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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by rjlockhart98 on October 29, 2005, at 23:30:12
I know dopamine is, when i have a hypomanic, even worse hypo-panic attack, dopamine and adrealine. It feels so stimulanting, its like i hear the slightest sound, with the stillness around me.
Serotoin has got to be in there.... i dont know why. Usally when i have a moderate episode i feel good about myself, and ready for anything. Sense of Well-being. Im like thank you Mind. THen it dies down fine.
I classify attacks in catagories
1. High Alert state
2. Anxiety High state
3. Panic feeling
4. Mania with Panic.
5. Mania.I dont want to be on medication that will dull me out, i would HATE that. I want to know how to self stablize myself by self talk, knowing inbalances.
Panic states are usally caused because a abnormal thoughts, I go "ok, I have to feel safe and alert"
I can have Manic states with 3mg of Clonazepam, I one time had a rage at my stepdad, i walked, he took my keys, i said fine, im walking to Fort Worth and get a job with out you bastard. I did, i got sunburned terribly but i didnt care, i was in a determined state, i am going to make it. I finally came back to normal state of mind, made it to fort worth, applied for jobs. Then called my mom at work after i re-came back to mind.
I was so sunburned it was 2nd degree, 98 degrees out side, but i didnt care while i was walking. I just said im going to make it, i have willpower and i am going to smash my stepdad.
I have gotten in fights with him, he said i was demon possed, he grabbed me, i punched him in the face and went CRAZY, broke my stereo speakers over him, I didnt care if i got hurt, in that state of mind, its your main goal. Take him out.
Sorry i got so intense. I havent posted when this happened becuase it was embarrasing and i was exhasted.
But Mania can be more stimulanting than amphetamine.
Matt
Posted by SLS on October 30, 2005, at 6:38:24
In reply to What nuerotransmitters active in Mania?, posted by rjlockhart98 on October 29, 2005, at 23:30:12
> I know dopamine is,
That was one of the prevailing thoughts for many years. I really don't know what modern neuroscience has to say on the subject.
> Serotoin has got to be in there....
SSRIs can precipitate mania, so why not?
> I classify attacks in catagories
> 1. High Alert state
> 2. Anxiety High state
> 3. Panic feeling
> 4. Mania with Panic.
> 5. Mania.Nice classification system!
> I dont want to be on medication that will dull me out, i would HATE that.
I know. That is one of the reasons it takes so much time to search for the right drugs to act as anti-manics or mood stabilizers.
> I want to know how to self stablize myself by self talk, knowing inbalances.
That's a tough one. With the degree of mania that you describe, I don't know how much success you will have treating it psychologically. I am not going to discourage you from trying it, but I think you ought to set some limits as to how many self-destructive manic events you allow yourself to have before bringing in medication. Actually, I found that hypomania is somewhat flexible psychologically. My manic state would heighten or lessen depending on my particular circumstance or thought process. Get to know your manic "themes". What thoughts and feelings appear consistently when you are at your most manic. Which thoughts tend to runaway with themselves. You need to be able to become aware of and recognize manic thinking and take control overseeing your thoughts and behavior. To some degree, you can change the way you feel by changing the way you think. You might have some luck using CBT to identify unrealistic thoughts and avoid unwelcomed behaviors. Relaxation exercises are important too.
Mania can be like a fire. Once it is kindled, it grows and takes on a dynamic of self-perpetuation. Sometimes, the only way to put the fire out is to use a somatic medical treatment like drug therapy.
Which drugs have you considered to treat the mania?
Which drugs do you feel are mind-numbing?
If Klonopin doesn't help to put out the fire, you might benefit from Zyprexa as an acute treatment. Most people don't describe it as being mind-numbing, and it can actually bring greater thought clarity. Depakote would probably be the anticonvulsant mood stabilizer with the best chance of controlling the mania. There is quite a selection of other drugs to work with. It is difficult to believe that none of them would make an acceptable treatment.
Try not to be too embarrassed. I have done some pretty bizarre things while in manic states. I am much more embarrassed by my manic behavior than by my depressed behavior because it occurs while I have absolutely no self-control. It is also very stark and visible to others and does not leave their memory so quickly.
So, what's the plan?
- Scott
Posted by Nickengland on October 30, 2005, at 7:55:41
In reply to Re: What nuerotransmitters active in Mania?, posted by SLS on October 30, 2005, at 6:38:24
Hi
>I have done some pretty bizarre things while in manic states.
Me too, I don't think I'd be able to write about the things I've done and experienced whilst hypomanic - as people would be incredibly shocked to say the least, at the same time parts of the things I've done in a sense i'm pretty much ashamed of and they lasted over periods of months, but on the flip side the experiences did offer some unique 'experiences' and events that I guess the 'normal' person would not encounter, and I do have those memories to look back on over the years, although its a tough one relecting back sometimes...
During the depressed phase that followed was awlful, as not only did I feel severely depressed, biologically, but psychologically was also left with the pain staking thoughts and memories/regrets of what I had done whilst 'up'.
Its good reminders like that everynow and then that remind me why I need to take these mood stabilisers to keep things in check and prevent those very things happening again, they can quite literally distroy your life in a matter of months, last time it happened I was lucky to get out of it whilst I did, other wise i'm not quite sure where i'd be right now but all I do know is it wouldn't be a good nice place..
Apologies for interupting on the thread, just reading about this was a pretty helpful reminder about medications ~ not that I forget to take mine lol but about the importance I guess of why I continue to do so..
>What nuerotransmitters active in Mania?
From my own experience, I think alot of things are active throughout the entire brain and body during mania to an incredible extent, although i'm not entirely sure which specific neurotransmitters are involved, I think it would be right in saying lots, muiltable/various ones...
Kind regards
Nick
Posted by blueberry on October 30, 2005, at 17:38:50
In reply to What nuerotransmitters active in Mania?, posted by rjlockhart98 on October 29, 2005, at 23:30:12
Yeah, I just recently came down from a bad mania that was, as you say, stronger than amphetamines. Horrible. I thought it was severe akathisia or severe anxiety. But it was mania, and it even had physical symptoms like trembling and quivering. Depokate put an end to that in just one day. But now I'm dealing with depression. Can't win.
I think all the neurotransmitters are involved...dopamine, norepinephrine, serotonin, glutamate. Probably lots of misfiring and crossed circuits going on.
Zyprexa did nothing to stop my mania. It actually made it worse as I tried higher doses. I'm taking depakote every day, but honestly I would like to just keep it on standby and use it only when I need it, because it works fast.
Posted by SLS on October 30, 2005, at 19:44:28
In reply to Re: What nuerotransmitters active in Mania? » rjlockhart98, posted by blueberry on October 30, 2005, at 17:38:50
Hi Blueberry.
> Yeah, I just recently came down from a bad mania that was, as you say, stronger than amphetamines.
Are you bipolar I?
Any mania that becomes severe (greater than hypomania) automatically places you in bipolar I. This can be an important distinction when choosing treatments.
> But now I'm dealing with depression.
Bipolar disorder tends to be a disease of oscillation. It is common that depression follows mania, regardless whether it is the natural course of the illness or the result of an antimanic medication. Prevent the mania and you prevent the depression. Hopefully, your next stop will be normothymia. Once you recover from depression, be sure to enact some type of mania prophylaxis (mood stabilizer) so as to prevent the oscillation from occuring in the first place.
> Can't win.
Oh, yes you can!
:-)
I am amazed that Zyprexa didn't act as an antimanic on you.
If you are bipolar I, I would offer the possibility that using a combination of lithium + Lamictal would work. If lithium is not for you, you can combine Depakote + Lamictal. Lamictal has been shown to be a prophylactic against depression in bipolar I disorder. When combining Depakote + Lamictal, the dosage of Lamictal must be reduced to 50% because Depakote reduces its elimination. The PDR explains everything well enough and posts suggested titration schedules when using this combination.
Of course, there are other mood-stabilization strategies out there.
- Scott
Posted by rjlockhart98 on October 30, 2005, at 20:14:12
In reply to Re: What nuerotransmitters active in Mania? » blueberry, posted by SLS on October 30, 2005, at 19:44:28
Right now im experienceing a more alert state. Its 7:50PM this is sort of the time these little "hypomanic" well i dont even know if it is. It could be a level under. I dont want to make any "label" of my self. It could be a state of mind.
Blueberry, you are right, i agree it can be almost so stimulating it feels good. A high dose of amphetamine can mimic it, but its more natural feeling, amphetmaine makes you do "little tasks" and feel like a machine. Sometimes i feel i can get on top of the world. But i have no depression, i dont know why. It may be just a "state of mind".
right now i feel i can increase it, the nuerotransmitters glumate, serotonin, norphenirine, and dopamine are active i think.
I'm afraid im labing myself of something that i dont have.
My hopes go to you. Do you take Xanax? does it all make it at least let up a bit?
Regards,
matt
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