Q:  Moods Are Tied to My Menstrual Cycle

I was diagnosed with BPII about 7 years ago.  I am 39.  My mood changes are tied totally to my menstrual cylce.  I am very "manic" from days 1 to 13 (dangerously hypersexual is the biggest problem) then get very down and irritable from days 18 to whenever my period starts.  I have only about 4 or 5 days that I feel "normal" and stable.  I have tried almost every med yet HATE the side effects and none have touched my labido.  I have spent the last few years trying to control this without meds.  Yet even though I can predict when the highs and lows will happen I  can't seem to control my behavior.  I realize I must get this under control for my family, my career and myself.  Given that this is tied completely to my menstrual cycle does it make more sense to see my OBGYN instead of my psychiatrist?

Maybe I don't even have BP?
 

Kathy, 

That is a very difficult problem.  I would first talk to your ob/gyn about trying to control your menstrual cycle and the hormone fluctuations that occur. Combining some type of birth control with lower dosages of mood stabilizers may help you avoid side effects.  Also you may want to try a combination of low dosage mood stabilizers such as Lithium or Depakote or Lamictal to see if the side effects can reduced.  The antipsychotic mood stabilizers (Abilify, Seroquel) are another route you and your psychiatrist could pursue for treatment.  Lastly, I would review your diagnosis with your psychiatrist to ensure that bipolar type II is the correct one. 

Dr Plyler

Published May, 2011