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Newly diagnosed - Medication question (and background info galore)

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Some background.  Skip if you'd like.  I really want to ask about the question in red below.


I have been dealing with the symptoms for the last 21 years without talking to anybody.  Just over a month ago I sought help and told my wife.  The short of it is I had major depression from the age of 12-14 or 15.  So bad that I literately cried myself to sleep every night for 3 straight years.  Not just praying that I wouldn't wake up but pleading with God to kill me.  From there I leveled out (completely withdrawn from people, did well in school, did well in sports, but 100% dead on the inside when it came to people) for several years.  


During college I started going more towards the manic side (all this time I know nothing about bipolar nor do I know anything is wrong) and getting into all sorts of things.  It took me 6 years to get two bachelors when it should have taken 4 at most (sounds odd but majors are very similar, Computer Science and Computer Security).  It took me that long because I wasn't able to sit in class many days let a lone study.  Most of my time was spent working, anything to stay busy (that is a recurring theme in my life).  


After college I went 100% manic just short of ruining my life.  First off I was doing major illegal activities and also I was about two months from going bankrupt before I changed jobs and doubled my salary (not a good life change for somebody in my condition at the time).  


Having your salary double overnight just means you can do more illegal stuff and spend more money.  Not a very good combination.  During these 5ish years I probably slept an average of 3 hours a night while not sleeping many nights.  I just worked my ass off and did my illegal crap.  I would work a good 120+ hours a week.  Working from home was the key to all of this.  I worked from home and traveled about 30% of the time, over the course of the 5 years.  I would go 6 months without traveling then a few traveling 100%.  It was one hell of a life.  


Then I met the person that would become my wife and things came crashing down.  After meeting her I suddenly had feelings for people and emotions out the ass.  I don't recall ever feeling compassion or empathy for people before meeting her.  It is like she jiggled something loose and it opened a fire-hose of emotions.  Now I imagine I am in a depressed state but I have up days and sometimes weeks so I am not sure.  It sounds odd but while I have feelings towards others I still have no empathy when it comes to my thoughts.  I'm sure everybody has a safe place or a comfort place they go to in their head when relaxing, idle, etc...  Well, mine is and always has been (even before the age of 12) about killing people.  I fantasize about being a serial killer, mass murderer, etc...  That REALLY bothers me and causes me to climb further down into my depression.


The only thing I am sure of is that I am having a very hard time holding it together especially with a 2 year old and a 2 month old.  


Anyway, I was diagnosed as Bipolar 2, borderline Bipolar 1.  I also have a degree of schizophrenia but more towards the delusional side and some negative symptoms.  I was seeing a LCSW for about a month before I saw a psychiatrist.  The first three or four I called couldn't see me for two months and I needed help immediately so I found somebody that could see me in a week (two days ago).  Well this guy turns out to be a follower of Andrew Weil so he is pushing a lot of vitamins and alternative meds.  I am not sure how I feel about this especially since one is Kava which is linked to major liver damage.  He did put me on 5mg of Abilify for two weeks then I have a follow-up to see about upping the dose.  My question is if I should seek a second opinion.  I expected to be put on lithium.  I am not sure how I feel about passion flower, fish oil, etc... as a treatment.  I don't know if it's the passion flower, Abilify, or just me but I am more testy/moody/irritable than ever since taking taking them.

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It is not automatic that you be put on lithium. I personally do not trust Andrew Weil, and if you feel the same way, and have realized your Dr. bases his practice on Weil's teachings, you have to decide if you can trust him. Do you feel you can raise these questions with him? If so, I would do it, and see what his response is. He may be willing to go to a more traditional treatment route if you you raise the issue. But to be honest, and this is just my opinion, he probably won't.


Again, this is my opinion, but if it were me, I'd look for a new pdoc. Don't stop the abilify, however, you don't want to do that unsupervised.


I had a neurology nurse (I forget what they are called when they are able to prescribe under supervision of a doctor) who was REALLY into herbs and supplements. I was so desperate, I tried them. When that nurse left, and I got a new nurse, she rolled her eyes, and said about my last nurse, "Yeah, she was into supplements big time." I have chronic daily migraine. Now I am on riboflavin and D3, both of which have some genuine research supporting them (although it is not conclusive). I also am on fish oil, because the nurse who does my psychiatric care wants me to do so, but I know that is controversial. But I figure it can't hurt.


I see nurses because the University of Utah has set up it's medical program that way, just to explain why I see nurses and not pdocs (psychiatrist) and ndocs (neurologist).

I'm sorry I didn't read the background very well, I have a migraine.

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I've never personally taken abilify, but when I started taking the Latuda, things gradually got more consistent I guess is the best way to put it. It was a gradual effect and I just noticed here and there that my symptoms were lessening, or going away completely. I think others have had more immediate results, but mine were gradual.

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In terms of abilify working, I found that my thoughts were clearer and less muddled. I am much calmer and not so reactive. It's amazing. But it doesn't work for everyone so keep an open mind.

In terms of supplements, I think unless they have a lot of research into them, why take them over something that has had the research and been approved for use in that circumstance.. I did take omega 3 EPA oil for a while by request of my pdoc, on top of my medication, but it was costing me £35 a month, which in the uk we have prescriptions for £8 per medication per month, so it was quadruple the price. It was also doing nothing, more to the point. In my mind supplements should be AS WELL AS medication, not instead of.

Hope you find another pdoc soon that you are comfortable with; that is the most important thing

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I agree with getting a second opinion.  For me, I knew abilify was working when the voices calmed down.  It took about 7 weeks for me to get the full benefit from it (I am on 45 mg/day).  You might find that you need a higher dose of Abilify, but that is something you need to talk to your pdoc about.

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