Can BP Hide Out in a Different Form like Panic Disorder...?
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Q:  Can BP Hide Out in a Different Form like Panic Disorder...?


In 1988 I was dx with panic disorder and have been taking Clonazepam 1mg twice a day since and it's worked. There have been periods of time when I have felt over anxious but got over. About a month ago I started itching all over my body and put up with it for three weeks then ended up at the ER and they treated me for the symptom. A shot of cortizone and dose pack of prednizone. I followed up with my M.D. and he prescribed wellbutrin. Shortly after I ended up in what my friends tell me was a manic state. Several days later I was unable to work due to sever depression. He took me off wellbutrin and prescribed depakote 250mg twice daily. My depression is better but my itching has retured. My doc had me take the questionaire posted on this page and hedx is that I'm bipolar. My mothers sister is bipolar. Can bipolar hide out in a different form like panic disorder and then appear in short order like this? It knocked me in the dirt quickly. I was going to see a Phd. as soon as I can get an appointment or should I trust my M.D.? And this itching has got to go. Is there a relationship to the wellbutrin and my phases of mania/depression? If so what is it. Because as soon as I stopped the wellbutrin and started the depakote I got to feeling better. Any suggestions on the itching?
Thanks


Dear Ms. M' --
You ask some very good questions for the situation you've found yourself in. Let's look at one at a time.

1. Can bipolar hide out in a different form like panic disorder and then appear in short order like this?
The simple answer is yes. For a bit more complex discussion of whether the panic episodes were a "co-occurring condition" or actually part of bipolar disorder, which is very tricky but may not really mean much now given the current diagnosis, read about
Anxiety as a Bipolar Symptom.

2. I was going to see a Phd. as soon as I can get an appointment or should I trust my M.D.?
Again, "yes". Both could be helpful. See the new data on
Psychotherapy for Bipolar disorder -- if you can find a Ph.D. who is familiar with one of these methods. She/he can also help you decide whether you should really accept this bipolar II diagnosis, without which acceptance, it's hard to proceed with the medications from the MD (the MD could do this step too, but may not have the time to do it well; my website section on BPII, in the section about diagnosis, might help some there too).

3. Is there a relationship to the wellbutrin and my phases of mania/depression?
Yes again, most likely. We can never know these things for sure. But antidepressants are well-known to sometimes induce manic symptoms, and manic phases are commonly followed by depressive phases (perhaps increased in that respect by Wellbutrin being removed, though most psychiatrists would probably agree that was a good move by the doc'). Glad to hear the Depakote helped, by comparison, even at a very low dose.

4. Any suggestions on the itching?
Uh, for symmetry purposes it would nice to say "yes", of course; but I'm not sure what that is. Once in a while I see people with itching as part of an anxiety symptom set, so it could be something that goes with the anxiety. But it could be unrelated, as this is not very common in bipolar disorder anyway. Sorry.

Dr. Phelps


Published November, 2003 

 

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