Son Bipolar, Mom Depressed

A double whammy here..my 18 yr. son diagnosed 3 days ago with bipolar disorder. Presently unable to function at school with 2 mos. left to graduate H.S. He's currently on Zyprexa(first 2.5 mg. & now 5 mg. daily)& started amitriptolyene (spelling?) last night also.  

However, my current question is about me, 46 yr. female diagnosed with depression 11 yrs. ago.  Was on Prozac for 8 yrs. with good success. Now on Effexor 150mg. daily for past 2 yrs.  Also on Adderall for 2 yrs. which has made a major difference in my attention,focus, and daily lethargy.  For the past 12 years I have been having monthly or twice monthly episodes where I wake up so tired that I can't get up.  I sleep for 2-3 days straight, rising only to eat ravenously or go to bathroom.  Recently severe headache has accompanied this.  I also have bad dreams during most of my sleep.  If the house burned down around me, I wouldn't care.  On the 3rd day, I start reviving in the afternoon and by the 4th day, I'm my usual self.  Only problem; I don't sleep for 2-3 nights afterward AT ALL. I'm ok after that but have noticed that I require less sleep than I used to and often only sleep 5-6 hrs. a night.  I've been diagnosed as Lupus but my ANA level is the only symptom that I have of Lupus.  I don't feel I have Lupus but NOTHING else fits, except Kelvin-Lein Synd. & the over sexed part does NOT fit me there!



The long sleep seems like it may be linked to my monthly cycle (also going through menopause for past 5-6 yrs. & taking lowest level of estrogen along with progesterin - these levels checked last month & said to be fine)and sometimes definitely linked to excessive stress.  This is the brief version but I'm wondering now, does this sound like some type of bipolar?  If not, then what the heck is it? I'm not "manic" when I'm up all night. My son is apparently not either, he's just awake but does get into art work.  I've been known to get interested in a craft project when I'm up all night and work on it all night but that's as "manic" as I get! I would be grateful for any thoughts you might have on either of us, any doctors in the Tyler- Dallas TX area that might help me with a diagnosis or that could help my son and his search for the correct medicine and dosage.  Obviously, there is a lot of history behind all this, especially with my son such as ADD, depression (we thought) 2 years ago, etc.



Thank you for your consideration.

Margo

Dear Margo -- 
Yeeps, pretty complicated.  However, I see this pattern all the time (so much that when a doctor friend started relating a similar story recently, I said "let me guess: late thirties, two kids and the first symptoms started showing up just after the second kid?" -- and I was right there, though wouldn't expect always to be).  It doesn't have a name yet; something like "perimenopausal bipolar-like symptom complex" comes to mind, but we'd obviously need something with more panache.  

An OB-GYN endocrine doc' I know uses just the hormones you're taking, as a treatment for the symptoms you're having.  So that was probably a good start.  Where to from here?  First, are those sleepless nights "manic"?  Well, no, technically not; but they could be "hypomanic".  I wrote a whole website about that, if you haven't seen it yet (Bipolar II section, www.psycheducation.org).  You might want to read it just as a general primer on what your son should know about medication approaches/options. 

As for you, you could try adding a tiny dose of a mood stabilizer and track what happens to those sleep changes.  If it seems like the right general direction, perhaps eventually you'd end up on a mood stabilizer and no antidepressant.  You are functioning, as opposed to your son; so you have the luxury of trying low doses of something and judging the "correctness" of that direction by whether you actually see some benefit!  Good luck with that, and with helping your son. 

Dr. Phelps


Published March, 2001