Posted by JahL on March 3, 2001, at 10:31:22
The background: I have unremitting life-long depression characterized by DYSPHORIA, IRRITABILITY, ANXIETY & suicidality. 20+ meds has had little impact. Extensive interpersonal, group & cognitive-behavioural therapy (in both public & private settings) achieved nothing & was not a little insulting towards my intelligence. Systemized common sense. I taught myself everything therapy has to offer (me) by age 11.
Anyway I am not confident in my current dx (dysthymia+double depr.) & am pondering a possible BIPOLAR II DX. During my years of mistreatment I have noticed the following:
1/ First ever AD (Paxil) brought about the fabled miracle cure overnight. Over the next month my mood swung wildly (RAPID CYCLING?) btwn agitated depression & (never b4 experienced) euthymia. When this petered out, the introduction of Prozac brought about another short period of euthymia.
2/ The above remissions/relapses were induced by a circadian 'switch' (would wake up cured or relapsed-no inbtwn).
3/ Sub-therapeutic doses of Paxil & Celexa brought about hypomania (8 days of).
4/ All these events were precipitated by a REDUCTION in dose (v strong correlation).
5/ Every mood stabilzer (Zyprexa, Risperdal, VPA, Lamotrigine) save Lithium (indicated for classic BP I) has quickly eliminated suicidal ideation.
Also to be considered:
1/ *V* strong family history of this disorder.
2/ Have been diagnosed Social Phobic + ADD (high Bipolar co-morbidity)
3/ No mood reactivity.
4/ Have never related to depression per se, or to those suffering. No problems with self-esteem, tearfulness etc. Cannot understand illogical depressive thought constructs. My symptoms are akin to schiz. neg. symptoms; dysphoria.
I am not so much depressed as wholly dysfunctional.
5/ I have a volatile temper.
6/ Have always been considered intellectually 'gifted'
7/ THE CLINCHER: started on Lamotrigine 25 mgs 10 days ago & already my derealisation has improved, my intellectual powers are returning & well I feel a little *hypomanic* (last night posted as much as I have in my whole PB 'career'!) This is a v low dose to be feeling such effects!
Well, do I have a case for possible BP II dx, or have I already answered my own question?
Or is this stretching the BP spectrum too far?
(Sorry 4 length of ths; wanted to get my facts straight)All replies gratefully received (& may be used in my next pdoc meet)
ta,
Jah.
poster:JahL
thread:55442
URL: http://www.dr-bob.org/babble/20010302/msgs/55442.html