What Could My Illness Be?
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Q:  What Could My Illness Be?

i was wondering if you could help me figure out in a general idea what some of the illness i might have. i do not believe i am bi-polar since unless im takin paxil i could careless about anything unless it interfers with my plans then ill kill it. no less. i have a uncontrolled, spontanous, viciuos temper which has increased after i stop taking my antidepressents. i for the most part dont trust my doctors due to the fact that after many visits they have dont nothing to help me but give me some medicine which i do not believe solves my problem. i started paxil.  it simple made me euphoric and placed me into a constant manic state. i visited a doctor when my supply ran out and he gave me some exphoxor (im not sure how to spell it(sounds like effector with an x in it)) this simply made me a very angry, tempermental, and hyperactive indvidual. not a good combination in a 16 year old. after 2 weeks on this drug i ended up getting angry about something and burnt a rose design into my forearm leaving all 3rd degree burns.(yeah its pretty messed up i know) after that incident i stopped that drug and returned to paxil and double my dosiage and was forced into consulling. now my consullor is telling me bi-polar only applies to mood swings or extended time (every 2-3 months) i personally think hes full of it ad cant see how he or any consullor could help at all. just recently i stopped taking paxil because i didnt like the manic effect and now am uncontrollably angry. the consullor also told me i try to act like a sociopath which i dont understand how i "try" to act like a sociopath. i found a site listing some charactoristics of a sociopath and meet all of them. everyone tells me im full of it but i dont really know waht to do. ive tried to see a phychitrist but where i live just about everyone has mental issues so he cant see until a month or so if not longer. im really messed up and dont know what to do about it. thank you for taking the time to answer this if you do. i apprecitate it.

Dear Steven -- 
If you take "uncontrollable" anger, and getting worse with Effexor, and getting "manic" on Paxil; and self-harm behavior, which can be seen in bipolar disorder; and maybe getting worse after stopping Paxil quickly, which we also see in bipolar disorder -- all that can be bipolar, all right.  And bipolar disorder can cause people to act like "antisocial personality disorder".  Now, of course you could just "have" antisocial personality disorder and an anger problem.  But if you did have bipolar disorder, that would be (in almost all the psychiatrist's opinion I know of) easier to treat and more likely to respond than "antisocial personality disorder".  So it's crucial not to miss that possibility.  The treatment could just be a dud, but done right it has a fairly low risk of hurting you, not too much worse than the risk from the antidepressants.  

So even though some of my colleagues (who, interestingly, don't read my website where I cite all the other national mood experts that lo and behold think like me...) think I "overdiagnose" bipolar disorder -- you're a perfect example of why I don't mind taking just that risk.  If you really have something like bipolar disorder and that does not get recognized and treated as such -- that would be a terrible shame, because the medications could really help you.  We're not talking help-a-little here, it could be a lot.  There might be more treatment after that you could use, like a good therapist someday maybe depending on how you're doing after a trial of mood stabilizers, but I'd recommend you try to get a try on things like Depakote (watch out for weight gain there, though).  Check out my site for some basics to back all this up.  

Dr. Phelps 

Published July, 2001


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