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Q: Can BP Hide Out in a Different Form like Panic Disorder...?
In 1988 I was dx with panic disorder and have been taking Clonazepam
1mg twice a day since and it's worked. There have been periods of time when I
have felt over anxious but got over. About a month ago I started itching all
over my body and put up with it for three weeks then ended up at the ER and they
treated me for the symptom. A shot of cortizone and dose pack of prednizone. I
followed up with my M.D. and he prescribed wellbutrin. Shortly after I ended up
in what my friends tell me was a manic state. Several days later I was unable to
work due to sever depression. He took me off wellbutrin and prescribed depakote
250mg twice daily. My depression is better but my itching has retured. My doc
had me take the questionaire posted on this page and hedx is that I'm bipolar.
My mothers sister is bipolar. Can bipolar hide out in a different form like
panic disorder and then appear in short order like this? It knocked me in the
dirt quickly. I was going to see a Phd. as soon as I can get an appointment or
should I trust my M.D.? And this itching has got to go. Is there a relationship
to the wellbutrin and my phases of mania/depression? If so what is it. Because
as soon as I stopped the wellbutrin and started the depakote I got to feeling
better. Any suggestions on the itching?
Thanks
Dear Ms. M' --
You ask some very good questions for the situation you've found yourself in.
Let's look at one at a time.
1. Can bipolar hide out in a different form like panic disorder and then
appear in short order like this?
The simple answer is yes. For a bit more complex discussion of whether the panic
episodes were a "co-occurring condition" or actually part of bipolar disorder,
which is very tricky but may not really mean much now given the current
diagnosis, read about
Anxiety as a Bipolar Symptom.
2. I was going to see a Phd. as soon as I can get an appointment or should I
trust my M.D.?
Again, "yes". Both could be helpful. See the new data on
Psychotherapy for Bipolar disorder
-- if you can find a Ph.D. who is familiar with one of these methods. She/he can
also help you decide whether you should really accept this bipolar II diagnosis,
without which acceptance, it's hard to proceed with the medications from the MD
(the MD could do this step too, but may not have the time to do it well; my
website
section on BPII,
in the section about diagnosis, might help some there too).
3. Is there a relationship to the wellbutrin and my phases of
mania/depression?
Yes again, most likely. We can never know these things for sure. But
antidepressants are well-known to sometimes induce manic symptoms, and manic
phases are commonly followed by depressive phases (perhaps increased in that
respect by Wellbutrin being removed, though most psychiatrists would probably
agree that was a good move by the doc'). Glad to hear the Depakote helped, by
comparison, even at a very low dose.
4. Any suggestions on the itching?
Uh, for symmetry purposes it would nice to say "yes", of course; but I'm not
sure what that is. Once in a while I see people with itching as part of an
anxiety symptom set, so it could be something that goes with the anxiety. But it
could be unrelated, as this is not very common in bipolar disorder anyway.
Sorry.
Dr. Phelps
Published November, 2003
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