PMDD VS Bipolar Disorder
Q: I was diagnosed with depression 2 years ago and have been
on many of the popular antidepressants. They work for a few weeks, and then
poop out entirely. Several weeks ago, I stopped taking birth control pills
and antidepressants at the request of my Naturopath. The St. Johns wort seemed
to have worked up until 4 days before my period. I'm a raging lunatic -- crying
hysterically and fits of rage within minutes of each other. My suicidal
and homicidal thoughts are what's most frightening. My doctor today mentioned
I may have Bipolar, which just doesn't ring true with me. Your site has made
me think it's PMDD.
Where can I go for the best treatment and evaluation for this disorder?
For two years I've been hardly living my life and I want to get back on track
as soon as possible. Is there a way to measure my hormones throughout the month?
The only reason I went on birth control was because my PMS was so out of control,
but in the past year, the pills didn't really help anyway. Please help,
Dr. Donnica: I am not usually able to answer individual emails immediately
or directly, but I am VERY concerned about your message because you mentioned
having suicidal and homicidal thoughts. You must take this VERY seriously
and get to a board-certified psychiatrist ASAP. If you don't know who to
see, go to www.AMA.org, where you can find physician recommendations based upon
your zip code and their specialty.
Based upon what you told me, it does sound like you have PMDD, not bipolar disorder.
When you call to make an appointment with the psychiatrist, ask if this particular
doctor has experience with PMDD. A psychiatrist can probably tell you
in one visit if they think you have PMDD or bipolar disorder and is much more
qualified than a naturopath to make that diagnosis.
Low dose birth control pills are often helpful to reduce the symptoms of PMS,
but they cannot treat PMDD. There are many medicines that can treat PMDD
very well and you should discuss this with the psychiatrist. Be aware,
however, that the first medicine you try may not be the right one, the right
dose, etc. Sometimes it takes a few months to get everything sorted out.
St. John's wort, by the way, can decrease the effectiveness of several other
antidepressants and birth control pills and in some cases, it can have negative
reactions with other antidepressants, so I'm glad you went off the prescription
medications before trying St. John's wort. In general, St. John's wort
is effective for mild and sometimes moderate depression, but once you have suicidal
or homicidal thoughts or feelings, prescription medicines are generally far
more effective, along with psychotherapy. Many antidepressant medicines
take a few weeks to work well and sometimes a few months to work up slowly to
the correct dose.
Good luck. Please let me know how you are doing in a month or so.
I'm pulling for you.
With best regards,
Donnica Moore, MD
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Created: 6/5/2001  - Donnica Moore, M.D.