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Don't know what to do

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It seems no meds are working. I've tried most of them it feels like. For some reason Adderrall doesn't even work anymore. It worked fine a year ago. Is my brain fried or am I just now tolerant to everything now? Seems like ect is my only option.

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I've tried all the standard meds for bp2, which is what I have. Lamictal, abilify, zyprexa, symbyax...a host of ADs. If you can think of it, I've probably tried it. I'll take recs though. I can't even get high recreationally anymore, which I know might sound like a weird thing to say, but I've never had that happen before in my life. Something strange is going on in my body. 


Currently on lithium, vybriid, Risperdal, abilify, and Xanax, which I think is the only thing that's working. I have multiple scripts for it (don't judge me, it's the only thing that works) I take about 1.5-2mgs a day.


I never thought I'd be up for ect, but if it's the only option, and the alternative is feeling like this, then I'd give it a shot. I'd rather be dead than how I am now. The only thing that keeps me going is hope for change.

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Your doctor shopping? Do any of your doctors even know you are on Xanax? Did you know Xanax can make you depressed?


Once again you are being extremely vague if you want any constructive advice. You've tried all the SSRIs, SNRIs, TCAs, MAOIs, and one-offs? Have you tried all the AAPs?

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I just went to the family doctor to get more xanax. My pdoc knows I'm on xanax. The reason I did it is because it's the only thing that helps with anxiety.


Of course I haven't tried all ADs, but I've tried the most common ones, which are a lot. I've tried all AAPs except for Geodon I think, but my main problem isn't mania, it's depresssion.


I'm not trying to be difficult, just looking for some help.

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Ok, looking at this from another angle, your response to meds can be governed by:


* How long have you suffered bipolar episodes and how long have they gone untreated until you got diagnosed and into treatment? 

Having a long history of untreated bipolar can make the episodes harder to medicate. It can also mean that your brain suffers self medication with OTC meds, alcohol, recreational drugs etc etc which can also then make figuring out what will work harder.


* When you say meds have pooped out, what does that mean?


Are we talking, 1 being in crisis and 10 being stable, you have gone from a 9 to a 6? Have you noticed your symptoms, have your loved ones? Is the life you used to live untenable? Sometimes breakthrough symptoms are a reality of life, sometimes a massive episode can risk everything you built. 


* How long did you trial meds for and did you take them as prescribed?

No judgment here, I go off my meds periodically. Some people post about a med not working then reveal they gave the med fourteen days and then quit at the first sign of a sniffle. There are meds that don't treat bipolar, and then other meds that do that don't work for an individual because of intolerable side effects.


*What is going on in your life?

We also get CB posters who say their meds poop out, and when questioned they reveal that by the way, they are in the middle of a divorce/cancer/house move that is making them all the more batshit. Stability does depend on meds, but if you have change or stress, even a cocktail that works can cease to be as effective.


* What is your preferred treatment plan?

It sounds like depression and anxiety are your main troublesome symptoms. Is it those you want to focus on? How much episodic instability can you accommodatr, are we going for maximum stability or something close to? Well or just anything better than this? If you are considering ECT, it sounds like you have tried a fair few and are a 'do what it takes' person. 


Have you had non medication interventions e.g talk therapy, self management, changes in lifestyle, exercise, diet, yanno, the stuff we all loathe to be suggested that helps meds work better?


* How are things with the pdoc?


If you and your pdoc have radically different goals or methods to your wellness, then this kind of thing can arise. Are you able to communicate and are you on the same page?

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I have bipolar, have done since I was 11, untreated till 21, didn't get stable till I was 25.


I tended more toward several months long depressive cycles when I got into treatment, with mania a few times a year. Over time, I switched more to mania, but mostly on the mild side of it. AD's made me horribly manic, plus I have anxiety issues anyway. We started with depakote and olanzapine, we trialled AAPs like Seroquel and Solian but ultimately, we needed to raise my baseline pervasive depression and then keep that stable.


I found Lithium to be my wonder drug. I used risperidone to sedate my psychotic tendencies, I weaned off a low dose a couple of years ago. When I was just on the Lithium, I found winter a bad time for long depression. We introduced Lamictal to some success.


The majority of AAP's are too sedating and give me akasthia. The majority of AD's (SSRI's) give me restless mania. I did use a tricyclic AD, which I personally felt did little for my mood.

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I've been in a funk since Strattera, which worked very well, stopped working. Then my girlfriend broke up with me. You might blame this episode on that but I was going through this before she did.


Meds typically work for me, just not for long. Now none are working. I was better off when I was just on ADs, before I started taking the heavy stuff. Something has changed in my body.


I feel like I'm on nothing, except xanax, and have exhausted my med options. Y'all can disregard this message. I guess I'll just wait and see what my pdoc says. I don't think I'll find an answer here.

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I didn't mean to come off judgy. It just often happens that the crucial info only comes out after some annoying questioning on our part.


I hear you on the whole symptoms then life event then crisis thing. It could be that the meds are inadequate for how much you have had going on lately. Med poop out is pretty rare and the meds don't work on a tolerance system, if they did, we'd all have to be upping our dose all the time. Mental health isn't static, it only takes a few factors to kick off an episode. Which makes self management a real bitch to deal with.


Waiting for your pdoc may be the best thing, but feel fre to vent, we've all been there.

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