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Q: Are These "Voices" I'm Hearing?
Though presenting symptoms of Bp disorder since pre/early teens, I was only
diagnosed Bp 3 years ago. Previous treatnment
from family physcian included anti-depressants, sleeping pills, and
anti-psychotics. I am concerned about having treatment resistant BP and
about compulsive, uncontrollable thoughts to hurt/kill myself. I trust no
one and fear being commited. As for the "hearing voices"...can you explain
this to me? I always thought this to mean a different and distinquishable
"voice" inside or outside of a person's mind "instructing" a person to behave or
involve themselves in detremental behaviors...ie: self harm or harm of
others. However, recent readings have lead me to question that the
compulsive thoughts I have to cut off my hand, cut my body, burn my body, kill
myself are "voices" that many professionals have inquired, "Do you here voices"
to which my reply is "No". Can you clarify for me what it means to "hear
voices" and what can I do to stop this maddening phenomena? I am currently
taking zoloft 150mg, clonapin, 1mg, and lithium 600-900mg (I do not tolerate the
lithium very well), and also remeron 30 mg to help me sleep. I find I
quickly become acclimated to a medication and they have to be increased to
continue to be affective. Then come the physical side affects of nausea,
disorientation, etc. Also, I have had episodes in which I believed myself
to be the ultimate "power" of the universe and episodes of paranoa in which I
believed my wife and mother to be conspiring to have me committed. I
realize there are alot of questions here....has my Bp diagnosis been
inaccurate...do I suffer from other mental disorders. I have equal
episodes of wanting to destroy the entire world as humanity is the lowest form
of life on this earth. Please help if you can. I am so lost and am
not able to accurately describe these things to my wife or therapist...neither
of which has proven to be trustworthy. I am afraid my only relief or peace
will come from death.
Dear Bud --
Of the several important questions here, I'll pick a couple I think are the most
likely to lead you somewhere good (I hope).
First, are these "voices" you're
hearing? It won't matter too much, as far as guiding treatment, in my view
-- that is, I would not make them the focus except to watch how much risk you
might face of following "their" instructions -- which could be
substantial and I hope your doc' is aware of them; if not, inform her/him.
If you can pretty clearly state you're not planning on following through on
those "voices" or thoughts, you're just having them, then she/he will
not be able to "commit" you (although one could argue that if she
sees/hears something in your report that does allow her to do so, you'd be best
off if she did, and that you (and me, sort of) shouldn't be second-guessing her
on that...). You've got serious symptoms, but fortunately they are
treatable in the vast majority of people, so you shouldn't hold back too much
now on trying to get them taken care of.
Second, about halfway through the paragraph I started
thinking a common thought for me as I read stories like this: "I hope
he's on an antidepressant". Because, for one thing, it's so often the
case. And for another, is there something that might be done to radically
change the course of things here without necessitating the really complex mixing
of mood stabilizers that can (here's an answer to one of those questions) often
help someone like you. In other words, there's the good option of
combining mood stabilizers, for the symptoms you describe. But first
there's the option of -- slowly, and with your doctor's awareness, consent,
and guidance -- having a look at things without an antidepressant on
board. This is a very standard recommendation from many mood
experts: to treat complex mixed states and rapid cycling, first try not
using (which usually means "stopping") an antidepressant (but, slowly
taper, and not on your own, ok?)
Has your diagnosis been accurate? There's nothing
in your letter to suggest otherwise. Get some help soon, it's very likely
to make your life better. Good luck, and I hope that's what happens
soon.
Dr. Phelps
Published June, 2003
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