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Hormone Imbalance, Not Bipolar Disorder

Bipolar Disorder is grossly over-diagnosed and mis-diagnosed. In many cases it is mistaken for hormonal fluctuations, irregularities or imbalances which can be readily diagnosed and treated, eliminating the diagnosis and miserable treatment of the non-existent BPD. Read More

I'm right here

My theory is in cement.

What are you not understanding?

I'll be happy to enlighten you.

Let's discuss this here and now, in front of everyone.

You go first.

Best of luck!


Sir; you remind me of Harold Stassen. Have a good evening. I will continue to deal with everyone else


That's what I thought.


I have figured this out on my own because of hormonal imbalance from the Mirena IUD. I had this in 3 years ago, 6 months later I had my first anti-depressant, after that emotional issue after emotional issue, inability to deal with stress anymore, overreacting, mood swings, irritability, yelling at people I love, basically being someone I'm not. Add also the diagnosis of ADHD, Major Depression, Anxiety, spondylitis, uveitis, numbness and tingling in the limbs, cold urticaria, raynauds syndrome, IBS, Acid Reflux, and having been to several specialists, unneccessary procedures and lab tests, and therapy.

Result? NOTHING! The imbalance became so harmful to my mental health that I almost lost my husband and job. I became suicidal and lost control over my mind. I came to the conclusion of hormones after much research, and calendar tracking of all my issues. One thing was in common. I was perfectly myself from the end of my cycle, until ovulation. Once ovulation hit, I was a terrible mess for 2 weeks, neck and back pain, eye pain, mental fogginess, memory loss, and all the mood disorder symptoms.

After two failed attemps to remove it now I have to have surgery, and everyone says, "Oh, I've never had this happen before," or, "I've never heard of such a thing."

It's frustrating and I am happy to see someone is doing research on this!! They wanted to peg me as bi-polar and my doctor even stopped returning my messages or calls.

Surgery is scheduled, and I stopped all medications but two. My medical debt and prescription cost has put me in the hole. I think it's absolutely wrong that physicians are taking advantage of imbalanced hormones to benefit the pharmaceutical companies. Would love to talk. :)


Indeed many men and women have mood issues secondary to hormone imbalances or insufficiencies. I have written about this before. Now I have seen several teenage and young women with refractory depression, supposed bipolar and other incorrect diagnoses induced by birth control pills and IUDs which reduce their estrogen levels too low and they are moody messes. They must be on high dose estrogen, or cycle without interference. If PMS is an issue Wellbutrin solves that. Peri-menopausal and post-menopausal women usually need vigorous HRT, estrogen and often testosterone for resolution of mood and cognitive disorders, not to mention libido.

I don't think many physicians "take advantage" of imbalanced hormones to benefit the drug companies. I know that a great number simply know nothing about what I, and a few others do and write, and think they're doing the right thing. They just are way behind the curve.


It is tremendously difficult not to assume so when I have been prescribed Wellbutrin, Cymbalta, Flexeril for pain, Phenergan for nausea, Klonopin for anxiety, some medication I never filled for IBS, another med I never filled for spondylitis(which I do not actually have.)another med I never filled for sinus problems, several different medicines for my uveitis, including glaucoma drops for high pressure as a result of the steroids. In other words, how are they not benefiting? The GYN refused to take it out a year ago, convinced me to keep it in.

It's embedded and I have to have a very expensive surgery. They have greatly benefited from me and I have yet to find a physician that actually cares at all. I would be interested in reading anything you have written previously regarding this. I'm trying to prevent other women from getting stuck in the same situation.

I don't have a positive view of physicians right now. I hope that changes in the future considering I am in the medical field.


Indeed the drug companies benefit. I do not defend them. It appears your treatment has been dreadful and unfortunately not unusual. I do not defend ignorant, cookbook, arrogant physicians. i clean up their messes several times a day. But most of them are foolish pawns of the drug companies, not co-conspirators.

How do I get tested?

Hoping you can help as I've been caught in the nigthmare that is the mental health system since 2008 (2008 diagnosis 'mild depression'; prescription antidepressants, 2011 diagnosis bi-polar disorder; prescription lithium and some other mood stablizers and told antidepressants are bad for me and I should never have taken them. I am waiting for my new 2014 diagnosis owing to what I fully believe were issues related to a Mirena IUD I had insterted in early December 2013 and new drug treatment plan which I do not intend to comply with (I need both the assessment and an action plan for work dissability forms and if I ever hope to be allowed back to work; likely to be problematic when I don't comply with the action plan to be a (prescription) druggie).

I'd like to look into this but my family doctor is already likely quite sick of all the headaches I've caused for her these last few weeks. I am in Canada, do you know of anywhere I could just go pay to have myself tested?



The only thing I can say is that I and a few of my colleagues here are working on this. I know of no one else.


I am one month or so post surgery for iud removal. My hormones are still leveling out (only sweat now during ovulation and menses) no more crazy mood swings, no more crippling back pain, no more suicidal thoughts, no more extreme fatigue, anxiety, nausea, night sweats, etc. I basically cured myself by deciding to have it removed!! I am finally functional and happy again. I agree the physicians are drones of the pharm companies...and am currently looking for a new PCP. able to think clearly again I am no longer so angry and bitter, I actually feel bad for them. For what is life without love and caring for others? I appreciate the work you are doing and am considering a career switch to medical research.

Naturopathic Medicine

Thanks Jen for the response and posting part of your story. Are you on twitter by any chance?

BTW in reponse to the March 26 relpy regarding testing; I've done a little investigation and it seems that hormone testing is fairly common, and perhaps even standard in natuopathic medicine.

Although in some cases (or natuopathic clinics) you may need a physician that supports natuopathic medicine in order have the testing ordered. Thankfully my physician not only supports this, she works in an integrated office where I can have both and chiropratcitic/massage and physoitherapy to help reduce the associated physical symptoms I have wrt stress & anxiety; and ultimately to look at resolving or better managing the underlying cause of my back/neck/shoulder problems. That should help with the irritating headaches and migraines too I'm thinking...


This was a good article. My husband fits just about every symptom of bipolar, but because he's Cushionoid & survived Reyes Syndrome, has hypogonadism as well as diabetes II, we are seeking consult with an endocrinologist as well as a psychiatrist. Do you have any protocols or things to test for we could pass forward to this new endocrinologist?

To possibly lend to your theory, my husband became impotent approximately the same time the bipolar symptoms appeared with any noticeability. However, this December, he started applying some expired testosterone gel while he was manic and it only made him the absolute worse raging bull. If I wasn't by myself, I'm guessing I could have had others join me to get him committed from those symptoms alone.


I do not have any "protocols". This requires people who think outside the box and can conceptualize not just the physiologic but the NeuroPsychiatric, behavioral, emotional and cognitive effects of these intertwined problems. I work with one endocrinologist here. Dr. Ed Klaiber in Worcester, MA is great.

I think you're definitely onto something here doc

I wonder if I have a hormone imbalance, I'm 34, relatively normal between the end of my cycle and ovulation and then bam: I'm sobbing, telling loved ones to get lost/F off, breaking whatever is close enough to throw across the room. I also get hot flashes in the morning, occasional night sweats when I'm menstruating, memory lapses and irregular PAINFUL periods.... This is very isolating and I've become very depressed because I used to be very social and fun 16 months ago before this all began. I think my pms got worse/very painful 2 years ago then my periods became irregular and my moodiness that I associated with the pms started happening at unpredictable times. I feel like a teenager again, I'm not even sure what I used to enjoy or who I used to be before all this. I went to a psychiatrist who gave me Wellbutrin and while it cheered me up a little it made temper even shorter like an occasional wild card, the doctors solution: to increase my dose... twice... after a year of that I decided to get off it but not before I had no friends and no job left. (NO one puts up with a Debbi downer for long) I remember feeling like this as a 15yr old but at 34 I thought I really knew myself and I trusted myself and I used to enjoy sex, sigh... now the thought of it just grosses me out... and when I give it a shot anyway I'm dry and uncomfortable, I imagine it's the way a young girl might feel if she were being raped I'm also afraid I'll get a urinary tract infection that I'll have to take an antibiotic for that will lead to the yeast infection BV back and forth that takes months to regulate. So I left my fiance who I love and used to enjoy very much sexually he shouldn't have to deal with this even if he says he wants to... I'm back living with my mother... She tells me she stopped getting her period completely at 41 and her doctor said her early menopause was due to stress. I've had a rough time scraping by and wondering how to make ends meet but I'm not a single mother like her... Could this be pre menopause? At my age? What are my options here? What should I get tested for? I have medicaid in NY but I might not be covered out here at my mom's place so there's that. Any advice can't hurt at this point. Thanks


I do not know of anyone who works the way I do. There is a great endocrinologist in Worcester, MA, Dr. Ed Klaiber. You might try him.

Thank you

Thank you

Thank you

Thank you

Thank you

Thank you

Just wanted to point

Just wanted to point something out because I'm seeing this everywhere -

"BPD" does not stand for "Bipolar Disorder", it stands for "Borderline Personality Disorder". Using "BPD" to refer to Bipolar causes confusion.

Thank you!

Why does everyone mix up BPD with BD? BPD is Borderline Personality Disorder, not Bipolar Disorder.


FYI. Nowadays BPD is true most comment abbreviation used for Bipolar in our charting in this area. True, BPD has been used for borderlines but usually we indicate Cluster B. At my hospital and with my colleagues this is our parlance.

Any thoughts are greatly appreciated!

I too can relate to the 34 year old woman's post with hormonal issues...I'm 35 and have three small children, but I feel like I'm 80. I have always had pms but things seemed to get worse when I started birth control in my early 20's. I was normal for a while, when I stopped the birth control, but since having children, I have become a mess. I have been given a wide array of opinions from various doctors, including omega-3 deficiency, vaginal atrophy from breast-feeding (when I was—two years ago), and the big shocker, you have three kids so you are stressed and need more sleep. I am on low dose celexa right now, and I am feeling even worse. It was prescribed for pms mood swings and depression. I am NOT depressed—except for the fact I cannot find any answers! I have had my thyroid and parathyroid checked (not anti-bodies yet), and I've wondered about adrenal fatigue. I am terrible (possibly even worse than right before my period) about 5 days after my period stops, right before ovulation, with extreme fatigue—scary fatigue, pelvic fullness/pain, low libido (it used to be high at this time), joint pain, extreme irritability, brain fog, but manic racing thoughts. I also experience night sweats like clockwork a few days before my period, which have been attributed to a side effect of the meds I'm on. The vaginal dryness, scant periods, wrinkled skin (my eyelids have waves in them when I smile), acne, hot flashes and moodiness make me feel like I must be going through menopause...they tested my LH and FSH (not on day three) and I was normal, I guess. I am not overweight, but I do have cellulite around my mid section. I have tried working out, which only makes me feel terrible if I push too hard like when taking a boot camp class...I used to be a professional ballet dancer—I should be able to work out hard core!! Please! I'm desperate for sound advice...I'm scheduled to go to my PC doc on Monday to switch to Wellbutrin. I'm wondering if I should see an endo or OB instead...I live near Kansas City...feeling hopeless about finding a doctor that even cares. It's truly sad! Your thoughts would be a Godsend at this point. Thank you for your time, I'm sure you are very busy! Your articles have been very informative and eye opening.

Also, what is your thought on the cause of all of this? Starting birth control? Another possibly related issue... I'm having my son tested for fragile x. I feel he could have a premutation, or be on the milder spectrum of being affected, but, obviously X chromosomal, I would have some issues, too, if positive.
Sorry, that was a lot to throw at you!


The situation you describe is c/w chronic estrogen suppression to the point of chronic peri-menopausal symptoms. Such an individual either should be on high dose estrogen BCP or, optimally, not on any BCP until normal endogenous hormone production and cycling resumes (with alternative contraception as desired). After 3-6 months a comprehensive metabolic re-evaluation should occur. No psych meds will help in the suppressed state. After a normal state is achieved and accurate diagnoses made then Wellbutrin is best for PMS in a proper pattern. Any psych diagnoses made in the artificially induced suppressed state must be re-considered as must treatment. I do not use SSRIs.

Thank you

Thank you for following up...
About your suggestion on BCP—I have not taken any in about a year and a half. I am still having a period, although it is lighter than it ever was before. I have never done well on BC, but maybe estrogen wasn't high enough? Would you recommend seeing an OB or reproductive endo for this and what is included in a comprehensive metabolic evaluation? seems I have to get very specific with my doctors to get the testing I need.

Thank you again for your time...


You need a cutting edge, out of the box physician. If you have to ask or instruct you are in the wrong place.

Too much confusion..

I started getting treated for severe depression, anxiety and the loss of a sex drive with pitiful weak erections and orgasms about 20 years ago; later that same initial year I also received a shocking concussion in a motorbike accident. SSRI's caused mania, suicidal ideation, continuous anxiety and periodical severe panic attacks (that last one was an SNRI). MAOI's did nothing. Lithium did nothing. The new style atypical anti-psychotics like Avanza sent me really psychotic. Chlorpromazine is soothing but tolerance builds up so fast (I can't take it anyway due to liver disease). I take benzos as required for minor anxiety. I asked a doctor about the sexual problems and was dismissed "we'll deal with that later". I just gave up; thinking this is going to be how it's going to be.

Recently I was prescribed two diuretics frusemide and spironolactone; the latter causing dramatic gynecomastia on top of already progressive hypogonadism. An MRI revealed a tiny microadenoma (but it should not be that) and my free Testosterone levels came back at 0.0 nmol/L although after re-calculation it worked out at: Free T at 0.0404 nmol/L and Bioavailable T at 0.693 nmol/L. I was prescribed T transdermal gel 1% and it was like I was given amphetamines by 12 hours after the first application. The first night I had dreams about sex for the first time in I can't even remember when. The second and third nights I was thinking about sex; a lot. Even knocked the top of it for the first time in years. Then anti diuretic hormone levels rose (I think) so I could get a full nights sleep without getting up every two hours. I realise I should have noticed nothing for 2 to 3 months but it was immediate and my doctor refuses to believe me.

What is going on?

After less than two weeks all those effects had stopped and I had to discontinue due to jaundice (liver recovered within two weeks).


Sir, I empathize with your situation. But you present such a complex history that I cannot begin to respond. It would require a full review of data, updated exam and consultations. I am sorry but I cannot give you a simple answer.

I appreciate your time

I actually saw my Endocrinologist a few days ago and he too is at a complete loss to explain what happened; he hasn't seen or heard of it happening before (T' HRT inducing hypomania at low plasma levels). The only positive that came out of it is that it has induced my metabolism to work more effectively at all sorts things. But that is rapidly coming to an end 9 weeks after discontinuation.
I have to have major surgery next week, but assuming I survive the Endocrinologist would like to see how my body responds to Testosterone levels at one eighth of normal minimum. I just wish I could find a way of reducing my SHBG levels which are two or three times higher than normal so the testosterone doesn't preferentially bind to that rather than be available.

update and thankyou

Jgoodman wrote:
... But you present such a complex history that I cannot begin to respond. It would require a full review of data, updated exam and consultations. I am sorry but I cannot give you a simple answer.

I absolutely understand. I'm blessed with enough of a sense of realism to understand you can't just donate a couple of thousand dollars worth of your time to everyone who'd like you to. However, nothing ventured; nothing gained. :)

Minor update:

I actually saw my Endocrinologist a few days ago and he too is at a complete loss to explain what happened (the extreme testosterone sensitivity; he hasn't seen or heard of it happening before. The only positive that came out of it is that it has induced my metabolism to work more effectively (measurable) at a variety of things. But that is rapidly coming to an end 9 weeks after discontinuation.

I have to have major surgery next week, but assuming I survive the Endocrinologist would like to see how my body responds to Testosterone levels at just one eighth of normal minimum. I just wish I could find a way of reducing my SHBG levels which are two or three times higher than normal so the testosterone doesn't preferentially bind to that rather than be available for use.

One step at a time I guess


Sir. It is not about time and money. It is simply too complicated without everything. ?Pituitary issue? ? are you rapid converter to free T? What are E levels at same time, and LH, FSH. I haven't posted yet but prior suppositions that free T affects renal tubular function are incorrect it is E, which varies wildly in rapid T metabolizers. So, sir, it is too much for a blog post.

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Jory F. Goodman, M.D., is a practicing psychiatrist in Beverly Hills, with more than thirty years of clinical experience.


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