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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Michelle123 on January 13, 2005, at 20:45:23
I have carefully read all of the responses to my last post and want to thank anyone who contributed. Here are a few more questions I have now that I am finding more and more good information and less and less helpful effects from the "mood stabilizers".
FIRST QUESTION: Just wondering if anyone here has found a "cure" for taking the edge off without experiencing the negative sedating and "absence of personality" effects. My mind irritates the crap out of me but anything I take to calm it just makes me feel depressed.
Even the antidepressants make me feel tired, sad, flat NOT better, and NEVER mania (blows the theory that they trigger mania in bp patients~ at least for me)SECOND QUESTION: Also wondering... could it be ADHD with impulsivity? The contant business in my brain with the quick temper, irritability, and impatientness....
Any comments are welcome.
Thanks again.
Michelle
Posted by CareBear04 on January 18, 2005, at 13:30:43
In reply to Bipolar ll or ADHD with impulsivity, posted by Michelle123 on January 13, 2005, at 20:45:23
hi michelle,
i too have been somewhere in the diagnosis spectrum between bipolar II and ADHD. mostly, i'm thought to be BPII with some drs adding ADD, inattentive-type. when i was in the hospital last year after a really serious OD, they told me i was impulsive, and they said depakote would help with that. they put me on 250mg twice a day and said that since i'm small, that should be enough. a doctor i had later said that the dose i was on isn't really therapeutic; it's what they like to put "borderlines" on b/c it's sedating and much less toxic than lithium. one problem is that i'm actually not an impulsive person. i planned the OD very deliberately and turned to it as a measure of last resort and not as a temporary way to ease pain. anyway, i guess depakote is a possibility if you haven't tried it.
as for the question of BPII or ADHD with impulsivity, i can't really lend much insight. i think it really depends on the dr diagnosing you and that DSM diagnoses are so subjective in that way and so black and white, all or nothing, when the DSM labels that kind of thinking as pathological and sticks usually an Axis II label on it. i'm pleasantly surprised that you haven't run into drs or therapists trying to label you as borderline if you are impulsive. another thing maybe to think about is your age. if you've made it, say, to middle age without being really debilitated by other symptoms of ADHD (eg, hyperactivity or inattentiveness), i would probably guess a mood disorder over ADHD. if you're young or you've always had ADHD-type problems that have been untreated, then maybe you should see a dr. who specializes in diagnosis and treatment of it.
i don't know if this helps, but good luck!
Posted by Michelle123 on January 18, 2005, at 17:43:52
In reply to Re: Bipolar ll or ADHD with impulsivity » Michelle123, posted by CareBear04 on January 18, 2005, at 13:30:43
> Hi carebear,
Thanks so much for the reply. I am a female in my thirties and although I haven't really had difficulty with hyperactivity, I do have some significant difficulty with impulsivity (interrupting others, acting on impulse - buying things - saying things that should only be thought to myself, not thinking before I act, etc.) But since I have had a partial and temporary help with antidpressants I fall into the category of BPll (at least that's how I understand what they tell me). However, none of the anti-convulsants worked, neither did lithium or the atypical antipsychotics, therefore I thought maybe it was ADHD (impulsivity) My mom sure thinks it's ADHD (LOL-she had to deal with me as a kid) Just wondering what to do as I can't seem to NOT REACT to situations which causes me major distress (I blow up at the littlest things and am very impatient, irritable, etc.) Still searching and any posts certainly are helpful as at least I know I am not alone. Thanks
Posted by CareBear04 on January 18, 2005, at 19:20:07
In reply to Re: Bipolar ll or ADHD with impulsivity, posted by Michelle123 on January 18, 2005, at 17:43:52
michelle-- you definitely aren't alone! maybe you do have both ADHD and Bipolar II. the impulsivity stuff, especially impulse buying, sound like hypomania or mania. irritality can be either, but i have that more with bipolar, especially during agitated depression states or sometimes when i'm more manic and speeding through thoughts and ideas and people can't keep up with me. have you ever tried stimulants? there has been a lot of controversy among drs about whether or not i should ever have been prescribed them, but all i can say is that they have really helped with my concentration and alertness-- they have really improved my attentiveness. i don't know much about the impulsive side of ADHD. my parents are actually in denial. i think two things, maybe three actually, kept me from being medicated as a child: (1) i was really high-functioning, skipping grades and such; (2) i was always really small, and stimulants can prevent weight gain or growth in children; and (3) my parents were very against it and denied that there was anything wrong with me. this is the same approach they have with my depression/bipolar diagnosis. it took hospitalizations and doctors telling them that i came this close to dying and would die without proper treatment for them to support me financially and, as much as they can, in my treatment. i'm glad to hear that your mom seems to believe you have a problem that needs treating, though i wasn't sure from your tone whether she supports you positively or gives you a hard time.
i don't think it really matters what your diagnosis is. two years ago, i begged my pdoc for a diagnosis, and he told me that dx are good only for drug trials and insurance companies. for two years, i searched for an answer and went from pdoc to pdoc, only to recently recognize that he was actually right. the labels, i believe, are meant to guide and simplify treatment, not to prevent patients from getting help-- even experimental help-- that they need. my starting on stimulants was based on symptoms more than a diagnosis. the ultimate question wasn't, "is she inattentive or more attentive than we can recognize and than she lets on?" it wasn't, "is she hyper b/c of ADHD, does she skip classes all the time because she has this problem or because she's just bored and classes don't suit her learning style?" these questions have always been there, but the ultimate question was, "this girl looks really tired and can't focus and that really shouldn't be the case. what can we do to help her?" if that's the case with you-- if your symptoms suggest that stimulants would help-- i think you should seek them out. they have helped me a lot by calming me down, waking me up, and helping me focus. whereas i had a very hard time before sitting still or focusing on reading or single tasks, now i'm able to do these things and without a lot of anxiety that some people have from stimulants.if you feel like your current treatment isn't addressing your problems, i would definitely encourage you to seek out other treatments, whether or not you seek out a definitive answers.
if you have other stuff you want to discuss, i'd love to hear from you. good luck!
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