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Q: Chronic Forgetfulness and Disorganization
I have recently been diagnosed with bipolar disorder (this is my
2nd diagnosis as I wanted a 2nd opinion). I have felt very strongly
over the last 3 years that I have adult ADD and not bipolar disorder, but it
seems that 2 Drs. disagree. My question stems from the fact that I do
not experience the mania or manic stage of bipolar disorder as it is
suggested in all of the material that I have read. I very rarely, if
ever have an "inflated" view of myself. I very rarely, if
ever, experience elation and I am constantly tired, I rarely, again, if
ever, have a decreased need for sleep. I have experienced weight gain,
(70 lbs in the last 9 years!) not weight loss. Other symptoms include
chronic forgetfulness and chronic disorganization to the point where I
forget important appointments or paying my bills or completing work
assignments (I am an Instructor at a comm. coll.). These 2 aspects of
whatever I have are the most trouble and the most invasive in my life as I
feel out of control in these areas. A doctor initially went along with
MY diagnosis and prescribed Depakote and Ritalin, but after taking the
medication for almost 2 months, I was still unable to organize my life and I
was still forgetting things on a daily basis. I saw him this passed
week and he has advised me that he feels that I am bipolar and has
prescribed Prozac along with the Depakote. I don't necessarily like
this guy alot, but I have no medical insurance and I can't keep jumping from
doctor to doctor. I would be interested to know if the characteristics
that I am having the most difficulty with are also characteristics of
Bi-polar disorder as well as ADD. I need to know what is wrong with
me. Thank You for your assistance.
Dear Lori --
What do you think about the idea that you might have both bipolar and ADHD
components in your symptoms? They are often found together.
However, a growing number of experts agree that treating the bipolar piece
first is the way to go; then, when the mood symptoms are really stable, you
can try adding a stimulant if your concentration is still poor (it looks to
me like a lot of folks see a dramatic improvement in their concentration
just from getting the mood symptoms controlled, though; enough to allow me
to take people off stimulants several times).
You may not like the doc' but you can ask him about
this general approach you read about (while you're at it ask about the
general idea that antidepressants can make bipolar disorder worse and that
many mood experts recommend not using them, or at least not using them until
the only mood symptoms remaining, after mood stabilizers are on board, are
just depression symptoms -- no insomnia, no irritability, anxiety, for
example) (you can read more about that general idea on my website).
Dr. Phelps
Published July, 2001 |