Think I might have bipolar II

[timB]

Hi,
I've always suffered from periods of quite deep depression (suicidal thoughts, struggling to concentrate, light self harm etc) interspersed with phases of fairly manic productive activity. Before Xmas the depression got so bad that I finally went to the GP for help (only took me 30 years...) and was put on Citaolpram (an SSRI) for the depression. Well all I can say is I reacted badly and it made things 10 times worse than they were before, mood swings all over the place, constant suicidal thoughts (I've done a lot of planning...). I initially went through it as I'd read a lot about side effects of SSRI's and figured these were just mine and that in 4-6 weeks I'd see some benefit. Basically the mood swings etc have never stopped, the GP dropped the dose to 10mg which improved things temporarily but they just started getting worse again. After seeing her yesterday I've now gone cold-turkey with a view to switching to a MOAI type anti-depressant in a week or so if the depression is still there.

Having done some reading last night it looks like my adverse reaction is fairly typical of bipolar II/cyclothymia (I'm not sure quite what the difference between the two is or if they're the same thing) to antidepressants without a mood stabiliser.

I realise the diagnosis of bipolar is difficult as it requires symptoms over time but given some of my manic up and down behaviour I suspect I probably would fit the diagnosis despite the fact I've always managed to remain functional, turn up for work etc.

I'm now worried about switching to a MOAI as I suspect that will have similar effects to the SSRI (although my depression does seem to fit the atypical symptoms which MOAI's are supposed to be more effective against).

I guess my questions are:

Should I be worried about going onto a MOAI?
How would I go about being diagnosed with bipolar (I'm not after the fashion badge, it'd just be nice to know I'm not the only one who's life is lived in the shadow of this unpredictable madness)? I'm reluctant just to ask for a mood stabiliser without a proper diagnosis.

Thanks,
Tim

 

[emski]

Hello Tim

It is my understanding that SSRIs can sometimes cause hypomanic/manic reactions in some people in general. They can also and very often do cause the reaction in people with a formal diagnosis of any type of bipolar affective disorder. In fact they, and related newer anti-depressants, are contra-indicated in anyone in a manic phase.

In my experience, having a bipolar diagnosis for 2 years but MH problems for 12, I have never been able to tolerate any type of antidepressant with the sole exception of mirtazapine.

However, the older anti-depressants MAOIs and tricyclics can also cause similar reactions and are contraindicated in manic phase. There are also lots of things you can't eat on MAOIs and you have to be careful.

That said, you could be fine with another type pf anti-depressant. Don't forget, lithium is a mood stabiliser not just used in bipolar but also in recurrent depression, but that again is not without it cautions. If it was me in this position, I wouldn't go on another anti-depressant without at least first having a screening with the doctor for bipolar/cyclothymia.

Hope this helps