Dear Ms. T' --
Guessing, I'd suppose that from 4 years ago until 2 years ago when these new
symptoms showed up, your mood symptoms were not perfectly controlled -- you'd
still have some "ups and downs", just not as dramatic as before
(presuming, obviously, that when you got that diagnosis you also got treatment
for it).
Under those circumstances I would presume that
your new symptoms are from the bipolar disorder, all right (but of course you'd
need to talk with your doctor about that to make sure she/he is also thinking
this way; and that your thyroid has been checked, whether you're on lithium or
not; and that other possible causes based on information we don't have here are
also considered (e.g. how old you are; any alcohol around?; other neurologic
symptoms; that kind of thing).
In other words, yes, I think these symptoms can
indeed be part of bipolar disorder (and sometimes its treatment as well, though
that's always hard to sort out).
You might find it encouraging to hear that one
of my patients who used to be a whiz at math, could play with numbers in her
head during a meeting and come up with the answer before somebody got it out of
the calculator, who had lost that ability entirely as her symptoms continued
only partially controlled, told me the other day "it's back!" -- her
math abilities had returned, quite suddenly, after about 4 months on a new
medication that had dramatically reduced her symptoms, basically to zero -- and
I think that may be pretty key, though it also raises the potential for serious
goose-chasing since about 1/3 of patients, according to a recent study, have
continued symptoms even under treatment at university medical centers. So the
bottom line, in my view, is "keep trying to reduce symptoms to zero, but
don't do so with the absolute expectation that this is possible, as for some
people the end-point is a choice about how many side effects they're willing to
endure in the name of getting symptoms reduced yet further". Or something
like that in fewer words....
Dr. Phelps
Published December, 2003