Bi-polar Disorder with Chronic Pain
 

I am 40 years old and have been diagnosed with type 2 Bi-polar disorder along with severe depression. I also suffer from chronic lower back pain due to 2 degenerating disks. My medications are:
Morphine Sulfate 100mg x2
Vicodin 7.5/500 x2
Cyclobenzaprine 10mg x1
Seroquel 200mg x1
Pristiq 50mg x1
Vyvanse 50mg x1

My question is this, (and it will be very difficult to answer, I apologize) How does the Bi-polar disorder effect the chronic pain issue and how does the chronic pain effect the Bi-polar disorder? I have no doubt that they work against each other. My current medications for the depression and Bi-polar are not working. I am with a new phychiatrist and he is not really aggressive with medications. I don't mind that, but I have GOT to find the right combination to feel better. I am not working right now and am trying to decide whether to apply for disability or wait and see if we can get to the right combination of medications so that I can return to work. In my current situation, there is no way I could hold down a job. This in itself is an extremely stressful situation and does not help matters. I will gladly accept any advise I can get.
Thank you.

I too live with Chronic Pain (RSD) and BiPolar 1.

I so far find no link between the two... I'm not saying that it isn't possible as anything is possible... just not in my case.

I can only suggest that you are completely open with your Psychiatrist. Let him/her know that the combination of medicines you are on are not working for you. REMEMBER: If you don't pass this information along, he/she will never know.

I wish you the best!
:)
Abbie

Hi,

Welcome.

Is your pain being treated?
That would certainly interact with mood.

Vicodin would interact with depression I'm guessing.
I'm sorry that I can't really give you imput on the list of meds -- not seeing anything on the list that jumps out at me because not an expert.
Is Vyvanse helping for ADHD or for mood?


The best thing to do is to talk to your pdoc.
Ask your pdoc to be more aggressive -- talk about your goals and needs. Talk about your expectations.
And if he or she cannot work with you, then find another pdoc.
Sometimes it helps to get the pdoc to talk to the other docs for you so that they can be on the same page (This only works sometimes because some docs don't communicate very well.)

Pushing hard to get on a better med plan can give you more opportunities than you have now. Whether or not you apply for disability, you can possibly (and quite probably) get your moods better regulated.

M.

Not positive, but I believe the seroquel might be what the doc thinks
will help the depression.

But I'm not sure about that. Because its known to help with anxeity.

I personally think, applying for Disability, and not needing it. WOuld be
better, than waiting and losing maybe a couple of years.

Because the way most chronic pain situations are lately, its taking a couple
of years or more.

So do what you need to do.

Donna

reply to all
 

The Vyvanse is for the treatment of fatigue. One of my major symptoms with depression is extreme fatigue. The Vyvanse does actually help that and makes me feel more "human" during the day. I like it and would recommend it to anyone who suffers from fatigue. (pretty much anyone who has severe depression...lol)

What meds are you guys taking, especially for Bi-Polar disorder? Is it working for you? I still know little about the disease and how it affects me on a daily basis, even though I have done a lot of research.

I read a little about the pristiq which is for depresson like effexor but "better". How long have you been on this?
you should ask your pdoc (psychiatrist) about a mood stabilizer. seroquel is good for anxiety. I take lamictal, it also has antidepressant qualities.
I also take geodon which is like seroquel, an antipsychotic.
keep us posted
hope you feel better soon!
beth

reply
 

I have been on the Pristiq for about 3 weeks "this time". I have taken it several times before and was on Effexor XR for a long time. Effexor is a good antidepressant but it makes me really mean. I had to stop taking it. The Pristiq only gives me headaches occassionally but its not bad.
The hard part about having several issues is finding a drug combination that will treat each issue effectively.

I have heard that coming off effexor can be hard...did you just switch over?
having any side effects? could be the reason for your headaches if you did just switch.
hoping that your day is alright.
beth

Effexor
 

No, I have been off the Effexor for some time. It is TOUGH coming off that stuff. It is almost like withdrawal from a narcotic. The Pristiq is supposed to be a "refined" version of Effexor. I have had no side effects with the Pristiq except for the headaches. There is also no withdrawal when you come off.
I may have mentioned this before, but the Vyvance is a great drug for severe depression. It is actually for ADHD but works really well for other symptoms.
I highly reccommend it.

Hi, I am recently diagnosed with BiPolar 2 as well...since June. Often we cannot take antidepressants ( I can't) because they make us manic (this could be acted out as mean). I took Prozac for years and then it just stopped working..my doc thought of BP2 right away with my other symptoms. I was in severs depression as well at the time. Now I am on Lithium Carbonate, lamictal and clonidine...seems to be working well as the dose of lamictal is increased.(you have to work up slowly) This site has been helpful to me, I hope it is for you. People here are very caring and understanding.
PS... I love your state...SC is beautiful, we are vacationing there in Sept.

reply to dogodlvr
 

Until recently, I had never even heard of Type 2 Bi-polar disorder. Everybody always told me that Bi-polar people would go through these periods of extreme happiness and euphoria. I knew I never went through that, far from it. It was a kind of releif to find out that the condition affects everybody differently. I am still not where I want, or need, to be with my meds, but were getting there. It is just hit or miss until you find something that works well. My problem is that I have sufferred from severe depression for a long time also. My body has gotten used to a lot of the normal drugs for depression. Sometimes, I have to rely on my psychiatrist to think "outside the box" with medications. We will keep plugging away until he finds the right combination. Sooner than later I hope.

That is a good attitude.
Donna

Hi,
I hope that "sooner" comes soon for you. http://bestsmileys.com/flowers/1.gif http://bestsmileys.com/flowers/1.gif http://bestsmileys.com/flowers/1.gif
Things really can get better.
And it seems that you have confidence in the pdoc -- that helps.

M.

Doc
 

Well..... I don't really have a lot of confidence in the psych. I have only been seeing him for about three months. When I first went to see him, he told me that he did not beleive in "over-medicating" patients. I don't know if I agree with that philosophy or not. If I need it, over-medicate the hell out of me...lol Don't hold back if that's what my condition requires. I guess time will tell if he is dedicated to solving my issues or not.
Whether I am approved for disability or not, I will continue to search for the doc that WILL help, whatever it takes.

Hi,
That sounds of dumb to me. Maybe he has changed since that first visit and started trying new ways of looking at you.
The pdoc should go with what the patient needs, not with his own system. :confused:
Here's a link I ran across recently related to this:

http://www.psycom.net/depression.central.expert.html
How Expert is Your Psychiatrist/Psychopharmacologist?

M.

reply to Mari
 

Well, that has yet to be seen. I will know a lot more about him after my next visit in two weeks. When I explain that I am still feeling like crap, he should take a bigger swing at the problem. If not, it may be time to look for someone else that will.

Hi,
Yes, sometimes you can have a heart to heart talk and ask for a bigger swing at the problem.

Sometimes getting better takes effort.

I used to have a formula that I made up with regards to my getting better:
Getting stable = 50% good luck and 50% pushing the pdocs hard.

That's something that I made up so it does not really mean anything but it makes a little sense to me.
-Sometimes we can make our luck.
-We can usually (almost always) find good pdocs.

I hope that you can feel better :)

M.

Dr. says what...???
 

As I have stated several times here in the past, my PDOC and I have been working to find the right combination of drugs for several months now with little success. I recently contacted the Dr's office to let him know that the current combination was not helping. The response shocked me. He had his secretary call me and say that he was not sure he would be able to do anything else for me. Huh? Isn't that what you do for a living?! My scheduled appointment is this Wed. I am interested to see what this dude has to say. If he tells me he can't do anything else for me to my face, I might smack him! lol! I have only been going to this doc for about 4 months. I certainly hope he is not giving up on my treatment already. That would be a real kick in the pants wouldn't it? Anyway, have you ever heard of such a thing?
I sure as hell hav'nt.

OMG!
Are you seeing a pain management specialist/clinic to manage your pain issues?
It is definately time to see a new doc!
if you have only been with him 4 months he doesn't have the patience to treat your chronic issues. You need a new doctor.
I went to a pain management seminar this last friday and it was wonderful.
She spoke of using methadone as a cheaper treatment option.
also there is a once a day dose now of pain killers called avinsa.
Have you tried the duragesic patches?
I think there is a chronic pain forum here at neurotalk...you may post there already....
what about cymbalta for the depression with pain issues????
I can't imagine suffering with chronic pain issues.
I am sorry that you do...I know that there are alot of you out there.
((((HUGS))))
bizi

HI,
This is disappointing. :(
I hope that the message from the secretary was not accurate.
You'll see on Wednesday.

If it is true that he is giving up on you, he is saving you a lot of time and trouble. It's good news in a way. You are free to go find someone else.

And don't think of it as "giving up on you." If in fact he does feel like he can't do any more for you, then that's because he can't. He has no more tricks in his bag.

M.

Like you I have Bipolar and Chronic Pain caused by Lupus.

Let me write about the pain aspect first.
From what I read, and gather from the drugs that you have been rx-ed the severity of your pain seems to be much more than mine. 50 mg of Tramadol keeps me going for about 6 hours. I don't take anymore because of its addictive nature. Within that six hour window I try and get things done. At least twice a week I skip it to make sure that the drug doesn't get me and make do with an assortment of Anti Inflammatory painkillers a few times a day. That of course keeps me at home where I merely function and find it difficult to even concentrate on a book.

Now for the Bipolar - this seven month of the Lupus flare has effected my mood. I have been on a comparatively high dose of Lamictal for years, but recently as I felt my mood was crawling towards the deep end the Lexapro has been upped.

Chronic pain can cause a darkening of mood, and the medications for both need to be adjusted. Lyrica was suggested to me to control the pain, but that is also another anti-seizer/mood stabiliser. It is also notorious for weight gain. And in the - I can not lie - mode, I would only take it at gunpoint.
I have put on about 70 lbs already. From svelte I have become matronly. Not nice! Tramadol can be a depressant, but is compensated by the extra Lexapro.

Holding down a job - does it involve running around, or is it a desk job?
Do you need to use a lot of concentration, is it high stress, long hours?
All that and more will need to be considered to decide your rx .

Hope it all settles down soon.

Hi,
I hope that the appt. goes well on Wednesday.

M.

I am taking Vyvance which also inrease seritonin which cAN AID IN DEPRESSION. gOOD LUCK TO YOU

I too have chronic pain and Bi-Polar. I sometimes think a Psychiatrist is the wrong specialist to treat pain. I found great relief going to Cleveland Clinic. I only go back once a year. Those folks are so familiar with medications that my pdoc has never even thought of. The resources are there to treat multiple problems. I go for Bi-Polar, epilepsy, migraines and pain. It was so worth it to me. I feel a lot better now. Life is too short to feel bad! Best to you.

Welcome to the forum Storres!

I also don't think it's appropriate for psychiatrists to treat pain disorders. They should be addressed by medical doctors- ideally ones who specialize in the reason for the pain. It's great that the Cleveland Clinic has been able to help you.

You've written some great replies, and given members some great advice here already! Would you consider starting an introduction thread so that we can get to know you better?

Welcome again! :)
Kay

I also agree a psychiatrist isn't the right doctor to treat pain. I see
a pain doctor. And he has helped me a lot. In many different incidences.

Donna:grouphug:

pain
 

Hello, I am sorry you are dealing with several issues. I wonder if you should investigate your pain issues more. Pain does make my depression worse, no question. I had the surgery, and lessoned the pain I was in. Depression got better when the pain wasn't as bad. I wish you all the best. ginnie