Dr Syl answers your comments: MANIA & BIPOLAR
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- Опубликовано: 28 май 2024
- Reviewing and answering your questions and comments. Comment any other questions you have below :)
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I would hope that once you reach the goal of being a psychiatrist you will continue learning. I like to think it's just another step in the journey, not the destination.
I'm glad you gave answered the question about mixed episodes. i hope one day you can make a video just on mixed episode. i basically only had mixed episodes and depressive episodes, only had mania once, and its why for the longest time i didnt believe my bipolar diagnose, nobody talked about mixed episodes and i could not find information on it online. mixed episodes truly are hell on earth. the worst mental pain ever. thanks for your videos
With bipolar it’s hard to know the difference between maniac and the “normal in between” depression.
Definitely when depression is the main part of you bipolar. Every good mood is seen as a possible manic episode. Definitely when you get Hypothermia.
The last time I was manic was in October last year when I became toxic on lithium and had to come off it. I had a eurphoric mania and did art non stop for two weeks solid. I wrote 11 zines (mini DIY magazines) and connected with people all over the internet to swap and trade and sell them and I could not sleep for the life of me because if I slept I'd miss out on all my ideas. I'm still paying subscriptions to all the adobe art programs I joined and probably will have to pay them unitl October. It seemed like a good idea at the time anyway. In any case, my seroquel-xr was increased, I can't take mood stabilisers as I've tried them all, and so it took some time but my mania (I was hospitalised) contained itself eventually. Now I have a box full of zines and am still apologising for my behaviour, if only it wasn't so public. I'm glad I didn't get psychotic. I'm well now and are the most well I've been in ages. Don't know why I'm writing this but it just seemed like, here at 4am in Australia, yes I'm doing art and I slept well, but life just feels good now and it's so quiet and calm outside because everyone is sleeping. Nice! Best of luck for your exam. I think you'll make a wonderful psychiatrist when you get there. I'm lucky to have the best psychiatrist in the world. You'll get there, you got this!!!
I just caught myself considering trying that idea🤦 I make a lot of art too
Thank you very much for sharing what you have been learning!
I am 71 and have suffered from these mental illnesses most of my life, but thankfully, I have been better the past several years. Of course, I don't expect much at this time of life! 😄
I pray you always find these endeavors rewarding and successful.
Very insightful video! I’m at risk for a bipolar disorder and it’s one of the things in my life I’ve been coming to terms with. Two of my siblings were diagnosed with bipolar and I’ve struggled with depression for years despite my young age. Your videos have helped me understand these disorders more and actually were one of the catalysts for my decision to pursue going to medical school. Keep up the good work and good luck on your exams!!
❤ my mom has biopolar disorder with psychotic episodes and so does 2 out of 5 of my siblings. I do not have it somehow. I see a psychiatrist every month since teen years just because I got so worried I’d not notice becoming bipolar. It didn’t happen and I’m 34 now. I still see a psychiatrist each month. Highly recommend just to be self aware and at peace that you’re being proactive about your mental health!
I've been manic for about 6 months now, but since I'm on quetiapine I am sleeping. I wonder if the quetiapine is sustaining the mania, because without it I would not be sleeping and would have maybe burned myself out by now. It has reduced the mania into hypomania so it is making it less out of control. I don't really want to tell my psych as he will double my meds so not sure what to do. I get it about amphetamines too, when I was younger and everyone was taking mdma and speed etc, if I took it I always had a bad time, I would get way too high, too fast, then crash into a really low mood or else have horrible racing thoughts, over talkativeness and tension, so they enhanced the bad traits I already had. I knew there was something different about my brain because I could not have a good time on these drugs like everyone else seemed to.
Hey Dr Syl! Thanks for talking about this - I always appreciate when "my" disorder is delved into as information is power with managing bipolar.
I was diagnosed privately last year at 27, after 15yrs of being misdiagnosed and managed under public metal health care in NZ. My psychiatrist started me on lithium this week as a "last resort" medication - It immediately helped with my depressive episode which was surprising to me, but pharmacologically makes sense given how it interacts with sodium gated channels. Hopefully it will be a good maintenance tool for hypo/manic/mixed episodes too.
yes, exactly. when i was in mixed episodes i had all the energy and the will to hurt myself.
Great video! I hate that media glorifies mania, but it’s also hard to explain it to people I feel. I just say that mania means crazy in Greek. It’s not fun
i understand that drug induced mania or psychosis from something like an amphetamine may not technically be either of those diagnoses because you cant see them when they are not on drugs.
what about prescribed drugs? I was on fluoxetine to treat depression, first time on any kind of anti depressant. for the first 6 months of it i was much more depressed than before but was trying to trust the process. eventually i ended up switching to 'mania'. elevated mood constantly over a few months, over spending, cheating and convinced my partner for an open relationship, using sex, other drugs and alcohol after it all came on. during this time i was really depressed as well, suicidal and stuff but i also felt undeniable 'mania', impulsivity and on top of the world in a way. maybe it was more hypomania because i could still work, but i failed uni, self harmed at work, never took lunch breaks stayed back 4 or more hours after my shift finished etc
after all this at some point i took myself off the meds, eventually it all calmed down. i still struggle with drinking, have days where i can feel sort of close to this, on top of the world, out of reality, usually i feel like im dissociating in a derealization/depersonalisation way. but it doesnt culminate into a whole episode, usually just a bit more energy for a few days and then either normal level or a bit more depressed than usual.wouldnt call it mania or hypomania but its like tipping that way a liiiittle and best way i can describe it.
im now on sertraline and experience all of this a lot less. sometimes its boring in a way and i more switch between 'normal' and more depressed. its hard to find the energy for most things and sometimes i miss having those days with more energy.
anyway i guess i want to know, if that was a manic/hypomanic episode, does that count as drug induced? or more factors need to be taken in?
Someone I love is bipolar and I’m learning so much from you so thank you.
As an aside, one thing I have consistently heard from autistic people is that they are commonly misdiagnosed as bipolar or BPD. It would be an interesting thing to learn more about.
Great video. Thanks Dr Syl.
What are your thoughts on the metabolic psychiatry approach? I'm asking because ketogenic diet applications are becoming increasingly popular for bipolar disorder and schizophrenia. What is your opinion?
I also have trouble with recognising my hypomania but I recognised it earlier this time around. Unfortunately the triage didn't agree so I got to full mania again before uping the anti's. In the pipeline for a change from lithium to sodium valproate, plus usual antipsychotic. I just don't get enough months well between episodes. Yes it is all serious and hypomania is certainly the best time to catch an episode but it doesn't stick out to me like full mania. No matter how much knowledge I have. I also have cptsd (bpd) and ocd and these new diagnoses seem to get in the road of my signs, insights and control over bipolar 1.
My eyes go big too but I've noticed the most severe episode the bigger my eyes. So I guess my episodes when I wasn't on meds my eyes were the most pronounced.
I get very irritated and rage a lot when manic. I’m better off staying away from people and online shopping when I’m manic.
Thx ❤
Would you consider going a video on Antidepressant Discontinuation Syndrome?
off topic, how long have you been playing the drums? that's so cool.
In horses, appaloosas have a white sclera, an anomaly in the horse world.
The last little bit of the video hits home for me. I was diagnosed with ADHD and autism (was told it would have been Asperger’s if that were still a diagnosis), as an adult… oh and PTSD. And I do have a history of childhood trauma. I’ve been very curious about whether it is just trauma or not… because although my symptoms go back as far as I can remember, so does the trauma. Chicken or egg?
Thanks Dr Syl, interesting as always. I'm diagnosed BP2, but was diagnosed during a 2 week inpatient involuntary stay 14 yrs ago. So I guess I should be BP1 ? Anyway, whatever the label I am what I am. I have a niece by marriage, that suddenly started having epileptic seizures. She had multiples per week. Now she has been diagnosed as bipolar. It makes me wonder did the epilepsy cause damage to create the bipolar or did the bipolar cause the epilepsy. I take Sodium valproate as my anti episodic, and it cured my migraines as well.
Will you be exploring Metabolic Psychiatry?
What’s the difference between a good mood / good week vs hypomania?
Have you heard of the COMT gene and its impact on mental health?
My estranged family member has this diagnosis. I dont contact because im afraid of triggering them.
Would like to know your thoughts about genome testing to determine which medication is best for an individual person. Have you any thoughts or info on this topic? Thank you!!
Is it typical fit people who experience mania to want to avoid accountability for their actions while manic? Blame others for instance? “I spent all my money because you didn’t lock it up”. Or would this be more of a personality thing? During mania we don’t hear from our adult daughter. It’s only when she realizes that she’s in trouble that she contacts us and it’s usually vi long winded text rants about how we are responsible for her predicament or her boyfriend or whoever was last around her. I’m not sure how to handle it. She can be quite vicious and I don’t feel like being around her but she’s also sick so I don’t wish to abandon her either. Do I just ride it out until her mania subsides and not take it personally? Anyone experience this with a loved one?
Could u please talk about D I D ,
I’m 54 was diagnozesd with severe cptsd and d I d 5 urs ago , maybe more , I cannot keep track of time and space , many disorders stem from both diagnoses , please
Thank u. Jo/ Joanne
It’s very difficult living with a bipolar person who only has a prescription for depression. The ripple effect goes through everyone she associates with.
Hi Dr. Syl--i wonder if you might consider doing a video comparing and contrasting symptoms in hypomania, anxiety, and ADHD? I have a history of anxiety disorders, chronic depression, OCD, and early PTSD. However, i have not responded responded well to high-dose SSRIs for 30 years either on the OCD, anxiety, or depression fronts. Mood stablizers have not helped either. Some people experience jitteriness or akathisia on the anti-depressants. I've been told i could have ADHD in there. One other doctor thought i could be cyclothymic and have mixed depression. These all overlap, but they have clinical implications. Does one remove the SSRIs? Does one try a stimulant? There's such overlap between these different conditions. I've also tried ketamine and TMS as well, and those have not helped much. Welcome your thoughts on these different conditions. thanks.
You say that most of the time people with Bipolar are depressed, is that what you observe the most? Because I am diagnosed with Bipolar 1, have had a few severe depressive episodes, but I'd say before I started using Lithium the number of hypomanias was much higher.
What's also curious in my case: I was Bipolar 2 when I was diagnosed, I have been on Lithium now for 2,5 years, no depression or hypomania since, but in the last few months I had two manic episodes (both lasting about two weeks), "upgrading" my diagnosis to Bipolar 1. Have you observed something like this before? At the time, it might have been due to my dosage being too low, but it was strange to just experience my first real mania like that.
Keep up the great work and good luck on your exam!
I would like to know if there is any psichiatric medication, treatment or recent research related to dementia in younger people (54), and how should the approach be for a person who is fast losing its cognitive skills and cannot cooperate with following up on secondary effects of psychiatric meds.
I would love to hear you talk on some anonymous peoples versions of whaat hypomania is to them, coming from clinically diagnosed bipolar 2, that is..not self diagnosed
Thank you for your videos my comments are usually critiques buts thats because I think you content is interesting. One thing I will say is I thought after the Rosenhan experiment (admittedly review years later on evidence) published in Science would have made psychiatry realise and self reflection like empathy and projection etc that there is no such thing as objective. In neuroscience we use "we" or "the author" and I don't expect my discipline to have that insight but was surprised psych doesn't.
I have Bipolar 1 and mixed states with paranoid psychosis. The psychosis is unpleasant. But mixed state close to suicide once until my behvaiour made someone look in my lab and I was discovered. It is the worst experience I would rather 3rd degree burns I've done the classic manic stuff it just makes all the decisions worse why not do meth maybe you'll feel better or whatever. Ironically of course for 10 years I was treated by some doctors and me and a few others I came to know were all diagnosed with treatment resistent depression before bipolar. Antidepressants ironically make me depressed. The other frustrating thing is despite textbook knowledge of neuroscience it hasn't helped my recovery I have had to rely and have made progress with my psychiatrist a bipolar researcher a prof of psych.
I showed him and this is just for your interest the upsidedown from stronger things when not full on psychosis I can get mood contingent otherworldly I showed him the arcade scene on youtube. He must have practiced for 30 or 40 years I asked him if someone has had this he has told me in the past perceptual disturbances are common in bipolar. He said not exactly maybe in words but they didn't have a video so he couldn't conceptualize it. Your mantra complex problems have complex solutions. Mine from my ASD is no two people are alike.
I don't have much more to add than what you've experienced already. I will say when I needed help mixed and hypomanic psych put it down to personality now thats off the cards I couldn't communicate ASD stress. Now I get sectioned a lot so I stay away from hospitals because occasionally you get paternalistic psychs. They know I know how to kill myself effectively they have my history and I guess its a red flag however my current strategy is I can get out so long as I give them my psych card he is respected AO etc and he will tell them I see him weekly and thats my norm and I'll be fine. I had three years of hypomania and mania - my mantra for public hospitals is "traumatised or your money back". I will say the first time if I wasn't scheduled I wouldn't be alive now but very much depends on the doctor you get and how much they care about understanding your case.
Also I think all psychiatrists and junior drs in the training programme should go to a random hospital and get scheduled for a weeks I think people would be more empathic or at the more knowledge. Also even though I studied neuroscience we do kidneys liver heart etc and I there are more medical errors in psych wards so I feel like they should all have a GP like a private hospital.
Hi Dr. Syl! I work as a provider for a child who has DMDD and experiences something that I believe may be similar to mania. Do you have any recommendations as to what supports I could recommend be offered in these moments?
Have you looked into ADHD?
@@watchthisheadspace I don't diagnose in my role, but I am open to recommendations of strategies that help manage ADHD as well!
They could well have ADHD, if interventions for ADHD help then it's highly likely and also it helps so win win. I do this for children who appear to have ADHD or autism and it usually helps, then then get diagnosed through school a few years later but it's often very obvious from early on
What is normal... 😂
If a person has had trauma in their lives . 😢
Do we really have a flat plain of a personality all our lives dr Syl. I guess not... Shit happens.. for reason...
Most people do not normally express this range of emotion on any one interaction. Are there actually this many "emotions" that can be felt rather than expressed facially, tonally, ect?
Assuming I'm supposed to feel what a person's face is saying.
I would just like to share with you a very interesting presentation about bipolar, showing studies results and interpretation to assess diagnose. The video is called "bipolar depression: translating receptor pharmacology to advance management" channel HMP Education. Very interesting recently studies of the brain, highly recommend.
A young man i see "stuck" standing for the entire day, his facial expression looks wild. He smiles, but you can see he is not in a good place. Maybe he doesnt realize hes been standing there for 6 +/- 7 hrs. :(
Lack of sleep can dramatically alter your mind in extreme and adverse ways. You may not have a condition but if you choose to over stimulate your mind as apposed to winding down and allowing sleep, even someone who has never had any mental condition in the past, could end up with a temporary mental condition. If you’re lucky enough you could be tagged and plagued with a diagnosis for the rest of your life. It is very difficult to regain trust once you loose it. This could happen to anyone! Just 48 hours of lost sleep, or a week of only a bit of sleep here or there and you are probably doing damage. Of course it depends on the person who are you? You really wanna test it? Get sleep people!
It really got me where he said about needing to feel safe and trust to sleep, I've had insomnia since childhood but had ocd before it started so don't think the sleep problem came first. I reacted to my anxiety about going to sleep by staying up doing ocd stuff all night, checking everything in the room was in the right place. I guess it's a chicken or egg question.
I can’t get a psychiatrist any where as they cost so much .is there any psychiatrist in Sydney Australia that are free Eg clinics .Hope your exams go okay
Two videos in 1 day, we're so spoiled!
Again found this information interesting could recognise symptoms in a handful of people
What do you do when hormones cause psychosis?
The hormone Prolactin when in high levels can cause psoriasis.
I need help.....sir
I've never had mania, but the way you described hypomania seems like something I may need to consider. I've been under an absolute tremendous amount of stress lately and was the first time I considered calling my PCP and telling him something wasn't right with me mentally. Today I am feeling a lot more settled, so I am thankful.
You only get one voice - I hope this fact helps someone with bipolar maintain balance forever - shout and scream and let it on out as a valued member of society
This is a great video, thank you :)
To your comment at the end about the love hearts, be aware that you leaving a heart will reduce the anonymity of the comments. A creator heart will raise the comment to near the top of the comment section. It doesn't give the commenter a notification that you liked their comment. You've left hearts on some of my comments and I only saw them when I went to re-watch the video, or when I got a notification about a reply to my comment. The hearts function to help you curate your comments section, it makes comments you like more visible to other viewers. They are not a very effective way to thank the commenter. If you want to do that, replying would be more effective :)