Question:

Hi Michael I’m just recently diagnosed, not qualified to give medical advice, and this should not be taken as medical advice, etc. Have you been on Paroxetine (Paxil, I think) for some time now? Is it working OK? Have you tried other drugs,too? If you’re lucky, you’re just really happy sometimes. Are you happy being ‘happy’? Or are you TOO happy, eventually becomming, annoying, impulsive, angry? If you’re just happy sometimes, I would be happy! Don’t worry about it. Could be, the Paroxetine is working!! But if the ‘happy times’ are also associated with self-destructive (destructive to your relationships, work, profession, or physical health) behavior, then see a doctor. (Or a specialist if necessary) Be careful to not self-diagnose. Otherwise, you can become ‘hypochondriac’. If there’s a web page about the disease, you might think you have that disease, when all you needed to do is sleep on your other side (Referring to the recent Dr.Koop article) There are many good resouces on the web, like http://home.att.net/~mercurial-mind/ (Has a links section) around. (With more experience than me!!) See your doctor if you’re still concerned. – Rob – Hide quoted text — Show quoted text – > i think i might be bipolar. i’m on Parotexite 40mg for depression, but > sometimes i can be really happy, almost hyperactive. how can i find out if > i’m bipolar? > Perhaps you’re not just depressed. > By this I mean, Like perhaps there are other problems as well, not just > depression. > I have been Dx with depression (‘persistent’ and ‘major’) by my GP, and > on AD’s for 1+1/2 years. (No, not that long, compared to some!) > First Prozac, then Effexor. Both gave the famous ‘poop-out’, etc., like > many people complain about. > Kept increasing the dosage, again & again… > So my GP recommends that I see a specialist (genuine p-doc!), since I’m > not responsing to the simple > treatment. > So he (p-doc) says Dx ‘manic-depressive’ or ‘bipolar’, (but mostly on > the depressed side.) > I think the higher doses of Effexor (225mg) had started to make some > ‘rapid cycling’, it was gettng really annoying, so I stopped the Effexor > (gradually!!, still lots of fun!), and talked to my GP, then he gave me > the referral. > It was bad enough to cause real chaos at work, and my manager was woried > about me, and is concerned that he never knows which one of me is > showing up for work each morning! > My GP recommended to find a p-doc with practice in one of the expensive > nicer towns here, turns out that’s where most practices are anyway near > here. > First visit (so far) with p-doc, he seems like a nice guy. > He mentioned ‘cycling below the line’ and ‘kindling’ (kindling like the > little sticks you use to set a fire) > Perhaps the brain-state when ‘high’ (though brief!) does damage which > causes the persistent ‘low’. > He said that ‘many’ people who are [long-term, major, persistent...], > depressed actually do better on a mood-stabilizer then an > antidepressant. (perhaps adding lower dosage A/D later) > I guess rather than feeling absolutelely horrible, then just really bad, > then incredibly horribly nasty, it smooths it out. > I was on a rollercoaster since the prozac (Effexor too), and sometimes > it really felt good, but mostly it was horrible. > I’m not saying A/D’s (like Prozac) are bad and evil, just maybe you > might consider you’re not purely depressed. > So I guess we’ll see where we (I!) go from here > brand new Rx for Depakote > p-doc says lithium is usually indicated for cases with extreme ‘high’s, > and probably ineffective for me. > I keep hoping for some hope! > Thoughts, comments appreciated. > (Please ‘reply to sender [email] and to newsgroup, as appropriate) > – Rob

Response:

Hi Michael, Welcome to ASDM. > i think i might be bipolar. i’m on Parotexite 40mg for depression, but > sometimes i can be really happy, almost hyperactive. how can i find out if > i’m bipolar?

By a thorough evaluation by a pdoc who is experiened in treating BP Disorde. They rely heavily on historical info. Do you experience mood swings…highs vacillating with lows? How often do these occur? http://mentalhelp.net/bipolar/wcg_bipolar5.htm HOW IS BIPOLAR DISORDER DIAGNOSED? If the initial symptoms of bipolar disorder are limited to depression, the condition is often diagnosed as depression; indeed about 16% of people with bipolar disorder do not have a manic episode until they have experienced three or more depressive episodes. An accurate diagnosis is important, particularly in light of a study that reported a higher incidence of rehospitalization in bipolar patients who were inappropriately medicated with antidepressants. A family history of manic-depressive illness may make a physician suspicious, but a diagnosis of bipolar disorder cannot be established until a manic episode has occurred. The American Psychiatric Association has established the following criteria for recognizing this phase of bipolar disorder: *       A distinct period of abnormally and persistently elevated, expansive, or irritable mood. *       During the mood disturbance, at least three of the following symptoms (four, if the primary mood disturbance is irritability): *       Inflated self-esteem, grandiosity; *       Decreased need for sleep; *       Excessive talking; *       Flight of ideas or racing thoughts; *       Distractibility when confronted by unimportant or irrelevant stimuli; *       Increased goal-directed activity (social, sexual, work or school); *       Excessive involvement in high-risk activities–e.g., unrestrained shopping, promiscuity. *       Mood disturbance severe enough to damage ones job or social functioning or relationships with others, or which requires hospitalization to prevent harm to others or self. *       Hallucinations or delusions absent for two weeks or more during normal periods (this would rule-out schizophrenia). This information is brought to you by Well Connected. You may order this complete guide or choose to subscribe to the complete library covering over 90 health and mental health problems.  Find a book: When making a diagnosis of bipolar disorder, it is important that the physician rule out other conditions that may be causing symptoms of mania. Hypomania, the less severe variant of mania, may be difficult to distinguish from normal joy or euphoria, but it can be differentiated by its persistence for more than a day. In addition, most hypomanic patients are easily distracted, overly talkative, and not functioning very well. Severe manic episodes with delusions and hallucinations may be easily confused with schizophrenia. (African American men, for instance, are more likely to be diagnosed with schizophrenia than with bipolar disorder.) Thyroid disorders may cause mood swings, as can adrenal disorders (e.g., Addison’s disease and Cushing’s syndrome), vitamin B12 deficiency, certain neurologic disorders (e.g., Huntington’s disease, epilepsy, brain tumors, encephalitis, multiple sclerosis), and various medications, including some drugs used to treat anxiety, Parkinson’s disease, and depression. Alcoholism and substance abuse occur often in bipolar patients, sometimes as a way of self medication. Both diagnosis and treatment are difficult in such cases, particularly since withdrawal from opiates or alcohol can cause symptoms of mania or severe depression. Children or adolescents with manic-depressive illness may be inappropriately diagnosed with attention deficit hyperactivity disorder; in some cases, however, ADHD may be a marker for an emerging bipolar disorder. Current research is seeking to discover factors in the blood that might help diagnose bipolar disorder and determine the effectiveness of treatment. Such tests would be particularly helpful in differentiating attention deficit hyperactivity disorder from bipolar disorder in young people. High levels of factors known as G proteins have been detected in both types I and type II bipolar patients, but studies have been contradictory, and there is no evidence yet that can be reliably used for diagnostic purposes. Some experts believe that bipolar disorder is only one link on a chain of psychiatric disorders ranging from schizophrenia to major depression, differing in expression and severity but sharing a common biologic cause. However, studies suggest that these conditions, including bipolar disorder, are distinct and caused by different mechanisms. For instance, magnetic resonance imaging (MRI) scans of brains of bipolar patients have revealed structural abnormalities in the hippocampus. This brain territory also shows abnormalities in the brains of people with schizophrenia. In one study of people with bipolar disorder, the left side of the hippocampus was significantly larger than the right, while in patients with schizophrenia the hippocampus volume was decreased. In both schizophrenia and bipolar disorder the pathways of the neurotransmitter dopamine appear to be important. (A neurotransmitter acts as a chemical messenger between nerve cells.) Dopamine has been a target of scientific investigation since researchers first observed that certain drugs that reduce the action of dopamine in the brain also reduce psychotic symptoms.