Manic Depression and meds, how good are they?

In My Humble Opinion
1

Pretty sure I am bipolar. I go for a week or two with a lot of energy, then basically don’t want to see anyone for a week or so.

Anyone with any experience with the medications that are commonly prescribed? I am not that dissatisfied with my life, although I have never held a straight job for more than a couple of years at a time. I get a lot done in both phases, just different things. When I am all energized I move mountains, when I go it to the depressed phase I tend to retire to my room and take care of sedentary things, surf the web, play video games etc. So it isn’t killing me.

But sometimes I wonder what it would be like to be on a more even keel. I just fear that these meds will take away what makes me me and make me boring and blah.

Anyone with any experience with these meds care to comment? Thanks!

2

I’ve just come off Zoloft. I have a confirmed diagnosis of PreMenstural Dysphoria Disorder, and my doctors were considering whether I was bipolar.

To start with the Zoloft was a godsend. It not only allowed me to stop feeling so funky and down, it gave me breathing space to recognise when those feelings were brewing and to try and head them off.

I didn’t have any of the side effects like anorgasmia, but I did start developing a tolerance. My dose was set to be increased again recently, just before I came off of it.

Since coming off of it I’ve noticed that the highs are higher and the lows are lower BUT the big difference it that I’m in a place mentally where I can push through the extremes and keep going, I wasn’t in that place before so they affected me in a worse way.

The meds didn’t take away what made me, Me. I still was the same person. I’ll just say… I was tempered a bit. The points were filed down a bit. I was more child-safe.

3

I am on Zoloft, Depakote, and Adderall. The Depakote is for the manic bits of my ups and downs. It does work. I am acting more and more like an adult when I am manic, and I don’t have that out-of-control, Im-going-to-fly-off-into-space, I- really- have-to-clean-everything feeling. The Zoloft is for the depressed bits and works really well. The Adderall is for the ADHD that follows both those cycles and actually helps when the mood swings seem to be too much for the dosages of the other meds.

I am taking a depakote vacation though. It makes me feel sleepy, sluggish, and I have a hard time with motivation.

4

I’m not bipolar, but I’ve been on mood stabilizers, including Depakote. The best way I can describe it is, it’s like being on a tether. You can still float up and down, but not too high and not too low.

5

I am close with a person with bipolar disorder. From my viewpoint the meds are literally a lifesaver. A person should also work with a therapist to help develop coping mechanisms. There are a number of possible medicines and combinations of same, and they seem to me to be very challenging to get into the best possible balance. A doctor specializing in psychopharmacology should be consulted regularly if at all possible.

6

My husband has Bipolar II. He takes Depakote and Paxil, and it works wonders. He still cycles a little…works like crazy for a few days, then crashes for an afternoon. But it’s not like it was before…his depressive states consist of a good long nap instead of a crying jag about his horrible life, and his manic stages are working a little bit of overtime to get that project done and do some work on his own fledgling business instead of staying up two nights straight to do whatever he’s passionate about at the moment.

I will say though…sometimes it can take awhile to get the meds right. My husband had to go through a few different combinations to get a good result. So hang in there and trust the process.

7

50mg of Zoloft here, and this is an excellent description. I had the same opinion as you initially. “Oh noes! I won’t be the same person!” Honestly, it’s total crap.

For me, at least, the change has been all positive, no negative. For the first week or so, I had trouble sleeping and had a little nausea, but after that, it has been fantastic. I am not exaggerating when I say it has been life-changing.

8

I’ve known bi-polar people who do extremely well with their meds. The key is consistency, always taking them and working with your doctor. As you age, your body is going to go through changes and respond differently to the meds. So what med works at age 25 may not at age 30. Or dosages of meds may have to be lowered or increased.

You have to remember if you’re bipolar you have an actual physical illness. And just like with diabetes or epilepsy or any other life long condition you must be on top of it every day. Yeah it’s a pain in the butt, but you have to do it.

Lastly you need a good relationship with your doctor and therapist. The meds help but you have to have a counselor of some sorts and a group too. I’m not saying you need to even go regularly but you must be in communication with an outside, who is objective that can tell if your meds are not helping you appropriately. It needs to be an outsider as family and friends are too close to you, to give objective data.

Even if you’re not bipolar it sounds like the OP has issues. We all do and NOW is the time to get help. Not tomorrow but NOW. If you’re in the USA and can’t afford mental health treatment, go to the website of your county in your state and look for mental health.

Counties often have sliding fee scales or referrals to such. You need to do this now as there are lists to get into to see counselors and doctors who deal with sliding fees and the public. If you call today, it could be two months before your first appointment. So you need to get on that list ASAP.

There may be nothing wrong with you, or there might be, but if you think there is, why not at least get checked out so you can make an informed decision. Like any illness from diabetes to heart disease or asthma or whatever, it’s always 100% easier to treat it and deal with it when it’s not in crisis mode.

Good luck

9

To reiterate, if you think you have bipolar like symptoms, make an appointment with a psychiatrist. If you need a referral, get one through your primary care provider.
Another point: antidepressants, like Zoloft or Lexapro or other SSRI (selective serotonin reuptake inhibitors) are NOT good monotreatment therapies for bipolar. They can actually spark a manic episode, so they are not what we call mood stabilizers. Most common mood stabilizers are lithium and Depakote (valproic acid). They work very differently from the common SSRIs, and have a different profile of side effects, although some of the symptoms can overlap.
So if you talk to a psychiatrist or your PCP, let them know all your symptoms, because if you’ve had any manic episodes, it requires a very different treatment from major depressive disorder (MDD).

10

If you’re concerned, get help. Simple as that. Don’t self-diagnose and don’t self-medicate.

That said, since this is IMHO, I’ll share my experience as a cautionary tale. A sample of one is never representative, obviously, so make of this what you will.

Through my life I’ve been variously diagnosed as major depressive disorder and bipolar (I forget which subtype). The latest was a bipolar “episode” (I dunno what the medical term is) that happened about two years ago. I sought help and was put on one common antidepressant first (sorry, I forget which. I can check my records later if it matters). It led to wild mood swings and involuntary muscle twitches and periods where I’d basically lie emotionally incapacitated on a couch all day, twitch randomly and alternately cry my ass off and laugh about how ridiculous I was being.

After a month or two, I asked for different medication and was switched to Depakote + Abilify. Though my moods stabilized, my emotional range became so narrow that I felt numb and dead all day and mentally… subdued, like there was a constant emotional haze that followed me and wouldn’t allow me to be human. It also severely impacted sexual function (couldn’t orgasm) and all in all I become very frustrated and severely depressed, though less manic.

Ironically, the emotional deadness led me to want to deaden it even further so I wouldn’t feel the emptiness. It eventually (few weeks) led to an alcoholic binge and I started taking the pills first by the couple and then by the handful and within a few weeks it led to a suicide attempt where I took all the remaining pills at once and chased them down with everything else in the medicine cabinet and god knows how much alcohol.

I never felt such loss of self-control, helplessness, or agitated confusion as I did during those few months – though I’ve never been what you’d call emotionally stable, the madness during that time was easily three times worse than any time before or since.

After the suicide attempt, I swore off synthetic drugs and have not had have any serious incidents since. In the years after, running and yoga helped MUCH, much more than the drugs ever did. I would likely try talk therapy again if I felt I needed it in the future, but not the drugs.

Not to get all hippie-acupuncture-meditator on you, but the most important thing I learned from that experience is that my happiness and sanity is a much more holistic experience than any of the shrinks suggested; an exercise routine and good friends were far more valuable than prescriptions.

11

Honestly, i’ve never understood the fear that people have around their personality changing due to psych meds. Physical side-effects I understand, but the reality is that mental illness kind of is a personality problem, in that it is driven by unhelpful cognitions and behaviors. If doping yourself up makes you into a happier and more likeable person, but maybe different than you were before, so what? Since starting back on depression meds I’ve become a little more hyper and giggly than usual, I’m a little more full of myself, I actually look strangers in the eye when I’m talking to them (even cute strangers) and people seem to like me more because my humor shines through what used to be an insecure and timid exterior persona. (I’m not implying the depression meds are a panacea - I still have severe depression, but the times I’m not depressed, I am much more vibrant and alive, and when I am suffering acutely, I’m more likely to figure out a way back to good.) I have no use for that other personality which drains me and others of energy all the time. Change my name, whatever, I don’t care. I like this person better.

12

I’ve been on meds for about four years now and, while they take some managing, they can be literally a life saver. Simply put, bipolar is a chemical imbalance. I’m on Effexor, Saphris, and Lamictal now. And I just started Lithium with the intent to drop the Lamictal as soon as the transition is complete. What meds work for you will depend on your own body. At 5 mg Saphris is great for me, but the minute I went up to 7.5 mg I had serious memory issues. As soon as I went back down to 5 mg I was fine. Others don’t work at all. I tried a small dose of Risperdal when I was in the hospital and immediately started acting like I was drunk. I couldn’t even stand! They had to put me in a wheel chair. It’s all very fine adjustments that take place over months. It’s a big commitment but I couldn’t live without them.

If you are feeling down (or up) you should talk to a therapist. They might be able to give you a better idea as to if talking to a psychiatrist is right for you.

13

Because most peoples’ sense of self is sacred. It’s possible to recognise your Self is broken, and still be afraid of losing that person. The other problem too is that for someone facing medication the first time, they don’t know what sort of person they’ll turn into.

A hallmark of bipolar behaviours and one of the things that makes it hard to maintain treatment is that people who are truly bipolar often LOVE themselves when they’re in a manic phase. They hate the depressive persona, but their manic persona is the best thing since sliced bread. It’s creative, active, gregarious - everything they wish they could be all the time. And they’re afraid that in medicating to get rid of what they see as the ‘negatives’, they’ll lose that awesome person that they get to be on their upswings.

I personally found that medicating made me much more even, but it also made me more prone to just accept things that probably weren’t right for me, because it made me afraid of things that did make me feel an extreme of emotion in either direction. Hence part of why I’m now trying alternate coping strategies.

14

Go talk to a doctor.

You don’t sound like a couple of people I’ve known diagnosed with bipolar disorder, or like any anecdotes I’ve heard. You sound like lots of people I know that run hot and cold in cycles. You don’t sound like you’re hitting either one of the extremes associated with BD. The symptoms you described are also commonly heard from people with depression, anxiety, and ADD. Just go see a doctor.

Personally I think you take drugs when you’ve got a real problem that can’t be resolved otherwise, but that’s your choice. Drugs could work wonderfully for some people. But sometimes, even when they are the best solution available, they are less than optimal. You wouldn’t want problems related to drugs to exceed the original problem you took the drugs to help.

Anyway, good luck. Talk to a doctor.

15

This explains why I didn’t want to jump on the pharmaceutical choo-choo train. Even if you absolutely despise yourself, at least you are the devil you know. The devil you DON’T know could be worse. And it would be a mistake to gloss over the possibility that drugs can indeed make you worse. I have been on meds that have made me an irritable bitch because they kept me from going to sleep. So not only where they not helping me with my troubles, they were making me mean, which made me feel guilty, which made me hate myself even more. So changing-personality fear is an understandable worry IMHO.

Stan, if you do start meds, don’t be afraid to do some research before popping pills. I’m not saying be all anxious about it. Just be prepared. You may get prescribed Abilify, for instance. It works well for many people, so I’m not going to bash it. But just know that it will likely cause the most horrible constipation ever. So get used to drinking prune juice every day (or night) and get a good toilet plunger. I had other side effects from the drug (like blurred vision…which I really hated), but constipation was the worse one. Even at the low dose that I was taking, it eventually started triggering involuntary mouth movements–a big red flag of badness–so I got off it with a quickness. But it did help some of my manic-like restlessness. If any drug starts causing involuntary movements, especially in the mouth and face, you need to call the doctor and let them know ASAP.

Since it takes awhile for drugs to kick in, you might have to suffer from the side-effects for awhile before seeing the benefits. Unless they are intolerable–and only you can be the judge of that–try to stick with the drug before giving up on it. I know, that’s harder said than done. I don’t think I’m a wuss and I’ve been able to stomach some really bad side effects. But daytime and early evening sleepiness were intolerable to me because they reduced my life to sleeping and zombiness. After a month and a half of that, I was like “nuh-uh.” Other people might find that stupid, though, and yell at me for giving up too soon. Oh well. Those same people might find weight gain to be intolerable, though. I’ve never experienced that on any drug I’ve been on, even though it’s always been on the “list” of potential side effects. So you never know what you’re gonna get. And you never know how tough or weak you’ll be when confronted with them, either.

That said, drugs have a long list of side effects associated with them. Chances are you will experience a couple of them for a couple of weeks and then they will go away. Don’t let the long list scare you off. But like I said, don’t be caught unprepared either. Always try to take a new med over a weekend (preferably a long one) so that you can deal with the first few days of side effects without also juggling work responsibilities at the same time.

Good luck to you. I know how discomfiting it feels to suspect that something’s not quite right, but knowing that going to the doctor is launching yourself into a major project. But it does get better. It sounds like you have a mild form of it, if you do have it, so perhaps only a low dose of whatever is called for. Let’s hope.

16

Most medication dampens the manic. That’s what it’s supposed to do. Try telling that to someone who’s in manic mode and they’ll likely tell you to jump out the window…or something to that effect.

I once had a close friend who deliberately didn’t take his meds for years exactly because of the reasons you described. It was a nightmare being around him when he was in full-throttle mania. He was complusive everything – gambling, sex, spending $, driving 90 mph down the highway, you name it. And god forbid if you tried stopping him :eek:

He attempted suicide a number of times when he swung to the depressive end.

He’s finally on meds now. He hated them at first because he gained a ton of weight, but as time went on, he truly began appreciating how much they quieted his brain chemistry. Oh, he still has llittle blips here and there, but nothing like he was pre-med.

17

Oh of course it’s what it’s supposed to do. But yeah, in a manic phase most bipolars will tell you precisely where you can shove your meds. And for someone who hasn’t been on meds at all before, often their mind goes to the darkest place possible. They don’t see HOW they can be the same person if all the edges are taken off their personality.

18

Yeah, I thought about that after I posted, and I can imagine that people who experience mania would experience a pretty profound sense of loss. I had a friend who was bipolar who struggled with meds for precisely the reasons you mention. I am fascinated by the concept of mania because it is so far removed from my every day experience that I really am not sure I could blame anyone for wanting to hang onto that, no matter how destructive a force it is in their lives.

I agree that the OP does not sound bipolar. It could be unipolar depression. There was a time when I thought I might be hypomanic (Bipolar II), because there were periods of time where I could be productive and energetic and kind of liked myself. It turns out that weird ‘‘energetic’’ person was who I am when I’m not depressed. I was mistaking ‘‘not depressed’’ for mania because I had never experienced life without depression. Sort of like I now ask my husband all the time if I’m becoming narcissistic, and he replies, ‘‘No, that’s called self-confidence.’’ It takes some getting used to.

Absolutely they can, and I didn’t mean to imply otherwise. My initial experience with meds, years ago, was pretty nightmarish, because I am really sensitive to side-effects. We tried like 13 different drugs in two years; it was often worse than the original problem they were trying to treat.

But that doesn’t mean people who are really suffering shouldn’t consider giving them a shot. It’s not like it’s an irreversible decision. If you don’t like who you are when you take them, you can take different ones, or none at all.

19

You make a good point, it can be very easy for the significantly depressed to think they’re bipolar, in reality what they are is depressed with occasional moments of lucidity. And in that instance I can see where the fear of the medications isn’t as profound. After all, they make you feel good.

Personally I don’t think I’m bipolar, if only because my ‘up’ phases don’t seem to reach the heights of true mania. But it was a concern for me, and I was afraid that medications would numb me so far that I couldn’t feel anything.

20

I didn’t really mean to make anyone feel bad for their personal concerns about medication. I think every individual has to make their own informed decision as far as that goes. Just offering another perspective, I guess. I actually know quite a few people who are bipolar (including my late uncle, who killed himself), and the ones who are medicated consistently seem to do far better than those who are not. In fact, one of my closest friends is bipolar and I routinely forget that fact because he has been medicated consistently for years. I’m not an expert, but bipolar seems to be similar to schizophrenia in that 1) it is extremely biological vs. environmental, and adequate treatment is therefore heavily dependent on proper medication and 2) treatment is a lifetime commitment. It sounds like a truly shitty thing to have to deal with.

As for the OP, I think asking about bipolar meds may be jumping the gun before even receiving a diagnosis. The best thing would be to see a psychologist, get a proper diagnosis and then learn about treatment options.