drug induced psychosis or bipolar?

i'm trying to figure out if i have drug induced psychosis or bipolar? ive been diagnosed with bipolar. the thing is i can relate to the depression of bipolar. but as far as my manic episodes go they all seem to be spured on by smoking marijuna, drinking and antideprsants. so i wonder if i need meds or not or wheather if i didnt smoke pot i could avoid episodes and not be bipolar. im currently on lithium. i've had 3 episodes in 2 years and they all where drug induced, at least it seems. the first when i was binge drinking for 2 weeks and acting manic. the second one i was on antidepressants (without a mood stailizer) and the third time i smoked lots of marijuna prior to episode. could i have a drug induced psychosis or does that still seem like bipolar?

I don't have Bipolar but I think what you raised is interesting.

I over the time frame of 2.5 years experimented with drugs, marijuana mostly but also speed twice and heroin twice and never again lol. I was a heavy pot smoker.

The more I smoked the normal I felt and that was probably the case that my body didn't know what was normal and what was drugs anymore.

My Step Sister has Epilepsy BUT how the seizures come about, her Family life and environment and also how she acts is very ADD / Bipolar ? and my point is that, her anti-epileptic drugs seemed to have aggravated problems within her, due to the way she was brought up.

So ...

I would avoid pot, even for a short period of time but preferably all together.

I think the manic episodes induce a deeper hell if drugs are taken too, as they aggravate the problem.

So be careful and report back soon.

I am in no place to say that it would be drug induced or not.

I hope I made sense

Having had a few manic episodes with psychotic features, all of which were during withdrawal from long-term use of serotonergic anti-depressants, and also like yourself having used and abused pot and alcohol (and LSD when I was younger), and finally, having studied psychology and the brain since before the Prozac revolution and followed as much of the research as I can, I have to say, the answer to your question is: good question.

There are certainly fixed views out there, and bipolar is all the rage these days among psychiatrists, who keep inventing new flavors to accommodate the patients they see who don't perfectly match the existing descriptions. Then there are studies showing brain scans of bipolar patients that show abnormalities in the frontal cortex, in the amygdala, etc, etc. However these studies have some critical flaws, some of which I've seen critiqued (and largely ignored) by other researchers, some of which I've yet to encounter but which seem obvious:

1. Studies showing brain structure abnormalities fail to control for other bipolar patients not given medications over the length of time it takes for structural changes to be observable. I.e. they fail to conclusively show that such brain abnormalities are not the result of medications.

2. The studies are on "bipolar patients". In other words, the studies divide people according to non-scientific, subjective labels given the subjects by psychiatrists. So what? Well, for one thing, these labels may be very likely to be given to anyone who has those brain abnormalities, and in that sense, those abnormalities may be responsible for the observed or reported behaviors, but then, saying that there is some separate, tangible reality that is bipolar, which both caused the diagnosis and caused the brain abnormalities is unsupported. Cause and effect are problem areas for psychiatric doctrine. These same results could indicate brain abnormalities arising from diverse causes, including but not limited to drug abuse or the prolonged use of some medications, which in turn give rise to mood cycling, depression, and psychosis, for any number of reasons.

Having said all that, it *is* known that many medications can induce mania and psychosis in a small percentage of people. To say that this is "revealing" previously unobserved bipolar is stretching credulity for me, given that there exists no way to demonstrate the existence of bipolar other than interpretation of reported or observed behavior. If there were a genetic test, and those people whose first manias arose from taking medications were then tested and found positive for the gene, this assertion would make sense.

Instead, the basis of the assertion, as far as I can tell, has to do with a few factors. 1) Doctors like to pathologize and sell treatment. 2) Plenty of data does show that each successive depressive manic episode correlates to an increased likelihood of future episodes, so doctors are wanting to err on what they perceive to be the side of caution (not remotely believing their treatments themselves might be part of the problem). And 3) psychiatry has fallen in love with the biochemical model that justifies medication as primary treatment and finally solidifies the idea that psychiatry is actual, medical science. Therefore, bipolar is real, it is a medical condition, and it is innate to an individual. Medications are treatment, theoretically cure, definitely not cause. And drugs, which of course are totally different from medications because they weren't created by Science, may mimic this medical condition, but could no more cause it than medications (since, after all, drugs are drugs are drugs).

There is A LOT of evidence that marijuana and hallucinogens aggravate and can initiate kindling, and thereby can cause or aggravate mania and psychosis. If you comprehend the idea that bipolar is NOT an established medical condition with an established etiology, but rather is NOTHING MORE than a syndrome of observable behaviors for which some treatments have been shown effective, than you may come to the conclusion, as I have, that mania and psychosis induced by drug abuse is still bipolar. And that before seeking extensive intrusive treatment for this, you are very wise to stop using drugs and alcohol, working as needed on the emotional issues that drive you to these in the first place.

The DSM says (of most disorders) that the patient must meet such and such criteria which cannot otherwise be explained by another diagnosis or by drug use. This clever legalese-like maneuvering implies that there is some underlying medical reality, which must not be mistaken for another similar-looking syndrome, while simultaneously providing a lot of leeway for the completely subjective and biased way in which psychiatrists actually choose a diagnosis. However it contains one bit of real wisdom, which is that if the condition *is* being caused by active drug use, or some other identifiable factor, you need to eliminate that factor as a first step.

And, coming full circle, one of the things I eventually figured out from my research and quite painful, damaging experiences, was not only to eliminate pot, but to eliminate the serotonergic drugs which have ALSO been linked to mania and psychosis, but for which EVEN LESS scientific research has been done as to why or how.

Being as jaded as I am, I also avoid psych meds as much as possible, with mixed results -- I still tend towards dysthymia and anxiety. But so far, no mania. I even feel less agitated in general, less likely to slip into insomnia, then when I was medicated. YMMV.[/i]

Yeah I have bipolar too. Since 28 - 46 now. Yeah drug induced psychosis is possible but you'd have to take a lot of it, good stuff, and maybe starve yourself for a week to pull it off.

Yours is a good question, but the answer is easier. And you don't need a Ph.D. in psychology for this answer.

It could be that once you take alcohol, you change how you're taking and therefore metabolizing the drugs because of a simple phenomenon known as 'forgetting'.

Dump the booze. Keep the pot if it gets you giggles - it probably won't hurt anything. Doubt it helps.

People use drugs to self medicate. Ask yourself, why do you self medicate? That, grasshopper, is the best question.

Look at it this way: For each time you deny missing your meds, I get to point to a 2 week drinking binge or other alcohol binge efforts and say "Gee, are you sure took your meds? Yeah? Oh so you were pissed to the tits and you know you took your meds. How wonderfully competent of you for someone strung out on drugs and alcohol - you must be freaking Superman."

I didn't even need my Ph.D. in psych for that one!

Take the drugs for 3 months - ensure that you don't do alcohol or other stuff that makes you barf or forget - cause you can barf up the drug. Give the lithium or whatever a good solid try. Control your caffeine intake to something reasonable. Then, after you've had a controlled period of proper usage, see how you feel.

Dump the booze. Keep the pot if it gets you giggles - it probably won't hurt anything. Doubt it helps.

Correction: as previously stated, pot is known to be connected to kindling, which can and frequently does not only aggravate but cause epilepsy and psychosis over prolonged use. It absolutely will aggravate bipolars, increase the frequency and severity of manic and depressive episodes. It will hurt things. Whether it also helps in some way is an open question.

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Correction: as previously stated, pot is known to be connected to kindling, which can and frequently does not only aggravate but cause epilepsy and psychosis over prolonged use.It will hurt things. Whether it also helps in some way is an open question.

Correction back to ya:

'Known to be connected' is a correlative statement, not direct causation.

'Can and frequently does' is supposition in this case - you failed to note whether or not the person was taking their meds. You're either ignoring data about his alcohol abuse, or there's a 'clinging' to a theory going on. I think it's far more frequent that bipolar people take their meds, feel good, then drop the meds (cause they feel good). Same thing happens with antibiotics. People take the meds, feel good, drop the meds, get sick again.

Kay(e?) Redfield Jamieson writes about this phenomenon. She reports on a study where they researched something like (from memory so don't pin me down on it) 'thousands' of medical doctors given antibiotics with strict controlled instructions as to when and how to take the antibiotics. The stunning result was some huge number of Ss, medical doctors, stopped taking the prescribed medication as soon as symptoms disappeared. Food for thought in that study. These were medical doctors, I remind you. So imagine now that we're dealing with a medication for bipolar disorder...

'Cause epilepsy' is interesting and perhaps true but the person does not have epilepsy. And if the causal link were strong then people with 30 years of abuse ought to show epilepsy, but I haven't seen any.

'It will hurt things' If you argue 'memory' is one of those 'things', maybe you'd have a case. But you're not. You're saying 'things' which is too general to debate.

"It absolutely will aggravate bipolars, increase the frequency and severity of manic and depressive episodes." That is a proclamation that may be true but by itself gives no reason to believe this person has 'kindled' abnormally due to pot. You've not opened the black box, and peered inside. You're supposing the contents of that box without examining it. The simpler 'guess' is non compliance.

Look I don't doubt your scholarship. I'm grumpy that the guy is blasted and not taking his meds and the issue of being blasted and upsetting his drug routine was forgotten and not given a fair chance.

Finally, the brain is the wrong level of analysis for the problem. The right level of analysis is behavioral and cognitive. Does he 100% take the prescribed drugs to specification? Is he doing therapy to ensure he's taking the drugs the right way all the time? If he's drunk, there's no way to be assured of compliance with the drug regime.

The simplest answer is: He doesn't take his meds as happens with hundreds of thousands of patients all the time. Booze can lead to forgetting. So can stress. Lots of things.

Drunk people don't remember things so good.

Remember that quote. If the person worries about pot messing with memory, he can drop that too. But my experience in the field and in life tells me the booze is the best culprit. Esp. with bipolars - it's a 'not very good for you' thing to do.

As for the other episodes, yeah take the meds. Even if you weren't drunk for all episodes, the pot was probably taken in an effort to self medicate.

Bipolars don't take their meds so good

d-vade you're bipolar. Get used to a life with the drug prescribed by your PDoc. If you give it a try, a fair and solid effort, see what happens after maybe 3 months.

I'm not going to post again on this. To be clear, what I *said* was, marijuana will make bipolar worse. Has nothing to do with being on or off your meds; it's a separate point. It's well-established by a lot of research. You can theorize otherwise or criticize as theory what I'm saying, but it's a disservice to tell anyone pot can't hurt. It can make them psychotic or epileptic. Does it do this to all people, all the time? Of course not. But bipolars should be very very cautious with the ganja.

Personally, I *have* seen both pot-induced psychosis and in one case, seizures resulting in death. Look up the kindling effect.

Yeah I'm not going to quibble about research findings because it's too time consuming to back up and nobody is going to pay me for it.

d-vade has done an uncontrolled study on himself and the study flopped. That's his problem in figuring it out.

If he wants to stop smoking pot because of the possibility for pot induced psychosis, he can knock himself out. If you don't want to smoke pot for the same reason, cool.

Pot induced psychosis would explain one of the findings, the third one given which reads "the third time i smoked lots of marijuna prior to episode". You're right.

This leaves the other two instances unexplained.

Not taking meds is a hunch too, but can explain all three. The first because he was binge drinking, the second cause he says no mood stabilizer, the third was using pot as a medication. All three could say not enough meds. No meds no sanity.

I'm tired too.