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Bipolar mania , or drug-induced ?

Hi, I've been wondering about this for a long time, and the psychiatrist I used to have didn't have the whole story to answer my questions right.

I was diagnosed as bipolar 2 years ago, when I was 21, when I had an onset of mania. Nothing of the sort had ever happened to me before, and according to what I read and heard, my symptoms fit "bipolar mania" perfectly: racing thoughts, euphoria, extreme creativeness and extroversion, intense happiness, and hypersexuality.

However, I never told my psychiatrist or therapist that I had been regularly using marijuana, and when I felt the onset of mania, I was high at the time. I had been smoking weed almost every day for about 3-4 months but nothing like that ever happened to me until then. I can trace the onset of the mania to an emotional trigger, but after a few months, when the mania died down, nothing like that ever happened to me again. I stopped taking the risperdal I was prescribed and it's been 2 years but never have I had either the ups or downs or cycling of emotions I read about that are a part of bipolar disorder. I stopped using marijuana a little bit after my manic episode, but when it comes to everything else about bipolar disorder, specifically the rapid changes in mood and mood shifts, I have never in my life had any of that, except when I was using drugs.

In short, I've had depression in my life before, but my mood has always been generally stable, and I've only ever had mania once as a result of drugs, which I no longer use. Does this really mean I am bipolar?
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replied February 13th, 2009
Experienced User
Hello Venison,

To be honest I really do not know the answer to your questinon. All I can suggest is that you go back to the doctor who knows you, who saw you during the onset of your mania. And let him know that you were on marijuana at the time. And see what he says re the marijuana causing your symptoms.

Also if you do actually have Bipolar Disorder going two years without an episode does not mean that you will not become manic again.

It may or may not happen for ten years (that ten years is a guess). As have read that those with Bipolar I can have some 5 to 6 manic episodes in their lifetime. Thus it stands to reason that the time period is possibly long between the episodes.

The following is from DSM-IV which to me makes it all the more confusing.

"Disorder (due to the direct effects of a medication, or other somatic treatments for depression, a drug of abuse, or toxin exposure) or of Mood Disorder Due to a General Medical Condition do not count toward a diagnosis of Bipolar I Disorder."

The same applied for Bipolar II Disorder.

I notice in my reading that some are disputing the exclusion of those who are on drugs.

All the best to you,

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replied June 6th, 2013

Jenny is correct about the DSM stating that if mania is caused by a drug, then a bipolar diagnosis is incorrect.

Personally, I wouldn't go back to the doctor who misdiagnosed you, doctors don't like to confess to their (or other doctor's) mistakes - for fear of malpractice suits. There's a "Wall of Silence" problem within the medical community.

I recommend you read Robert Whitaker's books, "Mad in America" (a history of the psychiatric industry) and "Anatomy of an Epidemic" (a book pointing a completely iatrogenic, meaning doctor caused, bipolar epidemic in the US, amoung other related subjects)

I also recommend researching Peter Breggin's work and read what interests you among his books. Once diagnosed, it's good to gain an understanding of the industry with which you're dealing. Best wishes for your continued good health.
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