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  • Jan. 21, 2012

    Depression sometimes shifts to bipolar disorder

    By David Mrazek, M.D.

42 comments posted

Many of you have suffered with depressive episodes for many years. Others are trying to cope with your first episode. I'm impressed that it's helpful for members of this "community" to share experiences. Particularly, those of you who've been successful in learning how to manage your illness can often provide insight to others who are just beginning to learn about their depression.

Need more help?
  • National Suicide Prevention Lifeline
    1-800-273-TALK (8255)
  • Go to the nearest hospital or emergency room
  • Call your physician, health provider or clergy
  • National Alliance on Mental Illness
    www.nami.org
    1-800-950-NAMI (6264)

Over the years, it's become clear to me that there's great variability in how depression can begin. Some children struggle with depressed mood from their earliest memories and by the time they're adolescents have already become relatively sophisticated about available treatment options. Others are free of depression through their entire adult life and then suddenly come face to face with the debilitating symptoms of the illness when they're ready to retire, anticipating some relaxing, satisfying years.

Of course, there are many stories that provide interesting contrasts.  A common time to become depressed is during the college years. Another is after childbirth. Certainly the middle years of life can bring depressive symptoms for the first time after losing a job and becoming financially distressed. There's no single story.

One of the potentially confusing dimensions of dealing with depressive symptoms is the transition of what appears to be a major depressive illness to a bipolar disorder which begins with prominent depressive episodes. A common pattern is to have one or two periods of depression in the late teenage years followed by aggressive treatment for the depression and then a sudden manic or hypomanic episode.

It's believed that the biological bases of these two problems are actually quite different, but the reality is that the clinical presentation of these two illnesses can be identical. The first clue that someone is actually bipolar may not occur until two or three years after they begin seeking treatment for depression.

I suspect that it would be helpful for you to learn about the different presentations of other readers.  It might be particularly interesting if you've experienced a shift from treatment for major depression to the treatment for bipolar disorder to share both the circumstances surrounding your first manic or hypomanic episode, as well as your experience with the two quite different forms of treatment. Thanks for sharing.

42 comments posted

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  • May 5, 2012 3:56 p.m.

    This is very helpful to read. I am 37 married mom of 4. I seem to be having a depressive time of life. My husband's been out of work for 3-4 years almost continually.I find my husband is so depressed that it's contageous. I struggle w/ outbursts & loss of desire to do anything. I am a Christian so I know in Jesus I have everything I need. I trust that He provides Dr's to help us, I think @ this time my depression is long term situational. I appreciated the advice to take it easy on ourselves & just find one enjoyable thing to do/focus on. I thank God for all who are willing to share to shed some light on others situations. Peace & God bless

    - Jen

  • April 27, 2012 7:45 a.m.

    My wife had been seeing a psychitrist for several years for major depressive disorder. She had been what she thought was a "poster child" successful SSRI medicine patient...then they no longer worked. Fast forward to now, she has tested positive for chronic, late stage Lyme disease and a very compromised immune system. While many on this blog seem to have bonafied "electrical" issues, others may be interested to research the symptoms of late stage lyme and "gut" imbalances and see if your conditions may be associated with the systemic factors. We learned the hard way by trusting a psychitrist who only spent 10 minutes a week with her pushing every know anti depressant and antipsychotic never once suggesting to her that there may be other physical medical conditions to check for. God bless and good luck

    - K

  • April 26, 2012 3:19 p.m.

    Why is my doctor reluctant to give me my full assessment on my depression?

    - Vincent

  • April 25, 2012 6:30 p.m.

    thanx alott for all the info its act been a really big help to me n helps me to understand alott of what im dealing with myself.

    - amanda

  • April 22, 2012 12:16 a.m.

    i have been diagnosed with bipolar I, anti-social and border-line personality. i am 50 years old and a 2 time widow, i have lost all my friends from cancer, murder and suicide. was heavily involved in drugs and gang activity. but i am fortunate to say i am not on my medications which were depakote syraquile and geodone...not sure on the spellings, ut doing well. moved from illinois to indiana. have been clean sober and dry for the last7 years. would love to say that i had all kinds of family support, but that wasn't the case. my mother is a mean cold woman, and my son doesn't understand. but thats not their fault. i live my life very quietly, work every day, and go home i have a couple very close friends that i treasure and a job that i love even though its only factory. what saved me is being saved Jesus never gave up on me, and that is what keeps me going every day. i forgave myself owned all my mistakes and asked for forgiveness both from family and Jesus. i live healthy and try to keep any toxic people away and out of my life along with any situations that can trigger my problems.

    - patricia

  • April 10, 2012 9:37 p.m.

    43 yrs old and finally diagnosed as bipolar after years of being treated for depression. SSRIs for depression always made me hypomanic, as did Adderall and stimulant Meds. I think my breaking point was after mt second child was born. The stresss of working full time and two babies was just too much. My hormones were all wacky too. It still took over a decade after that to be properly diagnosed and treated. Part of it was because I only went to a doctor when I felt depressed and suicidal. When I was up, I never went. Ever since I was a kid I was impulsive. Mania usually is marked by spending sprees, risky behavior, promiscuity, work performance suffers and drug seeking/use. The first few weeks of mania are great: fun, productive- like a whirlwind. Then things become painful, uncomfortable, unmanageable, and I end up falling off a cliff into the deepest despair. I tried to get disability but they would not do it. The rationale is that you can work with bipolar when you are well, which is true, but how do you hold a job? How do you work when you keep having to find a new job every few months or year? I hate myself. And I hate this disease. I hate that i spend all my families money, that i end up with men who take advantage of me, that i am ridiculously confident and also so insecure at the same. Wellbutrin xl 150 mg qd, lithium carbonate capsules 300 mg bid (but I think its too low), lorazepam .5 mg prn, estrogen patch vivelle twice weekly, and progesterone 100 mg qd.

    - Monkey girl

  • April 10, 2012 9:37 p.m.

    I am bipolar and on depakote and celexa. The depakote has worked wonders but my depression is at its all time low. I don't know what to do. I am also a hoarder which seems to be getting worse. I have discussed this with my Dr. who doesn't seem to be much help. I have also tried Zoloft and Prozac, separately and together to no avail. My Dr. Is retiring soon and I will see a new Dr. So hopefully, this will be a positive change. However, my choices are limited due to medical assistance. I am 38 and have dealt with this ever since I can remember. I don't know how much longer this has to go on. I am losing hope. I have been through so much and put those I love through alot also. I want to be the best person I can. Therapy is not helping. I feel lost. I want help and change soooo much. Can keep praying I guess if all else fails. Any suggestions would be welcome. Thanks.

    - Stacy

  • April 9, 2012 8:28 p.m.

    At the age of 26 my life fell apart. My husband had an affair and I left. I returned to my parents house which was an unpleasent situation due to my fathers alchoholism. I was in college full time, working full time, and was a newly single parent of a 4 year old. The stress of the situation and the heartbreak was more than I could bear. My mental health deteriorated quickly and I became psychotic. Thakfully my mother was able to intervene on my behalf and I was hospitalized. I was diagnosed as being bi polar and was put on a variety of drugs. As time went on and my mental health improved I was able to eliminate 2 drugs with the help of my mental health provider. I took a low dose of lithium faithfully for 3 years because I was scared to death that my symptoms might return. As I write this I am nearing 33 years old. I have not taken ANY medications including lithium for almost four years without any recurance of symptoms. I am remarried and my life is back on track. This experience has really made me wonder about the validity of my diagnosis... I would just like to add that I am in no way encouraging anyone to discontinue their medication. I'm just grateful to be healthy and of sound mind.

    - Shane

  • April 2, 2012 10:59 a.m.

    I have suffered from depression for many years. I am 64. I have lived my whole life with some type of mental illnes. My Dad was diagnosed Manic-Depressive and was on Lithium for 7 years but is in denial and from all my research I know that he is. I have a cousin who is Bi-polar and several cousins children have it. My husband has severe OCD and is currently doing well on Zoloft. He couldn't work for 7 years and I was told it was possible he might never work. Our son is Bi-polar with OCD and severe anxiety. He also has a rare hereditary spinal condition. He is on many meds and is currently doing well. He is 27 and has been hospitalized many times over a 10 year period. He also has addiction and we have almost lost him 4-5 times from accidental overdoses to get high and this combined with his own meds were almost a disaster. He is currently doing well and is stable. He has also been in jail and rehab several times. He was misdiagnosed in the beginning as just depression and ADHD but an antidepresant alone with dexadrine added sent in to major mania. It has been a long and winding roller coaster but we are all doing better. I am currently on Citalopram and it seems to be working. I often think I am bi-polar because I am very talkative and people say I have a lot of energy. I'm 64. I love to dance and party and do Karoake and Zumba. I have also done some very risky behaviors. I go to support groups like Alanon and NAMI. Good luck to those of you who have MI and don't lose hope!

    - BK

  • April 1, 2012 9:29 a.m.

    I have suffered with depression and anxiety for 20+ years and have finally maxed out on my medications. I am having TMS treatments for my depression and anxiety now and see some changes although I'm only beginning the 3rd week of my 6 week regimen. I'm excited about he possibilities of finally feeling happy! I don't think I remember how that feels although I can't wait to feel that again!Today is a bad day. It's taking every bit of energy I have to put one foot in front of the other but I do have hope now....not in the multitude of medications I've been on for quite a while but in science. I have had a wonderful psychiatrist who is forward thinking. We have been through a lot in the many years I have been seeing her. I encourage all who have posted on this forum to hang in there. Depression and anxiety are no longer hidden. It's out there and the world is finally recognizing it as a true illness!

    - Janie

  • March 31, 2012 7:03 p.m.

    I have to say, after reading a lot of these posts, I can honestly say that, what made me have an affair was because I was bi-polar. I had just had my first and only child at age 41, after 8 years of infertility. Right after he was born I started being depressed but didn't know what it was. Then I had an affair! Something that if you had told me just a year earlier would happen, I'd say you were "crazy"! Well...looks like I was the one who was crazy. They say you do things you wouldn't normally do when your bi-polar. After a divorce and 8 years later I still suffer from depression. I just wish my ex would have been more "understanding"...and help me find out "WHY" I was like I was. I'll never be married again!!!!!!!!!!!!!!

    - cheryl

  • March 28, 2012 1:23 p.m.

    @february 23 According to what Ive seen and read, your reaction is normal for your situation. It must be incredibly painful to lose close long-term friends. Some ways Im thinking that might help you getting through it are becoming more involved with your church community if youre religious, joining new clubs to find people who have similar interests as you,etc. Much love on this end for you. :)

    - Alan

  • March 28, 2012 12:40 p.m.

    This is very true for me. I have been treated on antidepressants since 2002, after my dad died and I developed alot of anxiety symptoms and a couple of panic attacks. Zoloft worked great for a couple years. Then Wellbutrin, then I was on Effexor until just recently. I needed Xanax 1.5 mg for sleep. After a 3 month period of feeling extremely "low" I woke up after a 4 hr sleep with tons of energy and zest for life. I felt great! My family however noticed I seemed "hyper" and I was extremely talkative to the point of never knowing when to stop. Remember now, I thought it was super not to be depressed anymore. That is the usual way this goes- I was diagnosed bipolar and am now on Depokote. I am learning alot about this illness. My doctor is great. But I don't even think he was aware of anything until I had the "hypomania" symptom. When you are in that state you can also make very poor decisions and spend alot of money! Serious consequences. I hope more people will seek help. I told my husband when I was depressed but he didn't know how to help me. Depokote will stabilize my mood better than any antidepressanr. Thanks.

    - Carol

  • March 27, 2012 10:59 p.m.

    So glad I discovered this forum as it seems like everyone else i know is happy and healthy. I just completed a two week partial hospitalization program and was doing well there but now that I am out, I am lost again. I don't want to return to the program because last time I was administered meds for bipolar, Depakote and then Tegratol, and ended up with severe cramping and bloating. They also diagnosed me as bipolar, which neither I nor my psychiatrist agree with. I don't have the severe mood swings. I am just terribly depressed and now that I am out of work and have little structure to my day, I am worse. I am taking Viibryd, a new anti-depressant, but it hasn't reached its therapeutic level yet. I hate this weaning process and I lose hope and patience as each day comes and I feel no better. Does anyone have experience with Viibryd? Thoughts on it? I am considering ECT if I still don't see a change in two weeks. I just can't take much more of this weaning on and off along with all the unpleasant side effects of each med. The new diagnosis of bipolar is also confusing to me as I am almost 40 and find it unlikely that my other meds (not for bipolar)would have worked so well for so long. I did experience a manic episode but I also hadn't slept in three days and had significant stress from my work situation. My supervisor greeted me back from my medical leave with a sudden list of concerns about my planning and preparation. All was fine prior to my leave.

    - bean

  • March 26, 2012 5:31 p.m.

    Wow this is really very helpful for me. I have been on anitdepressants since I was 20, I am 33 now. The depression I am struggling with currently is heavy. I was on a certain anti for a while almost two years that helped, it was better than anything else and I have a list of meds we have tried. I have had two children in two years. I think my Dr. is sending me to a psychiatrist because maybe this depression has gone on to bipolar. I just can't kick this one. No matter what....I think the lack of sleep with babies, hormones, and all that have really knocked me off balance. I am scared this time. I feel like I have been robbed of so much figting this disease. I don't really have manic episodes, I have times when I feel okay, or you know fine normal balanced but not so much anything more than that. I wish for a break through for relief.

    - Missie

  • March 19, 2012 4:22 p.m.

    This is for Peter, since you said Help at the end of your letter. I am similar to you in many ways, yet I think I´ve come a little farther (I´m 59 and have lived with illness since 1978, my first episode. I want to suggest: start with one little thing that sort of makes you happy and work it. Don´t try a relationship yet--it´s the hardest thing. There was a time when I had to just choose a word, any word, and work on it all day. Or a phrase, like "look at things all day and be amazed"--even if you have to Pretend! So much help can be had by just shifting your attitude. Work a little on things every moment of every day and don´t expect too much from yourself yet. Hang in there!

    - lucinda

  • March 14, 2012 9:35 p.m.

    I have read many of the comments on this blog. It seems that there is a large variety of depression and ways to treat them. I may have had depression in my youth and into early adult life, but it was complicated by alcohol and some drug use. It wasn't till I went through my first divorce that I saw a therapist. I got on a tricyclic depression med at that time. Ditto second divorce. I am currently sober and drug free for 6 years, but the manic phases of my depression seem to be increasing. I am taking a prozac generic and am under the care of a psychiatrist and going to a senior group with people with depression. I am 64 years of age.

    - Don

  • March 13, 2012 11:34 p.m.

    I have suffered with depression and associated disorders since my mother died when I was 12; I found her body in our home. I am 46. I suspect that there were likely symptoms previously as she was very abusive. She was also OCD. I was firsy hospitalized in 1995 and then in 98. I was treated for PTSD from 07-09 thru individual and group therapy; my going into treatment was percipitated by another breakdown during which I was strickened with agoraphobia. Getting better and staying better is a 365/24/7 job. I work full-time and sometimes it's a stuggle. I also suffer with cooccuring eczema, which is coupled with anxiety. What works: being gluten free has really helped; vitamin B-12 liquid, 4 times daily sublingually; iodine subligually, 4 drops daily; 1 multimineral daily; and my Effexor 150mg. I have been able to reduce my anxiety by taking melatonin for sleep; I take 1.5 dropper before bed, but the dosage is four droppers. I sleep like a log. Do I have a lot of family support? Not really, but I have a few close friends that understand my condition. The best thing I can suggest to anyone is that you find a good doctor and therapist or both. Listen to your treatment provider's feedback. I have been able to manage this illness by being able to recognize the clues and changes that occur in my body. Yes, this is really stressful, but life is better than death and that is true for all of us her in this forum.

    - princess

  • February 23, 2012 2:26 p.m.

    After reading many of the posts here, I'm wondering if my state of wellness is better than I thought! I have been depressed for most of my adult life, following a nervous breakdown at college. After nearly a decade of misdiagnoses (and treatment)I was finally diagnosed as bipolar and treated with lithium. I have never had another breakdown since that time 40 years ago and take a low (300 mg) maintenance dose of lithium daily. However, I have noticed an increase in depression over the past five years or so, during which I have lost 4 close friends. As I am a widow and have only one son several states away and no other family, the loss has affected me deeply. Could this be the cause of increased depression, and/or is it part of the aging process? Thank you.

    - Barb

  • February 22, 2012 1:24 a.m.

    Its 2AM I cant sleep I am 47 years old and I am not sure what I am going through. I am divorced have a dog and live by myself. I have no friends no interests i am just blah Nothing gets me going nothing makes me happy I was seeing someone who was wonderful but I pushed her away It seems like I am isolating myself I just want to be alone where I cant hurt anybody My financial situation is not good either I think about that constantly theres a bankruptcy in my future and just cant get it together everything is bad I wish I had what the other guy has I wish I was different dont know whats going to become of me not to happyI ve gone to counsiling nothing there some help but no big change couldnt afford it anymore just dont know what to do Help

    - Peter

  • February 19, 2012 11:54 p.m.

    Thanks P-S. He tries to help get me happy but he never has dealt with bipolar before and doesn't understand that you can't make someone happy. I think I keep wanting to push him away because I don't know how to deal with all my current stress. I have an alcoholic mother who I had to let go a few months back because it just became too much. I'm the only one in the family to step out and now my dad is trying to force me back into the system. I've been attending alanon and aca but it has become too overwhelming. I've lost an integral part of my bipolar support system and they don't even know I'm in partial hospitialization but it is best. I have a lot to process but yes the therapist helps and I'm hoping I get stabilized with meds before it gets to inpatient stage.

    - scary

  • February 19, 2012 1:00 p.m.

    I have battled depression for most of my life. I am now 43 and it has gotten worse. I have tremendous support from my husband and my family. I want to get better so bad. It seems as though a take a step forward and then take ten steps back. I pray every single day that I can get better and stop putting my loved ones through hell. My mother and husband are always there for me to support and comfort me. I just want to get better not just for myself but for my family. I love them so much. I guess it't myself that I do not love. I just do not know what to do or where to go. I only know that if I ever get thru this; I will help someone this is going thru the same thing.

    - She

  • February 19, 2012 1:06 a.m.

    I no this may not b the best place but I guess I just wanna have hope somewhere and no that I can get thru this, or other have gone thru it and suceeded. Well my mom will be celibrating her 10 yr in the high heavens while leaving us here and well 2002 I was married to a man I haD been w 4 12 yrs prior this our actual wedding date and my my mom was like the guest of honor instead of me I was the happiest bride ever come to find out 2 weeks later she DIED I spoke w her the the day be 4 to say I was coming to visit yet to my surprise she would not b there to accept me due to that pain in my heart my marriages for 4 yrs would suffer I couldnt hang w the WHAT IT'S I lost my hole body sole and the life I once had all for 2 yrs straight of ALWAYS ON THE RUN NEVER SLEEPING sleep killed me the most so I just ran eventually the cops would in prison me for 3 yrs I cleaned up I thought I was cured I thouht I handled my issues w my mom death yet every yr has gotten hard I move to California away from city drama in Vegas needless to say Calif started off great I had a job .as asst manager at cjr it was THE BEST THING EVER FOR ME I had a routine I had a.life I had a reason to love my.up and down life I HAD A 2 REAL CHANCE OF LIFE and well I lost it my sunshine my accomplishments I lost it AND NOW I'M STUCK I AM EMPTY I AM CONFUESS. I wanna cry I'm stuck HELP

    - desiree

  • February 18, 2012 1:29 p.m.

    Scary Don't give up hope! If he kicks you to the curb, it is his loss!! You are a valuable human being and keep the communication open with your support grougs and your therapist. They are there to help you! Please make your live worth living. I know it's hard - keep hope alive.

    - P-S

  • February 18, 2012 1:24 p.m.

    I was recently diagnosed with bipolar disorder. 30 years ago I attempted suicide twice, servived and told no one about it until 8 years later when depression hit again. I realize now that I've been depressed since childhood and had suffered a lot of childhood abuse. I'd been off medication for 9 years. 2 years ago I started sinking again and 10 months ago I started searching for a christian therapist. I finally admitted to her that thoughts of being dead consume me every day and it's all I can do to get out of bed and cry for no reason and feel that depression is trying to sink me under. After being examined by a psychicatrist and my doctor, it was concluded I have bipolar disorder, PTSD with secondary victimization, ADD,and anxiety. I'm being treated with the generic version of Depakote. From what I've read I have to be patient to see if it works. I'm seeking knowledge and reading up on these disorders in order to live a more fufilling life.

    - P-S

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