Depressive BiPolar Disorder- Common dx in ME/CFS?

[sparklehoof]

I moved and Medicare/Medicaid assigned me to an N.P. For primary care. I'm not very comfortable with the N.P, but I'm hoping things will improve as I have only been twice before today. The NP saw that I take a Dextroamphetamine and antidepressants and said that and in NC I need to be seen by a psych nurse who comes to their office 1 morning/month.

Today was my first visit with the psych nurse. She said that she doesn't diagnose on the first visit, but she thinks I may have bipolar depression rather than depression. She suggested that I read more about it. I've been looking for research or articles that explain more about this type of bipolar, but mostly find more general information that lumps all types of bipolar into a single article.

I wondered:
Has anyone else on PR has had this dx?
Is there any known connection with depressive bipolar and ME?
Can the symptoms of ME cause similar symptoms to bipolar depression or does ME mask the symptoms of bipolar depression thus making it more difficult for a psych provider to diagnose?

Thanks

 

[Jessie~]

Many many years ago I was misdiagnosed with Bipolar II disorder. My CFS was unknown/undiagnosed at the time. I had been taking antidepressants for depression for years prior to meeting with a Psychiatrist.

Upon meeting her, she got right to it and changed my diagnosis within the first 2 or 3 visits. Going from a diagnosis of Depression to Bipolar II disorder gave her a reason to start adding new medications to the antidepressants (mostly mood stabilizers), which was the beginning of many horrible years on psychiatric meds.

Having an inaccurate diagnosis and taking inappropriate medications for years was severely devastating.

My psychiatry experience began much like you describe in your post @sparklehoof. My pulse raised drastically from the flood of bad memories that came to me as I read it. I was trusting, hopeful, and very accepting of whatever my Psychiatrist said (at first). In the beginning she did a pretty good job of selling her ideas, and all kinds of meds to me.

Of course, I am not trying to imply that I could know whether you have Bipolar Depression or not. And I am not trying to turn you off to Psychiatry or meds. Sorry to be such a downer on the subject. I would never want anyone to go through what I did. I just hope that you are very cautious. And I hope that you receive accurate diagnosis and care for your specific needs.

 

[JES]

I wondered:
Has anyone else on PR has had this dx?
Is there any known connection with depressive bipolar and ME?
Can the symptoms of ME cause similar symptoms to bipolar depression or does ME mask the symptoms of bipolar depression thus making it more difficult for a psych provider to diagnose?

Thanks

Answering your last question, I would say no, ME does not share the characteristic symptom of bipolar disorder where you have periods of depressive mood followed by periods of elevated mood. Even if an ME patient had a period of elevated mood, the ME patient would still be limited in what he or she can do by the disease itself. ME can absolutely impact your mood and cause symptoms such as brainfog or anxiety, but it's not something that is relapsing or remitting. Also mania or feeling abnormally energetic, which is part of bipolar disorder, is something that ME by definition would basically exclude. ME patients suffer from lack of energy, they rarely have any extra energy.

 

[wastwater]

It would be unusual to be taking dextroamphetamine with BP2 as that would lead to mania,maybe it's more ADHD orADD

 

[Living Dead]

Dextroamphetamine and antidepressants

What dx/symptoms do you take them for?

bipolar depression rather than depression.

I wondered:
Has anyone else on PR has had this dx?

Bipolar depression isn't a separate dx, it only means you're in the depressive phase of the bipolar illness. There's bipolar 1 (with manic/psychotic episode) and bipolar 2 (with hypomanic, but not manic, episode).

Is there any known connection with depressive bipolar and ME?

There is no connection with depression (depression can not make you get ME nor "progress" into ME).

Can the symptoms of ME cause similar symptoms to bipolar depression

Yes, but not the other around. The typical symptom of ME is a post extertional malaise (exercise intolerance). This does not occur with bipolar depression, or any other type of depression.
ME can make you "depressed" (by fatigue in the brain), or, of course, genuinely depressed due to living with the condition.

or does ME mask the symptoms of bipolar depression thus making it more difficult for a psych provider to diagnose?

If a doctor doesn't know anything about ME, you can be sure you'll get a diagnosis of depression if you what you really have is ME.

If you describe that your ME gets better, then worse, maybe you'll get a dx of bipolar 2, if the doctor is absolutely crap.

 

[sparklehoof]

Jesse
I'm so sorry about your experience.
It sounds like you went through years of unnecessary turmoil.
When I became sick in 1999 my PMS progressed to PMDD. A psychiatrist put me on Celexa, but when combined with Prednisone my depression anxiety and first rationed intensified. The psych nurse that I saw today said that reaction occurs in people with bipolar.
I have no idea if her hunch that I have depressive bipolar is correct, but I'm trying to keep an open mind. I wish I had an ME specialist that could help me communicate with her and my new NP- they seem to have very little understanding of ME. After 16 intense years and seeing Lyme and ME specialists, I'm hesitant to trust them, but I'm trying.
Thank you again.

Many many years ago I was misdiagnosed with Bipolar II disorder. My CFS was unknown/undiagnosed at the time. I had been taking antidepressants for depression for years prior to meeting with a Psychiatrist.

Upon meeting her, she got right to it and changed my diagnosis within the first 2 or 3 visits. Going from a diagnosis of Depression to Bipolar II disorder gave her a reason to start adding new medications to the antidepressants (mostly mood stabilizers), which was the beginning of many horrible years on psychiatric meds.

Having an inaccurate diagnosis and taking inappropriate medications for years was severely devastating.

My psychiatry experience began much like you describe in your post @sparklehoof. My pulse raised drastically from the flood of bad memories that came to me as I read it. I was trusting, hopeful, and very accepting of whatever my Psychiatrist said (at first). In the beginning she did a pretty good job of selling her ideas, and all kinds of meds to me.

Of course, I am not trying to imply that I could know whether you have Bipolar Depression or not. And I am not trying to turn you off to Psychiatry or meds. Sorry to be such a downer on the subject. I would never want anyone to go through what I did. I just hope that you are very cautious. And I hope that you receive accurate diagnosis and care for your specific needs.

Many many years ago I was misdiagnosed with Bipolar II disorder. My CFS was unknown/undiagnosed at the time. I had been taking antidepressants for depression for years prior to meeting with a Psychiatrist.

Upon meeting her, she got right to it and changed my diagnosis within the first 2 or 3 visits. Going from a diagnosis of Depression to Bipolar II disorder gave her a reason to start adding new medications to the antidepressants (mostly mood stabilizers), which was the beginning of many horrible years on psychiatric meds.

Having an inaccurate diagnosis and taking inappropriate medications for years was severely devastating.

My psychiatry experience began much like you describe in your post @sparklehoof. My pulse raised drastically from the flood of bad memories that came to me as I read it. I was trusting, hopeful, and very accepting of whatever my Psychiatrist said (at first). In the beginning she did a pretty good job of selling her ideas, and all kinds of meds to me.

Of course, I am not trying to imply that I could know whether you have Bipolar Depression or not. And I am not trying to turn you off to Psychiatry or meds. Sorry to be such a downer on the subject. I would never want anyone to go through what I did. I just hope that you are very cautious. And I hope that you receive accurate diagnosis and care for your specific needs.

 

[sparklehoof]

Thank you for your post. I appreciate your thorough reply? If you're comfortable replying, Are you a medical doctor? If you have ME how long have you had it? Do you have bipolar or treat patients with bipolar?
You seem to have researched my questions so much that I wondered if you could share your research sources so that I can read them in their entirety. That would help me so much since I don't think I know as much about this area as you.

What dx/symptoms do you take them for?

1. Bipolar depression isn't a separate dx, it only means you're in the depressive phase of the bipolar illness. There's bipolar 1 (with manic/psychotic episode) and bipolar 2 (with hypomanic, but not manic, episode).

------How interesting. The nurse must have been referring to bipolar II using the incorrect name.


2. There is no connection with depression (depression can not make you get ME nor "progress" into ME).
-----If you are feeling up to it, could you post some links to studies that show that there is no connection between bipolar and ME? I wasn't sure if a possible correlation (as opposed to causation) had been studied.

3. Yes, but not the other around. The typical symptom of ME is a post extertional malaise (exercise intolerance). This does not occur with bipolar depression, or any other type of depression.
ME can make you "depressed" (by fatigue in the brain), or, of course, genuinely depressed due to living with the condition.
Yes, I would agree completely.

4. If a doctor doesn't know anything about ME, you can be sure you'll get a diagnosis of depression if you what you really have is ME.
------ Since depression is not uncommon in ME pts that makes a lot of sense.

If you describe that your ME gets better, then worse, maybe you'll get a dx of bipolar 2, if the doctor is absolutely crap.

------That sounds possible.

 

[sparklehoof]

It would be unusual to be taking dextroamphetamine with BP2 as that would lead to mania,maybe it's more ADHD orADD

Thank you. I do have ADD, but the amphetamines don't seem to trigger mania.

 

[sparklehoof]

I did find that someone else on PR posted a link to a 2014 lecture on Bipolar by Patrick McKeon. During the lecture he talks about how BP can have a very subtle elation period, so subtle that the patient may not notice, but those around him/her may. That tiny and brief high is followed by a much more extensive depression. He also explained that mania can appear to both the pt and those around them to be depression.

I have found that personally, as soon as my physical symptoms ease up, my depression dissipates effortlessly. When I'm at my worst I feel relieved just to be in bed and it feels comforting rather than confining. I have no worries about keeping up my to-do list, missing events, etc.. When I'm somewhere in between
Mostly bed and house bound, unable to eat a Paleo diet, exercise, be outside, be social or productive, all the positive self talk and meditation in the world only makes me feel more restless. I'm wondering if that restless feeling could be the hypo mania or if it's a common response to ME.

 

[alex3619]

Answering your last question, I would say no, ME does not share the characteristic symptom of bipolar disorder where you have periods of depressive mood followed by periods of elevated mood.

I agree. However there is no law that says you cannot have both, either.

 

[wastwater]

It might be the tired and wired effect
I also think things like prednisone among many other substances may effect inflammation and cause a manic like burst.
I find alcohol makes me quite manic.

 

[Living Dead]

You seem to have researched my questions so much that I wondered if you could share your research sources so that I can read them in their entirety. That would help me so much since I don't think I know as much about this area as you.

I am just a patient who has researched a lot. Wikipedia is the best source for information on information that is relatively non-controversial, such as bipolar.

When I became sick in 1999 my PMS progressed to PMDD. A psychiatrist put me on Celexa, but when combined with Prednisone my depression anxiety and first rationed intensified. The psych nurse that I saw today said that reaction occurs in people with bipolar.

That prednisone gives anxiety should be considered normal, in my opinion. It's a stress hormone, like adrenaline.

If you are feeling up to it, could you post some links to studies that show that there is no connection between bipolar and ME? I wasn't sure if a possible correlation (as opposed to causation) had been studied.

I'm not aware of any studies regarding bipolar. However, if there was a connection, it would be with the manic phase (overexterting the patient), not with the depressive phase. This is just common sense when you have read about these illnesses.
Any studies regarding psychiatric conditions in ME use very loose criteria for ME. Some patients fulfill these critera simply by having a psychiatric disorder. Thus, all of the research in this area is practically useless.

 

[A.B.]

It seems there are plenty of incompetent docs and psychs around who will diagnose bipolar just because the patient reports variable symptoms (which is of course reflected in mood as well). It's not bipolar unless the mood swings are really very abnormal.

Bipolar is also a more lucrative diagnosis for the industry and psychs since patients will be prescribed so many different medications.

 

[wonderoushope]

Edited. I just moved my post to my blog...as it was a bit long winded.

But yeah, basically my psychologist is wondering if I might have Bipolar II.