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jackbus01
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11 Mar 2011, 10:22 am

I have bipolar (type 2) and AS:
How does that combination effect you?

I am just wondering if I am the only one that has these problems together. I definetly have AS. I have all the traits and it was especially noticable in childhood.
AS has caused me problems, but nothing on par with the bipolar that has literally almost killed me. I can live with AS. Mood disorders are just a disease that I can do without.

I have had obvious depression problems and anxiety that have forced me to seek psychiatric help (over the period of 20 years). I need medication to manage my illness or I would not be alive and functional today. Part of my problem has been to understand because I am not a "typical" bipolar patient. No euphoric manias. No sadness type depression. I have a mood disorder that needs to be medicated, that has been proven. I have had the usual bad and good experiences with the mental health system (I won't waste my time ranting). I have taken all kinds of different medications of the years and finally found some that have made me functional. In short, I am a veteran patient.

My problem (besides AS) seems to be best defined by the the Bipolar Type 2 label. That is important because it determines treatment. I have been to bipolar support groups (can't deal with groups of people) and that is not helpful. I have read a lot about the bipolar spectrum. I have posted to bipolar forums, but no one seems to understand alexithymia in the contest of bipolar disorder. I really feel at home on WP--everyone is so friendly here and with useful post too. I have tried to explain this to various psychiatrists but I have been told that severe mood changes=bipolar. I am forced to control this with medication.

Ways of managing bipolar, include recognizing mood changes (I can't do this!), sleep patterns, energy levels, and medication. I try so hard but I still have the occassional problems. I have already confided in a close friend that if I ever become non-functional for longer than about 12 months, then I will kill myself, if possible. The thought of having another prolonged severe depression, just terrifies me. I have been suicidal 3 times in my life before. Don't worry, I am okay now--my life is under control.

It has taken me many years to figure this out but,
My life can best be summed up as follows: Does anyone have a life like this, I have been this way for about 20 years (probably will the rest of my life)?

90% alexithymia ("normal"): My feelings are sort of vague. I can describe energy levels and a vague "good/calm","stressed/anxious", but I cannot relate them to actual events. This is a problem since I have a mood disorder. It makes it harder to control.

19% anhedonia (depression) (anywhere from about 1 week to 2 months or so): I slowly fade into this and lack motivation and all emotion, unlike my normal state where I can feel something. This lack of motivation has gotten severe enough that I can barely get out of bed. In short, I have lost many jobs because of this. Then (for unknown reasons) it fades to "normal".

1% severe agitation (hypomania/mixed state) (1 week or so): I feel like I want to climb the walls. I get very little sleep and the whole world seems too intense. This just fades in and then back out again--it is not sudden.

Yes, I think I have the best medications I have to deal with this. Is this really what life is about :(
Yes, the medications dull (lessen the effects of this) so I can live. What a trade-off.
Sometimes it is hard to figure out if it is medication issues or just me.
Sometimes I hate that my brain is so dysfunctional.
Yes, I really am this messed-up.

Can Any Relate or am I truly a 1 in a million freak. Any random advice is welcome. Thanks for reading my post anyway. :)



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11 Mar 2011, 11:30 am

Hi jackbus!

I strongly suspect... well no, I know I have some kind of bipolar disorder, specifically something like Type II alternating between hypomania/mixed state, plain hypomania, anhedonia, and atypical (sad hibernation-type) depression.

The states can last a month or more or at other times switch really rapidly many times a day. As in, I'll be crying my heart out in existential despair one minute saying I don't know how I can continue living then I'll go upstairs and wash my face and come back down and be full of positive enthusiasm and singing cheerfully.

This has not been recognized by my doctors as bipolar disorder, however, and I was reading that bipolar disorder that does not fall neatly into the usual categories is often missed as bipolar disorder.

I do often have euphoric states but not in a way that harms me so I'd classify it as hypomania I guess since it doesn't fulfill manic criteria. And it's the one "good" state.

And as I said, unlike you, I do have sadness-type depression.

I can however relate to your alexithymic experiences, but in a different way. I can usually immediately define my exact mood if asked in detail and I BELIEVE I know what's causing it. But it often turns out that I didn't realize what was actually causing this mood, and I only recognize it days, weeks, months, or even years later. I may think I know what is causing an intense mood, but in my case I often pin it on something tangible, specifically some perceived flaw in my appearance (body dysmorphia). Then later I'll realize, wait, I looked fine - it was such-and-such particular event that caused me to feel so intensely.



jackbus01
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11 Mar 2011, 1:46 pm

purchase wrote:
Hi jackbus!

I strongly suspect... well no, I know I have some kind of bipolar disorder, specifically something like Type II alternating between hypomania/mixed state, plain hypomania, anhedonia, and atypical (sad hibernation-type) depression.

The states can last a month or more or at other times switch really rapidly many times a day. As in, I'll be crying my heart out in existential despair one minute saying I don't know how I can continue living then I'll go upstairs and wash my face and come back down and be full of positive enthusiasm and singing cheerfully.

This has not been recognized by my doctors as bipolar disorder, however, and I was reading that bipolar disorder that does not fall neatly into the usual categories is often missed as bipolar disorder.

I do often have euphoric states but not in a way that harms me so I'd classify it as hypomania I guess since it doesn't fulfill manic criteria. And it's the one "good" state.

And as I said, unlike you, I do have sadness-type depression.

I can however relate to your alexithymic experiences, but in a different way. I can usually immediately define my exact mood if asked in detail and I BELIEVE I know what's causing it. But it often turns out that I didn't realize what was actually causing this mood, and I only recognize it days, weeks, months, or even years later. I may think I know what is causing an intense mood, but in my case I often pin it on something tangible, specifically some perceived flaw in my appearance (body dysmorphia). Then later I'll realize, wait, I looked fine - it was such-and-such particular event that caused me to feel so intensely.


That sounds exactly like Bipolar Type 2. That really sounds like a typical bipolar type 2 story
. A lot of bipolar people have emotional instability between major mood swings. Also if you have a psychiatrist that doesn't recognize this as bipolar type 2 then find a new one. What meds are you taking and how bad is your depression?



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11 Mar 2011, 1:52 pm

Wow, it's nice to have some validation!

Luvox (Fluvoxamine maleate) for OCDish concerns/depression
and Klonopin (clonazepam) for anxiety (should be taking Zyprexa but too scared to restart it due to side effects)

Yes. I guess I'll bring this up again at the doctor's. The past 7 years have been exhausting.

Thank you very much for your advice and for detailing your own struggles; it was really helpful. I'm glad you're in a pretty good state now it seems (but could be better?)



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11 Mar 2011, 1:55 pm

Oh - forgot to answer your other question - the depression was historically of the atypical type where I slept most of the day and was anywhere from mildly to very sad. No anxiety.

Recently though it became typical depression, which I guess is depression mixed with anxiety? - both despairing thoughts and panic, and the tendency to eat and sleep less.

The medicines have helped some but I'm still pretty anxious and also still prone to extreme mood swings.



jackbus01
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12 Mar 2011, 5:35 am

purchase wrote:
Wow, it's nice to have some validation!

Luvox (Fluvoxamine maleate) for OCDish concerns/depression
and Klonopin (clonazepam) for anxiety (should be taking Zyprexa but too scared to restart it due to side effects)

Yes. I guess I'll bring this up again at the doctor's. The past 7 years have been exhausting.

Thank you very much for your advice and for detailing your own struggles; it was really helpful. I'm glad you're in a pretty good state now it seems (but could be better?)


I am not a psychiatrist (big disclaimer).
However ssri's by themselves (Luvox is an ssri antidepressant) can cause mood instability in people there prone to it. If you have bipolar 2 than you really need to have a mood stabilizer in addition. Lamotrigine seems to be the first-line choice for this. It is actually what I take. Also keep an eye on how much clonazepam you take. It is so easy to build a tolerance to benzo drugs.

A good web sight for medication information if you didn't already know: http://crazymeds.com not affiliated with drug companies.

I think some psychiatrists are good, but it really hard to sort stuff out in a typical 15 min med check apt. I would research this stuff as much as possible. That's what I do (one of my interests, I guess) :)

Anyway, I hope I have been helpful to you and thanks for reading my post. Sometimes, it is hard to know what the heck is going on. I obviously have the same problem.


The following article sums up why lamotrigine would be the preferred mood stabilizer for bipolar type 2
http://www.psycheducation.org/depression/meds/lamotrigine.htm

There is a big difference between treating "major depression" and "bipolar depression". The following article sums up why
http://www.mcmanweb.com/treating_bipolar_depression.html

You need to have a discussion with your psychiatrist about bipolar depression, mood stabilizers etc. Anyway, a few hours web surfing and you should be better informed of what is going on.
Best of luck to you, mood disorders just suck. Having a combination of that with aspergers is just bad (my opinion).



jackbus01
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12 Mar 2011, 5:42 am

purchase wrote:
Oh - forgot to answer your other question - the depression was historically of the atypical type where I slept most of the day and was anywhere from mildly to very sad. No anxiety.

Recently though it became typical depression, which I guess is depression mixed with anxiety? - both despairing thoughts and panic, and the tendency to eat and sleep less.

The medicines have helped some but I'm still pretty anxious and also still prone to extreme mood swings.


Hey, let's rant together--damn mood disorders suck and ruin our lives! :evil:

Anyway I hope you can get some insight into what is happening. Good Luck! :)



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12 Mar 2011, 8:50 am

Schizoaffective disorder, bipolar type. Originally I was diagnosed with psychotic depression, then BPtype 2, finally schizoaffective. When they got that diagnoses they tweaked my meds again, and suddenly things are much better.

I'm on lamotrigine and seroquel XR.



jackbus01
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12 Mar 2011, 10:27 am

mgran wrote:
Schizoaffective disorder, bipolar type. Originally I was diagnosed with psychotic depression, then BPtype 2, finally schizoaffective. When they got that diagnoses they tweaked my meds again, and suddenly things are much better.

I'm on lamotrigine and seroquel XR.


Ouch, sounds rough. I have never had depression that was psychotic. In fact I have never had anything resembling a psychosis. I am glad that you are doing better. Dealing with serious mental illness is scary, bad, and disruptive. :cry:

I do very poorly on antipsychotics although a lot of doctors want me to try them--they do not help me at all and I am very sensitive to them. If I am severely agitated I can take 50mg of Seroquel and it will knock me out for about 10 hours. I only take it rarely--been several months. Lamotrigine has been a wonder drug for me and has greatly improved my quality of life.

Thanks for reading my post.



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13 Mar 2011, 2:54 am

I was first diagnosed with bipolar and later asperger's. My psychiatrist has for a while believed me to have both, but as we've gone over more and more of my past and current behavior...he suspects that I'm much more aspie than previously thought...as it can sometimes present itself as bipolar.

I, too, am on meds...Lamotrigine, Vyvanse, and Haloperidol (I'm off the Lithium, thank god) and it has saved my life. I had crippling depressive states where I would hardly get out of bed. Someone not smiling back at me could actually ruin my entire day. I would also get extremely angry but I always took it out on myself. Unlike you, I was fully aware of my mood swings. It got to where i could recognize the trigger and could watch myself self-destruct like a row of dominos falling till I was in total meltdown mode. I was still powerless to stop it. I could not complete college or maintain a job. After a suicide attempt I realized that I was at the end of my rope. I was lucky enough to find an amazing doctor on the first try. :)



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15 Mar 2011, 2:00 pm

I know I have ASD, and have thought about BPD as well, especially when I have meltdowns. Basically, I have meltdowns and reverting to autistic behavior helps calm me down. Looking people in the eye, or going out to have "fun" doesn't work for me, it calms me down to put my head down, pace, and get lost in thought. I have a degree in psychology and would not trust any psychologist to assess me because they don't know me as well as I know myself. Honestly I think I just need some xanax for these meltdowns/shutdowns, labels are meaningless and most psychologists are complete hacks.



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18 Mar 2011, 5:30 am

I have bi polar one and Aspergers, both diagnosed.

I was diagnosed with Aspergers before the bi polar.

I only got diagnosed with bipolar last year, as I was being rather self destructive and very very manic. Then swinging into intense states of suicidal depression. Rapidly cycling and what not. Am glad I now know why, as I've been able to deal with it and am now much better!

I haven't really thought too much of how they interact with one another. I don't think social related anxiety helps the bi polar very much.



rabbit90
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18 Mar 2011, 5:31 am

I have bi polar one and Aspergers, both diagnosed.

I was diagnosed with Aspergers before the bi polar.

I only got diagnosed with bipolar last year, as I was being rather self destructive and very very manic. Then swinging into intense states of suicidal depression. Rapidly cycling and what not. Am glad I now know why, as I've been able to deal with it and am now much better!

I haven't really thought too much of how they interact with one another. I don't think social related anxiety helps the bi polar very much.



tadarida7
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18 Mar 2011, 2:45 pm

Its weird but I have both AS and Bipolar 2 being aware and picking trends and negative/positive infleurnces helps me and keeps me mostly away from drugs



jackbus01 wrote:
I have bipolar (type 2) and AS:
How does that combination effect you?

I am just wondering if I am the only one that has these problems together. I definetly have AS. I have all the traits and it was especially noticable in childhood.
AS has caused me problems, but nothing on par with the bipolar that has literally almost killed me. I can live with AS. Mood disorders are just a disease that I can do without.

I have had obvious depression problems and anxiety that have forced me to seek psychiatric help (over the period of 20 years). I need medication to manage my illness or I would not be alive and functional today. Part of my problem has been to understand because I am not a "typical" bipolar patient. No euphoric manias. No sadness type depression. I have a mood disorder that needs to be medicated, that has been proven. I have had the usual bad and good experiences with the mental health system (I won't waste my time ranting). I have taken all kinds of different medications of the years and finally found some that have made me functional. In short, I am a veteran patient.

My problem (besides AS) seems to be best defined by the the Bipolar Type 2 label. That is important because it determines treatment. I have been to bipolar support groups (can't deal with groups of people) and that is not helpful. I have read a lot about the bipolar spectrum. I have posted to bipolar forums, but no one seems to understand alexithymia in the contest of bipolar disorder. I really feel at home on WP--everyone is so friendly here and with useful post too. I have tried to explain this to various psychiatrists but I have been told that severe mood changes=bipolar. I am forced to control this with medication.

Ways of managing bipolar, include recognizing mood changes (I can't do this!), sleep patterns, energy levels, and medication. I try so hard but I still have the occassional problems. I have already confided in a close friend that if I ever become non-functional for longer than about 12 months, then I will kill myself, if possible. The thought of having another prolonged severe depression, just terrifies me. I have been suicidal 3 times in my life before. Don't worry, I am okay now--my life is under control.

It has taken me many years to figure this out but,
My life can best be summed up as follows: Does anyone have a life like this, I have been this way for about 20 years (probably will the rest of my life)?

90% alexithymia ("normal"): My feelings are sort of vague. I can describe energy levels and a vague "good/calm","stressed/anxious", but I cannot relate them to actual events. This is a problem since I have a mood disorder. It makes it harder to control.

19% anhedonia (depression) (anywhere from about 1 week to 2 months or so): I slowly fade into this and lack motivation and all emotion, unlike my normal state where I can feel something. This lack of motivation has gotten severe enough that I can barely get out of bed. In short, I have lost many jobs because of this. Then (for unknown reasons) it fades to "normal".

1% severe agitation (hypomania/mixed state) (1 week or so): I feel like I want to climb the walls. I get very little sleep and the whole world seems too intense. This just fades in and then back out again--it is not sudden.

Yes, I think I have the best medications I have to deal with this. Is this really what life is about :(
Yes, the medications dull (lessen the effects of this) so I can live. What a trade-off.
Sometimes it is hard to figure out if it is medication issues or just me.
Sometimes I hate that my brain is so dysfunctional.
Yes, I really am this messed-up.

Can Any Relate or am I truly a 1 in a million freak. Any random advice is welcome. Thanks for reading my post anyway. :)



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23 Mar 2011, 4:35 am

tadarida7 wrote:
Its weird but I have both AS and Bipolar 2 being aware and picking trends and negative/positive infleurnces helps me and keeps me mostly away from drugs


I am a neurological mix,I have Aspergers, Bipolar type 1, ADHD, Dyslexia, Dyspraxia and other differences like everyone, uniquely me. And I have rarely taken medication and I am happy with who I am, it took me a while. But I do feel by fully understanding, accepting and not fighting against who we are, helps. I have grown to love my extremes that gives me my own special window into the world, creative zones.

I have taken medication over the last few years only, as have been finding things a little harder to deal with, but my sister in law died, other issues and have had a few earth quakes here etc... to deal with. I have been taking Lamotrigine which has help to control my moods from escalating. But anxiety wise when stressed, overloading from things out of my control nothing works except walking within the nature world, which I often feel I connect with more than people and to do things I enjoy doing, capturing the world in my own unique way.I must admit before I fully understood this I didn't have the confidence to do so, now whatever I do is not held back by my insecurities in self, the not kowing reason was like a huge barrior for years.


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ChaunceyGardiner
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23 Mar 2011, 8:06 am

I haven't been diagnosed with Bipolar at this point but reading your description I can certainly relate to the cycles you're going through. I did notice that it was slightly stabilized (opposite of my expectations) when I started taking a moderate dose of Adderall for my ADHD, even though its not the intent I think its a decent off label usage particularly during depressive phases (note: I'm obviously not a doctor and this is entirely anecdotal; read: not necessarily advising it) to allow me to at least put up a facade of functioning. I haven't found any long term solution to the swingness of bipolar, and I'm fairly resistant to most anti-depressants (I personally hate the feeling of them, YMMV) but low-dose amphetamines might be a reasonable stop-gap in a pinch and might be worth asking your doctor about.