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Q: Abnormal Fatigue Episodes a Form of Bipolar...?
Our daughter was diagnosed with Dysthymia about 14 years ago, when
she was 11 years old. She has been on anti-depressants almost continually for
the last 14 years (Zoloft, Wellbutrin, Celexa). About 10 years ago she started
have abnormal fatigue episodes even on the medications. Increases in the
medication has not improved the situation. For the last 5 years the episodes
have been worsening dramatically. For 3 weeks out of every month she is
"normal"... eats well, exercises, is social etc. For one week each month, she
can not get out of bed, her speech slows dramatically, she at times eats and
drinks so little that her electrolytes go down to the point that she has
seizures. It is possible that the fatigue cycles could be tied to her cycle,
but it does not always coincide. The symptoms are much worse in winter than
summer. At time she has 2 cycles of fatigue in a month. Could this be a form
of bipolar II, maybe mixed with seasonal disorder as well?
Dear Ms. L' --
The short answer: "yes", it certainly seems possible this is a "bipolar
variation". Your having included the emphasis on her antidepressant treatment
suggests you are already wondering whether the antidepressants could be making
things cycle, which I too would wonder, although I should emphasize that I would
not necessarily start by assuming that "bipolar disorder" is needed to explain
what is going on.
For example, I just read an old colleague's analysis of
vitamin D levels and how they might relate to both depression and seasonal
affective disorder. He's been pretty careful with his literature review, it
looks like; although he's a rather unusual fellow himself, as I think he might
be the first to acknowledge, so I'd take what he's saying with a big grain of
salt until some more mainstream psychiatry types look over his hypothesis and
start commenting on it, which, if he's right, they will eventually do, but
probably not soon enough -- especially if he's actually right!
Dr. Phelps
Published October, 2004
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