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Quick story time:

i was unmedicated and homeless. Living on the streets was dangerous, but I felt awake and alive. I barely managed, but not having to deal with people and living off the grid and camping and biking across the west coast felt like the only way I could survive in this world. I eventually got into an emotionally abusive relationship and got a job in a punk collective where I could be weird and settled down a bit, but infuriated folks around me with my bouts of manic behavior and the flip side of that- I tend towards mixed states. I got into a car accident and thanks to a mild traumatic brain injury, my symptoms became more severe.

Magic happened: I found my career in an art field. 

Magic happened again. I was given an ultimatum by a boss: take meds or eventually be fired. 

I started taking meds, and eventually found lamictal to be a lifesaver. I became more productive, I know. I could better deal with people and got less migraines. I’ve made all the advances towards finding the perfect combo I can, but I can’t tolerate antipsychotics. I take them, they start to work, and the side effects become so severe that I can’t continue - and my job requires a lot of focus and alertness and fine precision (tattoo artist). But the antipsychotics Are the missing key. I need one that works to actually be better. When I was on geodon, before it started fucking with my coordination, I had an “aha” moment one day - THIS IS HOW OTHER PEOPLE FEEL. And it felt so good to have that delusional part of my brain just stop talking. The following week, my coordination was so far off that I touched my needle to my glove three times, and I immediately went off of it. 

I’ve tried other meds, but side effects continue to make them impossible. What the hell do i do? I’m sitting in a place where I often have the sensation that I am less alive and that it doesn’t make sense to continue to live this life. I have to hide my benzos and curl up in bed. I feel like I need more therapy support than once a week or a month. I am just not sure how to manage things - i’m better than I was, but i’m still barely functioning and sometimes, i’m not able to work. 

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12 hours ago, Spitfire said:

    i’m better than I was, but i’m still barely functioning and sometimes, i’m not able to work. 

I'm assuming you have a psychiatrist--have you told them about the problems you've been having?

If your doctor knows about these problems, what have they suggested to you?

What other meds have you tried?

Edited by CrazyRedhead

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Hi! My psychiatrist knows about what’s happening, for the most part. She really just focuses on physical things. Our appointments are short and she doesn’t spend very much time on my mental state, which doesn’t make a lot of sense to me, but that’s how it’s been. My psychologist is at the same organization, but they don’t seem to talk to each other. My last psychiatrist tried to get me into ECT and a hospital on our second appointment, without trying any medications other than lithium first, and i’m Afraid of losing my autonomy and ability to make my own choices, so I hightailed it out of there and found someone else. The 50’s style psychiatrist is the head of the bipolar section at the big university here, and the psychiatrist i’m seeing now is really my only other option here in my insurance network. 

That being said, i’ve Tried lithium, seroquel, buspar, Wellbutrin, Effexor, geodon, abilify, and most recently, Rexulti. Also, Ativan to calm me down and adderall to boost me up. My psychiatrist seems reluctant to try any other medications and keeps telling me we are running out of options. She listens to my symptoms, but doesn’t seem very concerned about impulse control issues or self harm/suicidal ideation or minor hallucinations. I don’t know if she doesn’t believe me or what, but I spend about half the time in a funk or aggressive and amped and feeling like this life isn’t real or like I don’t really need these medications. Which i’m pretty sure I do, it’s just so tiring being up and down so much. I just came out of three weeks of hypomania/extreme anxiety and agitation/hallucinations and I am trying to manage the crash. A friend suggested this place as a resource.

As for doctor’s suggestions, I really am not getting any. It’s just doctors who listen to me, but aren’t really giving me any advice or a back up plan. Just “call the hospital if things get out of control.”

Edited by Spitfire

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Have you tried the anti-convulsant class of medications?

Depakote

Tegretol

Trileptal

 

Edited by argh

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I agree on the second opinion.  There are so many different combinations and dosage tweaks to find something that works and keeps you balanced.

 

If you are having issues at work now, you should try and set up an appointment with a new pdoc for a second opinion, and really press your current psychiatrist.  She needs to know you are struggling at work.  With my pdoc, that is a huge deal and he takes it very serious because we collectively have work issues.  So if she doesn't take you seriously again, you can have another person lined up.

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2 hours ago, argh said:

Have you tried the anti-convulsant class of medications?

Depakote

Tegretol

Trileptal

 

I don't tolerate antipsychotics, but I found that my brain worked well with anti-convulsents (except Lamictal). When a I take an AC, I describe it as going from a noisy stadium in my brain to an empty room. Everyone is different though, but they are regularly used for BP. Depokate worked quite well but I got a rare side effect with it and had to give it up. ACs are super calming for me. There's some weight gain, but about the same as the older APs (like Risperdal). 

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4 hours ago, CrazyRedhead said:

Would it be possible for you to get a second opinion from another pdoc?

 This pdoc is a second/third opinion, and I can’t transfer to another one in this system. I transferred care once because i moved, and they won’t assign a different doctor to me. So my options at this point are:

1. return to the university of MN and deal with the psychiatrists that deal with bipolar disorder - all of which are overseen by the one psychiatrist that immediately recommended ECT (and who I don’t want overseeing any of my care)

2. Stay in this system and try to figure out a way to get more out of this relationship with my current psychiatrist. 

3 hours ago, argh said:

Have you tried the anti-convulsant class of medications?

Depakote

Tegretol

Trileptal

 

I’m currently on lamictal, which is definitely some special sort of magic. It’s just not enough on its own. My psychiatrist has floated the idea of putting me back on lithium as well, but i’m In a position that I may lose my healthcare and I wouldn’t be able to afford the regular blood draws.

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2 hours ago, Egads said:

I agree on the second opinion.  There are so many different combinations and dosage tweaks to find something that works and keeps you balanced.

 

If you are having issues at work now, you should try and set up an appointment with a new pdoc for a second opinion, and really press your current psychiatrist.  She needs to know you are struggling at work.  With my pdoc, that is a huge deal and he takes it very serious because we collectively have work issues.  So if she doesn't take you seriously again, you can have another person lined up.

This is a really good idea, i’m Just worried about seeing someone at the u of m because of my experience with the head of the psych department that specializes in bipolar disorder. 

 

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1 hour ago, Spitfire said:

 This pdoc is a second/third opinion, and I can’t transfer to another one in this system. I transferred care once because i moved, and they won’t assign a different doctor to me. So my options at this point are:

1. return to the university of MN and deal with the psychiatrists that deal with bipolar disorder - all of which are overseen by the one psychiatrist that immediately recommended ECT (and who I don’t want overseeing any of my care)

2. Stay in this system and try to figure out a way to get more out of this relationship with my current psychiatrist. 

I’m currently on lamictal, which is definitely some special sort of magic. It’s just not enough on its own. My psychiatrist has floated the idea of putting me back on lithium as well, but i’m In a position that I may lose my healthcare and I wouldn’t be able to afford the regular blood draws.

Depakote, Tegretol and Trileptal stabilize from the "top" by quashing manic symptoms while lamictal stabilizes from the "bottom" so works as an AD of sorts as well. Trileptal doesn't require blood tests, however Depakote requires testing to ensure that you are in the theraputic range. Tegretol does need testing, I believe for liver enzymes. There are others on this forum who take it, like @jt07 who might be able to give you a better idea of what it entails.

There are also some ACs which are questionable in efficacy for mood disorders like topamax, neurontin, lyrica and zonisamide, which might also help somewhat. None of those require blood tests.

 

 

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13 hours ago, Spitfire said:

Hi! My psychiatrist knows about what’s happening, for the most part. She really just focuses on physical things. Our appointments are short and she doesn’t spend very much time on my mental state, which doesn’t make a lot of sense to me, but that’s how it’s been.

Your psychiatrist is a medical doctor, that is what they are trained in, as you call it "the physical". They seek medical solutions and see your symptoms in a medical context. If you want to talk that is what a therapist is for and I see you have a psychologist. Make sure you have signed off on a HIPPA release for each so they can talk to the other. Stand back and don't expect them to talk to each other. They each see you from their context, medical or psychological so usually there is little to talk about. Both are thoroughly trained to diagnose, treat, and maintain you so what do they need to talk about ? If you need your psychiatrist to tell your psychologist you are not doing well or vise versa you need new doc''s (that is assuming your psychologist is a clinical one).

Most of my physical doc's write short summary letters to my generalist doc if they see me.

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5 hours ago, notloki said:

Your psychiatrist is a medical doctor, that is what they are trained in, as you call it "the physical". They seek medical solutions and see your symptoms in a medical context. If you want to talk that is what a therapist is for and I see you have a psychologist. Make sure you have signed off on a HIPPA release for each so they can talk to the other. Stand back and don't expect them to talk to each other. They each see you from their context, medical or psychological so usually there is little to talk about. Both are thoroughly trained to diagnose, treat, and maintain you so what do they need to talk about ? If you need your psychiatrist to tell your psychologist you are not doing well or vise versa you need new doc''s (that is assuming your psychologist is a clinical one).

Most of my physical doc's write short summary letters to my generalist doc if they see me.

I’m not talking about talk therapy - I have a psychologist, and I don’t love going, but I do it to try to make things better. When I say “the physical,” i am talking about physical symptoms vs mental symptoms. I’m talking about communicating with my psychiatrist about how medications affect my mental symptoms and feeling like i’m not being heard - and being told in response that we are running out of options, like there is something I can do about a medication making me physically (and sometimes mentally) unable to do my job. Since i’m Seeing her to help with mental symptoms, it seems like the status of those might be pertinent information to her. If i wanted a general doctor, I would see one. 

It’s not like i’m dismissing her - I’ve been seeing her for a couple of years now - but I am frustrated and looking for support because while I have gotten better with medication, it’s not as much as I need to in order to be functional. And if I can’t improve enough to be properly functional, then what’s the point of this?

The advice I was requesting is “what do I do to make things better?” If you don’t have advice to that end, it’s fine.

Edited by Spitfire
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