Bipolar or ADD?

A reminder: I’m an engineer. This is all my opinion based on readings in a field that is not my own. I request that as you read my posts, you also check my references.

Cigarettes are powerful anti-anxiety drugs. It’s my opinion that may smokers are self-medicating an anxiety disorder.

Nicotine has calming effects on stress-induced mood changes in females, but enhances aggressive mood in males

“Exposure to moderate stress significantly increased ratings of anxiety, discontent and aggression and nicotine blocked these mood changes in females, but enhanced them in males. This suggests that young women may start regular smoking as a form of stress self-medication, which implies that preventative and smoking cessation programmes would be more successful in women if they addressed issues of stress and anxiety, which may be core factors underlying initiation and maintenance of regular smoking.”

A bipolar most certainly will get a high score on an ADD screening test like the Copeland symptom checklist. The symptoms of ADD overlap with the symptoms of bipolar. A bipolar child scores higher on the ADD screening test that a child with ADD. Your GP isn’t qualified to make a differential diagnosis, and in fact is likely to misdiagnose you and make your illness worse.

I’m going to quote from articles about children because misdiagnosis kills so many of them. It applies to adults too, but we don’t have parents to FORCE us to continue taking ritalin when it is obviously tearing us to pieces.

Diagnosing Bipolar VS. ADHD: Similarities

“There is concern that ADHD is being overdiagnosed and bipolar disorder underdiagnosed in the population of children.”

That being said, yes, I have ADHD combined type. My psychiatrist diagnosed it after I’d been seeing him for 10 years and after an evaluation that DIDN’T included taking an ADD screening test. Screening tests are useless for bipolars. You have to be cautious.

I have been through the entire pharmacopia, or it seems that way. Every ADD med I’ve taken makes me hypomanic within a week. So how I work it is that on days I really REALLY need to focus I take it. I have tried:
Ritalin (methyphenidate) – this is the one they give our children. Somebody please explain to me why 40% of American children need psych meds?
Strattera – this was the absolute worst for me. It interferes with metabolism in the liver of SSRIs, resulting in a huge buildup of both drugs. I was up there in 3 days and in a nasty mixed state in a week.
Provigil – similar to Strattera, but takes longer to build up. YMMV! 🙂
Adderall – amphetamine. SPEED FREAK! Three days in a row and I’m have “racoon eyes” and am well on my way to psychosis.

Strattera Risks May Widen
FDA,s warning about Eli Lilly’s drug Strattera causing suicidal thinking in children used for ADHD caught many parents and doctors by surprise.

“Dr. Laughren says the agency also plans to ask Lilly to include a stronger caution on Strattera’s label about its risk of inducing mania and similar mood destabilization, along with the new “black box” warning out this week. The new warning will focus on the drug’s risks for kids with undiagnosed bipolar illness, according to Dr. Laughren. In fact, “very often bipolar illness is not recognized until you [give] patients a drug like Strattera,” he says.”

Bipolar Disorder, Co-occurring Conditions, and the Need for Extreme Caution Before Initiating Drug Treatment

“Now understanding that early-onset bipolar disorder is frequently co-morbid with other childhood psychiatric conditions, doctors and parents should be concerned that a medication used to treat these other conditions may “flush out” a previously quiescent bipolar gene that can significantly worsen the course of illness and potentially wreak havoc with that child’s life. It is therefore vitally important that parents learn everything they can about their family histories, and if mood disorders (depression or manic-depression), suicide, or alcoholism come to light, treatment should proceed very cautiously. Mood stabilizers should perhaps be the first line of treatment (and it may take two such medications to stabilize the child), and attentional, obsessional, or depressive symptoms be treated only after a therapeutic dose of the mood stabilizer is achieved.”

The Overlap With ADHD

Perhaps the greatest source of diagnostic confusion in childhood bipolar disorder is that its symptoms overlap with many of the symptoms of attention-deficit disorder with hyperactivity. At first glance, any child who can’t sit still, who is fidgety, impulsive, easily distracted or emotionally labile is more likely to receive a diagnosis of ADHD than bipolar disorder. However, since over 80 percent of children with a bipolar disorder will meet full criteria for attention-deficit disorder with hyperactivity, ADHD should be diagnosed only after bipolar disorder is ruled out. While these two conditions seem highly co-morbid, stimulants unopposed by a mood stabilizer can have an adverse effect on the bipolar condition. 65 percent of the children in our study had hypomanic, manic and aggressive reactions to stimulant medications. Parents wrote to us and described some of their children’s reactions to stimulants. They said things like: “He got sky-high on Ritalin and then violent”; “Ritalin caused physical aggression”; “She got psychotic on stimulants”; “He got suicidal and tried to get run over by a car”; “He went bonkers…”

Don’t let a GP play with screening tests. See a psychiatrist.

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