I must say, I am tremendously thrilled with my new pdoc, Dr. B. Any doctor who would willingly give you an hour's worth of his time (and who is a wonderful listener) is a gem.
And he made a few things about bipolar disorder completely clear, stuff that had me a little confused. This guy is the first doctor who's answered my questions in a direct manner. Perhaps my questions and his responses will help you. Or at least, leave you a little better informed.
Mar's Question 1: Why was I initially diagnosed as bipolar II and then 10 years later, rediagnosed as bipolar I?
Dr. B's Answer: Because sometimes the nature of the disorder changes. Maybe originally you were more depressed and had very few incidents of rapid cycling and mania, hence the diagnosis of bipolar II. Then as the years went by, you became more manic, with dysphoria rather than euphoria, and rapid cycling. This would indicate bipolar I.
Mar's Question 2: What's the connection between bipolar disorder and epilepsy? And why do anticonvulsants seem to work so well?
Dr. B's Answer: Bipolar disorder is really a seizure of the brain rather than the body, which is what epilepsy is. Both types of seizures respond well to anticonvulsants. When you are manic, your brain seizes up and you are subject to impulsiveness, delusions, bad judgment calls, paranoia, anger, and all the things that indicate mania. The anticonvulsant helps to stop that activity and allows the brain to work properly.
Mar's Question 3: I think I finally understand that I must stay on my medication for the rest of my life. But is that really true? Will I ever be able to go off of my meds?
Dr. B's Answer: Yes, it's true. And no, you should never go off your medication. It is believed that multiple episodes of the disorder cause brain damage. Your cognitive abilities become impaired. Without medication, the brain will sustain more damage as you grow older. The medication not only allows you to function but may in fact help repair some of the damage already there.
I left his office feeling more and more comforted that I have a neurological disorder, one that can be controlled. Even though I've always espoused this, there have been times after a particularly bad episode that I've doubted it. When your brain goes haywire, it's hard not to blame yourself rather than the disorder.
Case in point, regarding anticonvulsants being of enormous value in controlling these brain seizures. Last week, I had a terrifying episode, where I could actually feel my brain seize up. It happened while I was driving and suddenly, I felt almost suicidal. I began crying. I felt incoherent. Somehow, I got home safely but suddenly, I felt a wave of sheer anger overtake me, anger directed at a dear, beloved friend and companion. I wrote an angry email but somehow had the sense not to send it. I then hand wrote a note to him, the note being rather incoherent and vague.
Now, I'm on medication but fortunately, I can take an extra Seroquel or two if this happens. Which is exactly what I did. Within a half hour, I was OK. This time, I understood exactly what was going on, whereas before, I'd just get worse and worse until suddenly I felt better.
The next time I seize up, I'll know exactly how my brain felt from the previous episode and maybe I can nip it in the bud. The path to understanding this disorder is becoming less and less ambiguous. Thank God.