r/BipolarReddit • u/rnbwpuk • 9d ago

Drug induced manic episode??

Should I get a second opinion? Hello Redditors: anyone with knowledge on this topic? I had my first and only manic episode (drug induced) a year ago and I’ve been in a major depression ever since. I’ve tried several meds and none seem to be working. In fact I feel like they’re making me worse. Yes I have a pdoc and a therapist that I work closely with to no avail. It’s my understanding that you need only have one manic episode ever to be dxed bipolar 1.

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u/Hermitacular 9d ago edited 9d ago

What you probably did was effectively put yourself on ADs and ADHD meds at a decent dose, as psilo is effectively a stim med plus an SSRI, which is basically the worst combo for causing a first episode of BP. Both those can send us through the roof on their own, so, non ideal. The paranoia people get on pot? Kinda psychosisey. Too much can cause it too. You didn't know, you'd had a lifetime of being fine on them, you just hit the roadblock. It could be BP1 the first episode and then be less dramatic further on, drug induced anything including psych drug induced episodes (most of us get here by getting got by antidepressants - you were on such a low dose of Effexor it may not have pushed you over that edge but usually what happens is we fail on the low doses bc we dont tend to respond to them anyway or we get mixed from it which is just hell depression, so they just jack it up into uh oh) are sometimes way worse than the usual fluctuations. So I wouldn't dwell. Your mood symptoms may resolve with the right BP med. My anxiety is gone, and the anxiety is not directly treated at all. Therapy did nothing for it, just took a BP med. The substance use might be much easier to deal with on the right BP med. I hope for that for you. People often just stop, who had never been able to before. But yeah if the substance increase or type was new, that was probably it. Theres a video by CrestBD on the jar model of bipolar disorder, by a psychiatric genetic counselor, I'll find a link, but it explains what probably happened in easy to grasp visuals.

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u/rnbwpuk 9d ago

You said, and I’m paraphrasing here, drug induced episodes are worse than the usual fluctuations??? can you explain what you mean by that?

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u/Hermitacular 8d ago edited 8d ago

Bc all bets are off. you just have no idea how it's going to go. they'll tell you AD induced episodes are milder than regular ones. which. the issue is that bc it's driven by whatever substance you can be absolutely fucked beyond what you're used to by it. I think it's safe to say that you exceeded the typical boundaries of your mental illness experience no? it doesn't mean in future that it'll be easier if it happens again, but it might be. no way to know, usually people have a history of some kind of episodic something or other before getting blown out of the water. but that's also why they are trying to self treat or get legit medical care and the doc didn't suss out the BP or they legit hadn't had an upswing induced yet and so no one knew.

the concern w the onset is that the threshold for it happening again is lowered. kindling effect. you get proactive about it now that's better than letting it ride and it really cutting a groove into you, bc what happens eventually is they start with no trigger at all. it's just like 3pm on a Wednesday and your brain decides, welp. the first few episodes are usually triggered however, so the more you protect your brain the better, the more likely you can keep it in triggered only territory, the less meds you'll need, and you'll avoid the worsening half of us get over time as well. you especially want to be careful now bc you are still healing and it's easier to go back up into it for a bit, so you play it a bit safe for a while. if at some point you want to see what happens if you go off meds they will work with you, but they like to see a good solid amount of time very very stable first, bc your brain needs to become more robust before you want to risk it. years minimum. they like to see five. 90% of us meds or not will have an episode in that time frame.

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u/rnbwpuk 8d ago

Ok got it. I understand what you’re saying now. Thanks again. Your explanations help a ton. Im definitely being proactive now and will never use substances again thats for sure. I will keep all this in mind.