Closure

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  1. My diagnosis is Bipolar 1, but one thing that is apparent (to both me and my pdoc) is that I have negative symptoms, such as avolition and social withdrawal, in any mood (even when (hypo)manic), and I was wondering whether negative symptoms in bipolar are even a thing in the first place.
  2. I also get this, where I suddenly won't be able to express how I want to say something, for extended periods of time.
  3. Well, upping my risperidone to 4 mg, from where it had previously been lowered to at 1.5 mg, brought my rapid cycling to a screeching halt. Unfortunately it has not stabilized me, rather leaving me very depressed. I also am still quite paranoid - I still feel as if my coworkers and cars are watching me - as I was before, despite the extra risperidone; however, this is not surprising since my paranoia usually takes a while before it responds to any AP dose changes..
  4. Um just from reading the abstract, it says that they think that some subset of people with schizophrenia whose symptoms benefit from niacin supplementation, not that all or even most people with schizophrenia do. So I wouldn't be getting my hopes up. Feeding schizophrenics in general niacin in hopes of treating their psychosis would be like feeding people with MDD in general methylfolate in hopes of treating their depression; just like there is a subset of people with MDD who benefit from methylfolate but most people with MDD do not, there most likely is a subset of people with schizophrenia who would benefit from niacin but most people with schizophrenia would not.
  5. My pdoc hoped she could get me onto just cariprazine, because she thought that risperidone had lost some of its effectiveness (since I was still having some psychotic symptoms at 6 mg of risperidone), and that cariprazine would be more effective than risperidone had been. Unfortunately, it turned out that for positive symptoms for me, cariprazine is less effective than risperidone, which is why things unraveled as we crosstapered. But the reason to keep cariprazine in spite of that, rather than try another AP, is that cariprazine actually helps my negative symptoms, and as you know, negative symptoms are normally intractable. So hence my pdoc added more risperidone again but kept the cariprazine.
  6. Okay, my pdoc got a little more sense than usual in her today - she is upping my risperidone from 1.5 mg to 4 mg because the cariprazine seems to be less effective as an AP for me than risperidone, but she is keeping the cariprazine because it is helping with negative symptoms (and presumably because risperidone by itself is not sufficient for me, as shown by my having been paranoid and hallucinating on 6 mg of risperidone in the past). Maybe it has finally sunk in with her that I need more than one AP...
  7. I have been on primarily risperidone and cariprazine as my primary APs with regard to trying to treat psychosis, (hypo)mania, and mixed states. I was on quetiapine to treat depression in addition to risperidone, but my pdoc did not increase the dose that high because she does not feel comfortable prescribing higher doses of multiple AAPs (we also suspected that quetiapine may have been making me hallucinate, but I kept on hallucinating after I came off it). I was also on fluphenazine for one month, which was a disaster involving flat affect, akathisia, double vision, and a severe tremor. I was also on olanzapine for a short while in attempt to treat depression of all things (I don't understand why my pdoc at the time chose that).
  8. I'm quite depressed ATM - even though I'm thinking this may all be part of a mixed episode if it isn't rapid cycling - and quite paranoid, both of which are making me miserable here at work. I just want this to stop, the depression and the paranoia. It will be two weeks until I see my pdoc again, and this paranoia has varied day to day in intensity but shows no signs of actually going away.
  9. Aside from my predictable low level of paranoia over the weekend, while I have been paranoid at work today, the paranoia isn't nearly as intense as that on Friday, thank god. I still want to avoid being seen by my coworkers in the hallways, but I don't have this intense feeling of being watched all the time, and I am not as bothered when I actually am seen by my coworkers. On another note, the cariprazine definitely seems to be helping my avolition. I now take walks when it is nice out and I have time, I managed to purchase and replace my wifi card in my computer after having gone months without bothering to do so, I managed to take a shower when I didn't feel required to do so on Sunday, I am starting to engage in my hobbies again, and so on. I want to do things now. And this is not a mood thing, because even when my mood has been lowish I still feel less avolition than I had in the past during the same mood, I still want to do things.
  10. I just saw my pdoc (and am seeing my pdoc against in three weeks), and we are switching from 3 mg risperidone, 3 mg cariprazine to 1.5 mg risperidone, 4.5 mg cariprazine; she things the paranoia is appearing because we are in the middle of a crosstaper, and neither AP was at that high of a dose. We will see how this goes, though; I am concerned that 6 mg cariprazine by itself will not be enough, and I will still need, say, 1.5 mg risperidone alongside it
  11. I care about my dx because it gives things a name that ties everything together, rather than just being a collection of symptoms. Right now, my dx, when I asked, turned out to be BP1, but I do not believe it because I get psychotic symptoms outside of mood episodes (which should rule out BP1), and even my pdoc and tdoc themselves have stated that it is really only for insurance purposes (they were very reluctant to even tell me a dx). So that leaves me at that, well, I have mood symptoms and I have psychotic symptoms, without any real name accurately summarizing them, because I have not been given one that fits. That said, though, I would be treated the same way regardless of whether my dx were BP1 or SZA (my tdoc has offhandedly mentioned SZA as a possibility), and indeed my pdoc seems to be treating my psychotic symptoms as distinct from my mood symptoms. Interestingly enough they weren't this way with regard to my OCD traits, which my tdoc regularly directly refers to as such (she says "traits" because she does not think it is severe enough to count as actual OCD per se).
  12. I seriously almost did not come into work today - and I always come into work, no matter how symptomatic I am, unless I'm off normally, or I'm IP - just because I knew the paranoia would make me miserable, which it has. I decided against it because I've been paranoid all the way since Friday, and if I did not come into work each day I was paranoid I would have already used up six sick days, which I am intending on saving for things like IP or anything involving massive amounts of vomit or diarrhea.