Expert: Ivan Goldberg, M.D. - 7/19/2010

Question
I'm 36 male married 15 years 2 daughter 6 and 9 :) I am bipolar II rapid cycle taking 300mg Lamitcal. I have taken every medication known and this has been the best that has controlled my mood and allowed me to function "normally" with my family and at work. So that the briefing...

Since my wife and I had a huge fight (that i caused) i had an major suicidal episode where i woke up from the night of fighting with her, extremely tired, went to the bathroom and it was at the same time i looked in the mirror i began hearing these voices for the first time, really noises telling me to kill my self. I couldn't understand the words, but i knew the sounds and understood that they wanted me to die...it was all i could was to hold on to the sink...i remember looking around for my razor for something to hurt myself, but nothing was there...the noises kept going until i was able to get myself moving (30 minute(?)...then i got dressed, in my truck driving to work they were still making noise/voices and by the time i got to work and began working the voices/noises ceased.

However, it has happened several times sense (that was about 8 months ago)and again just this last Saturday.  it happens where the voices but really noises that i cant make out the words.. but i can understand that there talking...almost like what you hear in a crowd...but all directed to me. It causes a lot of anxiety with me, i feel myself getting very angry at the voices... and happening more frequently. How i stop it? I usually breath through it, get up, change my surrounding, start talking to someone...then it all goes away... so the million dollar question is... what does this mean? am i getting more crazy? did i have a psychotic break and cant get back?

Answer
Hi Brand . . .

People with severe mood disorders often have hallucinations and/or delusions. Such symptoms while VERY frightening can usually be easily gotten under control.

People with your symptoms usually require a combination of medications.  If you psychiatrist is unable to but together an effective set of medications, you might think about consulting one of the expert psychiatrists listed at:
http://www.psycom.net/depression.central.psychiatrists.html

In my experience, lithium should be part of the treatment plan for people with symptoms like yours.

Best regards . . .

Ivan
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