Dr. Michael Stone, MD

I would need to know more about you to be able to answer your question in a useful way. Was there anything hurtful or unpleasant happening in your family: parents or older siblings criticizing you harshly? Sickness or a death in the family? Not doing well at school? If none of those troublesome things were happening, then I would think whether at 12 you were having your first period? Quite a percentage of girls begin to have symptoms of depression and/or irritability - as they begin their menstrual life - even if everything else is OK in their family life, friendships, etc. If your depression turns out to be "hormonal" (because of the menstrual-induced changes), there are medicines that can lessen the depression. If your depression seems to have nothing to do with your period, then I'd want to know 2 things: are there other family members (parents, aunts & uncles, cousins, grandparents) who suffer from depression? And: are there any of those things I mentioned about family life, friends, school problems affecting you in a negative way that could trigger a depressed mood.

Dr. Stone

I wouldn’t say that the usual meds for bipolar disorder “change” one’s personality. Rather, they allow the better and more socially effective aspects of one’s personality to emerge stronger - while at the same time, the more problematic aspects of one’s personality will then recede. For example: if one were bipolar on the manic side, and were grandiose or given to outbursts of anger, treatment with mood stabilizers like lithium or lamotrigine or depakote would reduce those abnormal tendencies and restore one’s personality along more normal and agreeable and adaptive lines.

Not usually. The most commonly used antidepressants would not make one more depressed before they began to alleviate the depression a couple weeks later (they usually take several weeks before they help lift the depression). But sometimes there will be side effects like weight gain or interference with sleep that can be bothersome at first before the depression is lifted.

There are bipolar persons with mild signs who can be thought of as on the low end of the “bipolar spectrum “ - who actually function at extremely high levels socially and occupation ally: certain big corporate executives and certain famous authors and Hollywood celebrities are “on the bipolar spectrum” - but who obviously function at a very high level and have so much energy and capacity for hard work and being active on into the wee hours because of their diminished need for sleep

ADHD can come from either the maternal or the paternal line - or from both. I know many persons with the condition who have relatives with ADHD or other mood disorders on both sides of the family.

Seasonal Affective Disorder ("S.A.D.") is a variety of mood disorder characterized usually by a notable degree of depression that may interfere significantly with the ability to work, or even to leave the house and take care of one's ordinary daily tasks. The condition begins typically in the late fall (around Thanksgiving-time, for those in the US), and lasts on until early spring (such as mid-March). It is called a disorder - because it tends to recur at similar times each year, and to last about the same time-frame. SAD occurs more often in women (who are more susceptible to depression in general - just as men are more vulnerable to aggressive behaviors). People in northern areas are more likely to develop SAD than are others in southern areas. In the US, there would, for example, be more cases diagnosed in Vermont than in Florida (let alone in Panama). Many persons with the condition also are prone at other times - to bouts of "hypomania": periods of over- talkativeness, diminished need for sleep, racing thoughts, and feeling "super" lively and happy. This suggests that SAD can be considered as an element in the so-called Bipolar Spectrum (the new name for "manic-depression"), with such related condition as recurrent depression, full-blown mania (with delusions of grandeur), "Bipolar-Type-Two Disorder (characterized by mild "highs" alternating with serious depressions). Those who besides living in cold climates also wear dark clothes and don't absorb sufficient Vitamin D3 from the sun - are also more at risk. People with SAD are more likely (than those in the general population) to have close relatives (siblings, parents, grandparents, aunt, uncles, cousins) with various forms of bipolar disorder (either in full-blown form or in a milder condition). The typical treatment consists of exposure to bright white light for at least a week of 2500 lux in strength. Many patients use a machine that delivers intense light of this sort - especially upon awakening - say at 7 or7:30 in the morning, for about half and hour. -- repeating this daily for a week or so. Of course - where additional signs of mood disorder ("manic-depression," "bipolar disorder" of one type or another should also take a mood stabilizer to help minimize the intensity of the depression or hypomania. Medications such as lamotrigine, small doses of lithium or depakote - may prove useful in minimizing and in regulating yhr SAD - till time ("spring-time!") finally puts the mood-disorder to rest. Till next year, that is! But once knowing you have the condition, forewarned is forearmed - and next Thanksgiving (give or take).

If one has anxiety of "panic" proportions, where one is in a state of terror over what might happen to one, such a person would often go to an emergency room of a hospital, let the hospital staff know what one is suffering, and get help pretty quickly with medications that help calm that level of anxiety. Once the acute symptom was relieved, the next question would be: what had inspired the high anxiety in the first place: breakup of a love-relationship? A serious financial reversal in one' business? Death of a close relative? It might then be prudent to get further help with a psychotherapist who could learn from the patient what the major difficulty was in the person's life that led to the intense anxiety, feeling of hopelessness, etc., that led to the overwhelming anxiety in the first place. Medication could take care of the intense anxiety; then, psychotherapy could then help the patient to strengthen the coping mechanisms needed to deal adequately with the life situation that had precipitated the anxiety in the first place.

Dr. M. Stone, MD