Posted by SLS on July 12, 2005, at 17:23:24
In reply to Re: sinking » SLS, posted by linkadge on July 12, 2005, at 15:44:04
Hi Linkadge.
> I have never thrown that idea out the window, but I don't have highs.
I will be very interested to see the DSM V when it finally comes out. It is supposed to contain at least five variants of bipolar disorder (BD). One of those proposed is for an individual who remains in a chronic state of depression without expressing mania.
Regarding mood dysregulation, my guess is that yours has a bipolar diathesis and should be treated accordingly. That your mother's phenotype includes mania only goes to affirm this. We both know that much of the psychiatric community talks about "soft bipolar" and "bipolar spectrums". I think a bipolar diathesis demands the use of mood-stabilizers or anything else that seems to be especially necessary to treat bipolar disorder.
> I do ok, then *boom* some sort of panic strikes that lasts for hours, then all of these images and picutures of times of fairure, feelings of being trapped, they are so overwhelming that all I can think about it suicide. They vanish, and I seem to return to feeling normal. I don't feel bipolar, I feel extrordinarily emotionally frail. Under the right circumstances I can get by with no meds, but even small changes in the environment are enought to make me feel out of control. When I was young there was really no mother. Mother was a robot, so I feel that I have to be very self sufficant. If things get out of control, that seems like the only way I can help myself.
You are a tough nut to crack, Linkadge. Some of what you describe seems enigmatic if one were to focus solely on Axis I disorders. However, it is more likely that you have been "blessed" with comorbitity. I am beginning to think that you should focus some of your attention on Axis II disorders. Borderline Personality Disorder (BPD). It presents differently in males than it does in females. However, some of the symptoms of BPD include impulsive thinking and behavior that in your case might include suicidal thoughts. BPD seems to have some biological underpinnings, so that it can ebb and flow over short periods of time without environmental influence. These affective shifts can occur several times a day. Fear of abandonment is another hallmark symptom of BPD. BD and BPD often occur together. There might be other Axis II disorders that are more applicable. BPD is the one I am most familiar with.
Tegretol / Trileptal + Zyprexa can work wonders for treating BPD. However, there must very often be some additional attention paid to the content of the thoughts and feelings such that they be attended to using psychotherapy. Dialectic Behavior Therapy (DBT) is particularly well suited to treat BPD.
What has been your experience with Tegretol, Trileptal, or Zyprexa? I don't know how well the other atypical APs work. I just know that for now, Zyprexa is the one most often chosen.
I don't think there are going to be any easy answers for you, my friend. But I do feel that your talking to people and expressing your thoughts and feelings as you do here on Psycho-Babble has probably saved your life. I urge you to continue talking and posting. I believe your communication have prevented you from acting on urges and impulses that many others would have followed through with because they had no one to talk to.
For you, there indeed may not be a magic pill as there are for so many people whom suffer from uncomplicated forms of MDD or BD. With you, a comorbid personality disorder would leave you suffering despite the optimal treatment of the affective disorder component of your illnesses.
I wish there were an easier way for you.
Of the things I admire about you, your candor and lack of defensiveness when talking about yourself and your suffering is particularly compelling. That you have an open mind and do not judge any psychological contribution to your condition as being a character weakness deserves respect. If you continue down the path you have chosen to get well, you will. You are doing everything right, despite the possibility that your doctors are doing everything wrong. Keep going. You'll get there.
- Scott
poster:SLS
thread:526288
URL: http://www.dr-bob.org/babble/20050708/msgs/526806.html