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10/05/2010 04:54 PM

What to believe?!?

Posts: 422

Since being diagnosed, I have pretty much read everything I can get my hands on.. and of course searched the web, and also read many of the posts here, and my conclusion is that it is a wonder that ANY of us do well at all with this disease. Why??? because there is absolutely NO consensus between doctors treating BP2.

Here are a few examples...

One of the first things I read about (in Phelp's book) is that one of the worst things you can give someone with BP2 is an anti-depressent. it only should be given as an additional med, to get you over the initial depression.. mood stabalizers are to be the main drug.. Yet I have read many folks here who are only on anti-depressants.. so who is right?

Also we've all heard people who say BP gets worse with age.. but then you also here that it doesn't get worse with age.

The definitions of "rapid cycling" are all over the board too. some doctors don't even believe that a person can cycle up and down several times in a single day.. well.. I can, and HAVE and my doctor has seen it for his own eyes in his office...

Also, one of the things I've read about the difference between bp1 and bp2 is that people with bp2 can still function, even during their hypomanic phases.. yet, I read about alot of folks who have BP2, that are on disability and can't work because of the BP.

Also with medications... I was told by my doctor that you weren't even on a therapuetic dose of lamictal until you reached at least 200 mgs.. and yet lots of people here take MUCH less than that, and seem to do ok...

My suspicion is that nobody really is sure about this disease... and there is no formula, or constant... there is no "typical BP2"... I almost suspect that there are HUNDREDS of different forms of bp, that all need to be diagnosed and treated differently.. but they lump us all under 4 catagories, and none of them is adequate..

Anyway... I guess that was a bit of a rant... but, for someone, like me, who wants to have a clear understanding of my illness, and have a clear plan for fixing things.. it can be frustrating when everyone has different opinons, and different experiences... and I don't know about you all, but I am not feeling very pleased, or secure about using my body, and my mind as a guinee pig, to experiment with a variety of drugs, and sometimes 10+ different meds... that makes me very uncomfortable.. I guess I really admire and respect many of you long timers who have endured through all of this crap... Smile


10/05/2010 09:11 PM
Posts: 16692
Group Leader
I'm an Advocate

There is a lot of different stories that are said on the board. People are told different things I guess. It is confusing in the least. I take an antidepressant because I was depressed, but I also take a mood stabilizer. As long as you take one of those it's alright to take an antidepressant. Without a mood stabilizer it can push you into mania. I've heard the same thing as misshildy on the difference between bipolar 1 and 2 regarding 1 having full blown manic and 2 just hypo-mania. Medications, well everyone reacts differently to them. It's all trial and error. I hope you come to understand a little better. It really is confusing, but it's all about how you are and what you respond to. You do make it to stability though. I have reached stability and it's nice to not be pushed to extreme ups and downs. I hope you get your answers. Welcome to the group by the way. I hope you like it here. I love it. You get a lot of support.

10/05/2010 09:42 PM
Posts: 2012
Senior Member


Ditto what Joy and Miss Hildy said. One thing I wanted to bring up is that there are also many people w/bp who have additional psyche conditions and this can cloud the lines somewhat as far as how and what they are treated with. I have treatment resistant depression and it is part of bp2, so I am still given anti-d's but also a mood stabilizer etc. Anything, anything at all, that you are not sure about, ask your pdoc.

We are all here telling you our personal story, and that may not resemble what your treatment will be at all.

I have read that bp does get worse with age, but also read it doesn't. All I can tell you is from personal experience, the half dozen or so people that I know personally, have all had milder symptoms as they got older, 50+. But this is also a question you might want clarified by your pdoc.

The most important relationship you are going to have is with your pdoc. So jot down questions as they come to mind and then bring them up in session.

As far as meds go, pharmaceuticals have come a long way just in the last 10 years or so. There are an abundance of meds on the market, where not long ago you had a choice between x, y or z. This is part of the reason why you'll see such diversity in treatment also.

I know what you mean about being concerned about taking too many meds. Before I aquired fibro and chronic fatigue, the most I took was a Tylenol a couple times a year. Now between fibro and bp2, well I'm not thrilled with the meds, but I know that, for me, life is better with them. My major concern was looking like someone who's overdrugged in a stupor.

Be vigilant and proactive, which I can tell you are, and develop a reltionship w/your pdoc. You will be ok even though you're scared.

Write to us anytime and vent, ask questions etc.


10/08/2010 04:38 PM
Posts: 3311
Senior Member

10/09/2010 05:52 AM
Posts: 7506
Group Leader
I'm an Advocate

I felt the same way and even wondered if the docs were a bunch of quacks and didn't have any idea what they were doing. I fought the diagnosis tooth and nail and totally denied it. Well I fired my pdoc because he was just a pill pusher. I eventually found one that wasn't a pill pusher and she did not have his records.

Her conclusion over time is I have BPII.

Being the third pdoc to tell me this I finally had to come to terms with it.

All I can say is that after enduring all the med changes, the highs & lows and the total freak outs, I'm much better off than I was 6 years ago. I don't want to kill myself anymore, I still have my down times but nothing like it was.

I agree that there seems to be an abundance of BPII diagnosis with tons of variations but in the end its really about being stable and being able to live some kind of life without extremes.

For me I'm at the point where they can label me anything they want as long as I can get the meds I need to be stable.

10/09/2010 06:06 AM
Posts: 607

hey willowisp,

i've observed the same thing about contradictory information about bp. big, decades-long longitudinal studies are very expensive and difficult to administer and there seems to be a dearth of them in bipolar study - which goes some way to explaining the lack of certainty out there about this condition.

my pdoc said that he thought, in the future brain imaging technique will be able to parse one "form" of bipolar from another which will inform prognoses and prompt different treatment modalities. in the mean time, he said, we have these big unwealdy categories of bipolar I & II which contain significant variances within them just as they do between them.

in terms of that big prognosis question: i suppose i'm glad there appears to be a lack of consensus around the 'kindling' theory of bipolar worsening. better for it to be a known unknown than a known known really Smile

there seem to be tremendous variances in this illness. some people remaining episode-free, symptom-free and high functioning for many years...other's relapsing often with their mooods and functioning frequently poor.

i'd like to see some studies which compensated for a) substance abuse b) non-compliance with medication as triggers for relapse. it'd be good to know what the percentages looked like once these avoidable triggers were removed from the study.

Post edited by: bennyw, at: 10/09/2010 06:07 AM


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