husband just got dx with"possible"bi-polar-help please

Wotan is right, BP seems to be the illness du jour, although it is extremely likely to develop in people who have a family history, as it is mostly genetic.  It is NOT easy to diagnose, mania can have many symptoms of ADD or schitzophrenia, including voices and hallucinations in the type I category.    In reality, only 1% of the population has it.    To get a correct diagnosis, the person MUST have had at least one episode of mania.  Here are symptoms of mania, and the depression, too.

Signs and symptoms of mania include discrete periods of:

• Increased energy, activity, restlessness, racing thoughts, and rapid talking
• Excessive "high" or euphoric feelings
• Extreme irritability and distractibility
• Decreased need for sleep
• Unrealistic beliefs in one's abilities and powers
• Uncharacteristically poor judgment
• A sustained period of behavior that is different from usual
• Increased sexual drive
• Abuse of drugs, particularly cocaine, alcohol, and sleeping medications
• Provocative, intrusive, or aggressive behavior
• Denial that anything is wrong

Signs and symptoms of depression include discrete periods of:

• Persistent sad, anxious, or empty mood
• Feelings of hopelessness or pessimism
• Feelings of guilt, worthlessness, or helplessness
• Loss of interest or pleasure in ordinary activities, including sex
• Decreased energy, a feeling of fatigue or of being "slowed down"
• Difficulty concentrating, remembering, making decisions
• Restlessness or irritability
• Sleep disturbances
• Loss of appetite and weight, or weight gain
• Chronic pain or other persistent bodily symptoms that are not caused by physical disease
• Thoughts of death or suicide; suicide attempts

There needs to be almost all of the symptoms of mania present, not just one or two.    I'm curious, why did he seek help?   Did he see a psychiatrist or a GP?   BPs don't usually seek help when manic, because it feels good to the person.  They seek help when depressed, because it is usually so severe.  The disease usually starts showing symptoms in late teens, early twenties, but can develop later. 

but it's a test many pdocs use a primary screening for the criteria.  He must have at least MOST of the symptoms of mania  to qualify as bipolar.

The only REQUIREMENT is that he has had at least one manic episode.   Without a manic episode, he cannot be diagnosed as bipolar.  GPs do not use this test, most, and I say most, pdocs use this to help diagnose it.

http://www.dbsalliance.org/questionnaire/screening_intro.asp

Cymbalta is very likely to trigger mania, especially in type I patients, which is what he is, because of the psychotic features with mania, not just hypomania.  It is generally not recommended.  If a mood stabilizer is used, such as the depakote he is taking, there is a slightly reduced risk, but still very likely with the severity of his mania.  It is more customary to prescribe welbutrin and/or Lamictal first.  They work extremely well, and have no sexual side effects.  Not everyone can take it, tho, everyone's reaction is different.  Is he seeing a pdoc (psychiatrist) or GP.  It is best he sees a pdoc, since they specialize in mental illnesses.  Of course they aren't perfect, no one is, but they are much more likely to get the "cocktail" of meds right, and much quicker.  He will probably change meds and combinations of meds several times to balance both mania/depression.

Depakote is almost as good as lithium for stabilizing moods.  But the main side effects are weight gain (guaranteed), and possible hair loss.  It is safe physically, the liver damage is extremely rare, lithium is much more dangerous, causing kidney and thyroid  damage with prolonged use.  Remember all meds have side effects, you can't avoid the possibilities, but very dangerous effects are extremely rare.  There are a few other options, if he finds he cannot control his weight.

Post Edited (psychnurse) : 7/23/2005 8:09:58 AM (GMT-6)