![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 847 to 871 of 948. Go back in thread:
Posted by banga on March 6, 2005, at 1:41:03
In reply to Re: Light box - Vitamin D? » Elainep, posted by barbaracat on March 5, 2005, at 22:01:04
Hello,
I do not have a bipolar range diagnosis--at least for now--but the first thing that comes to mind as something non-medication to try is fish oil to get omega-3 essential fatty acids. Some studies show it can be very effective for bipolar disorder. Something to read up on, and definitely check in on the alternative board on this site if you have not already posted there RE amounts, brands that are recommended.
You might consider visiting a psychiatrist just to officially look into this and verify diagnosis...you can always say no to medication for now.
Posted by Larry Hoover on March 6, 2005, at 8:51:06
In reply to Re: Light box - Vitamin D? » Elainep, posted by barbaracat on March 5, 2005, at 22:01:04
> Unfortunately, light boxes stimulate melatonin but don't take care of this Vit D problem. Do you know what dosages are in the megadose range? I'd sure like to start supplementing before waiting for an appointment, test results, etc.
The RDA has fairly recently been bumped up to 400 IU, but investigations based on the normalization of parathyroid/calcium levels show that the RDA should actually be near 1600. The megadose therapy for depression is a 100,000 IU bolus. Despite warnings about vitamin D toxicity, there has never been a single report of adverse reactions to this large dose.
Lar
Posted by barbaracat on March 6, 2005, at 13:36:20
In reply to Re: Light box - Vitamin D? » barbaracat, posted by Larry Hoover on March 6, 2005, at 8:51:06
>>The megadose therapy for depression is a 100,000 IU bolus. Despite warnings about vitamin D toxicity, there has never been a single report of adverse reactions to this large dose.
>
**That is HUGE! I guess that's why it's a prescription item. Is this a one-time dose?
Posted by Elainep on March 6, 2005, at 14:11:29
In reply to Re: Light box - Vitamin D? » Larry Hoover, posted by barbaracat on March 6, 2005, at 13:36:20
I'm really excited that your doctor is on to something Barbara, and that Vitamin D is being discussed in medical forums. I'll add my two bits worth about dosage but Larry Hoover is right on the money, as I see he always is on these posts! I think my daughter was given 300,000 iu at once. She was really deficient, I guess that's why. Each pill was 50,000iu and she had six of them. Unless each pill was only 25,000. In all honesty I can't remember. So maybe she was given 150,000iu. In Europe, apparently it's common to give out 250,000 at one time. That's why it's important to test your calcium and phosphorus first though, because of something called hypercalceamia which I'm sure Larry Hoover can explain. So yes, with doses as large as 100,000iu and above, it's important to get a prescription from the doctor.
In the meantime though, with some researchers saying we need 4000iu a day, you could try taking that until the results come in. I'm sure it won't do you any harm for a week or so, and may do some good.
Oh, and about the summer question. My daughter started having what looking like cycling bouts of depression just like Quincy described, with three days down and about ten days 'up' (sometimes really up, hyper-up, one night she moved all of the furniture around in her bedroom at midnight for example) and all of that started at the beginning of summer and went through to the autumn when we finally figured out what was wrong. If you've been depleting for years, it doesn't matter when it happens, I think. Another reason it may not be diagnosed as SAD.
What one doctor told me about vit D is that it's involved in regulation of the mood chemicals through the adrenal glands. So it may not be that you're lacking serotonin or the other mood chems, they're just not being dispensed evenly to your brain.
I'm excited that some of you out there are getting tested: I can't say frequently enough how much it changed the life of my daughter. In hindsight now I see she was getting depleted for years: before the actual episodes of depression she had gradually become more and more withdrawn and had become creatively 'blue' (she wrote about very black things): I put it down to teenage angst but now I really wonder.
She also has scoleosis (a curved spine) which, of course, in hindsight, is a latter teenage development form of rickets, the age old sign of vit D deficiency. The only sign that my second daughter (who was also vit D deficient)had in common with my first daughter (Second daughter had no depression/cyclothymia), was they both noticed their jaws had begun to click.
In adults, soft bone pain and lots of cavities can be a sign of it all too. I'm not sure if I've included somewhere else in my posts an article that fybromyaglia can be undiagnosed osteomalacia, or the adult form of rickets from vit D deficiency.
So vit D is seriously big news, great that you're getting tested Barbara and I know it's hard to be patient about it all. But do be patient, you really don't want to megadose if there's any chance of hypercalcemia so it IS important to have the tests done first.
I can't wait to hear how you get on!
Elainep
Posted by barbaracat on March 6, 2005, at 23:15:05
In reply to Re: Light box - Vitamin D?, posted by Elainep on March 6, 2005, at 14:11:29
Thanks for the reply, Elaine. I'm excited about this too. In my research I discovered that low Vit D levels are linked to hypothyroidism, which I have. I also have fibromyalgia and thyroid has always been a suspect player in that. Those muscle cramps sure feel like hypocalceamia which makes sense since my calcium was tested low, but calcium supplements don't seem to help. My Mom had rickets as a child so there could be a genetic component as well.
Further urine metabolite testing indicated low adrenal sufficiency, so you're comment about adrenals hit home. Wouldn't it be too wonderful if Vitamin D could be at the root of all this? You mention your daughter and Quincy being sympomatic in the Summer. That has always been my worst time. It wouldn't seem like there'd be a vit D shortage in the Summer, but I thought the similarities were indicative of something or other.
I'll get myself 4,000Mg Vit D tomorrow and get myself tested. Will let you know how it goes. - Barbara
Posted by Elainep on March 7, 2005, at 15:09:58
In reply to Re: Light box - Vitamin D? » Elainep, posted by barbaracat on March 6, 2005, at 23:15:05
Wow Barbara!
I don't want to get over-excited here, but my skin was tingling as I read your note. I will SO cross my fingers for you. I have to say, it wouldn't surprise me at all, from what you say about your mother and living in a climate with little sun. If you come back deficient you should scream out loud and jump for joy. I swear Jo was completely better (mood wise) within about 2 or 3 days and has never relapsed since. The bone pain has taken longer to go away (I will warn you of that) but it's no biggie now that she's on an even keel again and socialsing and living life the way she should be doing.
I am so thankful that when Jo got sick there was the beginning of enough scientific evidence around to figure out the cause: hopefully 5 years from now doctors will be testing immediately for vit D deficiency when someone comes in with depression.
Oh, and I have an aunt who was diagnosed with bipolar 40 odd years ago. She lived in northern Ohio, and was found crying in the snow with her new baby inside. Guess what, post partum depression has also been linked to vit d deficiency and I have strong suspiscion now she never had bipolar at all but vit d deficiency. She's old now (78)and has been totally stuffed up from all the drugs they trialled on her over the years and the electrical shock treatment etc (I know things are better now but back in the early 60s they tried everything on her). Anyway I told my cousin (her daughter) about the vit d problem with Jo and she got her mother on to supplements and apparently she's the best she's been for years.
Well life is funny. Oh, I remember you had a question about dosing. Jo was diagnosed at 16 nmol/l (that's the British measurement system: don't know what equiv American is) and the range is meant to be 50-150. After her megadose, her blood was checked again a month later, was 86 nmol/l. As she still wasn't seeing enough sun, I put her on to 400 iu a day and got her tested again 6 months later. She was down to 67 nmol/l, still within normal range but slipping. She's now on 1000iu a day and I'll get her tested in six months again to see if that's the stable dose she needs, or if we even need to go up on that. So the megadose is to kick start you back into the normal range, then you work out your best dosage to maintain it.
Good luck, I have a very strong feeling about this...
Elaine
Posted by jrbecker on March 7, 2005, at 23:17:46
In reply to Re: Light box - Vitamin D?, posted by Elainep on February 2, 2005, at 18:06:45
http://www.dr-bob.org/babble/alter/20041108/msgs/415830.html
Posted by ClaudiaP on March 8, 2005, at 13:32:41
In reply to Re: cyclothymia, mood stabilizers & Sean's reading, posted by Susan on August 8, 1999, at 21:42:40
> >Have you noticed this change over time? Sometimes I wonder about the sort of long term course of this. I have read that there are physical changes in the brain that might be avoidable if I were to stay on a mood stabilizer more or less permanently.
>
> >Sean.
>
> Sean,
> Do you remember where you read this? Sometimes I wonder if using an antidepressant in the down phase is causing physical changes in my brain that results in faster cycling. But when I am up I am basically just normal so would a mood stabilizer be justified and would the benefits outweigh the risks? If so, which one would you try first? (With Effexor.)
>
> All,
> Reading your posts have assured me that I am not the only person who has cyclothymia symptoms. I only wish I had some of the creativity aspects!
>
> Susan
There is a very good artilce on bpkids.com that discusses the protective effects of lithium and other stabilizers from the neurological damage caused by moodswings.
Posted by Quincy on March 13, 2005, at 21:29:51
In reply to Re: Cyclothymia mood stabilizers, posted by Elainep on March 5, 2005, at 15:20:04
i wanted to say thank-you to everyone who replied to my posts, its really comforting, and good to know that people care.
Elaine, I can look into the vitamin D thing, I'm at college in the North East, but its basically the same amount of sunlight that i've always been getting, and over the summer i had a few down periods which is how I know theres a cycle, but thanks for the advice.
In responce to Scott, i wanted to say that my "up's" feel like pure joy at times. just like.... thats the only way to describe it, pure happiness and peace. like, I get extra excited about things and cant wait to share things and work on projects for my friends and create and dance, i mean, i feel like i'm on top of the world and thats exactly where i want to be.
So, I like my ups, because there isnt ever anything Wrong when i feel that way, it's the downs that worry me.
~thanks
Posted by Quincy on March 14, 2005, at 3:15:30
In reply to Re: Cyclothymia mood stabilizers, posted by Quincy on March 13, 2005, at 21:29:51
ok, i dont think i did too good of a job explaining my UP's. so i'll try again.
its not just being extra happy, but thats what i mostly feel. Like i get extra energy too. I feel like running around in circles because i'm happy, i guess, well, i look at puppy-dogs who like to run around chasing their tails, and i sort of feel like that. haha. I um, well, right now i cant sleep, but not because my mind is racing with thoughts about everything thats wrong in my life but because i'm excited about something, i guess it feels like the night before my birthday or christmas when theres so much to look forwards to the next day that going to bed just seems like the wrong thing to do. And right now i have an art project, well, several projects, theyre presents for my friends who are gruaduting this spring, and i really want to get up and work on them, but i know that if i dont sleep I probably will be tired tomorrow and i have class that i need to be awake for.
but now i'll go back to the word i used in my last post, happy... Its not just happy or content, its that plus something. There are definate times when I am "hyper" when I notice and everyone else notices that i have extra energy. But because i talk a lot and am really friendly to people anyway, sometimes being "hyper" doesnt feel wrong for lack of a better term. I simply feel extra-happy emotionally... Elated if you will.
And I havent ever really... well, noticing my downs was what made me think that something may be unstable. my ups feel less like somethign that i have to worry about because they feel so good. So, noticing the ups is harder, But I sort of think that I'm in one right now, because I feel extra happy, extra energy, i cant sleep because i'm simply awake, and i want to run around in circles and laugh. not like crazy laugh, but because i'm so happy. happy is the wrong word. its more like right now i feel like i'm a bubble floating up, i'm in no danger of bursting because i just am. i'm round and airy and colourful and floating and smiling because i'm so free and i am me. i feel light. and calm on the inside even though i have extra energy. i dont know, maybe i'm just not describing it the way i want to. but its just open.
Posted by sac on March 14, 2005, at 5:54:27
In reply to Re: Cyclothymia mood stabilizers, posted by Quincy on March 14, 2005, at 3:15:30
It sounds like the "expansiveness" they describe as part of the criteria for a manic/hypomanic episode. I've been where you are and I know the high periods are nice but, at least for me, there was a cycle and what goes up always came down....hard. I'd suggest a mood stabilizer eventually. Regards.
> ok, i dont think i did too good of a job explaining my UP's. so i'll try again.
>
> its not just being extra happy, but thats what i mostly feel. Like i get extra energy too. I feel like running around in circles because i'm happy, i guess, well, i look at puppy-dogs who like to run around chasing their tails, and i sort of feel like that. haha. I um, well, right now i cant sleep, but not because my mind is racing with thoughts about everything thats wrong in my life but because i'm excited about something, i guess it feels like the night before my birthday or christmas when theres so much to look forwards to the next day that going to bed just seems like the wrong thing to do. And right now i have an art project, well, several projects, theyre presents for my friends who are gruaduting this spring, and i really want to get up and work on them, but i know that if i dont sleep I probably will be tired tomorrow and i have class that i need to be awake for.
>
> but now i'll go back to the word i used in my last post, happy... Its not just happy or content, its that plus something. There are definate times when I am "hyper" when I notice and everyone else notices that i have extra energy. But because i talk a lot and am really friendly to people anyway, sometimes being "hyper" doesnt feel wrong for lack of a better term. I simply feel extra-happy emotionally... Elated if you will.
>
> And I havent ever really... well, noticing my downs was what made me think that something may be unstable. my ups feel less like somethign that i have to worry about because they feel so good. So, noticing the ups is harder, But I sort of think that I'm in one right now, because I feel extra happy, extra energy, i cant sleep because i'm simply awake, and i want to run around in circles and laugh. not like crazy laugh, but because i'm so happy. happy is the wrong word. its more like right now i feel like i'm a bubble floating up, i'm in no danger of bursting because i just am. i'm round and airy and colourful and floating and smiling because i'm so free and i am me. i feel light. and calm on the inside even though i have extra energy. i dont know, maybe i'm just not describing it the way i want to. but its just open.
Posted by dive407 on April 4, 2005, at 21:45:03
In reply to Re: Cyclothymia mood stabilizers, posted by Elainep on March 5, 2005, at 15:20:04
Hi Elaine and Quincy
I have just begun to investigate cyclothymia and am intrigued by the connection you alluded to between Vit D, hypothyroid, SAD and this rapid cycling I have been experiencing for over 25 years.
We recently returned to southern Canada from 2 weeks of sunshine in Florida and I fell inexplicably into a deep depression. My sister speculated that the crash may be attributable to the return to a cold climate where we generally avoid being outside-expecially after acclimatizing somehat to the warmth of Florida. She suggested I try full spectrum flourescent lighting-and I am just as likely to do that as I am to supplement with Vitamin D.
I work with two adolescent psychiatrists with children in care and thus am cautious about meds. Yet I am actually looking forward to discussing all of this with a psychiatrist in the near future.
I really look forward to reviewing all of the threads written over the past five years and greatly anticipate sharing and (mostly) learning.
regards
Dave
> Hi Quincy
>
> Your symptoms sound so creepily similar to my daughter's that I wanted to reply. I've written elsewhere on this post, see the whole set of
>
> http://www.dr-bob.org/babble/alter/20050131/msgs/451955.html
>
> But what I want to ask you, before you continue to see a counselor or seek out a psychiatrist, is some lifestyle questions.
>
> You see, my daughter eventually was diagnosed with a severe vitamin D deficiency and she never had to see a psychiatrist at all in the end.
>
> So what I want you to ask yourself is, do you see less sun than you did as a child, or 5 years ago, for any reason? Do you have an indoor lifestyle? Do you have any other symptoms like a sore back or (I know this will sound kind of weird) a clicking jaw? If you've travelled to another time zone, has that brought on a 'low' incident? Do you have any scoleosis (curved spine) or other structural skeletal anomolies?
>
> If you think you're not a very sunshine kind of person, and you don't eat much oily fish or egg yolks on a regular basis, you could be suffering from vit D deficiency, even if you eat vit D fortified foods (which are generally fortified with vit D2 rather than D3).
>
> Regardless, it might be worth checking this connection out, before you take anything else any further. If you follow the thread I gave in the ref above, you'll find a whole lot of references I've posted that refer to the fact that vit D deficiency is becoming widespread in the population again, and one of the symptoms is depression. Cyclothymia is what what my daughter had, she'd be okay for a couple of weeks, then come down again for 3 or 4 days. It was definitely a pattern with no triggering incidents that we could see. AND it happened at the end of the summer, not in the middle of the winter like SAD is supposed to express itself. It turned out she just hadn't been getting enough sun (for years) and had a major deficiency. I should also say that I have a minor vit D deficiency myself , despite seeing an awful lot more sun than my daughter. I'm neither sun seeking nor sun avoiding.
>
> So if you're wanting to check out alternatives before you go the whole hog of medication, please check out my other posts and read about my daughter's story.
>
> Good luck
>
> Elainep
>
Posted by kriskraft on April 14, 2005, at 14:18:50
In reply to Lithium Survey » BarbaraCat, posted by katia on August 31, 2003, at 16:36:22
Lithium: I'm taking it as an add on to AD remeron. My hands are shakey and my head feels foggy. And then anxious. Does anyone have any similar experiences?
Posted by Lazarus on April 14, 2005, at 20:01:19
In reply to Lithium, posted by kriskraft on April 14, 2005, at 14:18:50
Lithium should make you feel calm, not jittery. I take 600 mg daily and it really smooths things out.
If you're shaking on lithium you probably shouldn't be taking it.
Lazarus
Posted by barbaracat on April 14, 2005, at 23:03:21
In reply to Lithium, posted by kriskraft on April 14, 2005, at 14:18:50
Sounds like you might be on too much and/or you need some time to adjust. I had tremors when I first started lithium, and then when I added nortriptyline for a while and at the same time increased lithium from 600 to 900mg. The tremors went away after 2 months but I felt too groggy. I'm back down to 600 and that seems to be the best dose for me, even though it's far below the therapeutic blood level range.
Question: don't mean to pry, but might there perhaps be a better AD for you than Remeron? It pooped on me too after a nice start, lithium did not revive it, and I ended up putting on 40 pounds in a very short time. Along with lithium, another weight gainer, you'll really need to be diligent about dieting and exercise just to stay even.
I was constantly voracious for sugary carbs. I'd find myself in front of the freezer in the middle of the night snarfing down old frozen desert things. They'd been sitting in the freezer forever because I normally don't even like deserts or sugary carbs. Made me understand what it must be like to have a food obsession disorder.
> Lithium: I'm taking it as an add on to AD remeron. My hands are shakey and my head feels foggy. And then anxious. Does anyone have any similar experiences?
Posted by katia on April 15, 2005, at 0:38:19
In reply to Re: Lithium » kriskraft, posted by barbaracat on April 14, 2005, at 23:03:21
Hey Barb!
Nice to hear from you. I'm DYING from either a pinched nerve in my neck or a pulled muscle brought on by a chiropractor and his electrical stimulation machine. I'm in AGONY. I finally took that Vicadin you left and wish i had more! I need drugs!! Got any muscle relaxers you could send me? My pdoc gave me 6 valium out of pity, but it's not enough.How's it going?
You can respond via email if you want. I'm not at home and don't have your address.
katia
Posted by barbaracat on April 15, 2005, at 15:51:08
In reply to Re: Lithium » barbaracat, posted by katia on April 15, 2005, at 0:38:19
Hi Girlfriend!
I Babblemailed you so look in your inbox.Luv, B.
> Hey Barb!
> Nice to hear from you. I'm DYING from either a pinched nerve in my neck or a pulled muscle brought on by a chiropractor and his electrical stimulation machine. I'm in AGONY. I finally took that Vicadin you left and wish i had more! I need drugs!! Got any muscle relaxers you could send me? My pdoc gave me 6 valium out of pity, but it's not enough.
>
> How's it going?
> You can respond via email if you want. I'm not at home and don't have your address.
> katia
Posted by paintmom on June 3, 2005, at 22:24:21
In reply to Re: Best wishes to my friend B-Cat » Barbara Cat, posted by Ron Hill on August 3, 2003, at 20:52:13
> Barbara,
>
> > Here's what I think happened. When my sleep becomes disturbed, that's when the miseries start. I have fibromyalgia and loss of sleep is my downfall.
>
> Me too. Disruption of my sleep cycle triggers my bipolar symptoms. I take 800 mg of magnesium (half Mg Citrate and half Mg Malate) at bedtime and it is an excellent sleep aid (for me). You’re a nutritional supplement goo-rue so I’m sure you take some magnesium. How much do you take and what chelating agent? Have you ever tried taking it at bedtime?
>
> > A big learning as well was this time I finally stopped fighting it and somewhere a little light shined and reminded me that I'd been there before and for whatever reason, my feelings were valid and to be honored. No reason to hate myself for feeling like sh*t.
>
> I agree. Beating yourself up with negative self-talk makes it worse. Like you, it helps me to cognitively understand that my symptoms are directly related to my BPII and that this too shall pass.
>
> > Getting back to my meditating and some yoga, very slowly.
>
> Good. Prayer and exercise both improve brainchemistry for me.
>
> > So I'm on lithium 600mg and lamictal 125mg (more was causing an infernal itching).
>
> I like this combo. As it turns out, this combo doesn’t work for me because Lamictal causes a severe rash over a significant portion of my body. But for those BP patients that can tolerate it, I think it is a good combination.
>
> > Ron, I've had it with TCA's and SSRI's. I'm determined to do this on mood stabilizers until a med comes out that isn't a dud.
>
> Yeah, this has been my position for the past couple of years. But sometimes I wonder if Nardil or another MAOI in conjunction with Lithobid might be worth a trial. ENADA NADH continues to function pretty well to control my atypical depression, but if it were to poop-out on me, I might consider a Nardil trial. Also, serotonin elevating medications (e.g. SSRI’s) completely solve my dysphoric mood state problems (EXTREME irritability) but they also take away my drive and my emotions. But maybe Nardil would get rid of the irritability without turning me into what my wife affectionately refers to as her “do nothing boy”.
>
> Refresh my memory; you tried ENADA NADH, correct? Did it help, hurt, or provide no effect for you.
>
> > But I REALLY REALLY have to watch my sleep and not stress out.
>
> Again I agree with you. Stress is a HUGE factor affecting the onset of my BP symptoms. I have a theory (which may or may not be correct) that goes like this: People like you and I who experienced an inordinately high volume and intensity of childhood trauma damaged our stress response systems due to overuse, and now as adults, the slightest level of stress completely screws up our systems and adversely affects our brainchemistry.
>
> > Right now, this minute, I'm feeling pretty good, notable for the fact that I'm also feeling centered and focussed.
>
> Good.
>
> > I'm also very proud of myself for having made it through another battle.
>
> Yes indeed. Good job. I hope calm waters lie ahead.
>
> > Hope you're doing well.
>
> For the past month I’ve been having trouble with wretched dysphoric mood states. I don’t know if it should be classified as a mixed state condition, but it is hell to experience and it is hell for my wife when I’m screaming 24/7. Niacin (250 mg a couple times a day) helps to reduce my irritability and l-theanine (200 mg a couple times a day) helps even more, but neither one fully solve the irritability problem. Further, as with most nutritional supplements, if I use them every day they begin to loose their effectiveness. About two weeks ago I added 400 mg/day (200 bid) of Neurontin (gabapentin) to my Lithobid. It reduces (moderately well) my irritability within a few minutes of taking a dose, but the half-life of this stuff is so short that I begin to rebound back into an irritable mood state after about three hours and the rebound state is worse than if I had not taken it to begin with. If I bump up the dosage to 800 mg/day I experience cognitive blunting problems. I quit taking it a couple days ago. I don’t think I want to keep it in my cocktail. Exercise (stress relief) and prayer seem to be key in treating my dysphoric mood states. I’ve had some breakthroughs over the past couple of days and I’m doing fairly well today.
>
> > Thanks so very much for caring for me and the feeling is reciprocated. - Barbara
>
> And thank you as well Ms. B-Cat!
>
> -- Ron
>This post is from long ago...but from what I can tell...you guys have a lot in common with me....I LOVE your childhood stress theory.....Loss of sleep is my downfall too!
I used Enada for Chronic Fatigue syndrome and it was great....it helps with depression too? I have since been diagnosed with BP II ....and always had sleep problems...but now am having horrible ones since I've been on topamax..(otherwise I LOVE the topamax) would like to learn more from you guys
you can email me
chartisty@aol.comthanks
Paintmom
Posted by barbaracat on June 4, 2005, at 13:10:48
In reply to Re: Best wishes to my friend B-Cat, posted by paintmom on June 3, 2005, at 22:24:21
Hi PaintMom,
I believe we chatted a while back. Yes, I believe childhood stress affects certain brain structures and makes us more sensitive to stresses. But I also believe there is great healing possible from many sources. Neurons regenerate. Our bodies and brains are new every 7 years. It's the energy of our thoughts that hold patterns in place and these can be changed, if we learn how. I am learning how and I'm also finally on a med regimen that is working for me and I fervently hope continues to work for me.I'm currently taking a very small amount of Cymbalta (5mg) along with my usual standby, 600mg lithium. I also take thyroid meds and reproductive hormones as well. And Ambien for sleep and a benzo as needed. This combo works well.
My mood has improved greatly since beginning the Cymbalta, even though the amount is quite miniscule compared to what's typical. One thing I've learned for sure is Bipolars are very sensitive to alot of meds, especially SSRI type meds. We don't need as much and are usually prescribed amounts appropriate for unipolars. So we go into a hypomanic spin and dump the lot.
Since I've been feeling better, more stable and more optimistic, I'm using this good energy state to develop positive habits for myself. Getting more exercise, playing more piano, dancing more - stuff I really enjoy but have no energy for or interest in when I'm depressed or scattered. If I reach a bad place again for whatever reason, I'll have this support system available when I need it. But maybe I won't hit a bad time if I continue to do what gives me pleasure and energy. Practice, practice.
I'm also working on a thought philosophy that has helped me more than anything else I've read or studied. I'd be happy to share it with you but don't want to force it down anyone's throat.
So, I'm doing quite well - considering I was hospitalized just this past January for a complete meltdown. I know I need an antidepressant now. St. John's Wort worked as long as I didn't have extreme stress but wasn't enough when I ran into a bad stretch. Therefore, Cymbalta really has been a Godsend. I have no qualms about quaffing a benzo when I'm feeling frazzled cause stress is the bad guy. Lithium thankfully works for me and I cannot be without it. I've tried, and yikes! Bad idea. I didn't do well with Depakote or Topamax (made me too edgy). I musn't forget the thyroid. One of the reasons I landed in the hospital was because my hypothyroid condition had worsened considerably. Lithium will do that to you and it has to be closely monitored (thyroid, that is). Increasing the dose has made everything work better. I must get on my soapbox here and again urge everyone to get all their hormones tested - thyroid, estrogen, progesterone, testosterone, DHEA. When they're out of balance, no amount of mood meds are going to help for long.
I hope you find a combo that works for you. Keep trying. Now that you have a Bipolar dx you can better target and identify your moods and what helps. Personally, I'd much rather be bipolar than unipolar. Those hypomanias can be so much fun and productive as long as they stay in their place and don't skid into outright mania or mixed states. Blessings to you. - Barbara
Posted by paintmom on June 4, 2005, at 19:56:36
In reply to Re: Best wishes to my friend B-Cat » paintmom, posted by barbaracat on June 4, 2005, at 13:10:48
thanks for the reply:)
what are some bp meds that DON'T cause weight gain???
thankspaintmom
Posted by barbaracat on June 6, 2005, at 12:36:36
In reply to Re: Best wishes to my friend B-Cat, posted by paintmom on June 4, 2005, at 19:56:36
Topamax supposedly. I only lasted a few weeks because it was too activating. Lamictal, but there's the rash which I got. It is difficult. I have to exercise like crazy which is a good antidepressant in it's own right, but sometimes I just don't have the time to manaically work out. Try trolling this site:
www.psycheducation.org
It's a real goldmine with links leading to links forever. You'll eventually come upon everything you probably ever wanted to know about BP here.
- BarbaraCat
> thanks for the reply:)
> what are some bp meds that DON'T cause weight gain???
> thanks
>
> paintmom
Posted by paintmom on June 6, 2005, at 15:55:56
In reply to Re: Best wishes to my friend B-Cat » paintmom, posted by barbaracat on June 6, 2005, at 12:36:36
> Topamax supposedly. I only lasted a few weeks because it was too activating. Lamictal, but there's the rash which I got.
what do you mean by activating....
I can't sleep....and I am really not that tired considering...how was lamictal for sleep....
thanks for the site...gonna look....paintmom
Posted by barbaracat on June 7, 2005, at 11:51:28
In reply to Re: Best wishes to my friend B-Cat, posted by paintmom on June 6, 2005, at 15:55:56
>
> what do you mean by activating....
> I can't sleep....and I am really not that tired considering...**That's what I mean by activating. Trouble sleeping, feel speedy and revved up. I have anxiety disorder along with bipolar and have to be careful with things that speed me up.
>>how was lamictal for sleep....
**At each new level of a higher dose of Lam I felt activated, almost hypomanic. Didn't need as much sleep, a bit wired but in an enjoyable way. Then it would smooth out. I was able to maintain pretty well at 75mg for around 6 months, which is a fairly low dose. Along with the lithium, it was a very good combo. Then my Mom died suddenly and I went into a very bad tailspin and my pdoc raised the dose. At 125mg I started getting very itchy which is an impending sign of the rash, although neither I nor my pdoc realized it at the time (we were looking for a 'rash' not itchiness).
Raising it even higher did not help with the anxiety/depression/panic and the rash became worse. I eventually discontinued it becaue it just stopped being effective. I went on Nortriptyline and that worked well to pull me out of a very bad place.
I'm now taking Cymbalta, a SNRI, because I've discovered that I need an AD, although most definitely with a mood stabilzer on board. I hope it doesn't go the way most other meds have gone, that is, to poop out. But I think lithium stabilizes things so I've got my fingers crossed this good trend continues.
> thanks for the site...gonna look....
**Yes, it's a good one. What are you currently taking/feeling? - BCat
>
> paintmom
>
>
Posted by paintmom on June 7, 2005, at 16:39:44
In reply to Re: Best wishes to my friend B-Cat » paintmom, posted by barbaracat on June 7, 2005, at 11:51:28
thanks
I have BPII, anxiety....really bad sleep problems,....apnea...and chronic fatigue syndrome.
I am extremely med sensative....I am on tiny amounts of drugs....
less than 5mg of buspar
5mg lexapro
a smidg of elavil....it helps with the sleep but started pooping out and makes me gain weight...
I was on 100 mgs of topamax and felt great.....but activated.....was only getting 3-5 hours of sleep a nite...and broken sleep at that...which is insane for me with the chronic fatigue...yet I didn't feel that bad.
So yesterday ...we lowered the topamax to 50 and I took a little bit of tamazepam to help me to sleep....I slept 8 hours....I couldnt believe it.
I went to my P doc today...and she was like..."well you want to sleep and you dont want to gain weight...so that doesn't leave me many choices" Are those unreasonable requests????? She wanted to put me on lithium but I am reluctant cause of the weight gain....I'm gonna try adding OMega 3's to the topamax and see how that does...
She also upped my AD
This med stuff is such a bummer.
thanks for your help
Paintmom
Posted by barbaracat on June 7, 2005, at 21:24:41
In reply to Re: Best wishes to my friend B-Cat, posted by paintmom on June 7, 2005, at 16:39:44
Well, we sure sound similar. I'm BP, probably BP-I because of the severity, have sleep apnea, really bad insomnia and fibromyalgia! Do you use a CPAP for the apnea? When I use it I notice a vast improvement in the fibro pain and fatigue. It took a while to finally get used to it. At first I'd get a panic attack every time and didn't use it for a year. Finally started taking - temazapam - of all things, along with Ambien, to take the edge off the panic and it did the trick. I now like the gentle whish sound of it and fall asleep sooner, but I wake up feeling like my nose is being suctioned up all night.
I really love lithium. It's made the biggest difference in my life. I only take a small amount, 600mg, which is far below the 'therapeutic window' which is a bunch of crap in my opinion and no one should be forced into taking the high levels required to reach it. Taking more makes me have tremors and nauseous. One thing I've heard many places is that lithium and lamictal are the only true mood stabilizers in the way they affect the electrical potential of the neurons. Depakote also but in a different way. I hated depakote but some people find that it works well, especially with anxious bipolar. It sent me into a very lethargic crabby depression instead.
I too am extremely sensitive to most meds. Not so much to benzos. It takes alot to knock me out and I'm sure a dysfunction in my GABA receptors is probably behind alot of my problems. However, my pdoc is sympathetic to my need to avoid anxiety states since this is the key to managing the rest, and prescribes a variety of benzos to rotate to avoid some of the inevitable tolerance.
One other suggestion is to get your hormone levels checked. You don't have to be in menopause to have rollercoaster hormones and most of us in the mid-thirties and beyond could use extra progesterone. It comes in a cream and the best is ProGest, a natural form. It's definitely an anti-anxiety hormone, helps with sleep and CFS and fibro. Most doctors don't do hormone testing and don't believe in saliva tests, which are the best ways to get your levels. Naturopaths are usually the one's up on this. It might not hurt to try some and see. - Barbara
> I have BPII, anxiety....really bad sleep problems,....apnea...and chronic fatigue syndrome.
> I am extremely med sensative....I am on tiny amounts of drugs....
> less than 5mg of buspar
> 5mg lexapro
> a smidg of elavil....it helps with the sleep but started pooping out and makes me gain weight...
> I was on 100 mgs of topamax and felt great.....but activated.....was only getting 3-5 hours of sleep a nite...and broken sleep at that...which is insane for me with the chronic fatigue...yet I didn't feel that bad.
> So yesterday ...we lowered the topamax to 50 and I took a little bit of tamazepam to help me to sleep....I slept 8 hours....I couldnt believe it.
> I went to my P doc today...and she was like..."well you want to sleep and you dont want to gain weight...so that doesn't leave me many choices" Are those unreasonable requests????? She wanted to put me on lithium but I am reluctant cause of the weight gain....I'm gonna try adding OMega 3's to the topamax and see how that does...
> She also upped my AD
> This med stuff is such a bummer.
> thanks for your help
> Paintmom
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