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Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7662
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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Hi, I have been diagnosed with epilepsy and major depression.

Customer Question

Hi, I have been diagnosed with epilepsy and major depression. The major depression just recently started in April when I weaned off one of my seizure medications, and the symptoms of depression and me feeling like epilepsy controls my life finally showed. The medicine was depakote, a mood stabilizer. Anyways, I am currently battling major depression, and have suicidal and homicidal thoughts. Have self harmed twice, and have been hospitalized twice. I see a psychologist, psychiatrist, and take antidepressants. I am now on my third third antidepressant, and it is hard to get into the psychologist and psychiatrist, (like once every two weeks.) basically I am Doing everything I can do to get the help, and nothing seems to be good enough. Especially the medicines, they seem to just be hurting me. I just want to know if you have any suggestions, or advice for me? I barely make it through each day every day. And also, i have thoughts of hurting people and other animals, and hurt my dog once.
Submitted: 1 year ago.
Category: Mental Health
Expert:  Elliott, LPCC, NCC replied 1 year ago.

Elliott, LPCC, NCC :

Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Elliott, LPCC, NCC :

Dear friend,

Elliott, LPCC, NCC :

I believe that I can help.

Elliott, LPCC, NCC :

Why were you given the depakote, and then why were you taken off of it?

JACUSTOMER-vdfbxe9a- : Thank you. I was taken off the depakote because I was having MANY side effects. For example, eye twitching, convulsions, extreme difficulty in school, headaches every day. I was weaned off of it because I haven't had a seizure for over two years. And my other medicine I am on is zonisamide, and it is possible that that is the WHOLE reason for my depression, so they are also switching that medicine too, to a medicine called vimpat. So right now, I am currently counter-weaning zonisamide and vimpat, taking hydroxyzine for anxiety and paranoia, AND abikify and Zoloft.
Elliott, LPCC, NCC :

Did you have epilepsy before you took the Depakote?

JACUSTOMER-vdfbxe9a- : I was diagnosed with epilepsy four years ago, then put on depakote and zonisamide which where the right medicines for me.
Elliott, LPCC, NCC :

Going off Depakote has many side effects, including having seizures and of experiencing extreme depression. How quickly did you withdraw?

JACUSTOMER-vdfbxe9a- : The weaning process was over 8 weeks, this was hopefully to have no withdrawal side effects. But I was still on the zonisamide while weaning off the depakote, so I had no seizures. But do you think that depakote was stabilizing me, and then weaning off of it brought me into a state of deep depression?
Elliott, LPCC, NCC :

Depakote is not an antidepressant but might have been keeping you stable. When did these feelings of wanting to hurt others begin?

JACUSTOMER-vdfbxe9a- : I became severely depressed days after I weaned off the depakote. I have crazy thoughts of hurting people and myself. It just keeps getting worse. It went from epilepsy, to depression, to thoughts of hurting myself and others. And I said I was never going to hurt myself because my dream was to become a marine. And as you probably know, epilepsy is disqualifying. But when I told my neurologist I wanted to be in the military, he straight up told me no, that will most likel need happen. I also became depressed from that. That was the same appointment I weaned off the depakote. But while I was in the hospital I told my social worker I am confident that I will never ever hurt myself, because I have the drive to be a marine. And I found out I wasn't allowed to, and then I did! I'm just afraid that since I acted on the thoughts of hurting myself, when I said I never would, that I will act on hiring other people, when I don't want to. I want to be a good person, I want to be a marine for gods sake.
Elliott, LPCC, NCC :

I am so sorry that this dream has been shattered. I'm sure it was very frustrating and angering for you. Furthermore, Depakote DOES cause these suicidal/homicidal feelings in a small percentage of users (perhaps 1/3 of one percent).

Elliott, LPCC, NCC :

I strongly urge you to return to your psychiatrist and tell him or her about your feelings and about hurting your dog.

Elliott, LPCC, NCC :

You will probably be helped by the use of a different mood stabilizer.

JACUSTOMER-vdfbxe9a- : It's okay. I am not giving up though. I'm going to fight for my dream before I move on. I understand epilepsy should disqualify from being a soldier but it shouldn't disqualify me from being a drill instructor or recruiter. I'm willing to go court and fight for it. And really? So what do you suggest I do? Do you have any suggestions or advice? Like I put in the question I seem to be everything I'm Doug, taking antidepressants, but I'm on my third one already, and it is so hard to get into psychologists and psychiatrists. So do you have any suggestions or advice? What do you think my next step should be based on everything I told you?
Elliott, LPCC, NCC :

It is very possible that withdrawal from the Depakote has also triggered bipolar disorder which could explain you depression AND your negative thoughts.

Elliott, LPCC, NCC :

If you have a dream then you should DEFINITELY fight for what you want.

JACUSTOMER-vdfbxe9a- : Do you think I Might have bipolar disorder? Could you evaluate me right now?
Elliott, LPCC, NCC :

Do you have racing thoughts sometimes?

JACUSTOMER-vdfbxe9a- : This is really important to me. I want to get the proper treatment! The antidepressants might not be working because I might even have bipolar disorder! And not just major depression.
JACUSTOMER-vdfbxe9a- : And yes I do. More than half of the time.
Elliott, LPCC, NCC :

Do you become very talkative, often and speed up?\

JACUSTOMER-vdfbxe9a- : Not exactly but I become extremely irritable. For example I don't know if I became manic but I became extremely irritable and charged at my brother, and started to fight with him. And if my mom didn't pull me off of him I don't know if I would of stopped. I do notice that at times I am so depressed then days later I do feel kind of okay. Then days later I am depressed again.
Elliott, LPCC, NCC :

Are you easily distracted?

JACUSTOMER-vdfbxe9a- : But I don't normally stay up extremely late any days I am usually lethargic all day and fall asleep early every day, because of all the seizure medicines and the antidepressants. It's like I'm sedated.
JACUSTOMER-vdfbxe9a- : yes I am.
Elliott, LPCC, NCC :

That could be medications or depression making you lethargic - probably both.

Elliott, LPCC, NCC :

Are you prone to reckless behavior: driving, spending, sex, gambling, fighting?

JACUSTOMER-vdfbxe9a- : What do you think? I just think there is something else wrong but it wasn't diagnosed. I know usually depression is usually wrongly diagnosed and I don't know I may have been. Nothing seems to be helping me. And I am extremely irritable, but mostly a good kid. I have honestly never done any drugs or alcohol. Because I know they are known to induce seizures.
Elliott, LPCC, NCC :

I am still trying to assess you as you requested. I have just a few more questions.

Elliott, LPCC, NCC :

Are you prone to reckless behavior: driving, spending, sex, gambling, fighting?

JACUSTOMER-vdfbxe9a- : Not driving, spending, yes I seem to buy things without thinking. Sex, no. Gambling, no. Fighting, yes.
JACUSTOMER-vdfbxe9a- : Mainly only with my brother though.
Elliott, LPCC, NCC :

It seems to me that you are very likely to have bipolar disorder. There are two important factors for you to know.

JACUSTOMER-vdfbxe9a- : Please tell me
Elliott, LPCC, NCC :

First, is that someone with bipolar disorder, even if it is dormant, should be taking antipsychotic meds or mood stabilizers (and also antiepileptic meds help too). You were taken off the mood stabilizer which can often TRIGGER mania.

JACUSTOMER-vdfbxe9a- : And you think I had the one manic episode? Which was one I completely lost control and charged at my brother?
Elliott, LPCC, NCC :

Your depression is not part of mono-polar depression but of bipolar depression. Depression looks the same either way.

Elliott, LPCC, NCC :

Yes, but your spending habits and your racing thoughts are also symptoms as is your distractability.

JACUSTOMER-vdfbxe9a- : Thank you. I really think this makes sense.
Elliott, LPCC, NCC :

The other factor is that people with epilepsy tend to get bipolar disorder.

Elliott, LPCC, NCC :

Look at this article:

Elliott, LPCC, NCC :

http://www.ehow.com/facts_5686833_epilepsy-bipolar-disorder.html

JACUSTOMER-vdfbxe9a- : Is there any way you could contact my psychiatrist? If will be really important for him to hear all this from you and not me. I probably won't be able to say this right to him.
Elliott, LPCC, NCC :

I cannot contact him or you, and he cannot discuss your case with anyone even if I could. I am not permitted. HOWEVER, your psychiatrist SHOULD know these facts. Tell him that you believe that you have bipolar and that withdrawing from Depakote triggered your reactions.

JACUSTOMER-vdfbxe9a- : Okay I really will. Can you please make a list of everything I should tell him. Everything. And I will write them down?
Elliott, LPCC, NCC :

If he does not accept this then I would not argue with him but rather get a second opinion. Sometimes, some people in mental health do not like to admit they made a mistake, which is unfortunate for the patient.

Elliott, LPCC, NCC :

You can copy this chat and save it or print it.

Elliott, LPCC, NCC :

In the last paragraph above I pretty well summarized what to tell him but let me list it for you again if that helps. I am here help you.

Elliott, LPCC, NCC :



1) You have symptoms of depression (sadness, irritability, lethargy, somnolence)

JACUSTOMER-vdfbxe9a- : I honestly think I have this though.. I am going to mention this to him. And my first appointment with him he even asked do I have racing thoughts and I said "yes, a lot." But I don't know if he even thought about bipolar disorder. But am going to mention all of this to him.
Elliott, LPCC, NCC :


2) You have symptoms of mania (racing thoughts, easy distractability, very strong goal directed activity [desire to be a marine is very central and strong], poor judgment in spending and combativeness, and perhaps some grandiosity involved with you career goals as well)

Elliott, LPCC, NCC :


3) Symptoms began after withdrawal from mood stabilizer while you are still taking antidepressants

Elliott, LPCC, NCC :


4) People with epilepsy are more prone to bipolar disorder

Elliott, LPCC, NCC :


5) You have been hospitalized to protect yourself and/or others.

Elliott, LPCC, NCC :



6) This impairs your work, social, or personal functioning.

Elliott, LPCC, NCC :


He should restore a mood stabilizer or antipsychotic medication. If he does not agree, I suggest getting a second opinion.

JACUSTOMER-vdfbxe9a- : Thank you.
JACUSTOMER-vdfbxe9a- : Should I even print this whole thing out and send this to him? Because I am pretty covinced now that I have this, especially because people with epilepsy are more prone to it.
Elliott, LPCC, NCC :

I wish you great success in getting properly treated. You can live a normal life with this.

JACUSTOMER-vdfbxe9a- : Or at least bring it in my next appointment and show him. Maybe he will believe me.
Elliott, LPCC, NCC :

Yes you can. As I stated he may be defensive about it, and if he has a different opinion, I would ask another psychiatrist to assess you.

Elliott, LPCC, NCC :

It should not be up to him to believe you, but to make this professional assessment.

JACUSTOMER-vdfbxe9a- : I definitely will. Thank you so much. I wish you were my psychiatrist haha!
Elliott, LPCC, NCC :

Psychiatrists are very busy and have usually short visits.

Elliott, LPCC, NCC :

I shall keep you in my prayers for success.

Elliott, LPCC, NCC :

Warm regards XXXXX XXXXX

JACUSTOMER-vdfbxe9a- : Thanks again. This was definitely worth the money. I will give you the highest rating. Can I come back to you if I have any more questions?
Elliott, LPCC, NCC :

Elliott, MAE, LPCC, NCC, CCMHC

Elliott, LPCC, NCC :

Don't hesitate to come back to me, even after you rate me. I shall answer on this question.

JACUSTOMER-vdfbxe9a- : Okay I will. Elliot thanks So much.
Elliott, LPCC, NCC :

You are so welcome. :)

Elliott, LPCC, NCC :

Thank you. XXXXX bless you. I will gladly take your follow-up questions if you have any.

Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7662
Experience: 35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
Elliott, LPCC, NCC and other Mental Health Specialists are ready to help you
Customer: replied 1 year ago.
Hi Elliot, so my mom called my psychiatrist's nurse and she wrote down everything and she told my psychiatrist's that I think I have bipolar disorder or bipolar depression, and I am seeing him in 4 days, on Monday July 1st.
Expert:  Elliott, LPCC, NCC replied 1 year ago.
Dear friend,

Thank you so much. Bipolar depression is part of bipolar disorder. I am so glad that you are going to get an assessment. In the meanwhile, take fish oil or other sources of Omega-3 supplements which will help; stay off the caffeine and diet drinks, and avoid disturbing movies and TV show, and alcohol.

Thank you for taking such quick and intelligent action.

God bless,

Elliott
Customer: replied 1 year ago.
No Elliot, thank you! Just is there any more advice for me? I mean I just hope my psychiatrist will really believe all of this. And believe the I have bipolar disorder. I have a feeling that he will not want to be wrong, like you said. And he will just say "oh no, you don't have this, you have major depression" even with all of the evidence!
Expert:  Elliott, LPCC, NCC replied 1 year ago.
If he was a surgeon and you had an infection in your right arm and he wanted to removed your left arm, would you allow him because he said so or would you see someone else for a second opinion?

You are in charge. If you do not care for his services then find someone else to assess you.

There is enough logical evidence to point to a strong possibility that he is not giving you the best treatment. You are not feeling better but worse. Sometimes you just have to be proactive to get the help you need.

You are your own boss and he is not the final word in your life - you are.

There are other psychiatrists besides this one. If you are not pleased with him and you are not pleased with his treatment then you should find someone else. If you have Bipolar Disorder and he is only giving you antidepressants then he could be putting you in grave danger.

Read this article and if you have a responsible parent or guardian let them see it too:

http://www.webmd.com/anxiety-panic/guide/is-really-depression

Stand up for yourself, young man. I am here for you if you need me.

Best

Elliott
Customer: replied 1 year ago.
Elliot thank you again. But one more thing. Yes you are right. And I am being proactive. I am getting the help I need, and fast! But I mean when I told my mom all this she wasn't pretty happy with it. It's like she thought I was delusional! I have the belief that I 100% had bipolar disorder now, no matter what anybody else says. But my mom said "Ryan we are seeing your psychiatrist, and if he thought you had bipolar disorder before, then he would of diagnosed you, and given you those medicines. But he didn't even really evaluate me! I only remember him asking me "do you have racing thoughts" that was the only question he really asked me having to do with bipolar disorder. I will just print this all out and show him ALL the evidence, and say I really believe I have this. But Elliot, if he says I dont, my mom won't take me to any other psychiatrist. She says he is perfectly good. But I know I must have it. Maybe! I obviously might if you told me I might!
Customer: replied 1 year ago.
My one psychotherapist I talked to said based on my whole story I have symptoms of bipolar disorder, or bipolar depression. Could you evaluate me too? For a second opinion? Or would you like to know the whole story first?
Expert:  Elliott, LPCC, NCC replied 1 year ago.
Tell me your story and I will be happy to give you my thoughts.

Elliott
Customer: replied 1 year ago.
I'm sorry forget that, could you look at the one I toed before that?
Expert:  Elliott, LPCC, NCC replied 1 year ago.
You also gave me negative feedback after all of the service I have given you, which is not the best way to treat someone who cares about you and is trying to help.

Take a look at the official psychiatric criteria for mania and see what you think: if it fits you, then you are diagnosable.

Mania is one of the two building blocks of bipolar. The other is depression.


Mania DSM-IV

A) A distinct period of abnormally and persistently elevated, expansive or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary)

B) During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:

1) inflated self-esteem or grandiosity

2) decreased need for sleep (e.g., feels rested after only 3 hours of sleep)

3) more talkative than usual or pressure to keep talking

4) flight of ideas or subjective experience that thoughts are racing

5) distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)

6) increase in goal-directed activity (at work, at school, or sexually) or psychomotor agitation

7) excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

C) The symptoms do not meet criteria for a Mixed Episode

D) The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.

E) The symptoms are not due to the direct physiological effects of a substance or a general medical condition.

 

I see that as I sit here and spend my valuable time trying to help you you are sending me more negatives.

You can undo them by sending me another positive.

You are not my only client. You must be patient and kinder.

Warm regards,

 

Elliott




Customer: replied 1 year ago.
Yes Elliot I'm sorry. It wasn't intentional you are doing an amazing job. You just weren't replying right away I didn't think you had other people to answer I really apologize. I will give you a better rating now. Anyways, I do believe I fit the criteria of mania. I am completely irritable for a long period of time, about a week. Then I'm not. And normal, and depressed.
Expert:  Elliott, LPCC, NCC replied 1 year ago.
You have to show this to your mom. I have others I am working with right now but jumped in to answer you. My nose is already sore. :) We are fine and I understand your needs and concerns.

Warm regards,

Elliott
Customer: replied 1 year ago.
I'm sorry Elliot, one more thing. Everything listed above in the mania dsm-iv, is that everything that I have? Or just everything listed is what is usually found in mania?
Expert:  Elliott, LPCC, NCC replied 1 year ago.
That is the complete DSM-IV diagnostic criteria for mania.

If you have three or more of the criteria then you can be diagnosed. You have racing thoughts, distractability, increased goal directed activity (re: becoming a Marine), excessive involvement in pleasurable activities (unrestrained spending), and your reckless behavior (psychomotor agitation) getting into fights with your brother.

You were being treated for mania with the Depakote but then he withdrew it and you seemed to get worse.

I noticed you gave me two negatives: one poor and one bad. My bad, I guess.

:)

Warm regards,

Elliott
Customer: replied 1 year ago.
Hi, I did a little more research and I found out it is possible to have a mixed state of bipolar disorder, where the manic and depressive phases occur at the same time. Could you maybe evaluate me for that? Because when I think about it, this one seems to be make the most sense. I am extremely irritable even when I am depressed, my racing thoughts make me want to cry sometimes and sometimes I do tear up a little. I do have the spending sprees while I still seem to be in a depressed state, for example I paid to talk to you, which seemed to help actually. And one time I wasn't thinking and even randomly bought male enhancement pills a couple months ago! I just am extremely irritable and have the racing thoughts while I seem to be still really depressed. Do you think I qualify for the mixed state of bipolar disorder? That one makes the Most sense to me.
Expert:  Elliott, LPCC, NCC replied 1 year ago.
Dear XXXXX,

Paying to talk to me is not a spending spree. It is not wild spending, but rather money well spent. With two negative feedbacks on my record, which only you can lift, it is a mixed blessing for ME. You still want more out of me but you haven't removed the negatives by giving me another positive.

Nevertheless, I will answer this last question and you can do what your conscience dictates.

Mixed Episodes are more common in males and in young people. They often produce hospitalization and suicide attempts and impairs functioning. Depression and mania occur together, as you have described. You may very well have Mixed Episodes.

I do believe that for your own safety and the safety of others that you should get a second opinion, which will require your mother to go the extra distance to make sure that her son is OK and will not wind up killing himself or back in the hospital, because he was not possibly being treated correctly.

Best of luck and warm regards,

Elliott
Customer: replied 1 year ago.

Would you assess me for personality disorder?

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  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
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