FM and Bipolar, anyone???? Advice please

Discussion in 'Fibromyalgia Main Forum' started by jole, Feb 20, 2007.

  1. jole

    jole Member

    I was just diagnosed as bipolar today. It came as quite a shock because my symptoms are very mild..or I'm very unobservant. The psychiatrist said she was partly diagnosing me because of the medications that I cannot take.....antidepressants. They wire me up terribly, and if I had the energy could clean my whole house in 30 minutes. I also get a racing heart, palpitations, and just a weird feeling of something going to happen.

    She said it's very hard to treat bipolar and depression because the medications do not mix. Is this your experience also? I am just trying to read up on bipolar but not able to concentrate too well tonight. I also mentioned the racing brain at night - she laughed and asked where I'd heard that. Well, I guess she calls it something else, but says it is BP, not FM.

    This is all pretty confusing to me right now. Will check back in the morning when I can think better. Any infor will be appreciated, and thanks in advance!

    After doing some reading, I am not convinced that I have BP. I have never enjoyed being in crowds, never liked to be center stage or take chances, not had a problem with money, and have only "seen" things once, which was years ago when I was pregnant so I think it was a hormonal thing.

    I can't think that just because my dad was short-fused and terribly abusive, and the fact that I can't take antidepressants is enough to dx me, do you?

    [This Message was Edited on 02/21/2007]
    [This Message was Edited on 02/21/2007]
  2. 30feeling80

    30feeling80 New Member

    I take depakoke (valproic acid) to level out the mood, take away the shakiness and feeling wired. But it makes me feel a little bummed out.

    I'm also on Cymbalta (anti-depressant), which lifts my mood and also helps control the mild pain that comes with having fibromyalgia.

    Wish I had more answers. Just sharing my experience. Good luck,

    Darlene
  3. jole

    jole Member

    Thanks for your info. I have added a little to my post since you answered. I still am not sure I have this, and need some guidance from someone. what do you think?
  4. zenouchy

    zenouchy Member

    I'm Erika. Nice to meet you! After having the diagnosis of bipolar II (there's also bipolar I and other diagnoses similar to this) for ten years, I hope I can help you and shed some light on bipolar. It will help you immensely to find a good book on the subject. A VERY common book on bipolar is Bipolar Disorder: A Guide for Patients and Families (A Johns Hopkins Press Health Book). I have the book--it's pretty thorough.

    This is a LONG response. I spent a very long time writing it, and I hope it helps you! Bipolar is a tough diagnosis, and I know you are overwhelmed and confused. *I hope you will give me some feedback.

    You might also ask your P-Doc (abbreviation for psychiatrist). Books on the topic are MUCH MORE THOROUGH than the info you will get online. I highly recommend a good book on the subject because bipolar has many subtleties to it and varies so much in each person.

    While there are definitely similarities in symptoms from person to person, it's the differences that will help you understand what is unique to YOUR OWN SITUATION. That to me is very important. *Very often, the websites can confuse more than they can help. The symptoms they mention there are only guidelines--very often bipolars DO NOT have the symptoms they list--adding to that confusion. For example, I've NEVER been on a shopping spree either--sounds fun, but I have never done it nor thought about it. I've also never been up all night or have never called friends at 3 am. (Hence the confusion that the well-meaning bipolar websites can create.) They are trying to "soundbite" a complex illness, which is virtually impossible.

    At any rate, YES, a A VERY BIG SIGN of bipolar is not responding to anti-depressants. A bipolar person will get manic or hypomanic (ie, more sped up, or racy) on antidepressants. The symptoms of mania or hypomania (not as severe as mania) are EXTREMELY varied in each person, and they can even vary over time and likely will, even in each individual (hence, a complex disorder).

    Also, it's important to note that bipolar varies greatly in severity in each person. For one person it can be VERY SLIGHT and hardly noticeable. For others it can be so extreme that they have to hospitalized several times because they refuse to take meds, which destabilizes them more--it's just more extreme and hard to "soundbite" here. For many others, it falls somewhere in the middle, and they can experience similar (yet different!) symptoms.

    This illness is nothing to be ashamed of. There is a large co-morbidity with fibromyalgia too for some reason--probably because fibro affects the brain also. Bipolar affects the part of the brain that controls emotions. The explanation of how it affects the brain also way oversimplifed on websites. I'm not trying to put down the websites (too late probably) because they can do a great service in helping people know where to get help, find a psychiatrist and so on, which is fantastic in helping people get diagnosed. It's just the symptomology aspect of it that can confuse people a bit.

    I don't know why your doctor laughed when you said you felt like your brain was racing. That is quite common, especially at night. It's hard for people with bipolar to feel like their brains can "shut down" and "turn off".

    A common thread in people with bipolar is creativity, and our minds can be thinking of several things at once. The part of brain that is affected often (but not always) sparks creativity--weird, isn't it? (We DO have similarities too!) I don't know why your doc thought you just read that somewhere.

    When you are first diagnosed, it's overwhelming. **Also, if you aren't sure that your doc has dxed you properly (and it definitely sounds like you aren't) I URGE you to seek another opinion. Bipolar is another word for MANIC-DEPRESSION. Usually, a person starts off as "depressed" and then the doctor realizes it's "manic-depression"--it's not easy to diagnose. If your doc isn't helping you enough, PLEASE, get another opionin.

    You need a GREAT doc to help you. It's very easy to second guess this illness, especially if your doctor isn't explaining it to you properly, besides the fact that no one wants to have it in the first place. Bipolar can occur at any age, and it's a illness of the brain. It's the symptoms you are showing that help your doctor diagnose you--and your lack of tolerance to anti-ds does help her make the diagnosis- yes.

    I'm not a doctor, but I DO know that bipolars can't tolerate anti-depressants (my own P-Doc told me this, and I learned it first-hand--not fun). HOWEVER, ***You need to rule out OTHER REASONS that you can't tolerate anti-depressants.*** Some people just can't tolerate them. **I think that is critical.

    Your racing mind is also a POSSIBLE symptom of bipolar--but in my mind not definitive either. These are good signs, but she needs to explain things more to you. *If I were you, I would go back to her, and ask her PRECISELY how she made her diagnosis of bipolar and PRECISELY what bipolar is (since it's new to you--she should give you pamphlets, resources, book suggestions, where to get more info and not make you hunt the web) and HOW it AFFECTS YOU, AND WHAT HER IDEA of A TREATMENT PLAN IS FOR YOU. **You very much need to know these things!! *If she can't answer you, then you need to seek another opinion from another psychiatrist who will.

    Hope you will give me some feedback. Spent a long time responding. Much luck and good health.

    Warmly, Erika


  5. monicaz49

    monicaz49 New Member

    Intersting.
    I posted on here once about my weird mood probs since becoming ill 2 years ago.
    Anxiety has been one prob...but i also have extreme irritability for no reason and a short fuse. Worsens during pms but is not due to pms.

    Now, i do have RACING mind...during both day and night. But i NEVER have an ampt up body. Im never running around or out of my normal tired self.

    I went to see a therapist who said 2 things.

    #1 The fact that i have had adverse reactions to 3 antidepressants (increased anxiety, paranoia feeling, etc) is an indicator of possible Bipolar. However on their questionaire..i didnt check off ANY of the symptoms that go along with bipolar!

    So my question is maybe the cfs impairs my BODY from being able to be energetic...yet my mind is still free to be.

    i dont know. Just a thought. But i am in your shoes at the current moment. Not knowing what to do or take.
  6. zenouchy

    zenouchy Member

    After having bipolar II for ten years, I know more than I ever wanted to about the illness. I hope I can help. First of all, the questionnaires on the bipolar website are just a guideline, and they are often oversimplified. It often only adds to the confusion. A symptom you had two weeks ago or two months ago, you might not be experiencing today when you took the questionannaire. Symptoms vary widely over time.

    A website simply cannot diagnose a complex illness. You may or may not have bipolar. Only a psychiatrist (not a therapist) can accurately diagnosis this complex disease. Therapists while well-meaning, often overstep their professional expertise.

    They know a little (and a few even know a lot) about bipolar and medicines, but they do not have the extra years of medical training needed to DIAGNOSE the illness. As you know, fibromyalgia and/or CFS makes the diagnosing this all the more confusing, making the need to see a good psychiatrist that much more critical.

    I know I keep stressing the complexity of this illness, but it cannot be stressed enough. The brain is the most complex organ in our bodies, which is why people with bipolar, depression, shizophreniza and generalized anxiety disorders, often have unique, widely varied and different extremes of these symptoms even with the SAME DIAGNOSIS. I highly encourage you to see a caring, competent psychiatrist who can help you sort out your confusion and give you a definitive answer either way.

    Once you find a good psychiatrist, he/she can help you determine the best treatment plan or if one is needed in the first place. Best of luck--I hope this helps you.

    Warmly, Erika
  7. jole

    jole Member

    Thank you for your relplies....Erika, I think you're right. If it varies that much AND has to do with the emotions, maybe it's something I need to further investigate. I did tell her that when I was working I turned into a zombie - couldn't relate to other people, couldn't carry on a conversation, etc. I just couldn't seem to tolerate people because they were so "stupid" most of the time.

    I did a great job, went home and collapsed, day after day. But I also was in soooo much pain and the fatigue was overwhelming at the time, and I felt it was because I just had no energy for anything but my job. But I didn't even talk to my husband and family at that time, and when I did it was very monotone.

    Does this sound to you like anything, or just stress and fatigue, which I was certain it was??

    She told me after diagnosing me to go home, read everything I could about BP on my computer, and come back in a month. We would then talk more about it, she would explain more, and we would talk about a treatment plan at that time. She knew I was completely overwhelmed - I thought I was there for depression!!!

    I will take your advice and get the book, because the net is just soo confusing. Thanks, you helped so much.

    Monica, I hope you find your answers too. So far the racing brain and med reaction is all that I have to go on, so with education and great people like Erika, maybe we can learn together.

    Friends - Jole
  8. California31

    California31 New Member

    Wide range of symptoms with bipolar condition....I don't think that a diagnosis based on inability to "handle" anti-depressants is a qualifier....
  9. zenouchy

    zenouchy Member

    Hi Jole,

    A month is a long time to go after first getting diagnosed....I don't remember how long it was between my first and second appt- it was such a long time ago. She may want to give you some time to read and get a chance to get used to the diagnosis. Every doc is different. If you don't feel comfortable with the time frame, by all means, I'd call the office back and see if you can get an appt sooner. I don't blame you one bit!

    Cali, bipolars don't handle anti-depressants well because to put it in very simplistic terms, our brain chemistries are very different and there respond differently to medications. One has to be VERY SPECIFIC in what they mean by "don't handle". What that means in a person with bipolar is that the anti-depressants will induce mania and hypomania in people who have bipolar. Indeed, this is a HUGE MARKER for doctors because a depressed patient who tolerates meds will be improved on an anti-depressant medication while a bipolar medicaton will not be--it will make them WORSE.

    *Others "don't handle" anti-depressants for many other reasons--they can't tolerate medications in general, they have bad side effects from anti-depressants--all which is quite common. Cali, you bring up a good point, and it helps people learn the distinction.

    A competent psychiatrist needs to look at other markers and symptoms as well. I've done a lot of reading and gotten some good education from my docs. I've learned what bipolar "is" and "isn't"--much like we have about fibro and Cfids. Hope this helps.

    Much love, Erika
  10. zenouchy

    zenouchy Member

    In regards to what you are describing with your work situation--the stress, fatigue, being monotone when you got home..... That is where you get into a gray area and your psychiatrist will help you peel away the layers of the onion so to speak and determine if it's "regular job stress" b/c the job is really stressful or stress aggravated by fibro and/or bipolar. Most people with fibro can't work and you were! She will be able to help you figure it out quickly. She does this for a living, and this will be second nature to her.

    (And if she can't or doesn't of course, then that's your sign to find a doc who will. I'm not suggesting she won't, but I just know signs of good and bad docs having had this for 10 years!)

    Also, there's so many types of stress that fall into a "normal" range, and be please be assured that you are still "NORMAL" and will likely feel normal much of the time too. Mostbipolars experience a lot of periods of normalcy, especially when stabilized on medication.

    Hang in there--and ask more questions if you think of any.

    Erika :)





  11. dpl

    dpl New Member

    I was diagnosed Bipolar 11 15 years ago, they first started me on Lithium (drug of choice) but that didn't work for me I had terrible migraines and irritable bowel syndrome from it, so I started on Effexor and clonopin and believe it or not I am still on it and doing well, I have more depression that any manic episodes but manic can manifest itself in different forms such as anger, exploding, fast and rapid talking. Not just going out and spending money or thinking your are God and nothing can touch you etc. And yes are brains are constantly going and that is a manic trait also and that is called rumination! I also get that when I get really bad migraines, my brain will not shut down and it is very annoying when you have a migraine and just want to sleep. Antidepressants have worked well for me, but like I said I have more dpressive episodes. When I was first diagnosed I didn't even know what any of this was, so I did a lot of research and found out a lot, and you can't always go by what the Dr. says. Eveyone is different, our chemistries are all different and we react differenty to meds. I am lucky that my meds work. I don't like being Bipolar, but I am and I have peace with it now. I had one P Doc that took me off all meds cold turkey and I ended up in the ER with heart problems and dehydration, detoxing and it was a mess, I decided I had had it with the P Docs so my regular Fam. Phys. takes care of me now and he does an excellent job, I think he knows more than the P Doc, I can talk to him, cry in front of him which I couldn't do in front of the P Doc (they are so stoic and cold I never really liked any of them) and he has helped me more than any other Doc. But we do have an agreement that if I go beyond what he can do for me then I have to find a P Doc to help me. I respect him so much and he has pulled me out of the depths of depression many times. But I still think anti depressants do their jobs if taking the right ones. good luck.
  12. AllWXRider

    AllWXRider New Member

    Toxic metals can cause a wide variety of symptoms per the National Institute of Health. Enzymes are the main culprit here as they are the biological catalysts our our body. An enzyme consists of an amino acid with a metal ion. If the wrong metal ion is attached, as in an antagonist toxic metal, then wrong reactions are created.

    Enzymes are used to make neurotransmitters like serotonin, dopamine, norepinephrine...there are 50 of them today per my daughter's Biochem book.

    I found Lead, Antimony, Arsenic & Cadmium from a hair analysis.
    Lead weakens the immune system.
    Cadmium interferes with the tyroid hormone T4->T3 conversion.
    Arsenic is a neurotoxin from WWI.

    I finished my 7th round of chelation and my depression is less! I don't have bipolar, just mild depression.

    I also take natural tryptophan: honey-roasted cashews, turkey (dogs, bacon, deli & sausage, chili), bananas and some dairy (I'm allergic). Tryptophan is a precursor to serotonin.
  13. jole

    jole Member

    Thank you so much for your replies. I'm sorry, I didn't mean to be rude by not answering, but have been in bed with a migraine. It's better now, and I was very pleased to see your messages!!

    Everything you all have said makes sense. Yes, the net is a terrible spot to get info, so my daughter picked up the book from the library that you mentioned, Zenouchy, and I've started on it. Much more information there, thankfully. It is clearer to me now that I probably do have it - and I already have a list of questions going for my Pdoc.

    I no longer work - I quit in September because it all just got to be too much. I couldn't deal with work, couldn't deal with people, couldn't deal with stress, fatigue, pain, lack of sleep, etc. I honestly thought quiting was my answer, but the only thing that has changed is I no longer am a zombie. On most days I can actually think, and I can show emotion again.

    Anyway, if I have further questions I now know I can ask. No, I haven't been tested for metals. Perhaps I should be, but I just can't afford any more right now, and don't think that is my problem. Never know though, do we? Thanks again. You guys are just great!
  14. AllWXRider

    AllWXRider New Member

    MSG (monosodium glutamate, autolyzed yeast extract, yeast extract), sodium nitrate/nitrite, sulfites and red wines.

    The liver can change sulfites into sulfates (easy to pee out) when it has sufficient molybdenum.

    Also, the herb, yellowfever helps some with migraines.

    I also get migraines from sharp cheeses but that might be just me.
  15. suzannekart

    suzannekart New Member

    I will give you the short story not the long. Lots of twists and turns. I for years had a problem with my moods. Several years ago a Dr. in Seattle told me I had bipolar disorder. I was in the hosp. and went to groups while there of folks with bipolar. He started me on meds. after I went home I went to group every week and kept up with my meds. All the time I kept thinking I just don't feel like this is it. I was not seeing myself in what I was seeing in the other people. I did have a good time and made some good friends in these groups. I just didn't feel like I fit in. I really wanted very much for this to be the answer so at least I would have a name and a plan. None of the meds worked. I felt so ill all the time I was taking them. He tried several things nothing got better. Long story longer. One day I was going through old school papers and report cards of mine. We had just found out our 3 year old had ADHD. I went to my Dr. and asked if perhaps I had adult ADD. He said " well it's worth a try because bipolar is not the answer" He began to treat me for ADD and It was like a new world opened up for me. Yes I still have problems but nothing like before. Anyway I just wanted to share this with you. I guess it taught me to always have an open mind. I wish you all the best with your journey. Suzanne
  16. Slayadragon

    Slayadragon New Member

    Your doctor may be referring to what is known as extremely soft bipolar, or somethings Bipolar III or Bipolar IV.

    People with this may get hypomanic symptoms only when they use antidepressant drugs. They usually have at least a few family members with bipolar (or at least clearly chemical depression) in their families.

    These folks often get mild-to-severe depression, though. It's when they take antidepressants that the hypomanic symptoms (such as feeling wired) appear.

    If your doctor is right and you are very soft bipolar, the question becomes whether you are depressed enough to need antidepressants.

    Since you have FM/CFS, it may be that you are in fact not depressed at all, and that it is instead the FM/CFS that is causing what appears to be depression. If that's the case, you will be better off trying to treat the fatigue in other ways (multitudes of which appear on this board).

    Sometimes, I believe, doctors use antidepressants to try to treat pain symptoms. Obviously, there are other ways of addressing these problems.

    For a while, doctors did attempt to treat FM/CFS with antidepressants. This was by and large unsuccessful.....as you can see by the very few people on this board who have had good experiences with them.

    So it may be that antidepressants are totally inappropriate for you, in which case (as long as the emergence of the wired feeling when you take them is your only bipolar symptoms) you don't need to think about whether you're bipolar.

    The other possibility is that you are indeed suffering from "real" depression.

    It can be hard to tease apart depression from FM/CFS symptoms.

    One distinguishing characteristic is often that people with FM/CFS really want to do things (specific things) and are frustrated because they are too tired or in too much pain to do them.

    People with depression are more likely to lose interest in life. It's not so much that they can't do things, it's more that they are unable to think of anything they would want to do and think that life is pointless.

    With CFS, forcing yourself to do things makes you feel more tired later, even though you may feel good while you're doing them. With depression, you may feel miserable while you're doing things, but doing them doesn't make you feel worse in the future.

    I don't have FM, but I think the pattern is the same with it.

    Note that most of the people on this board feel at heart ticked off that they can't do the things in life that they would like to do. This would not be the case with a depression board.

    You will need to consider this (and hopefully read up on it more) if you are to get a good idea of whether depression (in addition to FM/CFS) is a problem for you.

    If so, you have a couple of options:

    * Try using pharmaceutical intervention.

    It is _conceivable_ that you might be able to take Wellbutrin on its own, since it is less likely to cause hypomania than other antidepressants.

    Otherwise you will have to use a mood stabilizer, on its own or in combination with an antidepressant. The anticonvulsant family is the most commonly used today.

    Lamictal lifts the mood somewhat, and so if you can tolerate it, that might be a good choice. (I use that one successfully, as do a number of people in my "real life". They don't have FM/CFS though.)

    Depakote is another commonly used mood stabilizer. It depresses moods in addition to stabilizing them, which means an antidepressant is often added to improve moods. Obviously this is a lot of drugs. (especially since Depakote is a hard drug to take and antidepressants have lots of side effects even for normal people.)

    * Try natural remedies.

    Many of these can lift moods in some people without causing hypomania or mood swings. (Mood swings can result from them in others, although less so in people with just "soft" bipolar.)

    Ones to explore might include:

    DLPA. This is an amino acid, and is commonly discussed on this board as helping both fibro pain and depression. It's conceivable it could especially useful for you, therefore.

    St. John's Wort. This is an herb commonly used to treat depression.

    5HTP. This is another amino acid, although its use seems to be a bit more controversial than the others.

    SAMe. This is more likely to cause hypomania than the others though. It's also quite expensive.

    l-Theanine. This is more calming in that it brings the brain into a similar state obtained in meditation. However, anxiety and depression are related, and so it's possible it might help.

    B vitamins and/or magnesium. Stress (including stress from illness) can cause B vitamin deficiencies, thus leading to depression. Most of the population suffers from magnesium deficiencies, and this can lead to anxiety as well as mucle pain. If depression is mild, this may be enough to fix it on its own.

    Traditional Chinese Medicine (TCM) apparently has the potential to treat depression, although finding a really good doctor (preferably one trained in China, Taiwan or Hong Kong) is far preferrred.

    * Do nothing.

    If depression is mild, pharmaceutical cures may be more harmful than beneficial, especially for those with soft bipolar. Obvioiusly treatment should be explored if symptoms are more severe.

    **

    It would be extremely rare for a single doctor to be able to give you advice about all these different things. if you are to explore them, you will need to gather information on your own, and preferably talk to at least a couple of health care professionals, if you are to make good decisions.

    I mentioned a bunch of nutritional supplements, but please don't take any of them without becoming informed and (especially) looking up interactions. Occasionally such supplements can be dangerous.

    If you do pursue pharmaceuticals, I would highly suggest finding a psychopharmacologist to help you. Regular psychiatrists do not do a very good job with bipolar-spectrum disorders. Obviously primary care physicians do not either. (On the whole, obviously. Some are fine, but I wouldn't take the chance.)

    There also are a whole bunch of books on bipolar available. I've seen (but not read) some newer ones that just deal with "soft bipolar." I would suggest looking into these before you go further.

    **

    I hope this is somewhat helpful. Good luck.

    Best, Lisa

    **

    Disclaimer:

    My intention in posting on this board is only to share my own experiences, provide observations about other people's experiences, and report comments offered by MD's and other medical professionals.

    If I seem to be offering medical advice of the sort that an MD should, this is unintentional. Please don't follow it.