Mood Stabilizers: Are they worth it?

[Bimbo Bear]

Hello there,

So I'm getting evaluated for Bipolar disorder on Thursday and during this waiting period, I thought I'd do some in depth research on the disorder. I'm 98% sure I'm going to get diagnosed with Bipolar II or Bipolar NOS (due to how rapid my cycles sometimes are), and since I'm on an antidepressant right now, I needed to see what meds Bipolar folk usually take. That's when I found out about mood stabilizers and all the ugly side effects that come along with them.

To be honest, I'm scared to try any of them with everything that I've read. I just need an antidepressant to keep me out of the depression I get. The hypomanic episodes I get aren't that bad. I'm not driving recklessly, I can control my shopping sprees and irresponsible flirting if I try, and the hypomanic moods keep me peppy at work. Who wouldn't want that???

...If it weren't for just how low those depressive episodes of mine get, I'd scrap the idea of meds altogether, but I can't. Without meds, I can't get out of bed (though my current meds hardly help that, now that I think about it), I'm emotionless or sad all of the time, I isolate, and I sometimes start to contemplate whether the world would be better off without me. It's really awful... but with the plethora of mood stabilizer side effects, is it even really worth it to try with those? I guess only my psychiatrist would know the answer to that (I question her judgement sometimes, though, since she tried putting me on an antidepressant again that previously made me suicidal the last time I needed to switch meds), but I thought I'd ask you guys:

Do you think you're better off with / without mood stabilizers? And why or why not?

[paintedsky]

Without medication my bipolar disorder has become progressively more severe. Each time I have not been on meds the manias and depressions are increasingly terrifying and disruptive. It has cost me jobs, friends, and dignity. It has resulted in legal trouble. 

I have had some side effects that were arguably almost not worth it. If I could do it without meds I certainly would. 

Sometimes I try to manage without meds, but the inevitable result is I can't and I need medical intervention. I would argue you are taking control of your life by taking meds. 

[melissaw72]

1 hour ago, Bimbo Bear said:

Do you think you're better off with / without mood stabilizers? And why or why not?

No, I am not better without mood stabilizers.  The reason why is because I start becoming symptomatic again (hard to explain what it is like, but I need the meds to keep me sane and feeling ok).

 

1 hour ago, Bimbo Bear said:

but with the plethora of mood stabilizer side effects, is it even really worth it to try with those?

IMO, yes.    If you try one and you can't handle the side effects after a couple of weeks, then I'd ask pdoc to try another one.

I think if you started on one and started feeling more stable, you just answered your own question ... that it was worth trying.

[Chantho]

I have no side effects from my mood stabilizer, but I'm not sure I have any effects at all. I still need an antidepressant for the depression. I guess it does help with the hypomania. But I still need an anti-psychotic to help with that. So basically, I'm not sure if I'm better off, but I'm certainly no worse off. The side effects can be nasty, but in my case, Lamictal has been good. And I think  the really nasty ones (like the Lamictal Rash) are pretty rare.

[Cale]

Lamictal is a life saver for me.

[sugarsugar]

I took various antidepressants for many years, without much benefit. It was discouraging. When my diagnosis changed to bipolar and my meds changed to Lamictal, I haven't had a serious depression in 10 years. That is life changing for me. I've had no side effects. So yes, it's worth it. I'm a little bitter about years of a missed diagnosis and ineffective meds but I try to focus on what's working now. 

[wadjet]

I was on lithium for about a decade. It did help. The side effects were not bad, especially compared to being suicidal. 

[KnickNak]

4 hours ago, Cale said:

Lamictal is a life saver for me.

Yeah, Lamictal really curves that merry-go-round of emotions for me. So, yes. Mood stabilizers are worth it. But when my depression is really bad i have to rely on other medications.

[dragonfly23]

My meds are listed below.  At the moment my cocktail is working very well.  Lots of trial and error. Without my seroquel and lamictal I would still be spinning through the universe.  I don't have many side effects that I would say are deal breakers.

IMO mood stabilizers are a must for me.  But we are all different.  Your Pdoc can use many meds to meet your needs. 

Good luck.

[Distant Rabbit]

I've taken Depakote for 15 years, and for me it has been totally worth it.  Fatigue is the only big side effect, so I take it right before bed.And it has been mostly effective.

[ovOidampUle]

Unfortunately, treating depression only will lead to a destructive mania. I was mostly harmlessly depressed, but on anti-depressants I became very unstable and destructive. If we could all be just a little hypomanic most of the time, I'm not sure anyone would ever go to a psychiatrist ... but hypomania and depression are inextricably linked; the piper must be paid eventually. 

I also haven't had much in the way of side effects for most of the mood stabilizers I've been. Lamictal has been fine; Latuda is currently fine ... Zyprexa made me really hungry and I put on some weight, but it also got me to a mental place where I was able to function and take care of myself; I've since switched off of it and am trying to take care of my mind with meditation and healthy activities. 

But, I have to say, it's really promising that you're going into this knowing what your behaviors are. It took me a long time, even after diagnosis, to recognize what hypomania looked like. Knowing *when* I have a problem has been a big help in reaching out to my p-doc and making adjustments. 

[mikl_pls]

On 1/15/2017 at 4:41 PM, Cale said:

Lamictal is a life saver for me.

Agreed. I got off of it for a little while because of the side effects, having Zonegran as my main mood stabilizer, but I am retitrating up on Lamictal now in hopes that it helps with my depressive episode. It literally saved my life, too.

Edited January 18, 2017 by mikrw33

[Micho]

Lamictal has helped me more than any med I've noticed and no side effects for me.

[melissaw72]

Another one for lamictal.

[cloudmonger]

16 hours ago, Bimbo Bear said:

Do you think you're better off with / without mood stabilizers? And why or why not?

If you look at the meds on my signature - I've tried MANY (about 20 in different classes). I took most of the major SSRI's and SNRI's antidepressants, A/Ps for many years, without benefit (in fact, most made me worse and had side effects of either major sedation, agitation, insomnia, sexual dysfunction, metabolic issues, weight gain, etc).

Several years I went off of all meds as a detox - trying every single natural remedy, spending thousands of $$ on naturopathic doctors, chinese medicine, nutritional supplements, you name it. None of that really helped either. These things can support overall wellness, but they do not even make a dent in major mood disorders.

I went back on Lamictal and it's honestly been the best med I've ever been on. I will definitely stay on it longterm & hope it never poops out on me! It takes the edge off (without being sedating or numbing my personality). The titration period is a bit slow (to find the right dosage) however the only side effect I've had is a bit of mild itching (right after I take it). I noticed a calming, mood balancing effects at about 75mg. Things stopped upsetting me so much. It's really a great gentle, staple medication. You can always decide to try to add on an antidepressant after if you still have issue with that.

Edited January 16, 2017 by cloudmonger

[Alien Navel Cord]

20 hours ago, Bimbo Bear said:

Hello there,

So I'm getting evaluated for Bipolar disorder on Thursday and during this waiting period, I thought I'd do some in depth research on the disorder. I'm 98% sure I'm going to get diagnosed with Bipolar II or Bipolar NOS (due to how rapid my cycles sometimes are), and since I'm on an antidepressant right now, I needed to see what meds Bipolar folk usually take. That's when I found out about mood stabilizers and all the ugly side effects that come along with them.

To be honest, I'm scared to try any of them with everything that I've read. I just need an antidepressant to keep me out of the depression I get. The hypomanic episodes I get aren't that bad. I'm not driving recklessly, I can control my shopping sprees and irresponsible flirting if I try, and the hypomanic moods keep me peppy at work. Who wouldn't want that???

...If it weren't for just how low those depressive episodes of mine get, I'd scrap the idea of meds altogether, but I can't. Without meds, I can't get out of bed (though my current meds hardly help that, now that I think about it), I'm emotionless or sad all of the time, I isolate, and I sometimes start to contemplate whether the world would be better off without me. It's really awful... but with the plethora of mood stabilizer side effects, is it even really worth it to try with those? I guess only my psychiatrist would know the answer to that (I question her judgement sometimes, though, since she tried putting me on an antidepressant again that previously made me suicidal the last time I needed to switch meds), but I thought I'd ask you guys:

Do you think you're better off with / without mood stabilizers? And why or why not?

I think they are good to take, because an anti depressant alone, when bipolar, can make you manic or bring your depression down even further like it did for me. Once for a little while, I was on just an Antipsychotic and an Anti Depressant, but it didn't last long because I needed something to moderate the meds. So they put me on lamictal which has very few side effects really. I didn't have any on lamictal. But I'm switching to lithium soon because now the lamictal doesn't seem to be helping me much, but I've been on it since 2006 basically, and maybe either the dose is wrong now, or I need something else. But the something else definitely has to stay there, because without a mood stabalizer, I will in fact swing one way or the other. 

I know hypomania right now feels great, but eventually it could lead to a lot of problems which is why it is good to nip that in the bud too. Unfortunately. I rarely get euphoric mania, but when I do it feels awesome but I know it won't last and I"ll crash out of it or I'll spin into dysphoric mania as per my usual. Everyone is different, though, so we'll see what your doc has to say!

[Bimbo Bear]

You know, last night I had a dream about switching medications. The mood stabilizer I was given was sitting right in front of me and I was so hesitant to take the pill, but I did and immediately the world around me lost its vibrant colors. It looked dull with a shade of black and white and suddenly I either felt drowsy, tired, or just not peppy like I usually am. Also, it left this really gross metallic taste in my mouth, kind of like an iron pill.

That wasn't the best effect to see in my dream, and I know it was only a dream, but even still I thought that I'd look on here again and thankfully everyone's words helped me to see the light again.

I'm so glad that mood stabilizers are actually effective and not just drugs from Hell. And I'm even more glad that they've helped all of you! It gives me peace of mind to think that I'll probably be okay and maybe even better off if my psychiatrist assigns me one of these.

[mcjimjam]

I think you have the wrong impression of mood stabilisers, in a way. A lot of those with BPII or NOS don't necessarily need heavy antimAnic drug regiments, so the chance that you'll need to suffer bad side effects is lower. A very popular mood stabiliser nowadays is lamictal, which is very well tolerated and very safe long term. A lot of people take it for unipolar depression.

Normal antidepressants are controversial for BP. Thought by many to make things worse Over the long run. Taking them without a mood stabiliser is considered to be very harmful.

Uncontrolled BP episodes damage the brain, causing the condition to get worse and worse over the years, with more frequent and severe episodes. Also the damage means cognitive issues and functioning get worse and worse. Taking mood stabilisers doesn't always fully prevent episodes, unfortunetely, but if you can reduce them any, you should IMO.

Basically, seeing antidepressants alone as safer is not right.

[0112358]

I've been on Lamictal for about seven years, and after some initial side effects I haven't noticed any at all. I'm also on Lithium and haven't noticed any side effects from that either, aside from probably a need to drink slightly more water. I'm on a low dose however. 

[jacques]

I've been on a mood stabilizer (depakote) for about a month (newly diagnosed), and I'd say it's helped a little bit. After weeks of actually solidly taking my meds every day (the first couple weeks were really irregular for me), my sleep is starting to even out so I get roughly the same amount every night and my mania has been seeing its way out since I started. I've also heard that leaving one pole untreated leaves you at risk for worse symptoms (ex. leave your hypomania untreated and you may develop full mania later).

However, I have heard that some bipolar patients are able to maintain some control without medication through diet, exercise, and carefully regulating their sleep. That sounds not only very difficult but near impossible for my lazy, insomniac, sweets and caffeine enthusiast self, so I personally go the medication route.

Long story short, I say mood stabilizers are worth it thus far (though I am far less experienced in them than most people, if not everyone, here) but if you decide they aren't for you then I definitely recommend putting serious effort into self regulating to lower the risk of your hypomanias.