I started it, albeit more numb and depressed, but I don't know if that has to do with the end of PMS or me trying to change my life circumstances or what. I don't think I'm bipolar because I've never had a euphoric mania... and I've never felt energetic unless maybe something happened in my life that was exciting. I suppose I could have gotten dysphoric manias in the past, if they manifested as mostly anxiety. I personally feel like my sertraline could just be pooping out on me and so the anxiety and irritability could be manifestations of breakthrough anxiety and depression. I'm also currently undergoing some stress right now in my life (don't we all), mostly about finances and the fact I feel trapped and I desperately want to go out and explore the world but currently I'm stuck in my hometown and living with my parents, which can certainly trigger feelings of anxiety and depression.

I don't know if I should post this on the bipolar forum or the anxiety forum or what instead, but I felt like I could get good answers here… have you ever gotten symptoms like mine as a result of SSRI poop-out? Is it normal to get major mood swings from depression anxiety? Or could it just be stress triggering these breakthrough episodes? Mine have never manifested this way, but I suppose symptoms can change over time. Thanks!

[convalescence]

I've only taken one SSRI for about a week, so I can't answer your first question.

To answer your mood swings question: yes. Anxiety disorders and depressive disorders can cause major mood swings. In fact anxiety often makes me highly irritable especially if I have been experiencing a severe bout of it. Not to mention that anxiety disorders can mimic symptoms of bipolar disorder in some individuals.

I have found that medications only work okay until I'm stressed out. If I get stressed then they aren't as effective as they were when I wasn't experiencing stress.

[Fizzyo]

Hi Greenspark,

The best person to discuss your concerns with is always the prescribing doc. However, I have in the past had benefit from lithium (an old mood stabiliser) even though I have never had a manic episode. Now I benefit from a low dose antipsychotic at night to help my anxiety and agitation and help me sleep, even though I have never experienced psychosis.

(The antipsychotic is the most helpful medicine I take just now)

My point is that sometimes a Pdoc will use something for a condition it would not normally be used for if they believe its effects, or side effects will benefit the person in front of them.

I hope you find some improvement in your symptoms soon!