Question for Haleycole re: Bipolar Disorder

Discussion in 'Fibromyalgia Main Forum' started by rainstorm, Nov 27, 2006.

  1. rainstorm

    rainstorm New Member

    This post is for Haleycole and anyone else who feels comfortable sharing information, questions, and concerns about bipolar disorder, especially bipolar II.

    Haley, I noticed your post on Redwillow's topic about being a highly sensitive person, and you mentioned that it is now debated as to whether bipolar II is actually a different illness from bipolar I, as opposed to being a variant of the same illness. Do you feel comfortable sharing more about this? I was diagnosed as being bipolar II about three years ago, and am interested in connecting with others who also struggle with this issue. I work as a counselor, and have plenty of clients with bipolar disorder, but that's different from getting a chance to connect with people in a personal way, where I'm not fulfilling the role of mental health professional.

    Like you, I don't want to offend anyone on this forum, or imply that anyone has a mental illness, but I am also wondering how many of us with CFS and/or FM may also have bipolar disorder.

    Thanks for being open and willing to share about your issues. Hoping to hear something from you and others...

    --Cerena
  2. netnut

    netnut New Member

    I have bipolar too. Not completely sure if it is one or two because the only truly manic episode I have experienced was due to antidepressant use. I do go hypomanic fairly often though. We think I might go manic more often if I wasnt so sick with fibro and arthritis. Its hard to be manic when you cant move...lol.

    I also have either borderline personality disorder or just borderline personality traits...we arent sure. We know I have ptsd. We tend to think I just have more of the traits for borderline and am not full blown. I think I may have just mellowed with age...lol.

    Dont know what you want to know but Im more than willing to talk. Just ask.
  3. Slayadragon

    Slayadragon New Member

    I have this disease and will tell you some of what I know about it (as well as make a few other comments regarding mental health).

    I had cyclothymia (mild highs, mild lows....never with major depression or manias) from adolescence until age 30. There were months and months when I was able to work 100 hours a week on really taxing academic stuff. At other times I felt low and not very ambitious. I was irritable some of the time.

    After a head injury in early 1995, the problem got much worse. (I did not have CFS at the time.)

    The lows were lower (sometimes down to moderately severe clinical depression). At other times I would have "mixed state" highs (feelings of energy mixed with extremely high irritability).

    I also had almost constant feelings of extreme anxiety. (I never had experienced any significant anxiety in my entire life prior to that).

    A trial of Prozac made me a total mess---alternating from crying hysterically to lying in bed comatose to screaming at people to feeling perfectly fine within a day or so.

    This was before I realized that I needed to be responsible for my own healthcare, and so I stayed in this state for more than a week because the psychiatrist I was seeing insisted that I keep taking the drug.

    It was the worst experience of my life.

    I then was stabilized by a good psychopharmacologist on Depakote (an anticonvulsant) and a series of antidepressants. (Antidepressants are okay for people with bipolar as long as they are stabilized first.) This worked tolerably well, although ceertainly not ideally.

    I now take another anticonvulsant, Lamictal. The dose is 350 mg per day. I also take DLPA (an amino acid) and St. Johns Wort, both of which lift up my mood a little bit.

    I have been on this combination for about five years. I have been on Lamictal for almost 10 years, but for a time it was in combination with some other drugs.

    This current mixture has succeeded in totally fixing my mood problems. Manic-depression has not seemed to be a problem for me in any way in years. Only on those few occasions that I have neglected to take one of the three items mentioned above for a day or two have I had instability.

    Of course I still have manic-depression, but it seems completely controlled by the drug/supplement mixture. Those substances have no side effects whatsoever for me.

    (As I mentioned recently in another post, I thank God at least a few times a week that GlaxoKlineSmith believed it could make a lot of money selling Lamictal so that they invested in the R&D and then testing of the drug. I know that wanting drug companies to be really profitable is not a popular stance, but it is one that I hold anyway.)

    Taking a whole bunch of hormones as well as avoiding certain allergic foods also has helped my mood. (Corn is especially effective at making me depressed.)

    The extent to which I am not depressed is pretty amazing considering that I have CFS, I think. I really wish that I didn't have this disease, but (according to every measure I've ever seen) I'm not _depressed_ about it.

    People used to think that depression _caused_ CFS. I am sure that they are separate problems, even though depressed people do feel tired. The distinguishing characteristic seems to be that with with depression, people tend to not want to do things. They also tend feel unhappy about life, and to have feelings of inadequacy or low self-worth.

    I no longer have those symptoms. I'm just tired. I get irritable when I push myself beyond my physical limits or am under huge emotional stress (such as when I was taking care of my dying grandmother), but rarely at any other time.

    On the other hand, people who are depressed generally do not feel worse a day or so after they push themselves to do more than they want. This is a key symptom of CFS, of course.

    There are lots of things that I want to do, and I think I make good use of the energy that I do have. I am trying extremely hard right now to get better because there are a great many things that I believe that I could do that would be both enjoyable and meaningful.....if I just had the energy to do them.

    My anxiety has almost totally dissipated as well (except on the rare occasions when I have a true reason to feel anxious....and even then, it is not problematic). Part of this may have to do with a treatment my doctor did for me to try to repair my head injury. It's also possible my brain healed over time on its own.

    I take Klonopin and Xanax, but only to get deeper sleep at night. (I sleep without it, but the sleep is not as restorative.) Very rarely (once every several months) do I have any desire to take it to reduce anxiety.

    As with Hayley, understanding what was caused by CFS and what was caused by the manic-depression was hard for me when neither was controlled. Not much at all was known about CFS when I first got it (early 1996), and so I was only able to chip away at it a little bit at the beginning. The manic-depression was easier to address since good drugs were just becoming available.

    If I had to choose, I would far prefer to have CFS (even if I were incapacitated) but with no mood problems than to be "physically" healthy with even moderate manic-depression. (I have had it both ways and so can state this definitively.)

    Manic-depression and CFS together is not a good mix at all. I'm very glad I'm not in that place now.

    I have a number of close relatives who have/had serious depression or manic-depression. I do not know if my mood problems would have gotten worses later in my life had it not been for the head injury.

    (The stabilizing effect of at least a little Lamictal would have been beneficial for me even prior to the head injury though, I believe. Had it been available then, of course.)

    Doctors (including psychiatrists) are not nearly vigilant enough about searching for signs of bipolar in depressed patients. This includes discussion of mood history, subjective tests about how people have felt, identification of close relatives with mood problems, and examination of previous accomplishments. (Many bipolars have stellar careers--sparked by superhuman energy--but then crash into deep depression for no reason.)

    If even mild bipolars are given antidepressants by themselves (as was the case with me), the results can be disastrous.

    About a year after the head injury and about five months after my horrible experience on Prozac, I "caught" the drop-dead flu that was the start of my CFS. Both of those first two events were extremely stressful, and undoubtedly contributed to the triggering of my illness. (Genetic testing suggests that I was at high risk for CFS and might well have ended up with it anyway, though.)

    As a side note, a number of people on the board recently have been taking antivirals (many in combination with other substances) and having major herxes. Based on what I have read, none of these disasters came even close to what I experienced during the time when I was taking Prozac alone. My own antiviral herx (which got me down to a 1....you can read about it on my Famvir post) was child's play in comparison.

    Hayley's comment that bipolars are more likely to have FM is interesting. (I suppose that covers CFS as well?)

    However, my grandfather almost certainly had CFS but did not suffer from any mood problems. None of his blood relatives (as far as I know) had mood problems either.

    My younger brother has had severe CFS since he was 15 (also following a head injury). When he first got it he was diagnosed as having depression even though he said he didn't feel depressed (just tired) and even though several anti-depressants had little effect on his ability to function. (He now seems not to be especially depressed even with his incapacitation; he says he has resigned himself to leading a quiet life.)

    On the other hand, none of my relatives with mood disorders have shown any signs of CFS. Neither have any of their blood relatives, as far as I know.

    A few individual case histories do not mean that there is not some validity to the theory that the diseases are related, however.

    As for the original question--

    Bipolar I is defined as manic highs and major depressions.

    Bipolar II is defined as milder highs and major depressions.

    Cyclothymia is defined as milder highs and mild depressions.

    Personally, I think it might possibly be more useful to segment bipolars into "rapid cyclers" and "non rapid cyclers."

    Rapid cyclers are people whose moods change frequently. Officially, this is defined as more than a few ups and downs per year. Practically, many bipolars swing up and down very frequently....in some cases, moods may shift from one extreme to the other within a few days or even hours. Both Bipolar I and Bipolar II patients can be rapid cyclers.

    The anti-convulsant drugs seem to work best for this type of patient. One theory is that it is caused by epilepsy of the frontal lobe of the brain (the part that controls mood). The fact that head injuries can cause epilepsy and manic-depression is consistent with that. It may have other components as well. Lithium tends to be much less helpful than anti-convulsants for this group.

    Non-rapid cyclers stay in one mood for a much longer period of time (i.e. months) before changing. In many cases, the mood rises slowly (at first being really good before becoming problematically high) and falls slowly (with a slight depression gradually moving into a major one).

    These types of patients are more likely to be helped by lithium. (Anti-convulsants also may be helpful.) The cause of this manic-depression is unclear, except insofar as it seems to be genetic. This form of the disease seems more common in Bipolar I, but may be seen in Bipolar II as well.

    Bipolar I and Bipolar II are purely descriptive terms. Bipolar I means that (if unmedicated) you sometimes get really "crazy" (sometimes even becoming psychotic). Bipolar II means that (if unmedicated) you sometimes have super-human energy and overly high self-confidence (or, perhaps, high energy mixed with irritability and unhappiness....called a "mixed state").

    This distinction is basically useful only for determining just how "nuts" someone might get without proper meds. Since meds now can stabilize (at least to some extent) almost all manic-depressives, that sort of distinction is starting to seem less useful.

    Another way to categorize bipolars is by the type of medication that is likely to help them (and, if possible, by the underlying cause of their illness). In that case, the rapid-cycling/non-rapid-cycling distinction conceivably might be more helpful.

    All of this is up for debate, however. This illness is still in the early stages of being understood. It has only been in the past 10-15 years that it has been treated at all effectively even by the best doctors. Many doctors still screw up the treatment of it royally.

    When I first realized that I had manic-depression, I did not talk about it with people because I felt that they would look at me negatively if they knew. Now, as you can see, I am happy to talk about it in considerable depth with anyone interested.

    A little bit of this is because I am currently well (in terms of the m-d).

    More, it is because most of the people that I encounter have a basic knowledge of the disease and view people who have it with sympathy (at least, once they have been diagnosed). I certainly get much more immediate understanding and sympathy when I talk about my manic-depression than my CFS.

    The fact that m-d is viewed as treatable seems to me a major reason for the fact that even people who have are not wholly well with regard to it (and even those who have chosen to go "off their meds") tend to be increasingly free of stigma.

    I especially like to talk about manic-depression because I think people should know more about it. This is not really so that they will be more understanding and supportive. It is because I do not want people who have the disease but do not know it to be treated with the wrong drugs and end up as basket cases, as I did.

    Interestingly, I have recently noted that the loaded term "mentally ill" seems to be used more and more frequently with regards only to people who have a) schizophrenia or b) severe personality disorders (such as sociopaths). These diseases still seem to have a negative stigma attached to them.

    On the other hand, people with manic-depression, plain depression, anxiety, and (increasingly) obsessive-compulsive problems seem (at least amongst the people I know....granted a pretty educated crowd) decreasingly referred to as "mentally ill." Instead, they are just described by the name of their disease. (This seems to make some sort of sense.....diabetes sufferers are usually not referred to as "the physically ill" ---even though they obviously do have a physical disease.)

    The stima associated with all these diseases seems to be rapidly fading. Considering that something like 50% of the population has suffered from one or more of these problems to at least a moderately disruptive degree at some point in their lives and that all of these problems are pretty treatable, this makes sense to me.

    Finally, I would like to point out that the "CFS" of the mental health world is Multiple Personality Disorder (also called Dissociative Identity Disorder).

    Many clinicians do not accept this as a real disease, and others refuse to treat it even when it is diagnosed because they do not know how to approach it.

    MPD/DID previously was thought to be extremely rare, but now is seen increasingly frequently as people start to learn about it.

    Patients often trudge from doctor to doctor with a long litany of non-specific complaints (depression, anxiety, low self-worth, "feeling bad") without getting much help either from drugs or conventional talk therapy.

    A high percentage of sufferers have no idea they have it.

    Support from family and community tends to be non-existent in many cases even when people are diagnosed, due to lack of understanding of the problem and from disbelief.

    MPD patients often are accused by professionals of "making things up" and not really being ill.

    Even people who supposedly specialize in the disease often do not know how to treat it (and sometimes make things worse by causing stress).

    Multiple Personality Disorder is almost exclusively caused by childhood sexual abuse. (In some cases, especially in war-torn countries, it can be caused by extreme trauma of other sorts over an extended period of time.)

    People who suffer from it are almost invariably extremely bright and very creative. Apparently the defense mechanism of holding the memories and feelings about the trauma in one or more "personalities" while the other parts of the self go on not remembering that anything has happened (and thus functioning pretty normally) is a strategy that only a small percentage of the population can pull off.

    These people often lead extremely successful early lives in terms of their careers. Depending on the extent of their illness, they may form healthy relationships as well.

    They are no more likely to be violent or to commit any other criminal acts than the average person, and actually may be less likely than average to commit at least some such acts.

    Multiple personalities often have no idea that they have a problem until well into adulthood, when they begin to experience various vague signs of emotional distress. It is at this time that memories of the trauma (previously held only by some of the "personalities") may begin to emerge.

    If the trauma can be remembered and explored emotionally, the emotional distress will begin to subside and the "personalities" will better be able to first work in harmony and then to fuse together.

    This can be a long process and takes active work, though.

    As with CFS, MPD never just goes away on its own. If it seems to go away spontaneously, it invariably comes back again fairly soon.

    Probably this is not a very good explanation, because it's hard to describe something this complex from scratch.

    However, I think that we as CFS sufferers should be especially aware of the reality of this problem and be sympathetic to those who have it. In a great number of ways, the issues they face are the same ones that we do.
  4. Shannonsparkles

    Shannonsparkles New Member

  5. Slayadragon

    Slayadragon New Member

    It certainly is the case that bipolar is related to reverses of the night/day cycle.

    A couple of comments:

    1) Cortisol levels in bipolars tend to be low in the morning (when they "should" be awake) and high at night (when they "should" be asleep). This tends not to be fixed merely by forcing oneself to go to sleep earlier for a while. (The over-the-counter supplement Seriphos is often said to be of help in reversing those patterns. If taken in the afternoon, it supposedly decreases evening cortisol levels.)

    2) A high percentage of people with bipolar have a "supercharged" version of seasonal Affect Disorder: too much sun makes them really high and not enough sun makes them really low.

    Note: This seems that it may have been a good bit of Van Gogh's problem. He lived most of his life in Holland and England, both of which tend to be cloudy all the time. He suffered from most depressions, mixed with mild highs, during this time. He moved to Paris to go to art school for two years, where it is moderately sunny. His mood improved. He then moved to the south of France, where it is _extremely_ sunny. Shortly after his arrival in April he was starting to feel pretty good, by early summer he was painting a new picture each day, and by sometime in early fall was in a mental institution. Sun is a dangerous thing!

    3) A day in a pitch-black room is the only thing other than drugs that ever has had a significant effect for me in calming an undesired "high" period.

    4) I have blinds in my bedroom that block out all light. They are less imperative now, but earlier in my life they were very useful.
  6. Slayadragon

    Slayadragon New Member

    Have you ever tried a larger amount of Lamictal? My p-doc believes that 200 mg is a pretty moderate dose.

    Of course you would talk to your doctor about this.
  7. singingirl

    singingirl New Member

    Thank you so much for all that have contributed to this subject.

    My daughter, who just turned 17 told me in Feb. that for 2 years she had been suicidal and cutting herself. Of course it floored me and my husband, and our pastor when I talked to him. My daughter is such an outgoing people person that no one ever thought she would have a problem. Her biological father (we have been with my husband now since my daughter was 4) is severe manic depression, a sociopath, and paranoid schizophrenic. I thought I would know "any" signs my daughter might come up with, boy was I wrong.

    My daughter does not care who knows about her md. She says it is part of who she is. She is so much stronger than I am.

    I have fm/cfs. I have had a very abusive past, both physical and mental and I suppose that is where this developed in me. My daughter has been complaining about hurting in her shoulders, neck, back, hips her jaw..... she also had mono about 2 years ago. I told her and my husband that I was so afraid she also has fibro, so it was really interesting to me that someone( I am sorry, I am kinda in a fog today so if this rambles please forgive me) I am not sure who, stated that people with manic depression were 158 times more likely to have fm/cfs. I never even thought that the chemical thing with the brain would connect the two. Thank you for the enlightment as to this possibility, and not me just imagining it.

    Have a blessed day
    Trecia
  8. singingirl

    singingirl New Member

    My daughter first saw a Christian therapist that deals with teens, and she in turn referred me to a Psychiatrist because she knew my daughter needed medicine. She is on Lexapro (which our regular MD put her on when I couldn't get an appoinment soon enough with the Psych. and she was still suicidal) and she is also on Seraquel. Thank the Lord she is doing really good on this combo.

    I asked her this morning....if you could be healed would you want to be, and she said " No, it is who I am" I said you would want to be on meds the rest of your life? and she said this is how I am, and I wouldn't know how to be any other way" She has her own style of dressing, and I was picking at her and told her that her style might come from being bipolar because her father dressed in his own "style" too, and she laughed and said "then I definatly wouldn't want to not be this way. Who wants to dress normal"

    Thank God she still has her wonderful sense of humor (most of the time ;-)
  9. Slayadragon

    Slayadragon New Member

    Wow, getting lockjaw as a reaction to Lamictal is really weird! And the idea that Benadryl would offset it is even more weird.

    A few years ago I knew pretty much everything about things related to m-d, but apparently I've gotten a bit rusty since I now am focusing on CFS.

    I assume you have gone up on the Lamictal _very_ slowly? Meaning about 25 mg every week? (In your case, maybe even more slowly?)

    I wonder if the supplement phosphatytil choline (that spelling looks wrong though) might be useful for you. It is the only OTC supplement that I've ever heard stabilizes moods. It also depresses them a bit. I tend to think of it as "mini-Depakote" since it had almost the same effect as a small dose of Depakote but without Depakote's taxing effect on my body.

    At one point there were some studies done that suggested that this indeed was effective as a mild mood stabilizer. Again, I haven't read the recent literature.

    Of course, despite the initial frequent protocol 10 years ago, Depakote itself and Lamictal are a bad combination because of the potential of that deadly Stevens-Johnson rash. I am not aware of any interactions that occur between p.c. and Lamictal.

    I used this stuff for quite a while before I started on Lamictal. It's not ideal for me since my "stabilized" moods tend to be on the low side, but it could be more appropriate for you.

    Read up on this and then discuss with your p-doc, of course. As I said, my knowledge is getting rusty, and so I could be totally wrong about its appropriateness. It seems worth at least a small amount of consideration, though.
  10. Slayadragon

    Slayadragon New Member

    Hayley mentioned this in her previous post.

    It is indeed true that sometimes if a medicine is working successfully and then is discontinued, it may not work if it is started again.

    Then again, medications that are taken continually for a long period of time may stop working too.

    I've never heard this happening with mood stabilizers, though. It does seem to happen at least on occasion for some people with antidepressants, however.

    In some cases, anti-depressants that "wear out" may start working again after a period of doing without them (or switching to another drug for a while).

    To my knowledge, no one understands the reason for this. It does seem to be a real effect, though.

    Another related issue is that of "kindling." Some professionals believe that if manic-depression is not treated, it will get worse over time than if it is treated.

    If this is the case, then it seems especially important for long term well-being that manic-depressives not "go off their meds".

    In addition, it suggests that people who develop signs of manic-depression at a young age may want to treat it then rather than waiting until it gets worse. (Often, manic-depression increases in severity over time and peaks at the mid to late 20's.)

    Of course, this needs to be balanced with the risk that the drug will cause harm to young people. Most psychiatric drugs have not been tested very much on teenagers, and I believe that the majority of mood stabilizers (definitely including Lamictal) as well as most anti-depressants carry "black-box" warnings suggesting that they may not be appropriate for people under age 16.

    Nonetheless, such drugs are sometimes used very successfully and (I believe) appropriately, especially if doses are low and mood problems are severe. Such treatment should to be done very carefully by a very good psycho-pharmacologist (MD who specializes in prescribing psychotropic drugs rather than also doing talk therapy) since these folks have far more experience with these sorts of cases, I believe.
  11. Slayadragon

    Slayadragon New Member

    Maybe I'm not reading carefully enough, but what do you mean by the "hair issue"?

  12. rainstorm

    rainstorm New Member

    ...for your thoughtful, informative replies! I don't have internet at home, only at work, and I only work part time (hence no money to have internet at home) so am only just now able to see your posts. Thank you for all the wonderful information, and for being so willing to share your experiences. It is SO REFRESHING to meet people willing to talk about their experiences with mental health.

    Haley, I have long SUSPECTED that FM and Bipolar are comorbid conditions, but I had never run across any info to confirm that; it was just a suspicion, based in large part on the number of my clients who present with both issues. That is an amazing statistic, that bipolar people are 158 times more likely to have FM.

    Lisa: I believe it was you who shared that you also have an eating disorder? Or am I confusing you with someone else? Regardless, I appreciate your sharing: I also struggle with anorexia. I used to cope with both my moods and eating issues through endurance exercise, specifically long distance running and cycling. When CFS and, later, FM hit me, that coping mechanism fell by the wayside. It has been a long battle to get to the point where I can once again take part in any kind of exercise program without either becoming exhausted, or sending myself into a flare. I believe that Valtrex has made this increase in exercise possible, though I wound up on Valtrex due to an ex-husband passing on herpes (knew he had it, lied about it, hence part of why he is now an ex, thank goodness).

    Re: info on antidepressants and mood stabilizers: I did know that antidepressants, particularly the SSRIs, tend to trigger hypomania and mania; that is what happened in my case, when I FINALLY sought meds through my PMD. Tried Lexapro, which did indeed lift the horrible depression I was, once again, battling...but it lifted me right into a period of hypomania, in which I slept for perhaps 3 hours a night, started all kinds of creative projects but didn't finish any, was very productive at work and took on a second part time business, and (impulsively) got involved with a now-ex who was an abusive, substance abusing alcoholic. Any of that sound familiar to anyone? My PMD and therapist both missed the signs, but then again, I wasn't checking in with either of them very often because, of course, I felt better.

    Subsequently, I sought help through a psychiatrist, got diagnosed with bipolar as well as PTSD, felt relieved as it made SO MUCH sense as to why I'd been trying for years to resolve the PTSD issues but kept sliding back into depression, and then began trying mood stabilizing meds. Tried Lamictal, couldn't tolerate the side effects, but DID have some success with lithim citrate (the syrup form of lithium, which a particularly creative psychiatrist I knew through my job had tried with a couple of bipolar, med sensitive, eating disordered patients). I developed some facial tics and drooling after titrating up to what my psychiatrist termed a "child's dose" of lithium citrate, and then heard about lithium aspartate and switched to that. THEN I heard about the benefits of fish oil for bipolar folks, from the current pyschiatrist on staff at my job...I think this guy is a bit of a donkey's hind end, but he DOES keep up pretty well on new info, so I thought I'd give it a try. Am up to 5,000 mg now, and the feelings of explosivity and extreme irritability have subsided, and I actually can cautiously say I feel pretty good. I've still have had some depressive episodes, but none as long lasting or as deeply intense as those I experienced before lithium and fish oil. Also added in St. John's wort and that appears to help. Plus B12, 1000 mcg time release version, and B1, B6, and folate.

    I don't do well on ativan or xanax...tiny doses do help with sleep and irritability, but the rebound effect when I stop makes me feel like chewing up 2 x 4's and spitting out toothpicks. Really, the best thing I've found for reducing anxiety and helping sleep is swimming; never my first choice before FM as a form of exercise, but definately my favorite now.

    Has anyone else had the experience of having been able to "self medicate" to a degree with exercise, only to have that option severely affected by CFS and/or FM?

    Haley, you mentioned bipolar IV and V being considered as appropriate diagnoses for those who have first or second degree relative with bipolar disorder. I believe that bipolar disorder runs in both sides of my family, but I am the first in my family to seek ongoing intervention. My father had repeated depressive episodes interspersed with occasional bursts of creativity. He wanted to work as an artist and writer, but couldn't sustain the effort needed to make a go of it financially. He turned to teaching English and was good at it, but always in trouble at work because he did the bare minimum to get by. It was the interpersonal interaction part of the job that was tough for him, that and taking direction from people whom he considered to be intellectually inferior to himself.

    My father's father had repeated depressive episodes and was hospitalized twice in his life for suicide attempts. He did uttimately successfully commit suicide. I don't know if he was creative, but he did work intermittently as an attorney when his symptoms would allow. He apparently found it hard to sustain consistent effort.

    My mother has had wild mood swings all her life, and is VERY hard to be around: she's pretty constantly hypomanic, but will become depressed, briefly, several times a year. She is quite creative and intelligent, but her mood swings and interpersonal interactions have made her a challenge to the two employers she's had in her life. She's usually been dependent on a man for financial support, first my father and now her current husband.

    Lisa, I believe it was you who mentioned that darkness has been shown to break manic and hypomanic episodes? I have very vivid memories as a child of pulling the drapes closed in the house, because I had noticed that when it was dark, my mother would calm down, and my mother calm and/or depressed was FAR preferrable to my mother non-depressed. (She doesn't ever really HAVE a "normal" episode, not that I can see). Her brother's children all have some kind of issue: the two boys both have problems with impulsivity, and though they are both very bright and charming, neither can hold a job for more than a few months at a time. No one in her side of the family, and certainly not my mother herself, wants to seek help.

    As far as periods of light and dark are concerned I know that for myself, I feel more internally comfortable in early fall and in late spring, when the periods of light are longer than in winter, but not as long and not as INTENSE as during the summer months. I feel calmer, not hypomanic and not suicidally depressed.

    It is getting to be time for me to leave work and I wanted to ask another question of you all: in what ways do you cope with work and your bipolar-ness, FM and CFS? And, to what percentage of any problems you may have with work are due to FM, or to bipolar? Over the years, my work productivity has declined as first CFS and, later, FM took their toll. But my mental health has also had a significant impact throughout my career, though it's harder to see that part as clearly because it is so much a part of me. I used to work full time and, a few years ago, was even building a part time business in SSI advocacy. Now, I have no business, and am lucky to be "job sharing." I share my position with a co-worker who also has mental and physical health issues, so we split the benefit package and each only work 20 hours a week. I can only afford to keep this up until the middle of next year, though: my mortgage and bare-bones living expenses exceed my part time income by a few hundred dollars a month, and I've been making up the difference with savings I squirreled away over the years. My goal is to return to full time employment, because if I don't or can't, I will have to sell my house, and I get an enormous sense of security, peace, and self esteem from my home. So, I am looking for ideas, input, commentary from fellow people with challenges.

    Thank you, again, for all the great input so far. I look forward to hearing more from everyone, and apologize in advance for the limited time I have available to participate in this forum. I do greatly value all your replies and anticipate future discussions and chances to share...

    Take care, all

    --Cerena
  13. netnut

    netnut New Member

    We believe my mother was either bipolar or more likely, schizoaffective, and I have a son with bipolar disorder. My son is who actually drove me to get my diagnoses. I read a book about early onset bipolar and it was like reading about my own life and I went...well DUH...now I know what has been wrong with me all these years!

    I think I had some weird fantasy that in order to be bipolar you had to think you could fly off buildings or something. Since that isnt one of my problems, I assumed I didnt have it...lol. Never mind that I have many assorted other problems that I just didnt know fell under the umbrella. I did know I wasnt normal but I would never tell anyone.

    Its taken me years to build up enough trust to start working on problems. I have years of abuse to overcome and it isnt easy.
  14. Slayadragon

    Slayadragon New Member

    No eating disorders for me. For a couple of years of this illness I had very little appetite, but I'm not sure why. (This was when I was pushing myself and holding a full-time job. Maybe my body didn't have any extra energy to digest food?)

    The year that was after the head injury (when the bipolar hit) and before the CFS, I was in my Ph.D. program. I got almost no work done that year. I'm not sure it was the m-d though. My brain was also messed up with the anxiety and some cognitive dysfunction.

    I was extremely productive at work until the head injury. The cyclothymia actually might not have been bad for that....the highs energy times more than covered the mild depressions where I'd have to push myself. Something for the occasional irritability part could have helped, though. Maybe just St. Johns Wort (which helps my irritability now) would have done it.

    Glad the info was useful, Rainstorm.
    [This Message was Edited on 11/29/2006]
  15. Slayadragon

    Slayadragon New Member

    I mentioned this a few minutes ago in another post.

    My psychopharmacologist sees about 20 patients per week, most every 3 to 6 months. This is a lot of patients. He spends a half hour with each, talking only about meds.

    (This is just his moonlighting job. He also has a job at a naval hospital.)

    He's very good, and I am certain a high percentage of his patients are bipolar.

    I am pretty sure I am his only patient who states that they have CFS.

    There could be others who think their CFS is actually a mood disorder. However, this makes me less sure that the correlation is _that_ high for CFS and m-d.

    Of course, you didn't say that the correlation was CFS and m-d. You said it was fibro and m-d. I have no idea if that one's true.

    This is just anecdotal evidence. But the number of bipolars on this list don't seem that high either.

    I could believe 2x or even 10x the average. But the number stated above sounds pretty outrageous.

    It could be right, though.
  16. Musica

    Musica New Member

    I just flew through this since it is getting very late, but I printed it out. Hayley, you seem very knowledgeable about bipolar, I'd love to hear more.

    I was diagnosed as bipolar years ago and was on lithium for many years. I convinced my p-doc to let me off it after finding I have severe osteoporosis and having both rheumy and PCP say that long term use of lithium could cause it. This doesn't seem to be well publicized, so anyone on lithium - get a baseline bone density (DEXA scan) if you can! Anyway, I have surprised her by doing well off it. I am on gabapentin, which you know is used for FMS, too, so that may be the reason I have not had worse FMS symptoms. My main dx is rheumatoid arthritis, but as you probably know, immune diseases are prone to other conditions, including FMS.

    Anyway, I digress. I was never convinced of the bipolar diagnosis, but my p-doc finally explained that bipolar is a continuum. Hearing it that way makes it easier to accept. My PCP recently attended a medical conference and learned quite a bit about Bipolar II. I guess the theory is that a very large percentage of people who seek help for depression are actually bipolar II. There IS a difference. For instance, I have been clinically depressed, but never manic in the classic or well known sense. I was diagnosed bipolar because of occasional intense emotional reactions (mostly anger) that came out so quickly I couldn't control them. That's what the gabapentin is for. She says it slows things down just enough so I have a few seconds to think instead of just blurting things out. As far as I am concerned, the gabapentin has been the most helpful as a mood stabilizer.

    It seems that a bipolar diagnosis is considered to make treating FMS so much more difficult. It's bad enough having one or the other, but then having two "voodoo" type diagnoses can really make us seem like nut cases. Certainly, both stem from the brain, but bipolar has to do with neurons firing across the synapses incorrectly, I believe. I'm not sure how brain activity relates between FMS and bipolar.

    I'm getting too tired and too loopy, so I'm not sure if that last part made sense. Anyway, this was a fascinating thread to read, so I thought I would put in my two cents.
    [This Message was Edited on 11/29/2006]