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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by ST on May 31, 2004, at 5:57:18
Hi,
I was diagnosed as a bi polar II ten years ago. I had gone through many deep depressions, each worsening with the years. I had attempted suicide. Prior to finally seeking help, I went through a period that can be considered mania. When I wasn't depressed, I displayed a dynamic, energetic personality. I haved a sister who is bi polar I and is very ill. So of course i was diagnosed as a bp! I was immediately put on Depakote (I think 1200 or 1500 mg; is that the average starting dose??)
It was way too much - I became a total zombie and the depression was horrible. I then began the cycle of musical ADs in addition the the ever present Depakote, whose dose has lowered over the years. I've had a more stable life in the past ten years, but something major has changed.
Despite being taken hostage several times a year by debilitating depressions, before meds I had an intense drive and ambition (I am an artist). Even with the recurring depressions, I had a quick mind and a sharp sense of humor. My mind moved fluidly and I had passion and enthusiasm for my chosen field. I was considered to be extremely talented and a "go-getter".
Over the years, under pdocs' supervision, I lessened the Depakote dosage until I took only 250 mgs a day. As I near another birthday and the 10 year mark of being on Depakote, I have decided to go off. My pdoc and I have discussed my not taking Depakote anymore, since my dosage is not even considered "therapeutic", but I don't see him until the end of June. So I made this decision on my own. It has been 11 days and I have noticed absolutely no onset of hypomania or mania. Nothing has changed. I'm on 300 mgs a day of Wellbutrin and 200 mgs daily of Serzone.
Now, I'm perplexed: ten years ago, three different doctors diagnosed me as bi polar II. My problem had really been the depressions. Pre-Depakote, I used to be very energetic and enthusiastic and sharp. Since Depakote, I've lost the spark, the drive, the enthusiasm, the joy of life. It's like an anhedonia. I feel dulled and have a very sedate life now without much creativity. Sure, the ADs stave off the depression, but the Depakote has made me feel smothered and numb.
Has anyone wondered if their diagnosis is correct? Any bi polars out there ever just go off the mood stabilizer and feel fine? Or not...? Can anxiety seem like a manic episode to a pdoc? Is it possible to exhibit signs of mania but "out grow" them? Can an illness shift and change over the years?
Any thoughts on this are most appreciated.
Thank you,
Sarah
Posted by HappyGirl on May 31, 2004, at 9:44:21
In reply to Decided to go off Depakote after ten years..., posted by ST on May 31, 2004, at 5:57:18
Hi Sarah:
In answer to your post/question;>>> When I wasn't depressed, I displayed a dynamic, energetic personality. <<<
--- This is typical 'hypomanic symptom stemmed from Bp II. ---
>>> Depakote (I think 1200 or 1500 mg; is that the average starting dose??) <<<
--- 900 mg. is 'normal' dosage as far as I know, but higher than 900 mg. is used in order to control Bp symptoms in timely manners. ---
>>> became a total zombie and the depression was horrible.<<<<
--- as you suspecting, Depakote causes this 'zombi' feeling, ... in other words, to 'numb' Bp symptoms that normaly has 'angry burst' such as punching a fist into the wall with rageous fits. ---
>>>> Despite being taken hostage several times a year by debilitating depressions, before meds I had an intense drive and ambition <<<<
--- It's VERY hard to say, ... it could be due to the experience of 'hypo-mania,' ... or just because of your 'own'/born talent. ----
>>> It has been 11 days and I have noticed absolutely no onset of hypomania or mania. Nothing has changed. I'm on 300 mgs a day of Wellbutrin and 200 mgs daily of Serzone. <<<
--- in my guess, probably your Bp getting under control as years went by, ... but Hypomania sometimes comes back when you get into stressful situation, such as drastic life-change, loss of loved one or etc. So, be cautious!! Because, in my knowledge along with my own personal experience, ... I'm too Bp II, ... if you have Bp, it's very prone to get 'hypomanic,/milder form of manic episode' ... not 'mania' that is Bp I.
Re: WB sr and Serzone combo. is a 'terrifc' AD combo. which I am too on. Because, this med. combo. is one of 'MOST' safest AD combo. for Bp II, ... not risking to get in 'hypomania,' although WB sr 300 mg. may cause 'hyper' due to stimulating effect. For this, Serzone normaly added because of subduing effect, ... suppress 'hyper episodes.' --->>> Since Depakote, I've lost the spark, the drive, the enthusiasm, the joy of life.<<<
--- If three pdocs. announced you having Bp II, I assume you *had* Bp II. Re: Depakote, ... this med. is a kind 'sedating' med. that causes none-energetic, no motivation and all negative effects on your productive activities,... but again, it works on Hypomania and depression, both. ----
>>> Can anxiety seem like a manic episode to a pdoc? Is it possible to exhibit signs of mania but "out grow" them? Can an illness shift and change over the years? <<<
--- Anxiety is not related 'manic,' since hypomania is a sort 'good' and 'energetic' feelings, On the otherhand, Anxiety is ill-feelings.
Re: 'out-grow,' ... in this regard, you need to speak to your pdoc., because hypomania is sometimes mistakenly taken 'feel well,' even 'getting better,' and some of Bp II stop taking M.S. and later only find its 'consequence.' Then, you need to be careful for this 'self-conclusion/dx.' Only, professionals are able to find 'true' nature of your M.I. ---In my suggestion, rather than taking a risk of getting 'hypomanic' episodes for not taking the M.S., call your pdoc. to ask a proper direction on your current M.I. situation. ---
H.G.
Posted by ST on May 31, 2004, at 16:29:21
In reply to Re: Decided to go off Depakote after ten years..., posted by HappyGirl on May 31, 2004, at 9:44:21
Thank you! Yes, I was thinking that I may feel fine now, but a stressful situation could induce an episode. My boyfriend of seven years is watching me closely as well as my close friends. I'm trying to get in to see my pdoc sooner.
Another reason for wanting to stop Depakote is that my liver function is low, my thyroid is slow and I cannot lose the weight I've put on over the past few years. I do acupuncute and naturopathy and I've been told my body is having a hard time flushing out toxins. I think it may be the Depakote over the years. It does worry me that I'm harming my organs. I've also just learned that Serzone is being pulled for hepatoxicity.
But I'm wondering if going into slight hypomania is even a bad thing. I think I may be willing to deal with a more up and down life if only to get back in touch with myself and my emotions. And I intend to stay on the ADs.
Again, thank you for your thoughful response.
Sarah
Posted by psychosage on June 1, 2004, at 1:09:55
In reply to Re: Decided to go off Depakote after ten years..., posted by ST on May 31, 2004, at 16:29:21
Your story is interesting, and I definitely identify with your concern about depakote as a mood stabilizer.
I have only been on a mood stabilizer for a year, and I continue to struggle with moods and life. Therefore, I can not offer anything practical except to say keep reading about bipolar, the bipolar temperament, and perhaps temporal lobe epilepsy.
There are many sources about artists and other creative people that may help you figure out how much "fire" you can handle.
If you haven't been to these sources, then I hope you find them useful.
http://www.mhsource.com
http://www.bipolarworld.netBooks by Dr. Kay Redfield Jamison
a book called _Seized_ by E. Laplante {not sure of the spelling}We constantly are making new frameworks on our illness even if it goes into remission, so it's good to learn from neuroscience, social science, and literary works.
Good luck!
Posted by ST on June 1, 2004, at 1:25:36
In reply to Re: Decided to go off Depakote after ten years... » ST, posted by psychosage on June 1, 2004, at 1:09:55
Thank you for your response!
Were you prescribed just a mood stabilizer when you were diagnosed or are you on any ADs? And do you notice any dampening of your personality since being on a stabilizer?
I've read the Redfield books and thanks for the info on Seized.
My deal is that I've never fallen in to the classic bi polar description with hypomania and manic episodes. It was deep depression interspersed with my feeling like myself: an energetic, positive, creative, funny person. It's hard to imagine this was just my illness and not "me". Now I'm very lethargic and creativity is not always at my fingertips. Depakote causes liver and thyroid damage which seems to be the blame for weight gain and lethargy. That;s a big reason for my getting off it: general health.
Anyway, thanks again. I will keep reading and researching. Ten years ago, I never thought I'd be considering this.
Sarah
Posted by joebob on June 1, 2004, at 12:00:38
In reply to Decided to go off Depakote after ten years..., posted by ST on May 31, 2004, at 5:57:18
i started lexapro and on the third day felt manic...went to doc and asked for depakote to stabilize the onset of the lex
it worked fine
my doc billed $450 for the appt...the insurance co wouldn't pay, so she changed my dx to bp2,when in fact if i have any bp it is type 3, induced by meds
i now take 250mg/day and am considering stopping altogether....i do take some lithium orotate which i like
scary story, huh?
Posted by Sebastian on June 1, 2004, at 15:02:47
In reply to Decided to go off Depakote after ten years..., posted by ST on May 31, 2004, at 5:57:18
I think you get farther away from the beginning of the illness, that you forget. Your life has changed. Now the bad times are in the past.
Posted by ST on June 1, 2004, at 17:16:28
In reply to my story, depakote and ad's, posted by joebob on June 1, 2004, at 12:00:38
that is scary....
> i started lexapro and on the third day felt manic...went to doc and asked for depakote to stabilize the onset of the lex
>
> it worked fine
>
> my doc billed $450 for the appt...the insurance co wouldn't pay, so she changed my dx to bp2,when in fact if i have any bp it is type 3, induced by meds
>
> i now take 250mg/day and am considering stopping altogether....i do take some lithium orotate which i like
>
> scary story, huh?
Posted by ST on June 1, 2004, at 17:18:52
In reply to Re: Decided to go off Depakote after ten years..., posted by Sebastian on June 1, 2004, at 15:02:47
Good point! It's been about two weeks now and still no change as far as mania goes...but I am a bit more depressed. Maybe the Depakote helped with the effects of the ADs. Hmmmmm....
> I think you get farther away from the beginning of the illness, that you forget. Your life has changed. Now the bad times are in the past.
Posted by ST on June 21, 2004, at 0:53:05
In reply to Decided to go off Depakote after ten years..., posted by ST on May 31, 2004, at 5:57:18
Hi,
It's been over four weeks since I went off Depakote and I am glad I did. My friends notice I am returning my old self and that I have a spark in my eye once more. My creativity is once again starting to flow and I am feeling everything, like it or not.
The sedation I've experienced over the past ten years on Depakote gave me a certain stability, but I felt numb. I now feel e v e r y t h i n g. It's amazing. Things stress me out a little since I'm now not a zombie. There is so much stimuli and my mind takes it all in, as if I am a prisoner having just been released. It is, in turns, exhilarhating and overwhelming.
My boyfriend of seven years notices these changes and others that are also positive. He has not noticed any signs of hypo-mania, nor have my friends, who are watching me closely. Since I was always prone to deep, deep depressions and not hypo-mania (I had one episode), I feel that perhaps going off Depakote is right for me at this time. I'm sleeping well and I have not noticed any rush in thoughts or agitation or euphoria.
My natural personality was one of energy and optimism. My mind and tongue were always sharp. These were not sympoms of hypo-mania, but my personality at it's base level, when I was not depressed. So at first I worried that as the Depakote left my system, people would see these traits return in me and instantly assume hypo-mania. But no - my old friends say they recognize me again!
I'm under the care of a pdoc who agrees with this chnage in my medication (I am still on Wellbutrin, but slowly weaning off Serzone, due to the liver toxicity factor). I'm under no illusion that I'm "fixed" or that I will never experience once again the hell of being bi polar. I'm well aware that I will fall in to the depths of despair or feel euphoric swings throughout my life. I will continue to watch that the spark in my eye does not turn in to a raging fire.
Thanks for listening!
Sarah
PS: In no way do I promote that those who have been diagnosed with bp or any other disorder go off their medication. Antidepressants saved my life and medications for the mentally ill are a godsend for so many. This is simply a choice I have made that I feel is right for me.
This is the end of the thread.
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