Bipolar Disorder

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Does anyone here have any experience with bipolar disorder? I have anxiety, severe depression but also what I would call hypo manic episodes. My grandmother is pretty strongly bipolar and was on lithium until her kidneys couldn't take it anymore and she requires dialysis. All her children are either ADHD or depressed. I have never been emotionally stable. SSRIs really just increase my agitation but let me get stuff done, and vyvanse is wonderful. I am getting kind of scared because I still struggle with my thoughts, and two nights ago I had an episode where they were completely out of character. Homocidal, suicidal, jealous, delusional. I do have my cello with me to calm me down though, my grandma just had the TV on and I was getting really agitated and tired. It was like in an instant I was going to throw everything away and I just had to stop myself from doing anything. I was wondering if mood stabilizers might work for me, maybe Wellbutrin again, I did pretty well on it, though I don't remember taking it, that was a dark time for me.

I did pretty well last semester though, 3.75, slacked off and did half my homework again and slipped by in everything on account of being a lucky genius on amphetamines.

Okay, regarding this occasion when you had thoughts which were homicidal, suicidal, jealous, delusional, one Emory psychiatrist said that if a person believes the world is connected in strange and wonderful ways, this is actually more of a sign of being bipolar, and not so much schizophrenia like people might think.  He also says that in his judgment there is actual overlap between bipolar and schizophrenia and many of the same medications work for both.
http://www.cnn.com/2010/HEALTH/expert.q ... index.html

And you seem to have a good, solid, mature understanding of the episode, that . .  One, it was out of character.  Two, if you can just weather the storm and not do anything destructive during the storm.  And third, maybe the immediate circumstances of being agitated by the TV.  I know I can get 'TVed out' so to speak.

Do you think coming down from the amphetamines for studying and it wrecked havoc with your sleep schedule?  And another issue for me, when I look back, yes, it did bother me that academic success did not translate to social connections.  Might this also be an issue?

Regarding medication, what I have read from several different sources, that everyone's biochem is a little different and it's trial and error in a respectful sense, and no doctor in the world can tell in advance.  And actually, this is good medicine.  It's only bad medicine if the doctor becomes a stick in the mud and says 'no, you must continue this medicine,' even when it's clearly not working.  I've also read that it's important to phase onto a medicine, and probably even more important to phase off in steps.  Is this vyvanse a real possibility?

I'd talk to the doctor who prescribed you the Vyvanse, unless that doctor is not a psychiatrist, in which case I would go to a psychiatrist. It looks like you have several issues to sort out, such as increased agitation on the SSRI* and any stimulating effects from the stimulant, which can imitate hypomania or mania. I would only try to sort them out with a psychiatrist.

* According to the DSM-5, this by itself does not indicate bipolar disorder. If you are having full-blown hypomanic or manic episodes on SSRI's only, on the other hand, then that's a different story.

AardvarkGoodSwimmer,

Where did the OP discuss thinking things are connected?

EDIT: I will also say this to the OP, if see a new psychiatrist and that psychiatrist does not give you at least an hour for the diagnostic interview and especially if in addition to that they diagnose a serious and lifelong disorder like bipolar disorder in less than an hour, then I would strongly recommend a second opinion, especially considering there are issues with reactions to medications.

I was diagnosed as ADHD, which vyvanse does help with, and it calms me immensely. I take 40mg in the morning and I am not sure I can even tell when it wears on and off. I am more worried about the Prozac I am taking and GI side effects I am having.

If a stimulant actually calms you down, that seems to go against bipolar disorder. That sounds more like true ADHD, actually.

I would discuss the concerns you have with your psychiatrist and see what the psychiatrist says. I would not assume that you have any particular disorder.

Hi, when I said thinking the world is connected in strange and wonderful ways, I had in mind the part where you said your experience from two nights ago included being delusional. But I might well be mistaken about this.

Are there not many different ways in which a person may be delusional and not just in thinking "the world is connected in strange and wonderful ways?" I agree that the kind of delusion you mention is fairly specific to bipolar mania--and what I've read on the Rorschach suggests that it's actually rare or nonexistent in schizoaffective mania--but you kinda need to hear what the delusions themselves are and the context they play in the patient's mind and worldview, before coming to any sorta conclusion.

People with schizophrenia have something similar to the connectedness, but it tends to be rooted much more in confusion about boundaries and "about their own point of view" with "solipsistic" themes ("Varieties of Self Experience", Sass L, Pienkos E, 2013).

Hi TornadoEvil,

I have struggled with my mental health for the past six years, whereas previously I was fairly brilliant and successful. I avoided any medical intervention for a year and a half, by which time I had lost my career, friends, money, house etc. and put myself in danger on my quest to save the world. I finally succumbed to intervention by my GP. He gave me an SSRI, which I took for two weeks before being admitted to hospital with a scary psychotic episode, which I believe now to have been a mixed mood episode. I was given respiridal, which caused awful extrapyramidal symptoms, then changed to abilify, and an SNRI effexor added with an additional diagnosis of depression. I recovered from this episode working in a simple job and eventually made it back to professional practice. All was not right though, I began to have the same difficulties again and I left professional practice for good. Shortly after this I decided to come off my medication, which resulted in me feeling great - for about two weeks until I was admitted to hospital again with mania. I was then given the diagnosis of bipolar disorder 1. I went back to my simple job, got married to a wonderful man - and then he got kidney failure, went on dialysis and we went overseas to his family for a transplant. I managed all of this and stayed strong until it was all over and we came back home. Then I had another hospitalisation and manic episode. All of this year I have devoted to recovery. I found a psychologist who treated me for PTSD, and that has helped my headspace a lot. I have the following advice if you have bipolar disorder.

1. Make a list of early warning signs and how you are going to manage them.
2. Keep a strict schedule of sleep, food, medication and events
3. Do some relaxation or yoga and some sort of spiritual thing.
4. Learn how to mange emotions better. We bipolars tend to overestimate other people's emotions, that is, thinking someone is angry when they are just a little irritated.
5. Treat other disorders or problems - like your ADHD
6. Do some kind of meaningful work, even if voluntary, or a hobby if you can.
7. Although it is a horrible illness, do not think of yourself as disabled. You can do what anyone else can do, and perhaps you are more creative. But you do have to manage your illness.
8. Never change your medication except in partnership with your psychiatrist. Never go off it cold turkey. Write down every little symptom and rate your mood on a scale of 1-10 for that day. Take these notes to the psychiatrist.
9. Take responsibility for managing your illness and don't expect friends and family to carry you. This will improve your relationships.
10. don't think of yourself as emotionally weak or unstable. Despite my illness I have been consistently strong for my husband. It takes strength and courage to meet this illness head on and to tackle it.

Medication: Mood stabilisers are the first line of defence. Lithium is still used but the dosage is kept in check by regular blood tests. (I'm sorry for your grandmother and what she has had to suffer with her bipolar and her kidney failure. My husband and I have both these disorders between us and can't imagine having to put up with both).
Other mood stabilisers are antiepileptics and antipsychotics. An additional antipsychotic may be added.
SSRIs are used to manage depression but only in conjunction with a mood stabiliser.

I am not really sure how Prozac affects me by itself, but it does make me really sleepy. I skipped my meds for a day and I let myself sleep. I also took a bike on an icy taxiway without a helmet, 500 feet in those conditions would have been an accomplishment.

I had a fuzzy hat though.

Feeling better, again, but in a slightly better way. Sleep does help immensely compared to everything else.

I think taking some acetaminophen for the pain after my fall also helped me relax a bit. Also, Imodium appears to have brought my bowel movements under control. Apparently he main ingredient is an opioid that stays out of the central nervous system. I probably have some irritable bowel syndrome. Also got an expensive gastroenterologist recommended probiotic, align. Given some abdominal pain and intermittent blood, there might be an additional issue in there. So apparently I am getting a flexible tube stuffed up my anus, fun.

Just a shirt follow-up, I am trying a minimum dose of abilify and it does seem to have a calming effect. It does amplify Prozac, so that might be partly responsible. Some of my impulsiveness and instant gratification seems a bit better, and the more severe reactions seemed dampened.

These days, doctors think that giving people stimulants is the cure-all for everything.

The problem is, as you may already know ...bipolar patients don't handle stimulants well, so you end up trading one benefit for another diagnosis. You lose by running the ball into the wrong end of the stadium.

I'd find a new doctor ASAP, the first one that tries something besides a stimulant.

I would also check to see if you have any food allergies. You might be surprised how eating poison every day can affect your mood.

I just found out that I'm allergic to either wheat or yeast, or both, and WOW .... do I feel better by avoiding those two things ....

I knew stimulants could cause problems, but I figured it was worth the risk and my antidepressant had stabilized me somewhat. I knew I would respond well enough and how to handle it, just the forced ups and downs were getting rather severe.

I don't know of any allergies, but I definitely have a bowel problem, not celiac, and inflammatory.