BIPOLAR I AND PMDD - WHAT TO DO WITH MEDS?

Hi, I have Bipolar I AND PMDD, which definitely does not make for an easy equation. But it is especially dumbfounding when it comes to what to do with medications. I know birth control pills help, and I have been on a birth control pill since 15 years old, Ocella, the generic for Yasmin, when I stopped having a period, and the pill gave me back regular periods. I have also heard that antidepressants help with PMDD, but doctors usually try to a avoid antidepressants with Bipolar patients because of a possibility of the patient going into mania. BUT, I have also heard that there are certain days around the pms time to for these individuals when it is actually advised to take the antidepressants and a certain to stop. Does anyone know about this, or what the entire story is?? Thanks, and I hope someone can help answer this or try to. You can see I'm on a good bit of meds, but nothing like when I first was sick with Bipolar. Doctors are trying to figure out what else to ADD or SUBSTITUTE to help with my very bad PMDD. Again, any thoughts are welcomed and appreciated... Thank you very much.

I also have Bipolar I and PMDD along with several other diagnoses. Most of my problems got worse since I had my last child so I know that they are hormonal and nutritional. I have noticed that since I started taking fish oil that my symptoms of both disorders are more manageable. I couldn't take hormonal birth control because it caused depression and weight gain. I cannot take antidepressants because they make me rapid cycle and have mixed episodes. The fish oil seems to help with mood swings, anxiety, irritability, insomnia, and depression for me. My doctor said it helps regulate hormones so that makes sense. Also I have found that exercise first thing in the morning is crucial. I do not sleep well without it. Also my doctor advised me to take a Vitamin D with calcium supplement because Vitamin D tends to be deficient in people with depression. I would suggest you talk to your doctor about these options and hope that helps some.

Thank you Suthrnsweets! I actually have been on Omega 3 Fish Oils and vitaimin D capsules for years now, and upon testing for calcium deficiency, I am in the normal range, just on the low end. My psychiatrist is reluctant to give me a true antidepressant right now, but I do know that there is a regimen that includes an antidepressant for certain days of the month around one's period, but it costs a lot to go the best medical centers where the docs help with this sort of thing. Am still trying to research it and talk to doctors. One thing I am not in a regular habit of doing is exercise for whatever reason / excuse... it feels so depressing. May I ask what you, Suthrsweets, tell yourself to get ready to exercise or even what you include in your exercise routine? And I still appeal to anyone who might know information regarding the antidepressant for that certain regimen, OR any other further helpful information! Thanks so much again Suthrnsweets, and always a big thank you to anyone who reads this, or who may share tips...

I have tried some antidepressants for my PMDD such as Zoloft, Paxil, Celexa, Lexapro, Wellbutrin, Effexor, and Trazadone. Zoloft, Paxil, Celexa, Cymbalta, and Lexapro are the ones that my doctor reccommends for women with PMDD. They can be used as needed to help with depression and mostly anxiety. Zoloft was the first one I tried and it made all my cares go away, which I don't know if that was good or bad. Then I started getting side effects, insomnia, weight loss due to inability to eat, and social anxiety. Then after a week, which is when most antidepressants start to really take effect, I became manic and started having mood swings every few hours. Paxil is not quite as strong as Zoloft and I do have some on hand to take as needed during the 10 days before my menstrual cycle. It still causes insomnia and anorexia, but not as much as Zoloft. My doctor advised me that antidepressants do not have to be taken every day, especially in bipolar disorder. I, for one, cannot take them every day. They make my mood swings worse. The debate is still out whether antidepressant use worsens bipolar disorder long term so doctors are very reluctant to prescribe them for bipolar patients. Some doctors believe they harm more than help. As far as exercise, I know I had no desire to exercise when I was on more than one prescription medication. My doctor and I have been lowering my dosage over the past couple of years so that I am only on one prescription. I got fed up with all the side effects so I found a doctor who prefers to take care of my medical issues first, nutritional issues second, and medication is a last resort. This is the first doctor who has ever run blood tests to check for vitamin and mineral deficiencies. And I'm glad he found them! As far as exercise, I walk an hour every morning at 8am. The morning sunlight is wonderful for my mood. Also I lift weights for 30 min twice a week. I have to talk myself into it by telling myself that if I don't, I won't sleep well and will not be able to relax. Then I will have mania and anxiety and will be miserable. It sounds like you can't exercise because of the depression, so don't beat yourself up over that.

Hello -

I too have BP 1 and PMDD. Not fun at all. I get ragingly paranoid and nearly psychotic during that time. I start hating everything and everyone and feel people are out to get me at times. My anxiety is so bad that I am sure something horrendous is going to happen so I have to take Xanax too. My depression gets so bad I literally feel like if I had the guts, I would throw myself out of the window. It feels all I can do to hang on at times.

I currently take just 20 mg. of Cymbalta and I this last time around, I did double up on it for a few days and I think I did fee slightly better, but I am so afraid of meds these days and was worried about then going into withdrawal, that I didn't do it the rest of my period. But I am going to make an appt. and talk to my doc about it.

I have heard about that - taken an SSRI or SSNRI maybe 10-12 days or so before the period begins.

Might be worth a shot.

I also exercise (brisk walking) quite a bit and while I thought it was helping, when I got my period, I was even worse off and could not walk, so it seems to want to gang up on me no matter what I do.

I also am fed up with meds and am trying to take less of them. But this means I have to work with a lot of other tools, which I am willing to do.

I really need to save up some money to get a naturopath to test the same things or a doctor who will.

Please update to what you find out!

catw1101,

I agree - these illness are hell! And then some more....

But I was happy for you to read that you are thinking about seeing your drs. I'm no doc, but I've helped as a peer support specialist ( well-trained in mental illnesses to work with other with similar diagnoses) and know that this IS an important time to talk to your doctors!

Here's why: Self medicating (doubling up on meds without a doctor's prescription) can be VERY bad, making you sicker and for longer. And, by the way, and as long as you know I am not good enough to give doctor's advice, I still know some. When the people I helped were on Cymbalta, they had a good chance of suicidal thoughts. For others it was a wonder drug. I would encourage you to be very careful!!

Psychiatrists are around for a reason. It definitely makes the difference as to whether you have a good psychiatrist or one that just flat out doesn't care. But you should care, and know that there are really really good drs. out there that WANT to HELP you!

As for a naturopath, I know that they can help, but not like a good psychiatrist can almost eliminate your symptoms and help you "manage" your illnesses. If you are looking for a great pscyh dr., there are ways to find them. I know some organizations and support groups around the U.S., if you might be interested at all in them. Please let me know if you'd like to know further about all of this.

*** Thank you for taking the time to read through this. It may not be what you're looking for, but then again, it's here in case you think it would be helpful to you. I definitely know what it's like for me from my own torture deriving from the combination of these illnesses combined. I have had these illnesses for 16 years, but I don't know where I'd be if I hadn't persevered with caring psychiatrists. I wouldn't even be the me I know today. Psych docs are important.

I hope you feel better whatever happens.

Best Wishes,
PickyPetunia