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Hypomanic Episode After Withdrawal


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#1 Pattie

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    To research why I'm currently in a hypomanic episode after quitting Cymbalta. I've never been diagnosed as being bipolar. No matter what i've told various primary care providers and 1 psychiatrist over the past 12 years, they all said I was suffering from depression. However, is it possible that Im actually Bipolar II?

Posted 12 December 2010 - 06:36 PM

I'm new here and desperate for any past experiences or knowledge regarding my hypomanic episode that started almost a month after stopping cymbalta cold turkey, and I have refused to take any other antidepressant until I find past experiences, knowledge, and opinions of other and until I find a psychiatrist to give me a real diagnosis of what's been going on for the last 12 years of antidepressant therapy for depression. I was on Cymbalta 4 months, and decided to get all this antidepressant s__t out of me so that I could find out who I really am and what is really wrong with me.

I went through two continuous weeks of nausea, headaches, and brain fog. After two the weeks, the nausea, headaches, and brain fog would start again after a day or two, several times. My PCP insisted it was not withdrawal because withdrawal stops within 24 hours (PCP actually believes there is no withdrawal from antidepressants.) She said I needed another antidepressant and gave me zoloft (3rd time on zoloft). I took it two or three days and stopped. I do not want antidepressants. She then gave me xanax xr to relieve anxiety. Turns out that I have a paradoxical effect to xanax. The levels of anxiety went up and I could not fall asleep even with my normal 10 mg dose of ambien. Would sleep maybe 2-4 hours. Decided to try 20 mg of ambien. Same thing, maybe slept 2-3 hours. Had only taken the xanax sometimes, but seemed to make my anxiety and insomnia worse (Although, I have to admit that I was in a happy mood.) I stopped xanax. Then I went into a true hypomanic episode, which became more and more apparent, the last 4 days of which there was no denial it was hypomania. Then, over a 4 day period I could not sleep at all. During that 4 days I dozed off maybe a total of 4-5 hours. Hypomania more and more apparent and I was on the verge of collapse. Yesterday, I went to an after hours doctor at a clinic. He said that he was pretty sure it was a hypomanic episode resulting from being Bipolar II. However, since he was not a Pdoc he could not give me that diagnosis, but added that his opinion is usually 90 percent acurate and that I needed to find a PDOC asap to get a firm diagnosis of my real problem. In the meantime, he have me a scrip for Klonopin.

The above explanation does not explain the weird things I've been doing for over a week non-stop all day and almost all night and all the other things characteristic of hypomania.

Now, here are my actual questions:
-Could I have been misdiagnosed with depression all these years when I actually have a mood disorder? (None of the antidepressants I've taken during the past 12 years have made me feel any better or able to function. If I had anxiety, doctor(s) insisted it was depression. If I had bad muscle aches and pains, doctors insisted it was depression. If I had horrible brain fog and headaches, doctor(s) insisted it was depression. If I couldn't sleep, it was depression. etc., etc. I sank lower and lower each year until I had to retire early from the corporation I worked for about 1-1/2 years ago. Then things seemed to get even worst)>

-Could the cymbalta withdrawal cause a hypomanic episode if I am not Bipolar II? Or, did it bring out a hypomanic episode that was more severe and obvious than others I may have had in the past and that I really am Bipolar II?


FYI- For past year have also been suffering from incredible lower back pain and severe all-over muscle aches and pains. Also, bad pain in my right hand. Xrays of back showed only mild arthritis. Nuclear bone scan came up with nothing. Hand xray showed only mild osteoporis. Heavy doses of Ibuprophen and Tylenol 4s did not alleviate pain. However, here's the real 'kicker!' As soon as the withdrawal side effects of Cymbalta started -- All pain stopped! Still pain free.

Sorry this was so long, but if you have managed to get down to this line, I would appreciate your thoughts. Thanks for your time.

#2 Dadio73

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Posted 12 December 2010 - 09:11 PM

Hi Pattie, I looked around and found this on the web, hope it helps. Last night I had a sleepwalking episode and almost burned my house down. I don't remember a thing about it till the smoke alarm woke me up. Cymbalta is some nasty stuff, God only knows what it does to people. Anyway, here it is.

Hypomanic Episode
SYMPTOMS

A hypomanic episode is not a disorder in itself, but rather is a description of a part of a type of bipolar disorder.

A hypomanic episode is characterized by a distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days, that is clearly different from the person's usual mood.

During the period of mood disturbance, 3 or more of the following symptoms have persisted (4 if the mood is only irritable) and have been present to a significant degree:

* Inflated self-esteem or grandiosity
* Decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
* More talkative than usual or pressure to keep talking
* Flight of ideas or subjective experience that thoughts are racing
* Distractibility (e.g., attention too easily drawn to unimportant or irrelevant external stimuli)
* Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
* Excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., the person engages in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

A hypomanic episode is associated with a change in functioning that is uncharacteristic of the person. For example, the individual may be far more productive or outgoing and socialable than they usually are. This change in functioning and in mood are not subtle -- the change is directly noticeable by others (usually friends or family members) during a hypomanic episode.

A hypomanic episode is also not severe enough to cause serious impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features. The observable symptoms of a hypomanic episode must not be due to substance use or abuse (e.g., alcohol, drugs, medications) or caused by a general medical condition (e.g., hyperthyroidism or diabetes).

People who experience a hypomanic episode are often diagnosed with a type of bipolar disorder.

Dadio73

#3 cookie

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Posted 13 December 2010 - 12:54 AM

Dear Pattie:

I started the medication because I was suffering from Major Depression (unipolar). My mood was always very low, dark, felt hopeless prior to the medication. I took it for 5 years, and have been weaning slowly. One of my main symptoms since I started weaning has been extreme mood swings. One day I am very low, dark, hopeless, feel despair, and then the next day I am fine. Since I started weaning I´ve had 2 episodes of hypomania in which I feel euphoric, extremely talkative and with endless energy. Today I couldn´t stop cleaning and organizing things. Other days I have extreme irritable mood. It is just so painful, to live in this rollercoaster, and not be able to plan anything for my life, because I just do not know how I am going to feel the next day or hours.

If I went to a new doctor and told him the symptoms I am having NOW, I am sure he will diagnose Bipolar. However, I know myself, I know exactly how I felt prior to the medication and I know I never had these extreme mood swings or euphoria. So I know it is a withdrawal symptom. And I do not want to take another medication to treat a withdrawal symptom.

What worries me is if this symptom doesn´t dissapear, and if somehow taking an antidepressant for 5 years, changed my brain chemistry and triggered hypomanic symptoms. What if this is a drug induced hypomania and not underlying bipolarity that was not previously diagnosed? The only way I would know this would be to turn back time and not have taken any antidepressant all these years. Then I would know if my Depression would turn into Bipolarity (which I do not think so) because I spent a lot of time without medication an it was always a unipolar depression.

Could you describe your hypomanic episode???? What symptoms did you have????
From what you mentioned, you have suffered from Depression the past 12 years. And have been prescribed a long list of medications: zoloft, xanax, ambien, klonopin. Be careful with so many changes of medication.

I do not think you were migdiagnosed all these years. However I am not a doctor.




#4 Pattie

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    To research why I'm currently in a hypomanic episode after quitting Cymbalta. I've never been diagnosed as being bipolar. No matter what i've told various primary care providers and 1 psychiatrist over the past 12 years, they all said I was suffering from depression. However, is it possible that Im actually Bipolar II?

Posted 13 December 2010 - 11:40 AM

Dear Cookie,

Your situation seems somewhat similar to mine. However, when I first went on this 12 year journey of antidepressants, I wasn't feeling depression. I had anxiety that would get almost unbearable at times. I would find it very difficult to function at work. I just wanted a mild tranquilizer that I could use when I had a task to do or a situation to face on my job that at times my nerves would put me into such a state I couldn't function - I think like a panic attack. This wasn't all time time. I just wanted something at those absolute worth times. I didn't want to be on any medication that I would have to be on every day for an unknown amount of time. Of course, all doctors believe anxiety and depression are linked and if you have one, you have the other. I don't believe that, but that's another topic.

All the different antidepressants I've been on created one problem or another, so they said I had to try another. Sometimes, one would take the edge off the anxiety slightly, one would make the anxiety worst, one would put me into a deep depression, one would make it impossible to sleep, etc. etc. If I tried to quit the meds, the withdrawal would get so bad, I would have to go back on it. If I wasn't working at the time, I would have suffered to the withdrawal. Over the years, I didn't know who I was or how i would react to any situation. My co-workers and supervisors would make comments. I started missing a lot of work because I got no sleep the night before, or because I was in such a brain fog I couldn't function at work, much less drive there, etc. etc. I finally had to retire from the corporation because I couldn't function anymore. That was a year and a half ago. So now, you would think I might be getting better - without all the stress, commitments, etc., but I didn't. Went to a PDoc finally for 7 months. Unfortunately, this guy was not fit to practice anything. It was one of my worst experiences. I tried to make progress on my own, taking advice of everything I could find during my research. Then I went back to PDoc and was excited to tell him where I'm at. He was in the twighlight zone, and I think he comprehended a thing I said. He fell asleep 3 times while I was talking.

Anyways, going back to my current hypomania, here are some of the notable things I've been doing -- all of which are totally uncharacteristic of me:

-Put up a Xmas tree and decorations for the first time in over 15 years, which then led me to
-Start cleaning and organizing the house. Couldn't concentrate on one room or task at a time. Long story short, the whole house, every room is in total upheaval, piles of stuff in the middle of rooms, and although I thought at the time I was really accomplishing something, there it all sits, because now I have to:
-Listen to a couple of 'Rolling Stones' concerts I recorded on the DVR. I loved the Rolling Stones 30-40 years ago. The last couple of years I would not listen to anykind of music--couldn't stand it. And if I thought or did anything nostalgia it would hurt me emotionally and I have to stay away or not think of anything nostalgic. Well, watching 2 of these Rolling Stones concerts a lot wasn't enough. I needed sound - LOUD BOOMING SOUND - it took me half a day to move my unused sterio system with the big speakers and sub-woofers from the corner they were sitting in for over 10 years, unused. Managed to get it all hooked up to the TV. (not a clue where the knowledge came from to enable me to do this. What the heck do I know about all these wires and jacks and numerous inputs in all the equipment.) But, now I'm ready. Boomed out these 2 concerts with vibrating volume over and over and over, maybe for 20 hours straight, sitting there. Trying to force myself from doing this the last couple days, but still have to keep doing it.
-I have a friend that I haven't talk to her in two years because she had her land line disconnected and she never called me, until a week and a half ago. She is bigtime Bipolar I, about as bad as they get. So, yesterday and the day before have talked to her on the phone for about 10 hours. (I hate talking on the phone. Turn off my ringer half the time so noone will bother me)
-Hadn't been able to sleep in days--ready to collapse--but can't sleep. (Klonopin from last doc finally allowed me to sleep.)
-Still manic, or I wouldn't be writing this long note. I HATE writing.

I am enjoying the opinions and experiences of others. I love you all. I love everyone now.

I'm also wondering if 12 years of antidepressants were actually preventing a hypomanic episode. There have been some extremely short periods of happiness somewhat over the years. At times i would insist to my doctors that I wasn't depressed, but they insisted that i was.

Had had it with this antidepressant roller coaster. I'm no longer working and I'm getting off this crap to find out who I am and what's really going on that might be hidden. Having read of others who withdraw very slowly, but from what I can tell, in the end, I feel they just prolonged the withdrawal symptoms, and in the end still got hit quite hard. If I could get hard and fast, maybe some doctors will be forced to take another course of action.

#5 wheresmylife

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Posted 13 December 2010 - 02:22 PM

I don't know about hypomania, but 2 months after withdrawal from cymbalta I got Akathisia.
Unable to sit or stand still nothing but pacing at 100 mph.
Doctor tried to treat it with benzos-first xanax then ativan. They both worked initially but after a couple of weeks I too seemed to have a paradoxical reaction. It made me pace even faster and out of control.
Doctor kept me on it for another 2 1/2 months even though I kept saying it was worse.
I then had to cold turkey off the ativan.
This put my body into shock, much suffering.
That was 7 months ago. I still have the akathisia worse than ever. Over 1 year off cymbalta. Head is buzzing can't think straight. Vision is distorted with severe depersonalization and derealization. Numb from head to toe.
I don't know if that is similar to what you are talking about. I am in Hell!!!!!!

#6 cookie

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Posted 13 December 2010 - 10:18 PM

Dear Pattie: Yes, the same thing happened to me. The first time I was diagnosed with Depression, I didn´t feel depressed, I was having panic attacks. . The second time I was diagnosed with Depression, I did feel depressed, but didn´t have anxiety. I am sorry to hear that your co-workers and supervisors would make comments at work. . I totally understand when you say that you thought you will be getting better when you quit work but it happened totally the opposite. In my case, I lost my 7 year job, and instead of having less stress, I have more stress from not being able to function or be productive. It is curious that you mention that you put up Xmas tree and decoration. Your description is EXACTLY what is happening to me. I hadn´t decorated the house in so many years. I couldn´t stop cleaning and organizing. I couldn´t concentrate on one room. My relatives were excited to see me decorating, they thought I was getting better. But the horrible thing is that after a day like this, I wake up feeling very dark, low and depressed the next day. You mentioned that you think “that people who withdraw very slowly, just prolonged the withdrawal symptoms, and in the end still got hit quite hard”. I am weaning very slowly, and it is true that I do not know if I am going to suffer full withdrawals once I am down to 0mg. However I do believe, that decreasing very slow gives the body and brain time to adjust. I hope it does. <BR style="mso-special-character: line-break"><BR style="mso-special-character: line-break">

#7 cookie

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Posted 13 December 2010 - 10:22 PM

I don't know about hypomania, but 2 months after withdrawal from cymbalta I got Akathisia.
Unable to sit or stand still nothing but pacing at 100 mph.
Doctor tried to treat it with benzos-first xanax then ativan. They both worked initially but after a couple of weeks I too seemed to have a paradoxical reaction. It made me pace even faster and out of control.
Doctor kept me on it for another 2 1/2 months even though I kept saying it was worse.
I then had to cold turkey off the ativan.
This put my body into shock, much suffering.
That was 7 months ago. I still have the akathisia worse than ever. Over 1 year off cymbalta. Head is buzzing can't think straight. Vision is distorted with severe depersonalization and derealization. Numb from head to toe.
I don't know if that is similar to what you are talking about. I am in Hell!!!!!!



Dear Wheresmylife:
It is shocking to hear that after one year of quitting the medication you are still having these symptoms. Had you experienced depersonalization and derealization prior to the medication???

#8 wheresmylife

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Posted 14 December 2010 - 02:24 PM

Never in my life did I experience anything like this.
Except for the akathisia which remains in full force everything else, I believe came from the benzos the Doctor gave me to combat the akathisia.
I am in Hell

#9 Pattie

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    To research why I'm currently in a hypomanic episode after quitting Cymbalta. I've never been diagnosed as being bipolar. No matter what i've told various primary care providers and 1 psychiatrist over the past 12 years, they all said I was suffering from depression. However, is it possible that Im actually Bipolar II?

Posted 16 December 2010 - 11:41 AM

WheresmyLife - I found these article on Wiki regarding akinasia My link and Serotonin syndromeMy link. I don't know if you've come across these yet or if it might help some. The spellings are a little different from what you have, so I don't know if it's the same thing.

#10 wheresmylife

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Posted 16 December 2010 - 03:07 PM

WheresmyLife - I found these article on Wiki regarding akinasia My link and Serotonin syndromeMy link. I don't know if you've come across these yet or if it might help some. The spellings are a little different from what you have, so I don't know if it's the same thing.

Pattie
I am not doing well
My body and mind is racing 1000mph and I can't do anything to stop it.24/7
can't talk right now
I am about to explode
You can't do anything to stop this couldn't even exercise if I wanted to.
can't stop pacing and gasping for air.

#11 wheresmylife

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Posted 17 December 2010 - 02:09 PM

I am going 1000 mph. Can't stop for a minute to meditate. Mind is completely confused.Head is numb. skin is numb.vision distorted.



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