[psych1168]

I began therapy/counseling three years ago for relationship issues I was having at that time. Over the course of these three years there were many developments in my life -- finally was able to bring some issues with my past out into the light --- found my birth mother and her family -- just a lot of things.

When i first began therapy it was hard for me to openly talk with my T -- but after a lot of changes in my life I became very stressed and became more dependent/abusive of alcohol that intensified my issues. My T had talked to me about medication to help with my depression and anxiety - but I was very reluctant to take it. It became apparent that I needed medication and my T referred me to a doctor that could prescribe medication.

To make this long story short --- I have asked both my T and the dr. how prescribes my medication what they have diagnosed me with because several of the medications I have been prescribed are for bi-polar disorder. Both T and dr. say I do not have bi-polar -- just severe depression and boughts of anxiety. Right now I am on Wellbutin and Effoxr (300 mg a piece) and Seroquil. I just read today where Seroquil is prescribed for bi-polar disorder.

I'm really confused - as my T and dr. still say I do not have bi-polar. How do I find out the truth?

Also, my husband has told me that I am worse now than when I even began Therapy much less the medication. He doesn't feel either or helping and since he has called a lawyer to ask questions about a divorce - I don't think I am any better.

I am really confused.

[JustForToday]

Originally Posted by psych1168

I began therapy/counseling three years ago for relationship issues I was having at that time. Over the course of these three years there were many developments in my life -- finally was able to bring some issues with my past out into the light --- found my birth mother and her family -- just a lot of things.

When i first began therapy it was hard for me to openly talk with my T -- but after a lot of changes in my life I became very stressed and became more dependent/abusive of alcohol that intensified my issues. My T had talked to me about medication to help with my depression and anxiety - but I was very reluctant to take it. It became apparent that I needed medication and my T referred me to a doctor that could prescribe medication.

To make this long story short --- I have asked both my T and the dr. how prescribes my medication what they have diagnosed me with because several of the medications I have been prescribed are for bi-polar disorder. Both T and dr. say I do not have bi-polar -- just severe depression and boughts of anxiety. Right now I am on Wellbutin and Effoxr (300 mg a piece) and Seroquil. I just read today where Seroquil is prescribed for bi-polar disorder.

I'm really confused - as my T and dr. still say I do not have bi-polar. How do I find out the truth?

Also, my husband has told me that I am worse now than when I even began Therapy much less the medication. He doesn't feel either or helping and since he has called a lawyer to ask questions about a divorce - I don't think I am any better.

I am really confused.

First, effexor and wellbutrin are both antidepressants. Effexor is sometime used as an antidepressant in those who have bipolar, but it is not a bipolar med. Seroquel is actually an anti-psychotic, but it has found to be of use to treat depression and/or as a mood stabilizer in those who have bipolar. Some of the pdocs I work with use low-dose seroquel as a sleep med, and it seems to have an antidepressant property when used in this manner. Many psych meds have off-label uses, meaning they are prescribed to treat illnesses for which they were not intended to treat. This is the case with seroquel and bipolar. Your pdoc should be able to explain why he has you taking the meds he has prescribed you.

Second, therapy often causes a change in people or in their way of thinking that those close to us don't always like. It may be that your H is used to you acting or reacting in a certain way, and it is uncomfortable for him when you act/react differently. I don't know if this is true in your case. Have you discussed this with T?

Hang in there!

[serafim_etal]

I agree with everything Justfortoday said and want to add that seroquel is also sometimes used to treat anxiety. I take it in a very low dose for sleep and anxiety.

[PsyChris]

Everyone is right on par here. Physicians often prescribe medication for uses other than what they are approved for. This is called off-label dosing and is almost always backed by evidenced based approaches. The FDA does not permit pharmaceutical companies to mention anything about their off-label uses to physicians or in their advertising.

For instance antipsychotics are marketed for the treatment of Schizophrenia and acute mania in Bipolar Disorder. However, they are prescribed more in low dosages to treat depression and anxiety.

I'm sure if you tell us the dosage of your medications it will be quite clear they are being used for off-label treatment of depression and anxiety instead of Bipolar Disorder.

The important thing is that you use these medications as a stabilizer and a way to make therapy more effective. Have you made a plan with your therapist to discuss how long you will be on these meds?

[psych1168]

Thank you for responding. I believe the dose is 25 mg. I don't have the "listed" behaviors of bi-polar, but I do have anxiety and depression - for a while now. I also have a 1/2 sister who has bi-polar (as I was adopted and found my birth mother and her family 3 years ago) - this is probably the main reason I worry about bi-polar. I'm just having a real hard time coping with a lot of things and was worried about this. I sincerely appreciate your straight forward answers and response.

Thanks

Originally Posted by PsyChris

Everyone is right on par here. Physicians often prescribe medication for uses other than what they are approved for. This is called off-label dosing and is almost always backed by evidenced based approaches. The FDA does not permit pharmaceutical companies to mention anything about their off-label uses to physicians or in their advertising.

For instance antipsychotics are marketed for the treatment of Schizophrenia and acute mania in Bipolar Disorder. However, they are prescribed more in low dosages to treat depression and anxiety.

I'm sure if you tell us the dosage of your medications it will be quite clear they are being used for off-label treatment of depression and anxiety instead of Bipolar Disorder.

The important thing is that you use these medications as a stabilizer and a way to make therapy more effective. Have you made a plan with your therapist to discuss how long you will be on these meds?

[serafim_etal]

Seroquel at 25 mgs is a very, very low dose. My pdoc tells me that at 25 mgs it really has no anti-psychotic properties at all...a therapeutic dose for psychosis is much higher. By the way...25 mgs is what I take for sleep and anxiety. It's such a small dose that my pdoc rarely has samples that low and I end up cutting 50's or 100's to get my 25's.