LEXAPRO: Judge Experiences Antidepressant-Induced Hypomania

A doctor who is telling the truth about the hypomanic episode this
judge experienced from his antidepressant?!!!!! How refreshing that
the patient is getting the truth rather than being told he had an
“underlying” Bipolar Disorder that was manifest by his antidepressant
use!!!!! Why can’t other doctors be as honest and come right out and
tell the patient that their Bipolar symptoms have been brought on by
their antidepressant?

BUT when a patient experiences mania or hypomania from an
antidepressant, it is ABSOLUTELY INSANE to think they will not
experience it again on a different antidepressant! He and his family
had better hold their breaths!

What a shame when this happened that he did not have a copy of my DVD,
“Bipolar, Shmypolar! Are You Really Bipolar or Misdiagnosed Due to the
Use of or Abrupt Discontinuation of an Antidepressant?” If he had, the
DVD would have served as a warning for him about this common reaction
to both antidepressant use and abrupt withdrawal from antidepressants.

Why are these “Bipolar” patients not told they are suffering
continuous mild seizure activity which is what Bipolar Disorder is – a
sleep/seizure disorder brought on by the drugs?! ANTI-depressants are
stimulants, stimulants over stimulate the brain producing seizures.
The one time of day we all are in seizure activity is during REM sleep
– the dream state. So antidepressants are basically chemically
inducing the dream state during wakefulness.

By the way, the names “Mania” and “Hypomania” should be changed to
“Shear Hell on Earth!!!!!!!”

Ann Blake-Tracy, Executive Director
International Coalition for Drug Awareness
www.drugawareness.org & www.ssristories.drugawareness.org
Author: Prozac: Panacea or Pandora? – Our Serotonin
Nightmare – The Complete Truth of the Full Impact of
Antidepressants Upon Us & Our World & Help! I
Can’t Get Off My Antidepressant!

First, there was his heart stent surgery in the spring of 2009.

Following surgery, he found himself feeling depressed, a scenario
experienced by some heart patients, he later learned. The depression
was compounded by the death of a good friend, he said.

Next, came a period of his taking an antidepressant, Lexapro,  that he
found helpful. But, he said, he stopped the medicine, on his own, too
quickly.

What happened next, he said, was later diagnosed as an episode of
hypomania, an expression of bipolar disorder. . .

Blanche [Downing’s physician], though, describes the episode as a case
of antidepressant-induced hypomania, attributing it to a second
antidepressant that Downing was later prescribed by another physician.

“Medications can commonly cause hypomania, and it’s not really
understood why,” said Dr. Mark Townsend, a professor of psychiatry at
the LSU Health Sciences Center in New Orleans.

Antidepressants can bring on hypomania, as can steroids, he said.

“There’s really not a diagnostic category for antidepressant-induced
hypomania” in the current Diagnostic and Statistical Manual of Mental
Disorders, Blanche said, but he predicted there will be one in the
manual’s next edition.

Find this article at:

http://www.2theadvocate.com/features/people/Handling-hypomania.html?showAll=y&c=y

Former Judge Bob Downing explains episode that led to his resignation

By ELLYN COUVILLION
Advocate staff writer
Published: Mar 13, 2011 – Page: 1D

Comments (3)

Bob Downing, former 1st Circuit Court of Appeal judge, whose sudden
resignation from the bench last summer was surrounded by confusion,
can sort  out the events on a kind of timeline.

First, there was his heart stent surgery in the spring of 2009.

Following surgery, he found himself feeling depressed, a scenario
experienced by some heart patients, he later learned. The depression
was compounded by the death of a good friend, he said.

Next, came a period of his taking an antidepressant, Lexapro,  that he
found helpful. But, he said, he stopped the medicine, on his own, too
quickly.

What happened next, he said, was later diagnosed as an episode of
hypomania, an expression of bipolar disorder.

During the episode that lasted approximately three months, Downing
spent money wildly, alienated family, friends and employees and
resigned from the judicial bench, about the time he was hospitalized
and treated.

“It was a short period. It seemed like an eternity,” Downing, 61, said
recently from an office at the law firm of Dué, Price, Guidry,
Piedrahita and Andrews, where he’s working in an “of counsel” status.

In that capacity, Downing said that attorneys with the firm will work
with him on cases he brings in, but he is not on salary at the firm.
Downing handles personal injury cases.

Now being treated with medication for what was likely a one-time event
and back to feeling like himself, Downing said he recently decided to
speak out about his experience for several reasons.

“For people who have open heart surgery or stents, watch out for
depression,” Downing said.

One in five people experience an episode of depression after having
heart surgery, according to the website,http://www.psychcentral.com,
an independent mental health and psychology network run by mental
health professionals.

Downing also advises people taking antidepressants to stay in touch
with their doctor.

And, he said, “If you start feeling really wonderful and start
spending a lot of money, you need to see a counselor,” Downing said.

Hypomania is “a condition similar to mania but less severe,” according
to MedicineNet.com, a physician-produced online health-care publishing
company.

“The symptoms are similar, with elevated mood, increased activity,
decreased need for sleep, grandiosity, racing thoughts and the like,”
the company reports at its medical dictionary
website,http://www.medterms.com.

“It is important to diagnose hypomania, because, as an expression of
bipolar disorder, it can cycle into depression and carry an increased
risk of suicide,” the site reports.

Bipolar disorder is marked by periods of elevated or irritable mood —
the mania — alternating with depression, according to the National
Institutes of Health.

The mood swings between mania and depression can be very abrupt, it reports.

“Whether it’s hypomania or mania is a matter of severity,” said local
psychiatrist Dr. Robert Blanche, who is Downing’s physician.

“In general, it’s an elevated or an irritable mood that’s not normal
for the person,” Blanche said.

“In his (Downing’s) case, he was irritable and also, maybe the word is
‘expansive’ in his affects, (showing) euphoria, elation and
excitement,” Blanche said.

“He had never had a history of this before,” Blanche said.

Downing theorizes that his stopping his antidepressant too quickly, on
his own, led to the episode.

Blanche, though, describes the episode as a case of
antidepressant-induced hypomania, attributing it to a second
antidepressant that Downing was later prescribed by another physician.

“Medications can commonly cause hypomania, and it’s not really
understood why,” said Dr. Mark Townsend, a professor of psychiatry at
the LSU Health Sciences Center in New Orleans.

Antidepressants can bring on hypomania, as can steroids, he said.

“There’s really not a diagnostic category for antidepressant-induced
hypomania” in the current Diagnostic and Statistical Manual of Mental
Disorders, Blanche said, but he predicted there will be one in the
manual’s next edition.

Blanche said the only way to arrest the condition of hypomania is for
the person to go into the hospital so that their medications can be
adjusted.

During his own hospitalization, Downing was prescribed a mood
stabilizer, Depakote, classified as an anti-seizure medicine and the
medicine most commonly prescribed for mania by psychiatrists, Blanche
said.

The medicine acts to bind up what can be described as “excitatory”
chemicals in the brain, Blanche said.

Ultimately, though, that can result in a depletion of those chemicals
and a person can slide into a depression, Blanche said.

“If (a patient) is on a mood stabilizer, you can introduce an
antidepressant,” he said.

Downing said that his current antidepressant, Wellbutrin, is working
well for him.

After living through a hypomanic episode, some patients choose to stay
on the medicine, Blanche said.

“Some people will actually choose to stay on the medicine, just
because they don’t want it to ever happen again,” he said.

Fortunately, the condition “is one of the most treatable conditions in
psychiatry,” added Blanche, who serves as the psychiatrist at the East
Baton Rouge Parish jail and is the medical director of an emergency
psychiatric treatment center affiliated with the Earl K. Long Medical
Center.

Downing’s experiences this summer seem to have had all the markings of
manic episodes of bipolar disorder.

“Around the first of June 2010, I started feeling really good, started
talking a lot more, making big plans,” Downing said.

Around that time, he went to speak at a law conference in Carmel, Calif.

“I went to Yosemite, it was beautiful. I would wake up at 3 o’clock, 4
o’clock, 5 o’clock (thinking) ‘You need to retire, buy some foreclosed
properties, fix them up and make money to help people in India dig
wells,” Downing said.

“I was making grandiose plans,” he said.

Usually frugal, he started spending money, too, he said.

Before the episode was over, he had run up debts of almost $100,000,
buying such things as a 1971 Rolls Royce, three Harley-Davidson
motorcycles and a 1952 police car, he said.

He also bought a $1,000 commercial pressure washer, a large lawn
tractor and expensive new tools to help put a formerly homeless man
into business, he said.

“He just wasn’t himself,” said his wife, Pam Downing.

The couple will have been married 30 years on March 29.

“When the person is in that condition, you really can’t reason with
them,” Blanche said.

“The amazing thing about it is that it robs the person of their
insight,” he said.

In contrast, people are “painfully aware” of the other aspect of
bipolar disorder — depression, Blanche said.

Physicians and employers may miss a condition like hypomania, said
Townsend, because, like most people, “we like happy people, perky
people.”

“There’s a little more-rapid thinking, (rapid) speech, a decreased
need for sleep” in someone with mania, he said.

“When it becomes a condition is when it affects functioning,” Townsend said.

“It’s wonderful that the judge is willing to be an advocate for
bipolar disorder” awareness, Townsend said, referring to Downing.

“It’s very common, and people with it can be very productive members
of our society. It’s all around us,” he said.

Downing’s symptoms brought along misunderstandings among friends and
family members and conflicting ideas on the cause and solution of the
situation, he and family members said
Downing said he refused to seek treatment.

Finally, at one point, his eldest daughter, Kathryne Hart, 27, after
consulting with a physician, sought to have her father committed to a
hospital. Hart’s efforts came after Downing threatened suicide if
there was any more talk about his going to see a doctor.

“She was very brave,” Downing said.

But Downing wasn’t at home as expected when sheriff’s deputies arrived
to bring him to the hospital.

Pam Downing, who supported Hart in the decision, had taken the
couple’s son, Wes Downing, then 24, to visit a relative in Missouri
and to get away from the stressful situation at that time. The
Downings also have another daughter,  Kiera Downing, 26.

Shortly afterward, a group of Downing’s friends brought Downing to see
Blanche, who then admitted Downing into a psychiatric hospital, and
Downing began the recovery process, Kathryne Hart said.

Hart said that the threat of her father taking his life was something
she couldn’t ignore.

When she was in middle school, she said, two fellow students killed
themselves within a week of each other.

“I couldn’t take that chance,” she said. “I was going to do anything
to save him.”

The family said it took about a month after his hospitalization for
Downing to begin seeming like himself again and to understand what had
happened.

Downing said he has struggled with guilt over the debt he accrued
during the manic episode.

He’s taken heart, he said, from something he read in the book “Words
to Lift Your Spirit” by Dale Brown:

“When we do experience failure in our jobs or in our personal lives,
we must not shackle ourselves with guilt, because it can lead to the
silent suffocation of our spirit.”

Downing said that his speaking about his experience is a way to bring
something positive from it.

“He’s 100 percent better,” Hart said. “He’s completely back to normal.
He’s reconciled with all of us.”

“Something like this either tears a family apart or makes it
stronger,” Pam Downing said.

For them, the experience has made the family stronger, she said,
adding that they received a lot of support from the pastors of their
church, First Presbyterian.

Downing, who receives a pension for his years of public service,
served as a district judge for 15 years and as a 1st Circuit Court of
Appeal judge for 10 years.

Over the years, he also worked in various volunteer programs for
prison inmates, such as a Bible study and a program that prepared
inmates for getting jobs when they were released.

He also previously served on the boards of Cenikor, a treatment
community to help people end substance abuse, and the Baton Rouge
Marine Institute, now AMIkids Baton Rouge.

Looking back on the events of last summer, he said, “Twenty-five years
in public service and, then, at the end of my career, people are
going, ‘What’s happening? Something’s wrong.’”

Looking ahead to the future, Downing said, “I’ve been a positive
person most of my life. I can see light at the end of the tunnel.”

Bipolar disorder, classified as a mood disorder, affects about 5.7
million Americans or approximately 2.6 percent of the U.S. population.

The disorder, which affects men and women equally, involves periods of
mania — elevated or irritable mood — alternating with periods of
depression. There are two types. Bipolar disorder type I involves
periods of major depression and was formerly called manic depression.
Bipolar disorder type II involves hypomania, with symptoms that aren’t
as extreme as the symptoms of mania.

In most people with bipolar disorder, there is no clear cause.

The following, though, may trigger a manic episode in people
vulnerable to the illness:

Life changes such as childbirth.
Medication such as antidepressants and steroids.
Periods of sleeplessness.
Recreational drug use.

Symptoms of the manic phase can last from days to months and include:

Agitation or irritation.
Inflated self-esteem.
Noticeably elevated mood.
Poor temper control.
Impaired judgment.
Spending sprees.

Medicines called mood stabilizers are the first line of treatment.
Antidepressant medications can be added to mood-stabilizing drugs.
Other medications used to treat bipolar disorder are anti-psychotic
drugs and anti-anxiety drugs.

Source: The National Institutes of Health

Capitol news bureau writer Michelle Millhollon contributed to this story.

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