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Skeletor

What is the rationale behind prescribing antipsychotics for Depression, Panic, Anxiety and OCD?

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1 hour ago, Skeletor said:

Curiosity.

manic as in "reckless behavior, excessive money spending, doing drugs, feeling invincible?" ...

Yup. Although, for me personally, really excessive spending has never been a huge issue. Or doing drugs. I’m more of a pressured speech, racing thoughts, magical thinking, hypersexuality, insomnia, forgetting to eat, whatdoyoumeanspeedlimit, kinda girl. 

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5 minutes ago, Iceberg said:

it can also lead to a dysphoric type mania (which isn’t technically the term anymore but just for making the point) where people can become extremely irritable and have a hair trigger 

This is interesting. Never heard of this before... so some kind of "masked mania"...?

2 minutes ago, Gearhead said:

Yup. Although, for me personally, really excessive spending has never been a huge issue. Or doing drugs. I’m more of a pressured speech, racing thoughts, magical thinking, hypersexuality, insomnia, forgetting to eat, whatdoyoumeanspeedlimit, kinda girl. 

Interesting! How did you get diagnosed? It seems difficult do diagnose something like this, because many conditions share these kind of symptoms... 

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4 minutes ago, Skeletor said:

Interesting! How did you get diagnosed? It seems difficult do diagnose something like this, because many conditions share these kind of symptoms... 

I get the full manic-to-depressed cycle. When it comes to bipolar l, I’m a classic textbook case.

https://www.webmd.com/bipolar-disorder/guide/bipolar-1-disorder#1

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@Skeletor the common term is “mixed mania” meaning that you get some elevated classic-mania symptoms but also get some symptoms that don’t exactly resemble classic mania, such as severe agitation among other things. It is often described as having mania and depressive symptoms at the same time, which is very dangerous because situations can result where a person can be suicidal and more likely to act on it because they have excess energy. In the latest DSM it is called “mania with mixed features” and it is horrible. I have been hospitalized for it before 

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Posted (edited)
On 4/1/2020 at 11:00 PM, Iceberg said:

@Skeletor the common term is “mixed mania” meaning that you get some elevated classic-mania symptoms but also get some symptoms that don’t exactly resemble classic mania, such as severe agitation among other things. It is often described as having mania and depressive symptoms at the same time, which is very dangerous because situations can result where a person can be suicidal and more likely to act on it because they have excess energy. In the latest DSM it is called “mania with mixed features” and it is horrible. I have been hospitalized for it before 

Thanks for clarifying it. I myself have been suspecting some form of "mixed states" affecting me. I have deeply dysphoric states, but they change from dysphoric to "okay" within the span of one day... sometimes many times in a day: In the morning I am dysphoric, depressive and ful of  despair, in the afternoon I feel okay, but have my head full of thoughts and can't concentrate on a task, then in the evening it is somewhat worse... dysphoria, bad mood, and in late evening and night I feel good... not perfect, but good... clear mind, somewhat relaxed. (I have lots of psychomotor agitation: even as a child I was psychomotorically agitated.) I've never looked into Bipolar Disorder. I suspected maybe some form of ADHD, but am not sure. I am always tardy and have difficulties organizing myself and my day. Too much stuff in my head, too agitated.

btw: How were your experiences with Remeron and Zoloft? How did they affect you and your BP?

Edited by Skeletor

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16 minutes ago, Skeletor said:

Thanks for clarifying it. I myself have been suspecting some form of Cyclothymia affecting me. I have deeply dysphoric states, but they change from dysphoric to "okay" within the span of one day... sometimes many times in a day: In the morning I am dysphoric, depressive and ful of  despair, in the afternoon I feel okay, but have my head full of thoughts and can't concentrate on a task, then in the evening it is somewhat worse... dysphoria, bad mood, and in late evening and night I feel good... not perfect, but good... clear mind, somewhat relaxed. (I have lots of psychomotor agitation: even as a child I was psychomotorically agitated.) I've never looked into Bipolar Disorder. I suspected maybe some form of ADHD, but am not sure. I am always tardy and have difficulties organizing myself and my day. Too much stuff in my head, too agitated.

btw: How were your experiences with Remeron and Zoloft? How did they affect you and your BP?

Remeron didn’t really do anything, Zoloft never got a chance to do anything cuz pdocs disagred about. Using it and it got pulled after only a few weeks. Only 1 of the 4 main docs I’ve had was a believer of using SSRIs with BP 1. The other three ranged from “bad idea” to “it won’t work (for me)” 

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Posted (edited)
14 minutes ago, Iceberg said:

Remeron didn’t really do anything, Zoloft never got a chance to do anything cuz pdocs disagred about. Using it and it got pulled after only a few weeks. Only 1 of the 4 main docs I’ve had was a believer of using SSRIs with BP 1. The other three ranged from “bad idea” to “it won’t work (for me)” 

Hey @Iceberg were you on Lamictal before you started Lithium? I'm curious why you'd stay on both, since Lamictal is not a heavy-hitter as far as an anti-manic. I'm assuming your pdoc is ok with Adderall because its treating the ADHD...I always thought that was a huge no no for BP folks also. The whole BP/ cyclical spectrum thing is so complicated to treat. Interesting thread for sure.

Edited by Blahblah
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1 hour ago, Blahblah said:

Hey @Iceberg were you on Lamictal before you started Lithium? I'm curious why you'd stay on both, since Lamictal is not a heavy-hitter as far as an anti-manic. I'm assuming your pdoc is ok with Adderall because its treating the ADHD...I always thought that was a huge no no for BP folks also. The whole BP/ cyclical spectrum thing is so complicated to treat. Interesting thread for sure.

Complicated it is. No, lamictal was later but it was a retry. I had been at a much lower lithium dose when I originally tried it, so we thought there might be more combined effectiveness when my lithium was significantly higher. It was added more to help maintain stability after an episode than to actually treat it. I don’t really get any side effects, so now it’s more of an “if it ain’t broke, don’t fix it” type of thing. Unfortunately Lithium as a lone mood stabilizer, even it super high doses, has proven to not be enough to keep things stable in either direction.

the “possible ADHD in my sig was actually from a complete psych evaluation done years ago, I’ve never explicitly taken a med for it. The adderall is for a couple reasons. One; while I may not have ADHD, there are certain parts of my illness that make it hard for me to function cognitively in some settings, such as academically. Second, clozaril sedation is heavy, but apparently I get it even worse than most. Once it helped settle down the episode I was in, we used the adderall so I could function while things stabilized dose-wise, finally making the cost/benefit choice that cloz + adderall is better than no cloz at all... considering it’s been highly effective for me. Third, I have tried almost every strategy deemed safe to treat my depressive episodes. At the time, nothing had worked so we’re hoping to get some relief from depression as a side benefit. We did, it helps me feel driven and motivated through the day. You’re correct, it’s not a common option, but we were basically out of choices 

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Posted (edited)
8 hours ago, Iceberg said:

Complicated it is. No, lamictal was later but it was a retry. I had been at a much lower lithium dose when I originally tried it, so we thought there might be more combined effectiveness when my lithium was significantly higher. It was added more to help maintain stability after an episode than to actually treat it. I don’t really get any side effects, so now it’s more of an “if it ain’t broke, don’t fix it” type of thing. Unfortunately Lithium as a lone mood stabilizer, even it super high doses, has proven to not be enough to keep things stable in either direction.

the “possible ADHD in my sig was actually from a complete psych evaluation done years ago, I’ve never explicitly taken a med for it. The adderall is for a couple reasons. One; while I may not have ADHD, there are certain parts of my illness that make it hard for me to function cognitively in some settings, such as academically. Second, clozaril sedation is heavy, but apparently I get it even worse than most. Once it helped settle down the episode I was in, we used the adderall so I could function while things stabilized dose-wise, finally making the cost/benefit choice that cloz + adderall is better than no cloz at all... considering it’s been highly effective for me. Third, I have tried almost every strategy deemed safe to treat my depressive episodes. At the time, nothing had worked so we’re hoping to get some relief from depression as a side benefit. We did, it helps me feel driven and motivated through the day. You’re correct, it’s not a common option, but we were basically out of choices 

Makes sense! I hear you with the "ain't broke don't fix it" I'm not sure what Lamictal is doing, but it's been years, and I'm afraid to stop it. Especially as it has fewest side effects (at low doses). I recall Lithium being pretty strong/numbing (at the recommended doses) that's surprising that it isn't more effective.

I also don't have diagnosed ADD, but the Ritalin really helps with cognitive function, focus, and drive, it helps mitigate brain fog side effects of other meds. Have you had to increase the dose very often or take breaks from it? I wish we didn't have to keep throwing different curveballs at our brains 😕

Edited by Blahblah
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10 hours ago, Blahblah said:

Makes sense! I hear you with the "ain't broke don't fix it" I'm not sure what Lamictal is doing, but it's been years, and I'm afraid to stop it. Especially as it has fewest side effects (at low doses). I recall Lithium being pretty strong/numbing (at the recommended doses) that's surprising that it isn't more effective.

I also don't have diagnosed ADD, but the Ritalin really helps with cognitive function, focus, and drive, it helps mitigate brain fog side effects of other meds. Have you had to increase the dose very often or take breaks from it? I wish we didn't have to keep throwing different curveballs at our brains 😕

I had my lithium level up to 1.5 at one point, which was knocking on the door of toxicity. it was good as a stabilizer for awhile, but once I got into an episode it couldn't get me out (on multiple occasions) I do back off on the  Adderall  when I'm not in focus-intensive situations or situations that require me to be alert (ex. driving), but not typically a full "break" and my pdoc gives me some discretion about when to back on the does depending on what my situation is   

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On 3/31/2020 at 10:34 AM, notloki said:

There is a dopamine component to depression.

Too much dopamine?
Not enough dopamine?

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2 hours ago, Adolf_H8 said:

Too much dopamine?
Not enough dopamine?

Too simplistic a model.

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18 minutes ago, notloki said:

Too simplistic a model.

What is the right model?

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Well is sure is not a simple hot/cold, more of this and less of that operation. Honestly don't you get it that we don't know for sure.

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On 4/8/2020 at 1:08 AM, notloki said:

Honestly don't you get it that we don't know for sure.

Nope.

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