Mental Health Bipolar spectrum disorders: An Introduction. I know a lot, and want to help.

[appies]

Hello all, my name is appie. I have a ten year history of Bipolar I but usually find myself in the uncomfortable position of Mixed States (usually hypo-mania and depression).

I have psychoanalyzed myself extensively, as well as read case studies, medical journal entries... basically anything I can find on the topic mood disorders, medications, healthy living, and also the dark side of the disorder.

This is just an introduction, I want you to know you are not alone, and if you are having issues with anything, please ask for some opinions/guidance from me or any other well educated user in this forum.

Since this is an introduction, I'll give you a brief version of my story:

I remember (vividly) the first time I felt this disease take a bite out of my personality. It was in 8th grade (I am 26 now), and I remember a sensation of cold washing over me. It was as if someone had put a swamp cooler right next to me. I shut down. I could not respond emotionally in any appropriate fashion for months. I was expelled from school, attempted suicide (very close call on this one), and was admitted to a mental hospital for a week long hold and evaluation. The consensus at the time was that I was suffering from Major Depression. Many people with a BP disorder are first diagnosed with MD because when things are going well (possibly due to hypomania, possibly because your symptoms have just not come on yet. This disease generally develops in a persons late teens to early twenties), there is no perceived problem.

I got back on track, got back into the school I was dismissed from (it was a private school), and although I had bouts of depression occasionally, in retrospect I think they were just normal adolescent mood swings. Things were going great, I thought this would be a one time problem. I had many friends, was a "cool kid", and I scored at 32 on the ACT, the highest in my class. Looking back, I have always had problems in school (paying attention, doing homework), but always tested very well because of my intelligence. It is important to recognize that BP disorders have a positive side. When a person is in a hypomanic state, even sightly, his or her brain is working at an amazing speed. This is why you can be very social, charismatic, productive, creative... In my opinion, with proper med management or lifestyle choices, a slight hypomanic state is a good place to be. BUT, you need to pay close attention (ask a friend or parent, somebody you see often who can pick up these signals) to your sleep, impulsiveness, and overall decision making. Make sure you are sound, not swinging back to one side of the spectrum.

Ok back to my story. I hate meds, but I recognize their importance in treating BP. Currently I take Lithium and a few different benzos, depending on whats going on at any given time. I stopped taking my meds (very common amongst patients with BP, its called non-compliance) because it gave me a "high", a rush. The only problem is that, as with any high, you eventually crash. I wasnt sleeping, I was spending money like crazy, I was out all night doing all sorts of wild things. This took a toll on me. I was hospitalized for acute mania, and honestly I don't remember much from that time period. Once I got the mania under control, it was obvious that I did not have Major Depression or Unipolar Depression.

The next few years were marked by stints of medication compliance and periods where I did not take meds. I was all over the place. Personally, I stay on the manic side of the scale (mostly hypomanic), but often feel symptoms of depression as well. This is called Mixed State Bipolar. Unfortunately, this is a very dangerous condition. Suicide attempt rates are sky high, as is risk taking, and anhedonia (defined as the inexperience to feel pleasure). I have been told many times by people who have BP but are more depressive in nature that "Im lucky" to be in a hypomanic state most of the time. I disagree. I have trouble with personal interactions, cannot save money, and have a whole lot of guilt and shame that is inaccessible due to the hypomania. I cannot get it out while this is in the way, and its very hard for me. I have had, to date, 2 episodes of sever depression, 3 episodes of mania, and a nearly constant hypomania that sometimes comes close to full mania. Also, with the mixed state thing going on, my life is not on track. I try, but I fail. But I keep on trying. NEVER GIVE UP.

Now you know a little about me, I would love to hear some of your stories. If you have questions, I would love to answer them. As I said, I have studied this disease compulsively for ten years. I know more about it than my P doc. If you dont feel comfortable posting on a public page, feel free to PM me.

Thanks, I hope I get to know some of you and can help make a difference in your lives!
appie

 

[sliceofcake]

Thanks for sharing your story appie. It is a story that seems very familiar to me.

I have heard that depression and anxiety can act like BP and may be treated the same way. Do you know anything about this?

Also, do you have any knowledge of or experience with the drug Latuda as used to treat BP or anxiety/depression?

Thanks~
soc

 

[appies]

In my personal experience, anxiety often caused by ruminating or thinking too much about the past, which often happens when someone is experiencing depression. For me, the equivalent of anxiety in a manic state is irritability and anger. Anxiety treated with benzos can sometimes worsen depression, and if that's the case you're better of with a SSRI. I've been through the gauntlet of meds for bp, but I do not have any experience with latuda. Latuda has the following pharmokinetics:

Lurasidone acts as an antagonist of the following sites:[17][30]

α1-adrenergic receptor (Ki = 48 nM)
α2A-adrenergic receptor (Ki = 1.6 nM)
α2C-adrenergic receptor (Ki = 10.8 nM)
D1 receptor (Ki = 262 nM)
D2 receptor (Ki = 1.7 nM)
5-HT2A receptor (Ki = 2.0 nM)
5-HT2C receptor (Ki = 415 nM)
5-HT7 receptor (Ki = 0.5 nM)
And as a partial agonist of the following sites:[17]

5-HT1A receptor (Ki = 6.8 nM)

It is an antipsychotic medication, and very well could help you if you are in bipolar depression. You should talk to your pdoc, I'm just an informed person with experience in this area, but always take medical advice from a good doctor.