![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by Jackd on April 5, 2002, at 16:21:52
Hey guys, just wanted to fill you in again, and hopefully get some more input. Here's a recap of what I've had and what's been happening: I have ADD, anxiety and depression. I have tried Wellbutrin and Remeron, the first of which threw me into a severe hypomania, followed by a long dark depression. About 8 months later, I tried Remeron, 60 mg a day. It worked great! For two months I felt "right" and everything was going great, until I noticed a cycling that gradually got worse and worse until I was really depressed (even more so than I usually am). This lasted a few months. Now, I have finally realized that I am most likely bipolar, for a number of reasons and empirical evidence. So I have now restarted Remeron, 30mg a day, along with Lithium which I have just now reached 1200mg a day after about 3-4 weeks (i think). I have been feeling OK... functional, but have still been cycling (several times a day, and very subtly). I have been more stable since going up to 900, and hopefully 1200 should be even better.
So here are my questions this time... should I even be on an antidepressant if I'm bipolar II? What if the lithium just slows the inevitable slide towards depression that antidepressants all seem to cause? Are there better options for rapid cycling (or is that just cause by having the Remeron in the mix)?
I think John was right about my anxiety having something to do with "mixed states", because the Lithium seems to generally be helping it. Basically, I'm all out of answers, and just remaining on Lithium seems like a bleak answer to my problems. I want to feel happy, vibrant, CONTENT. Is that possible for a bipolar person?
P.S. I also take 18mg of Concerta and 1mg of Klonopin a day.
Posted by Jackd on April 5, 2002, at 16:24:49
In reply to JohnX and BarbaraCat, posted by Jackd on April 5, 2002, at 16:21:52
Dr.Kramer, maybe you could shed some light on my problems. Oh, and I forgot to mention, Effexor made me cycle too, and the three, Effexor, Remeron and Wellbutrin, don't make me cycle up and down, just WAY UP and then down and down and down. Paxil, and other strictly serotonin medicines don't make me cycle, but they don't seem to affect my depression much either.
Posted by JohnX2 on April 5, 2002, at 18:15:34
In reply to JohnX and BarbaraCat, posted by Jackd on April 5, 2002, at 16:21:52
Hi Jack,Its good to hear from you again, sorry to see that things are still a bit up-n-down.
> Hey guys, just wanted to fill you in again, and hopefully get some more input. Here's a recap of what I've had and what's been happening: I have ADD, anxiety and depression. I have tried Wellbutrin and Remeron, the first of which threw me into a severe hypomania, followed by a long dark depression. About 8 months later, I tried Remeron, 60 mg a day. It worked great! For two months I felt "right" and everything was going great, until I noticed a cycling that gradually got worse and worse until I was really depressed (even more so than I usually am). This lasted a few months. Now, I have finally realized that I am most likely bipolar, for a number of reasons and empirical evidence. So I have now restarted Remeron, 30mg a day, along with Lithium which I have just now reached 1200mg a day after about 3-4 weeks (i think). I have been feeling OK... functional, but have still been cycling (several times a day, and very subtly). I have been more stable since going up to 900, and hopefully 1200 should be even better.
>Its good to hear that the lithium is helping out some this is a good sign!
> So here are my questions this time... should I even be on an antidepressant if I'm bipolar II? What if the lithium just slows the inevitable slide towards depression that antidepressants all seem to cause? Are there better options for rapid cycling (or is that just cause by having the Remeron in the mix)?
>I think you have a lot of room to improve your situation Jack. As far as the cycling goes, you can do a few things (I'm wondering what your pdoc thinks?):
- see what the Li bump does for you
- A Depakote augmentation
Depakote is an *execellent* 1st line treatment for cycling in bipolar. It also has anxiolytic properties for many. This may definatly relieve agitation and cycling. You can add this quickly to your regimine (it can be dosed up rather rapidly).
- Lamictal. This is a favorite of many. The downside is that it takes a long time to dose up to a thereaputic level, but you may be able to take lamictal without an AD, or a very low dose of an AD. Also lamictal has benign side effects for many and has good AD profiles for a mood stabilizer (I take lamictal).
- Try a trileptal augmentation, maybe a 2nd choice mood stabilizer to augment after Depakote.
- Drop the AD. Well this one is controversial. Ideally for treating bipolar, one may want to start with the mood stabilizers and then slowly add in the ADs (at least this is my pdocs opinion).I dunno, given your current state, it sounds like maybe you could give a quick run of a depakote add-on to the Lithium if the lithium bump doesn't work well for you. After that , you may consider changing strategies and trying a medicine like Lamictal.
Lithium, Depakote, and Lamictal are all good medicines for Bipolar, but who will do well on which medicines is trial and error. And the antidepressant question is very hit or miss.
I get a really robust AD response on Wellbutrin, almost too good, but it doesn't hold. Same thing for Zoloft. I've tried every angle to make these medicines work, but it just doesn't happen. The only AD that can hold for me is Serzone, that's just me!
Personally I'm a very biased Lamictal advocate. I feel it is a very good base medicine to have. It may not do all the work for you, but it should smooth out most of the roller coaster with a good side effect profile.
But you have invested a lot of time in Remeron + Lithium, so maybe wait that out and add on Depakote or Trileptal if you are still cycling (quicker response). You could slowly add in Lamictal too (go for the long term play). But the Depakote may be better for agitation.
Sorry I can't give concrete answers. Just gotta go through the trial and error and work closely with your doctor.
So what do you think?
BTW, when you feel well on the ADs, be honest, do you feel "better than well" i.e. quite euphoric?
Best Wishes,
John
> I think John was right about my anxiety having something to do with "mixed states", because the Lithium seems to generally be helping it. Basically, I'm all out of answers, and just remaining on Lithium seems like a bleak answer to my problems. I want to feel happy, vibrant, CONTENT. Is that possible for a bipolar person?
>
> P.S. I also take 18mg of Concerta and 1mg of Klonopin a day.
Posted by shelliR on April 5, 2002, at 20:31:42
In reply to JohnX and BarbaraCat, posted by Jackd on April 5, 2002, at 16:21:52
Hi John,
I'm going to second the idea of lamictal. I'm not certain about lamictal and lithium--I think it's all right. Anyway, if it is, lamictal seems to have been very successful with many people on the board. I think it's worth a try.
for what it's worth,
Shelli
Posted by JohnX2 on April 6, 2002, at 14:57:05
In reply to Re:Lamictal » Jackd, posted by shelliR on April 5, 2002, at 20:31:42
> Hi John,
>
> I'm going to second the idea of lamictal. I'm not certain about lamictal and lithium--I think it's all right. Anyway, if it is, lamictal seems to have been very successful with many people on the board. I think it's worth a try.
>
> for what it's worth,
>
> Shelli
Actually I primarily use Lamictal right now and it works great. I added Serzone but it keeps me in a low lying agitated hypomania. So I think I am going to add in a dash of Lithium because I ran out off mood stabilizer options. I've seen some really good results with Li + Lamictal. One person with a long road of treatment resistant bipolar ultimately stumbled on this combo. I may even be able to cut back on my other meds if i add a bit of lithium (that is a hope).John
Posted by Jackd on April 7, 2002, at 15:15:45
In reply to Re:Lamictal, posted by JohnX2 on April 6, 2002, at 14:57:05
Thanks guys, I'll give the other mood stabilizers a shot. As for feeling "better than well", it's hard to remember how I felt exactly, but I don't remember it being euphoric. I just felt good, had energy, motivation. So you say that the Serzone keeps you in a low hypomanic state, eh? So then it IS possibly to maintain hypomania? Maybe that will be my new goal: the search for a constant hypomania.
Posted by JohnX2 on April 7, 2002, at 19:15:07
In reply to Re:Lamictal, posted by Jackd on April 7, 2002, at 15:15:45
> Thanks guys, I'll give the other mood stabilizers a shot. As for feeling "better than well", it's hard to remember how I felt exactly, but I don't remember it being euphoric. I just felt good, had energy, motivation. So you say that the Serzone keeps you in a low hypomanic state, eh? So then it IS possibly to maintain hypomania?
> Maybe that will be my new goal: the search for a constant hypomania.
Oh no, this is difficult to achieve and *quite annoying* frankly. I liken it to my spring break trip where after a number of days you feel obliged to wake up at 7 am and start drinking beer to keep the party going. It wears you down and gets really old after a while. Trust me on this one. ;-)John
Posted by Ponder on April 8, 2002, at 18:52:01
In reply to Re:Lamictal » Jackd, posted by JohnX2 on April 7, 2002, at 19:15:07
> > Thanks guys, I'll give the other mood stabilizers a shot. As for feeling "better than well", it's hard to remember how I felt exactly, but I don't remember it being euphoric. I just felt good, had energy, motivation. So you say that the Serzone keeps you in a low hypomanic state, eh? So then it IS possibly to maintain hypomania?
>> > Maybe that will be my new goal: the search for a constant hypomania.
>
>
> Oh no, this is difficult to achieve and *quite annoying* frankly. I liken it to my spring break trip where after a number of days you feel obliged to wake up at 7 am and start drinking beer to keep the party going. It wears you down and gets really old after a while. Trust me on this one. ;-)
>
> John> I feel like I should know the answer to this question. I am seeing a new psychotherapist. One of the things I have asked her to do is to help me monitor my mood and watch for trends up or down. I "lose insight" as they say, when either depressed or hypomanic and often don't take appropriate action until things get extreme.
This women has said to me that I should not be concerned about hypomania; that I should just go with it and enjoy it. I always thought that an important part of avoiding depression was controlling hypomania...the what-goes-up-must-come-down concept. She says this is not true. Now I'm confused. Input?
Posted by JohnX2 on April 8, 2002, at 19:57:21
In reply to The price you pay for hypomania, posted by Ponder on April 8, 2002, at 18:52:01
> > > Thanks guys, I'll give the other mood stabilizers a shot. As for feeling "better than well", it's hard to remember how I felt exactly, but I don't remember it being euphoric. I just felt good, had energy, motivation. So you say that the Serzone keeps you in a low hypomanic state, eh? So then it IS possibly to maintain hypomania?
> >
>
> > > Maybe that will be my new goal: the search for a constant hypomania.
> >
> >
> > Oh no, this is difficult to achieve and *quite annoying* frankly. I liken it to my spring break trip where after a number of days you feel obliged to wake up at 7 am and start drinking beer to keep the party going. It wears you down and gets really old after a while. Trust me on this one. ;-)
> >
> > John
>
> > I feel like I should know the answer to this question. I am seeing a new psychotherapist. One of the things I have asked her to do is to help me monitor my mood and watch for trends up or down. I "lose insight" as they say, when either depressed or hypomanic and often don't take appropriate action until things get extreme.
> This women has said to me that I should not be concerned about hypomania; that I should just go with it and enjoy it. I always thought that an important part of avoiding depression was controlling hypomania...the what-goes-up-must-come-down concept. She says this is not true. Now I'm confused. Input?I wish there was more discussion on this board about hypomanic experiences, but there isn't so I don't see the trends, nor do I have good answers either.... As always, people are less likely to "complain" about hypomania so that probably answers my 1st statement. Also we may do embarrasing things that we don't want to talk about (at least I do).
My doctor is very concerned about the "what-goes-up-must-come-down concept". So I think it does apply for many patients. Because of this he is very anti-AD as much as possible for bipolar. I have found that ADs that made me extremely manic crap out so quickly that it is a non issue. Only one AD seems to give a steady state behavior for me and that is Serzone (for whatever reason). It seems to be a mild AD. I was at a low-lying hypomanic state for a while on Serzone (and I think Topamax believe it or not was adding fire) with my Lamictal (which doesn't make me manic).
I think it is true. If you feel good, run with it (unless full blown manic). But I tend to get agitated and lose judgement so I can only run with it while in solitary confinement to keep me out of trouble. Thats no fun, I want to socialize but I need to stay away from my friends so that I don't do something offensive and stupid! Plus after a number of days of my body running at full bore I feel stimulated yet worn out at the same time and it sucks.
I did have a really bad series of manic bouts recently (and I was recategorized as Bipolar I), and when I came off of them it was CRASH (big depression). So for me it seems to be a bit of a function of just "how good" things are going...
So, I dont know...
Do you have long running hypomanic bouts?
Regards,
John
Posted by Ponder on April 9, 2002, at 10:32:05
In reply to Re: The price you pay for hypomania » Ponder, posted by JohnX2 on April 8, 2002, at 19:57:21
> > > > Thanks guys, I'll give the other mood stabilizers a shot. As for feeling "better than well", it's hard to remember how I felt exactly, but I don't remember it being euphoric. I just felt good, had energy, motivation. So you say that the Serzone keeps you in a low hypomanic state, eh? So then it IS possibly to maintain hypomania?
> > >
> >
> > > > Maybe that will be my new goal: the search for a constant hypomania.
> > >
> > >
> > > Oh no, this is difficult to achieve and *quite annoying* frankly. I liken it to my spring break trip where after a number of days you feel obliged to wake up at 7 am and start drinking beer to keep the party going. It wears you down and gets really old after a while. Trust me on this one. ;-)
> > >
> > > John
> >
> > > I feel like I should know the answer to this question. I am seeing a new psychotherapist. One of the things I have asked her to do is to help me monitor my mood and watch for trends up or down. I "lose insight" as they say, when either depressed or hypomanic and often don't take appropriate action until things get extreme.
> > This women has said to me that I should not be concerned about hypomania; that I should just go with it and enjoy it. I always thought that an important part of avoiding depression was controlling hypomania...the what-goes-up-must-come-down concept. She says this is not true. Now I'm confused. Input?
>
> I wish there was more discussion on this board about hypomanic experiences, but there isn't so I don't see the trends, nor do I have good answers either.... As always, people are less likely to "complain" about hypomania so that probably answers my 1st statement. Also we may do embarrasing things that we don't want to talk about (at least I do).
>
> My doctor is very concerned about the "what-goes-up-must-come-down concept". So I think it does apply for many patients. Because of this he is very anti-AD as much as possible for bipolar. I have found that ADs that made me extremely manic crap out so quickly that it is a non issue. Only one AD seems to give a steady state behavior for me and that is Serzone (for whatever reason). It seems to be a mild AD. I was at a low-lying hypomanic state for a while on Serzone (and I think Topamax believe it or not was adding fire) with my Lamictal (which doesn't make me manic).
>
> I think it is true. If you feel good, run with it (unless full blown manic). But I tend to get agitated and lose judgement so I can only run with it while in solitary confinement to keep me out of trouble. Thats no fun, I want to socialize but I need to stay away from my friends so that I don't do something offensive and stupid! Plus after a number of days of my body running at full bore I feel stimulated yet worn out at the same time and it sucks.
>
> I did have a really bad series of manic bouts recently (and I was recategorized as Bipolar I), and when I came off of them it was CRASH (big depression). So for me it seems to be a bit of a function of just "how good" things are going...
>
> So, I dont know...
>
> Do you have long running hypomanic bouts?
>
> Regards,
> JohnJohn,
Historically, I have had fairly long runs with hypomania which contributed significantly to my career success. But, over time, the hypomania has become less frequent, the depression more frequent, enduring and debilitating. I know what you mean about embarrassing social stuff. There's a fine line between charismatic hypomania and just plain over-the-top behavior that gets weird for everyone. Are you still on the Topa?
Posted by JohnX2 on April 9, 2002, at 16:06:48
In reply to Re: The price you pay for hypomania » JohnX2, posted by Ponder on April 9, 2002, at 10:32:05
> > > > > Thanks guys, I'll give the other mood stabilizers a shot. As for feeling "better than well", it's hard to remember how I felt exactly, but I don't remember it being euphoric. I just felt good, had energy, motivation. So you say that the Serzone keeps you in a low hypomanic state, eh? So then it IS possibly to maintain hypomania?
> > > >
> > >
> > > > > Maybe that will be my new goal: the search for a constant hypomania.
> > > >
> > > >
> > > > Oh no, this is difficult to achieve and *quite annoying* frankly. I liken it to my spring break trip where after a number of days you feel obliged to wake up at 7 am and start drinking beer to keep the party going. It wears you down and gets really old after a while. Trust me on this one. ;-)
> > > >
> > > > John
> > >
> > > > I feel like I should know the answer to this question. I am seeing a new psychotherapist. One of the things I have asked her to do is to help me monitor my mood and watch for trends up or down. I "lose insight" as they say, when either depressed or hypomanic and often don't take appropriate action until things get extreme.
> > > This women has said to me that I should not be concerned about hypomania; that I should just go with it and enjoy it. I always thought that an important part of avoiding depression was controlling hypomania...the what-goes-up-must-come-down concept. She says this is not true. Now I'm confused. Input?
> >
> > I wish there was more discussion on this board about hypomanic experiences, but there isn't so I don't see the trends, nor do I have good answers either.... As always, people are less likely to "complain" about hypomania so that probably answers my 1st statement. Also we may do embarrasing things that we don't want to talk about (at least I do).
> >
> > My doctor is very concerned about the "what-goes-up-must-come-down concept". So I think it does apply for many patients. Because of this he is very anti-AD as much as possible for bipolar. I have found that ADs that made me extremely manic crap out so quickly that it is a non issue. Only one AD seems to give a steady state behavior for me and that is Serzone (for whatever reason). It seems to be a mild AD. I was at a low-lying hypomanic state for a while on Serzone (and I think Topamax believe it or not was adding fire) with my Lamictal (which doesn't make me manic).
> >
> > I think it is true. If you feel good, run with it (unless full blown manic). But I tend to get agitated and lose judgement so I can only run with it while in solitary confinement to keep me out of trouble. Thats no fun, I want to socialize but I need to stay away from my friends so that I don't do something offensive and stupid! Plus after a number of days of my body running at full bore I feel stimulated yet worn out at the same time and it sucks.
> >
> > I did have a really bad series of manic bouts recently (and I was recategorized as Bipolar I), and when I came off of them it was CRASH (big depression). So for me it seems to be a bit of a function of just "how good" things are going...
> >
> > So, I dont know...
> >
> > Do you have long running hypomanic bouts?
> >
> > Regards,
> > John
>
> John,
> Historically, I have had fairly long runs with hypomania which contributed significantly to my career success. But, over time, the hypomania has become less frequent, the depression more frequent, enduring and debilitating. I know what you mean about embarrassing social stuff. There's a fine line between charismatic hypomania and just plain over-the-top behavior that gets weird for everyone. Are you still on the Topa?My doctor claims that long bouts of productive work I had were mild hypomanic phases (I would get mad because other people could never keep up with me and didn't seem to have the same vigor).
I never crashed during those times...But I drank a lot to help with the agitation at night.I'm still taking Topamax, but I've lowered the dose. This seems to have calmed me down.
Regards,
John
Posted by rainbowlight on April 10, 2002, at 1:32:11
In reply to Re: The price you pay for hypomania » Ponder, posted by JohnX2 on April 9, 2002, at 16:06:48
I am bipolar, and for the majority of my life I am hypomanic. Every so many years (or when there is something traumatic in my live) I go into a deep depression. From everyone I have talked to about hypomania on the net, it always seems to come with alot of agitation and anxiety. Yes, it also comes with high productivity, but at a high price. I am now taking Zoloft for OCD, and anxiety. It has stopped the hypomania in it's tracks and I feel like I am in slow motion. It is really hard for me, but actually I am now doing things at a normal pace, not a manic pace. This is definately going to take some getting used to. But you know what the weird thing is, I am just as productive as I was when I was hypomanic. Strange huh? I think everyone is searching for a "happy" hypomanic. I've been on tons of meds, and I have never found it. Unfortunately! But, I do have once tip for those looking for it, don't tell your pdoc you are looking for it, they just think you want to be manic and will squelch that plan real quick! LOL!
Posted by Elizabeth on April 11, 2002, at 9:03:57
In reply to The price you pay for hypomania, posted by Ponder on April 8, 2002, at 18:52:01
I thought that the price you pay for hypomania is equal to the sum of the limits on all your credit cards. ?
-elizabeth
Posted by Ponder on April 11, 2002, at 9:22:34
In reply to Re: The price you pay for hypomania » Ponder, posted by Elizabeth on April 11, 2002, at 9:03:57
> I thought that the price you pay for hypomania is equal to the sum of the limits on all your credit cards. ?
>
> -elizabeth
Oh-my-Gawd, Elizabeth! Who told you about my credit card balances? ;-)
Posted by crepuscular on April 11, 2002, at 11:28:32
In reply to The price you pay for hypomania, posted by Ponder on April 8, 2002, at 18:52:01
if only the price were pecuniary!!
i have found that the price is also social and developmental. time wasted on crazy relationships, pursuing wacky schemes (but you do learn a lot) and not passing through the phases of evolution to adulthood with your peers.
but this is not all bad, provided the depressions don't kill you. i do have to say my hypomanias have provided me with a broad range of knowledge and the laterality to spontaneuosly "connect the dots" during conversations. have also been through periods of *intense* musical productivity which have been of benefit to others.
what i think sucks about bipolar mania/hypomania is the quasi-narcissism of the state. you're so sucked up into this cresting wave of awesomeness that nothing and nobody else compares to the "big picture." this does damage to other people but you just can't see it at the time.
Posted by Ponder on April 11, 2002, at 12:17:09
In reply to Re: The price you pay for hypomania, posted by crepuscular on April 11, 2002, at 11:28:32
Wow! You write well and have much to say. Can you elaborate on this idea of arrested evolution to adulthood? Also, the "quasi-narcissism" of "being caught up in the cresting wave"?
I was talking with a casual friend of mine last night whose father is bipolar. Amy longs for her father's love, but feels she never gets it. When he is hypomanic, of course, he just loves her to death. But he loves everybody else and everything else as well and Amy knows it is not "real". Then when he's depressed...well, we don't need to go there.
I think the self-involvement that accompanies any mental illness is one of the worst things about it. During periods of euthymia, you see what you really could be to others, to your community, but it is not sustainable unless you are one of the lucky ones who finds effective long-term treatment.
For me, Lamictal, Wellbutrin SR and vagus nerve stimulation are working well for now. Been through too many relapses to trust this one until a year or two has gone by. Still struggle with hypomanic tendencies and anxiety, but find them fairly easy to control, for now, with Ativan.
(Gotta work some med stuff into this message to avoid redirect).I really want to hear more about your ideas.
> if only the price were pecuniary!!
>
> i have found that the price is also social and developmental. time wasted on crazy relationships, pursuing wacky schemes (but you do learn a lot) and not passing through the phases of evolution to adulthood with your peers.
>
> but this is not all bad, provided the depressions don't kill you. i do have to say my hypomanias have provided me with a broad range of knowledge and the laterality to spontaneuosly "connect the dots" during conversations. have also been through periods of *intense* musical productivity which have been of benefit to others.
>
> what i think sucks about bipolar mania/hypomania is the quasi-narcissism of the state. you're so sucked up into this cresting wave of awesomeness that nothing and nobody else compares to the "big picture." this does damage to other people but you just can't see it at the time.
Posted by wendy b. on April 12, 2002, at 11:57:40
In reply to The price you pay for hypomania, posted by Ponder on April 8, 2002, at 18:52:01
> > > Maybe that will be my new goal: the search for a constant hypomania.
> >>
> > I feel like I should know the answer to this question. I am seeing a new psychotherapist. One of the things I have asked her to do is to help me monitor my mood and watch for trends up or down. I "lose insight" as they say, when either depressed or hypomanic and often don't take appropriate action until things get extreme.
> This women has said to me that I should not be concerned about hypomania; that I should just go with it and enjoy it. I always thought that an important part of avoiding depression was controlling hypomania...the what-goes-up-must-come-down concept. She says this is not true. Now I'm confused. Input?
Hi there,I suffer from bipolar 2, and am on a ton of Neurontin, which seems to work well for the mood-stabilizing effect, and Wellbutrin. Xanax as needed for anxiety. I am sorry - your therapist is not right about letting the hypomanic phases do what they will, I'm afraid.
Hypomanic phases can always escalate into full-blown mania, & believe me, you DO NOT want to go there. ANY hypomanic phase has the potential to do this, and the longer you let those neurotransmitters keep firing in the same ways they always have, the harder it is to control. Full-blown mania is where you walk naked down the streets carrying large pieces of furniture and get picked up by the police, or get in fights and really hurt somebody, or kill yourself, or just end up in a hospital in restraints. I don't mean to scare you, but it's true - for a real wakeup call, read Kay Redfield Jamison's books, listed in the book club page on this Board. You do not want the mania.
The aim in a bipolar's medication regime is to bring your mood disorder to a level where you can function (career-wise and in relationships), so the highs do not get as high, and the lows do not drop so low. The medication (when it works right) brings your brain functioning to a normal pattern, not so erratic, and thus not so harmful to your system. Sure you will go up and down, but it is possible to be AS productive as you were during your hypomania, just not so self-aggrandizing as before, not so sure "this is the best thing anyone has ever accomplished on the face of the planet," etc, etc. Please ask for a mood-stabilizer that gets you out of those hypomanias ASAP, and if you ARE on medication, have it checked again and tell them you need to come down from that high.
Also look up the "kindling effect" on the search function of this Board, and find out more, in general, about your illness. There is so much on the web about bipolar.
I know it's hard to let go of your "old self," but the new self will be healthier with the right meds.
Off my soapbox,
Wendy
Posted by Ponder on April 12, 2002, at 13:18:09
In reply to Re: The price you pay for hypomania » Ponder, posted by wendy b. on April 12, 2002, at 11:57:40
Wendy,
Thanks for your response. My therapist says that since I have never had a full-blown manic phase, that I will not have one. But, as you can tell, I question her credibility on this. And my own experience with hypomania suggests that there is generally a depression to follow.If I'm understanding you correctly, any Bipolar II sufferer could escalate from hypomania to mania, even if this has never happened before. Is that your understanding?
Posted by crepuscular on April 12, 2002, at 16:38:38
In reply to Re: The price you pay for hypomania » wendy b., posted by Ponder on April 12, 2002, at 13:18:09
i suppose there is no way to 100% garantee that a person who has only hypomanias in the past will never develop classic psychotic mania, but there have been some studies that suggest they are two different diseases.
i agree about the healthier person being preferable. ya just got to give it some time to know yourself again...
Posted by wendy b. on April 12, 2002, at 18:09:30
In reply to Re: The price you pay for hypomania » wendy b., posted by Ponder on April 12, 2002, at 13:18:09
> Wendy,
> Thanks for your response. My therapist says that since I have never had a full-blown manic phase, that I will not have one. But, as you can tell, I question her credibility on this. And my own experience with hypomania suggests that there is generally a depression to follow.
>
> If I'm understanding you correctly, any Bipolar II sufferer could escalate from hypomania to mania, even if this has never happened before. Is that your understanding?
This is my understanding, yes. I think one could have a manic episode any ol' time, and just cuz you haven't had one yet doesn't mean you're immune, quite the contrary. I wish I had more time before I go, to do a check in the literature, but check what Jamison says in her books. Plus check the suggested pages on this site for bipolar mood disorder. I just think you don't want to play around with this illness, and caution is better than flying high and crashing...all best, will check back in about 5 days,
Wendy
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