What has Thrown Me into This Tailspin...
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Q:  What has Thrown Me into This Tailspin...


Hi,
I have never been diagnosed with BP disorder. My father and a brother had BP11.  I have been treated for depression and anxiety since 1989. This came out of the blue and knocked me down back then. I have never recovered. My anxiety levels stay so high! I am completely irritable and grumpy all of the time. I never want to do anything or feel up to anything. Last February I began having a lot of muscular pain and was placed on Neurontin by a pdoc. I was already on Zoloft. Last April I attempted suicide and was put into a great institute in Ga. There I was placed on Serzone, Buspar and Wellbutrin in addition to the Neurontin. The Pdoc at the intitute wanted to take me off the Neurontin but left it there for pain killing purposes. I stopped the Serzone in December because I am sick of all these meds. I went from one med to 5!
The problem is that I tried to get off the Neurontin in December of last year. I think the Neurontin is making me worse emotionally. Although the Neurontin was tapered off over several weeks the minute the Neurontin was stopped I started itching. I itched severely for 3 solid weeks. I could not sleep and my anxiety level skyrocketed because of the itching. The minute I took the Neurontin even at a dose of 300 mg when I was on 2400 mg before, the itching stopped. needless to say my new Pdoc (I moved) wants to keep me on it now. He thinks the itching was anxiety! Well I have had anxiety for many, many years and never had that happen before. Basically, I feel overmedicated, high, my short term memory is shot, my anxiety level is very high, I am constantly irritable. I go from no energy, lethargic, depressed to fast talking, a high feeling, depersonalization, then sometimes, rarely, I feel "normal".  Does you see anything here in my post that would appear to be a problem? I don't know if my dx is incorrect. When I was in the hospital last year my dx went to Anxiety, Major Depression, PTSD, DID, OCD and Personality Disorder NOS. I had anxiety and depression since 1989.  Klonopin is the only med that ever really helped me and I was taken off it due to the addictive properties.  No Pdoc has mentioned putting me back on it. I know something is bad wrong. My meds are wrong or something. I was nowhere near this condition before the Neurontin, Wellbutrin, Buspar combo. I believe that was what made me suicidal. My anxiety had become unbearable. I stress out over the least little thing!
Thanks for your reponse


My brother was Bipolar and committed suicide.  I was absolutely "normal" until taking a flu vaccine in October 1989.  I immediately became ill.  Vomiting, diarrhea, uncontrollable shaking and spasms and severe mania and anxiety.  This continued for 5-6 weeks.  The illness was basically undiagnosed so they assumed it was an allergic reaction to the flu shot. I got over that part of it. 

In January 1990, I was due to board a plane and for no apparent reason began having a major panic attack.  I flew all the time but I just knew that if I got on that plane I would die.  This attack lasted for hours.  No further attacks came until 04/1990.

I was driving home from work one day and started losing vision in my eyes and just felt cognitively deficient. I pulled over and my hands became numb.  My thought process was all messed up.  I tried to right a note and although my brain knew what it wanted to say my hand could not write it.  Same with speech and it was slurred.  Was examined for stroke, migraines, etc with a clean bill of health.  Doc said COULD be TIAs.  This never happened again.

Later on in the year the inability to concentrate and feelings of euphoria or rather depersonalization began.  I could not drive because I could not keep my mind on the road. I was floating. 

In December 1991 I began having major panic attacks. Could not breath, feelings of impending death, the whole shebang.  This led me to become agoraphobic because when I was not having the attacks I was having anticipatory fear.  I was in therapy forever.  finally in Feb 1992, I gave up and went to a doc.  I was placed on klonopin.  This med helped my anxiety remarkedbly.  I got out more over a period of time but never became my old self again.  I still barely drive and have not flown at all.  In 1995 I moved and my new doc took me off Klonopin because of the addictive properties and put me on Paxil.  The problems began.  I was then switched to Zolfot.   The anxiety was under some control and the depression was better.  My husband died in 1996 which threw me in a tailspin. 

In jan 2000, I was dx with Fibromyalgia and again was switched back to paxil and traezedone.  Mood swings galore.  Switched back to Zoloft.  pain became so bad from Fibro that I stayed in bed for 2 weeks.  Pdoc put me on Neurontin In March 2000.  I was hospitalized in 04/00 for attempted suicide.  I have not stabilized since.

In December I tried to come off Neurontin (my other posts tells about this one).  I was given a cortisone injection and thought for 2 days that I would die.  I was not manic but very depressed.  I could not get up.  I was floating in an alternate reality where death was certain.

OK so bottom line is.  I am not well.  I have had some major life stressors, Mom and Dad died, brother committed suicide, brother died of cancer, husband died of cancer, but the Anxiety attacks were the first sign of any illness.  I have always been treated for depression and anxiety.

What has thrown me into this tailspin that I can not recover from?

Thanks so much.  I know this is a lot of history but I am hoping it will help.  I have all new docs now because I moved.  Mine is a "5 minute" psychiatrist and does not listen to me.
 


Dear Ms. F' -- 

First, let's try to help you and your doc's figure out if you might have a bipolar condition going on underneath all these symptoms.  Read the diagnosis section of my website on bipolar disorder and take the Mood Disorders Questionnaire you'll find there at the end of that section.  Print the MDQ (you can get a fresh one here) and take that to your doc.  If it's "positive" for bipolar disorder, then you could ask that the diagnosis be considered and that your treatment go accordingly (you are suspecting this diagnosis, perhaps, having written here).  You might also want to read the section on borderline personality disorder and bipolar disorder, in case that was a label that has been invoked for you as well.  

If you do indeed have bipolar disorder, if we were somehow able to "know" that in some perfect way (someday we'll have a "lab test" for this condition, but even then, it will have it's false positives and false negatives), then you would probably find your treatment guided in a different direction, relying on mood stabilizers and being very cautious about antidepressants.  If you did indeed have bipolar disorder, that would -- i.e. you would have been right -- explain why some of the medications you have taken seemed to have made things worse.  Neurontin can act much like an antidepressant in that respect.  Sometimes it must be tapered extremely slowly, like 100 mg steps every week or even more slowly sometimes.  Klonopin can be very useful in treating some versions of bipolar disorder and if it is understood that the dose will never go above 3 mg per day, you can get some doc's to go along with that -- just emphasize that you understand the "addictive potential" and that you will take responsibility for handling that part (if you have a big history of problems with alcohol, this is not such a hot idea, but could still be considered under some circumstances).  

Good luck with the process; it can be slow with a doc' you see so briefly, but it can be done.  

Dr. Phelps


Published August, 2002

 

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