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experiment with meds?

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Ask for the lithium. Lamictal isn't generally a super stabilizing med right off the bat. Would you be open to that?

I mean, that's just my opinion. No one here can tell you if you need meds or not. You were diagnosed very late in life. You don't have full blown mania/psychosis. But your pdoc thinks you need lithium so give it a whirl. See if it makes you feel better. If it doesn't then you can try your little experiment. If it were me, I'd go with the dr's recommendation first before I totally disregarded what he/she had to say.

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I think that zoloft is probably destabilizing yes, if you are really bipolar. It's generally considered one of the worst SSRis for BP. I will also add that from my OWN experience of SSRIs, I don't recover from them quickly, meaning that I have to be on a spectacular amount of meds while my brain just stops fucking up.

That said, I don't think that means that the RIGHT meds won't help you. If you tend towards mania, and clearly you do (though that may have been exacerbated by zoloft, but it's still gonna affect you for a while) then lamictal alone is not the greatest stabilizer for mania, generally.

So my answer is yes, you may not be on the RIGHT meds yet, but going unmedicated isn't probably really the greatest answer either. I think lithium would be a great choice to try, and I will also add that if it were not for side effects that were not good (kidney stuff, which is totally rare) I'd probably still be taking it. So I'd say it's not such a bad idea to give lithium a chance.

I don't really think the answer for you is to go unmedicated. At least right now. Your brain already broke, for whatever reason, the initial meds probably helped it break more, and now you need some time to heal.

Again, this is my unscientific opinion, but I'd advise against your plan. I really really would. I don't see it going anywhere great, other than perpetuating the crisis you have been in for the last year.


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If you're bipolar, and you sound bipolar to me, then SSRI's, including Zoloft, may very well make you unstable. Go read this:


But the fact that one class of drugs is not good for bipolar patients does not mean that other classes aren't good. You need a mood stabilizer. Possibly an AAP. Why? Because you've already had a couple of bad meltdowns, and having had those, you are more likely to have more in the future. This is called kindling. Go read this:



So what you have to lose if you go manic or get crashingly depressed again is that the pathways in your brain that already know how to do that, and are inclined to do it, will get a little stronger, more deeply entrenched. Why do that to yourself?

Edit: Actually, read this:


Much more concise.

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I disagree that a controlled trial without meds is a bad idea for Lilly.

For most of us who have been diagnosed and rediagnosed and on and off meds for years, it's stupid. However, med-induced hypomania isn't always indicative of an underlying bipolar disorder. After spending a year on meds that have most likely been destabilizing, I don't think it's such a horrible idea to see what her baseline is having never been on meds before.

Done in a safe, controlled manner with a knowledgeable psych team, it could help determine where her treatment needs to go next. It's sad to me that she wasn't given something like an AAP or lithium months ago when she was a lot more hypomanic than now, or at least pulled off the Zoloft, but that's water under the bridge at this point.

Obviously something sent her to the doctor for that initial script of Zoloft, but it may not have been bipolar disorder. And that's something to at least keep in mind. I do, think, though, you're going to have to come to terms with being on meds, Lilly, because there was obviously something going on in your brain.

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It's your body so you must do what you think is best. As for me, I tend to agree with muriel. If you do do this experiment, make sure that it is controlled with follow up. And at the first sign of depression or mania get back to the pdoc ASAP. It's always easier if you catch it before it gets too much of a hold on you.

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Guest Vapourware

Well, ultimately whether or not you decide to experiment with medication is up to you, but personally I would be wary of going unmedicated. No matter what the actual issue is, there IS something happening - be it bipolar or another label. Not being medicated can mean you run the risk of destabilising yourself even more. I guess I say this from personal experience - I've tried a few times to reduce medication or not being medicated at all, and I think most of the board are aware of what happened with those attempts.

It could be that the Zoloft was causing the hypomania, or at the least, exacerbating it. If I were to experiment with meds, I'd probably try out a mood stabiliser alone first, like lithium or valproate, then maybe add other medication if required.

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I agree with Vapour. For one thing you've had more than one MD think it was psychiatric, and one even admitted you were beyond his capabilities. Most MDs (and there are definitely exceptions) drag their feet about admitting that they don't know what to do, and you basically have had a couple of them admit it. They thought something was wrong. And you did have a panic attack. People do have isolated panic attacks in their lives, but you already felt like there was something wrong with your mood. To me, that is more evidence that something is up.

Your therapist, who is not an MD, at first dismissed the depression, but suddenly became very serious about it when you got hypo. So now you have several doctors and a therapist that are concerned. And a pdoc. It is true that the Zoloft may be "mimicking" and not causing hypomania, but I am under the impression that while you aren't necessarily bipolar if that happens, it does indicate an underlying condition of some sort.

I also think you should try a mood stabilizer, and lithium is the gold standard for bipolar illness, plus is now being used to treat some cases of depression. If it works for either reason, you're golden. Also, your pdoc is going to be more willing to stop meds, and try new things when you are not tolerating something, if s/he feels s/he can rely on you to be compliant.

Of course, the choice is yours. But I know what I would do if I were in your place.

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It is possible for someone to have one episode of depression or stress-induced anxiety in their lifetime and never have symptoms of mental illness again. Since Lilly's presentation of illness has been so late in life and a somewhat atypical presentation of bipolar disorder, it might just be the meds.

I'm not of the mind that everyone should be medicated for life with no breaks once they show any sign of mental illness.

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Guest Vapourware

Forgive me if I'm remembering this wrong, but I was under the impression that Lilly has had issues for years, that were only recently recognised and diagnosed? Ignore if I recalled wrong.

I also agree that not everyone requires lifetime medication, but on the other hand, if there has been a pervasive pattern of mood and anxiety disturbances over the years, then I think it's more than likely that whatever is happening is going to persist in remaining.

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i feel as though if i were a responsible grown up i should tell you don't do that.

however, i did it myself almost a year ago. for sort of the same reasons. i needed to know where my brain really would go without meds. it had been so long with so many med changes that never worked and had side effects that might be the cause of other symptoms (like maybe i wouldn't have them in the first place) and yanno... pretty much what you've already said. i wasn't evern sure of my own dx anymore. so i tapered my meds really quick and stayed off them for a few months before telling pdoc what i did.

pdoc said okay fine, if this is what you feel you need to do, then have some fish oil and by all means call me if (when) the crazy gets unbearable. of course it became unbearable faster than you can say "stupididea".

my life pretty much fell apart. off meds i went hypo, then mixed, then suicidal. restarting meds never had a chance to catch up before i was admitted IP.

so, now i know what my brain does without meds. i can say i'm kinda glad i do know now, since now my dx is clearer to me and my treatment providers, and the meds i'm on are much more appropriate (no more SSRI shit like the zoloft you mentioned).

the bad part: being nuts without meds caused me to lose my job. i lost my (blossoming, young) business. i lost most of my memory for about four months (sure i was hypo enough to have a dozen people over for xmas dinner, but i don't remember most of it and i don't even know what gifts i bought). i spent every bit of savings and accumulated some debt. i ended up spending a month in the hospital. i scared the shit out of my family so bad they can't forget it. i was closer to dying than i think i've ever been. it was hell on earth once the hypo state wore off.

so, if you're willing to go through hell and stop the meds, BE PREPARED for what might happen. have a back up plan with your family for what happens if you become episodic in any way. safeguard your job if you can (ask for time off or something until you know you're alright). give the debit/credit cards to someone. if you have med stockpiles, give them to someone else to hold. don't make any big decisions about moving or changing relationships. and by all means, set a TIME LIMIT for how long you think you'd like the no-med trial to be. remember it's an experiment, not a decision you're making about the rest of your life (yet).

and please stay in touch with your medical team. close touch.

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Without reading all responses, just between the lines, ssri's can cause issues if you are prone to mood swings. Zoloft is one of those meds. That said, they could make all the difference if they can give the understanding and time... Good luck to you x

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Well, I may personally strongly agree with your pdoc, but you kinda knew he was going to feel that way, didn't you? So if you are committed to trying this, take it with a few grains of salt. I would try to stay on good terms, however.

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I'm with the "bad idea" crowd, but I do understand wanting to see what your baseline is... I often think, Hmm, I wonder if I'm this bad because I'm on the Wellbutrin but then I need to slap myself because my baseline consisted of: depressed/mixed for weeks at a time then maybe 2 or 3 hypo days, then right back to depressed and/or mixed. WTH I would want to try that again, I don't know. Sooo, point being, does it help reminding yourself why you ended up at the pdoc in the first place?

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she put some conditions on it. i have to be stable first, and i have to be stable for awhile. which sort of goes against the whole purpose of my experiment.

pdoc was totally against it.

If you find yourself stable, why the hell would you want to mess with that? And wouldn't it answer your question about whether you need to be on meds or not-in the affirmative?

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Not everyone needs to medicated for life. She didn't present with bipolar disorder until very late in life and after being on an SSRI. Her case isn't the case of most of us here on this board.

Lilly may be one of those people that doesn't need to be medicated all the time and for whom medication caused a lot of her symptoms. I personally would want to know in her situation.

She understands the risks and is willing to do things the right way. Being on meds causes other problems that if one could avoid would be nice.

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