Bipolar sucks so much.
i got a high paying job and it’s not glamorous at all. I’m a woman, and it’s traveling in construction management. I actually used to work for the same company several years ago and did very well, but I wasn’t cycling and was unmedicated with no need for medication. My how times have changed.
im very sick now. I’ve been off work for 6 months and tried to get back to work and thought this would be a good job. I must be crazy. I can’t handle the stress at all. It’s destabilizing me rapidly. Another thing that’s a ticking time bomb that just tells me I need to quit ASAP. My psychiatrist back home. The last time I saw him was October 18th. I told him I was going to get back to work and travel and he thought it was a good idea and he assured me he could call in my scripts to any state and as long as I saw him once a year that would be fine. Well, I called about a month later to get call in scripts and he was taking time off and having another pdoc call in his scripts. Gulp. So I have been doing that since October and I think my state medical board only allows another dr to do that for two months. I have enough meds hoarded for another month and a half. I called my psychiatrist and he was supposed to be back mid December and now they are saying mid February so now I am stranded with no psychiatrist and 5 meds including geodon and klonopin I’m dependent on.
so I’m in trouble. Plus I’ve been cycling since I started working even on meds. I’m realizing I can’t work like I used to and I just need to face reality and move in with my parents and file disability. It’s hard to face. Hard. My sister is friends with a psychiatrist and she called him last night. I have two options on the table now. 1. Quit my job at the end of the week and tell my boss the truth and deal with him being mad and just get over it and make the 12 hour drive home and check myself into the hospital and see the new psychiatrist and get my meds changed and tweaked. 2. Wait on a call from the psychiatrist to my sister tonight telling her if he has any outpatient appointments over Christmas and if he does see him then and try to get him to call in scripts across state lines and keep working anyway even though it’s breaking me down. I couldn’t change meds because I wouldn’t have any time off to do so.
I think I know what I have to do but I’m terrified to talk to my boss. The company is based out of my hometown and I’m not sure what to say. I was considering talking about my doctor disappearing on me and not being able to get my scripts and needing them immediately or I will have seizures. Or just outright saying I have bipolar and I can’t do this and I apologize. I can’t work anymore and this is disabling and I didn’t want to think it was. Or just say I quit and I’m leaving my computer and company phone and it’s effective immediately. Help. What do I do and say? I wish I hadn’t gotten into this mess. The problem is he will have to replace me immediately or the job will shut down. I have to look at that as not my problem. My problem is my lifelong bipolar diagnosis and the fact that I could go psychotic if I don’t get help. That’s my problem. Not this project.
Any helpful advice is welcomed. I wished this had gone differently but I guess bipolar just blew up my life. It’s about to ruin my finances and burden my parents to care for me until I get ssdi. Plus I own a house that my parents will have to pay for until we rent or sell it. I feel like I’m made of glass. I used to handle stress without a worry. Now it destroys my life. I feel like I’m crying inside right now.
Welbutrin (Bupropion) is a dopamine-norepinephrine reuptake inhibitor; its occupancy at dopamine transporter (DAT) is 23%; whereas over 75% causes euphoria (ex. cocaine). A dopamine reuptake inhibitor (DRI) is a class of drug which acts as a reuptake inhibitor of the monoamine neurotransmitter dopamine by blocking the action of the dopamine transporter (DAT). Reuptake inhibition is achieved when extracellular dopamine not absorbed by the postsynaptic neuron is blocked from re-entering the presynaptic neuron. This results in increased extracellular concentrations of dopamine and increase in dopaminergic neurotransmission.
I am currently taking Abilify 400 mg every 3 weeks (~ 20 mg / day) and 300 mg of Welbutrin.
I was complaining to my psychiatrist about the side effects of Abilify I was suffering from; depression (low mood), sexual dysfunction, anhedonia, from a condition called "Neuroleptic Induced Deficit Syndrome" . I complained that I had totally lost my motivation, drive, and initiative and was experiencing anhedonia (lack of pleasure), emotional suppression, etc. It is like living in a mental restraint "straigthjacket". So my psychiatrist added Welbutrin. Abilify dampens down dopaminergic activity in three of the four dopaminergic pathways; It is the only Antipsychotic that I know of that can increase mesocortical dopaminergic activity. Other partial agonists like Brexiprazole and Cariprazine might do this also, whereas a silent antagonist cannot. Welbutrin has treated my low mood; I am euthymic now, but I am still anhedonic from Abilify being so frequent for such a dose; I am taking the daily equivalent of 20 mg: 400 mg per 3 weeks. At lower doses Abilify has a more stimulating effect. The Welbutrin he added certainly helps; but is unfortunately not enough.
I am considering adding a dopamine full agonist such as Ropinirole, Rotigotine, Cabergoline and Pramipexole to my prescription meds. Some dopamine agonists are useful at treating depression resistant to SSRI-treatment. Dopamine agonists can be given to counteract the side effects of antipsychotics and serotonergic antidepressants. No doubt that dopamine antagonism has a negative effect on mood. In the mesolimbic pathway *(reward pathway)* Aripriprazole reduces dopaminergic activity; which reduces motivation - salience (liking, rewarding), which can be identified as a major source of anhedonia. Aripriprazole does not reduce dopamine transmission in the mesocortical pathway in people whose mesocortical pathway has .less than normal activity. The dopamine boost that Welbutrin provides keeps me stable; counterbalances some of the negative effects of Abilify. I just need more help in alleviating this zombified state of existence in which I am alienated from my own real self. and cannot enjoy the things I used to enjoy; food, drugs, sex. I live in anhedonia, a state of a loss of pleasure; due to the neurological inhibition caused by Abilify. Welbutrin works as a wakefullness promoting agent, a mild stimulant.
Hi everyone, it's been a while.
So, I took the full 6 months of my short term disability, and I just started a new job. It's a little stressful, but it pays well. It is a contract job, and it required me to move to the location of the contract. I'm salaried though, and my company is putting me up in an extended stay hotel, and they are flying my home once a month and getting me a rental car when I am home...so I can come home and see my sisters and parents. That is a blessing. I can see my best friend too.
I am struggling with the never ending anxiety that I can never beat. I take a lot of meds for my bipolar. I think mine is really non specified because I'm so hard to treat. I take geodon, gabapentin, topamax, klonopin and lunesta plus vitamins. If I could wean off klonopin I could probably wean off everything but geodon. I'm just not ready to wean off klonopin, and I take .5 mg even though I'm prescribed 1 mg.
I am doing therapy online with betterhelp since I am on the road, and it is going pretty good. I just selected and therapist, and am sticking with her. I don't like her as much as my IOP therapist, but it is online, so I acknowledge the quality of therapy won't be as good but it is consistent.
I did go no contact with my ex boyfriend because that relationship was slowly killing me. He'd been abusive in the past, and was a narcissist. I loved him so much that it contributed to my breakdown in a serious way, and taking this job moved me out of state and away from him and helped me go no contact, so I am working through that with my therapist. It's hard. I've had ptsd over the past couple months since my short term disability was about to run out and I wasn't sure what I was going to do about money, and I knew I had to do something about him. I was waking up with nightmares and night terrors thinking someone was trying to kill me or I was going to die or the world was going to end. I don't know how to describe it. It was terrifying. I felt completely untethered from this world and it felt like I was threatened and like I was going to not live or survive or maybe subconsciously didn't want to. That was the scariest thing. I slowly started to feel disconnected from everything. Like I am just meaningless and one of billions of people and what does it matter? Those weren't my thoughts but my feelings. I was fighting that daily. I have been fighting that.
ive also been fighting some mortality issues with my age. Since I just broke up, I just turned 39, and I am traveling and single again. I am scared I won't meet anyone again or fall in love again. I worry about my parents aging. All of a sudden this stuff is in my head. I think because I have leaned on them so much this year since it has been so hard.
'I guess the good news is, I stopped having nightmares a few nights ago. No more night terrors and waking up thinking I'm going to die. I enjoyed music at work today. I went to a recovery group at church last night and that was helpful to talk and heal about what I went through with my ex. I'm trying to do the best I can at work. If it works out, great. If it doesn't, life will go on, and hopefully, so will I. I am trying to live more in the moment and practice mindfulness to help with my anxiety. Trying to take things one day at a time and if I can't do that, take things one moment at a time.
I know bipolar is for life, but I think recovery is possible, and it is possible to function with this illness, but maybe we just have to modify our lifestyles. Right now I just come to the hotel, take it very easy and am very gentle with myself and rest at night. I try to exercise when I feel like it. I need to be a little better with my diet. But it's not that bad. I'm not pushing myself working late or volunteering to work longer hours even though I know I can. I know what that leads to...cycling. My goal is boring stability. I take turmeric and magnesium to keep brain fog at bay but I wish I knew what I could do about these feelings of despair and loneliness. Maybe that's not mental illness. Maybe that's just heartbreak, and will take time to heal on its own.
Love to you guys and to everyone living with mental illness.
Just an update based on my posts earlier during this year. I ultimately wound up remaining on the oral antipsychotic (Latuda 20mg) which I started taking after completing my 2nd probation term in this decade in January 2018 stemming from a January 2015 motor vehicle offense which ultimately slammed me with a 3rd degree felony (after already acquiring a misdemeanor for resisting arrest on foot in June 2012) related to having schizoaffective disorder and experiencing manic episodes and hallucinations. I was previously diagnosed with Bipolar 1 With Psychotic Features after the 1st incident I was involved in back in June 2012.
My main issue the entire time I was serving both probation terms was that I was always court ordered by a judge to continue taking the antipsychotics by injection and to continue my psychological treatment. My primary concerns with the antipsychotic medication was always having intolerable akathisia (inability to sit still), tremendous amounts of weight gain (My height is 5'8 with a small to medium frame and my weight maxed out in January 2018 at almost 310lb after being around 155lb until after June 2012, severe gynecomastia (recently won Risperdal / Invega class-action lawsuit), anxiety, depression, and disorganized speech (currently seeing a speech pathologist to suppress language disorder).
Following the completion of my 2nd probation term, I was initially placed on Latuda 40mg taken with food at night and then tested out Fanapt 6mg. I was still experiencing most of the side-effects and was still outright desperate to eliminate all of the symptoms I just mentioned. By the beginning of March 2018, I did ultimately try consulting with my psychiatrist about switching to a mood-stabilizer as monotherapy acting in place of an antipsychotic and accepted the risk that if I actually suffer from schizoaffective disorder and it wasn't Bipolar 1 With Psychotic Features that I would probably relapse and hallucinate again and I was even in agreement to keep a bottle of antipsychotics as a PRN and to just eat them like crazy if anything happened.
I discussed everything with him (I never considered him to be a control freak) and he said that he would eventually be willing to try my suggestion but asked me if I had any other idea in mind that involved remaining on an antipsychotic for slightly longer. I suggested to him that I'd be willing to try taking the Latuda at 20mg instead of 40mg before switching to a completely different class of drugs.
In retrospect, I'm not even completely certain if any of the oral antipsychotics including the higher dosage of Latuda or Fanapt were even that badly tolerated.. Now, I'm not condemning an entire class of drugs because I now support some of the low-dose oral antipsychotics for myself but I ultimately think that my former overall disgust and intolerance for the antipsychotics was because I was only ever taking them when I was either locked up in county jail and the overall quality of the drugs was really bad and primarily because the only time I was ever actually taking them was when I was taking court-ordered injections. That basically explains why my experience with the mental health system always sucked up to that point.
I'm not trying to speak to highly of myself here but my psychiatrist has always said that he considers me to be one of his higher functioning patients, therefore the reason why he thinks I was always so vocal about all the underlying side effects from the injections and was more sensitive to them than the majority of his patients, even at 260, 280 or 310 pounds, my weight was never really a factor for me in terms of reacting to the meds with less sensitivity.
It simply didn't matter what injection he would put me on. I was on so many of them including Invega, Aristada, and Invega and they always caused more damage than they did anything positive for me. I always felt like the compromises I had to make to not hallucinate and remain out of legal trouble were simply too much to take. The slow-release form of the injections was always too intense for me but I was honestly being completely forthright when I admitted that I didn't want another episode involving the boys in blue to occur ever again.
At the time of my last post, my dosage was already reduced to 20mg and I was still complaining on a regular basis about everything I was still feeling but it wasn't until the end of March when the restless / walking on hot sand feeling finally began to subside. My overall appetite decreased enough to where I lost over 50 pounds by the beginning of the summer (since then the weight loss has stopped at around 260lb unfortunately but I have remained generally stable in terms of my weight). I won a class-action lawsuit against Risperdal / Invega in February and my weight became low enough where my plastic surgeon agreed to perform male-breast reduction surgery on me after denying me previously because I became so overweight / obese after I was released from county jail and the results were very successful without needing revision surgery thus far.
My speech disorder did improve a little but unfortunately wasn't completely going away by the end of the summer. I still felt like I had something like aphasia where I couldn't think of common words or name common objects and the words wouldn't return to my mind until 10 or 20 minutes after the conversation took place. The speech pathologist I eventually saw for this referred me to the audiology department at my local hospital for Central Auditory Processing Testing and it was revealed that I do in fact have a language decoding disorder (my intuition was right all along) which is certainly aggravated by having schizoaffective disorder and maybe even still by the medication.
I only become somewhat anxiety-ridden and become depressed right after I take the medication with some food, therefore I normally take it right before I go to sleep. By the time I wake up, I am no longer experiencing the anxiety and paranoia but I never become psychotic.
Still, the most important thing is that I'm no longer experiencing any of that indescribable akathisia and thank god the weight gain reversed before I hit 350 and I no longer have to walk around with female-like breasts anymore.
This is easily the most balanced I've felt since I developed the mental illness in the beginning of this decade. I'm not a morbidly obese zombie with female-like breasts pacing all day and night with akathisia but I'm also not hallucinating and running away from the local police department during a welfare check or speeding from the state troopers on major highways either. The delusions are still there at certain times except mild enough where I just laugh them off most of the time and don't believe the majority my own deception.
I worked my way up to 5mg of Zyprexa last 10 days, but still very irritable. I snap at everyone, so everyone is naturally leaving me alone. I don't like living this way. Left a message with my prescribing doctor about this irritability issue. Update, prescribing doc called and suggested I go up 1/4 of a tablet and get the irritability and mood swings under control before I start the Lamictal. So, took another 1/4 tablet which makes 1/2 of a 5 mg tablet I have taken so far this morning.
Seizure doc prescribed Lamictal, but holding off starting that until I feel more stable on Zyprexa.
Zyprexa used to calm my mind, not sure why it's not working so well this time around. I have been on all the other anti-psychotics and Zyprexa is the only one I can tolerate. Anti-depressants don't work for me, can't tolerate any of the SSRI's.
In the middle of a card game last Monday, I got mad at one of the players, threw my cards down on the table and left. That is not like me, I never display anger towards anyone. Very upset over all this irritability and moodiness and now what happened at the card game, very ashamed of my behavior. I have since apologized to the person I offended, will attend the card game this evening and see how I do. Gulp !!