Are These Symptoms Part of a Mood Disorder?
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Q:  Are These Symptoms Part of a Mood Disorder?

I was diagnosed with bipolar depression 4 years ago. I suffered from the typical ups and downs Then two years ago I started suffering from new symptoms. It is like as if my brain has become smaller I am no longer able to take things in, to process them, to retain them. I used to be very creative and I no longer have any ideas coming into my head. I have lost my imagination and am no longer very good with young children. I have lost my capacity to being creative. I can no longer make people laugh (I used to have a really sharp wit) I am hopeless in social situations (I can't think of anything to say) In your opinion are these symptoms part of a mood disorder? or is this something else. I need to know as I am no longer functioning in any aspect of my life.



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


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