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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by holymama on May 22, 2005, at 22:49:45
Or am I crazy to consider it?
I was in the hospital 1 year ago for depression; I'm bipolar and although I'm much more *stable* now, I'm so annoyed with my mood swings/sense of boredom or mild state of depression or absense of hypomania and inspiration or whatever it is...that I often feel like I want to give up on this med thing.
I have my life much more under control now -- three young kids, back in grad school part time, working part time, my depressions are so much more mild. But my creative bursts are gone, my passionate and deep side is subdued. I feel like I spend a great deal of time feeling mildly depressed and uninspired, unfocused, slightly dumb.
I cycle still.
Is this all I can expect?
Should I expect more from my medication?
Should I try a different med?
Go off meds and see how I do? Or is that too dangerous?
I just hate feeling this dumb. My mind feels blank.
Posted by med_empowered on May 23, 2005, at 0:24:11
In reply to Is this a good reason to go off meds?, posted by holymama on May 22, 2005, at 22:49:45
hey! I'm bipolar as well. I'm younger than you (I'm 20), and I have a lot less experience, but I guess I'll just share what happened with me. When I was first DX'd as bipolar, I was 18. My well-intentioned doctor at the time loaded me up on meds (7 by the time I quit seeing her) and I basically spent a year feeling just as you described--my "symptoms" were under control, but my inner-life, my creativity, all that, had gone to hell. So, I quit taking my meds. About 6months later, I got severely depressed. Eventually, I developed "psychotic depression"--hearing voices, that kind of thing (which is somewhat common for people with bipolar disorder). Again, I was put on medication--this time anti-depressants, anti-anxiety drugs and an anti-psychotic--that fixed the "symptoms" but left me feeling dull, blank, and stagnant. So, I quit taking those meds. Then I had an odd episode--possibly mania, possibly mixed-state...anyway, I don't remember any of the actual episode; all I remember is waking up in the mental hospital. I had been committed. So, now, I'm on a much better medication combo. I take an anti-depressant, BuSpar, and relatively low-dose mood-stabilizer (900mgs of Trileptal a day). I also take hydroxyzine for sleep as needed. I've finally found the *ideal* situation. I still have mild mood swings, both up and down, and I still get a bit hypomanic. Sometimes I love the hypomania and I let ir ride for a few days. But, the most *SEVERE* aspects of the disorder are covered--no psychosis, no deep depressions or frightening manias, and I also don't have any medication side-effects as far as I can tell. I guess my advice would be to work with your meds instead of thinking of managing bipolar disorder as an all (lots of meds and med-related problems) or nothing (no meds, but severe mood problems) situation. I'd also suggest that you try to be *very* assertive with any doctor who treats you. Here's what I learned: shrinks can be helpful, but they have flaws. The love normality. They see their role primarily as bringing people with mood-disorders into "normality" (which is ill-defined), even if doing so kills of the person's creativity and "spark". As I see it, my job is to advocate for myself. These days, when a shrink says such and such sounds "hypomanic," or "depressive," I kindly tell them that I'm doing fine, thanks, and that I can handle it right now; if I need their assistance, I'll let them know. I also tell my doctor flat out that I'm a person, not just a combination of "symptoms" and "disorders," and, like any person, I have the right to determine how I want to live and so on; I don't need anyone, a shrink or any other "expert" telling me what I should "accept" from medication or what my "therapeutic goals" are. I hope this has helped you some. Good luck!
Posted by HappyGirl on May 23, 2005, at 0:50:39
In reply to Is this a good reason to go off meds?, posted by holymama on May 22, 2005, at 22:49:45
Hi:
I've been somehow similar to your current situation, ... feel 'almost' normal. I never cycle as I did before (my Bp is a stubbourn type, 'ultra' rapid-cycler) ... but still once awhile I feel mildly 'depressed,' 'unfocused,' and among other 'depressive' feelings, particularly when on stressful events. In general, I feel OK tho', but still Bipolar follows me around like a 'shadow,' no matter where I go. However, I definitely feel MUCH improved not feel 'manic/hypomanic,' nor 'depressed' like I was a year or so ago. For this 'progress'/imporvement, I certainly giving a good 'credit' to the med. combo. I've been on for the past years.Like weather-changing, ... from Spring to Summer, ... not only Bipolar also any 'illnesse' takes the time to feel well. However, I never plan to go off of meds.(four in all). Because, once I experimented this, I paid a 'price.' Then, in my view/opinion, ... you STILL have Bipolar, particularly you need an intense focus/work on a depressive side of your Bp.
Going off of any meds. without the pdoc.'s permission is a VERY risky, ... in my opinion through the literature and reading other 'semi' normal Bpers. At least, you need to continue taking a minimum amount of meds. until you feel 'fully' remission without any Bp symptoms, particularly a depressive side of Bp. In my knowledge throuth the readings,... once having dx'ed with Bp, you need to take the meds. for the rest of your life, like Diabetics.
H.G.
Posted by SLS on May 23, 2005, at 8:17:52
In reply to Is this a good reason to go off meds?, posted by holymama on May 22, 2005, at 22:49:45
> I was in the hospital 1 year ago for depression; I'm bipolar and although I'm much more *stable* now, I'm so annoyed with my mood swings/sense of boredom or mild state of depression or absense of hypomania and inspiration or whatever it is...that I often feel like I want to give up on this med thing.
Sometimes, it is desirable not to treat a self-limiting hypomania with medication.
However:
> I have my life much more under control now --
I think in this statement lies the key as to whether or not treatment is indicated for you.
I fully understand the desire to have your cake and eat it too. Some of the most productive people in history have been hypomanic. I have been transiently hypomanic, so I can attest to how good it feels and the "power" it can give you.
What medications are you currently taking? Perhaps there are less "dulling" alternatives you have not yet tried or combined.
- Scott
Posted by holymama on May 23, 2005, at 8:34:51
In reply to Re: Is this a good reason to go off meds? » holymama, posted by SLS on May 23, 2005, at 8:17:52
Yes, I'm sure there are other drugs to try.
I'm taking 600mgLithium
150 mg Wellbutrin XL
20 mg Paxil
75 mcg synthroid
.25-1 mg lorazapam (ativan) for sleep
While lithium got me out of the hospital and fairly stabilized, in some ways being a miracle drug for me, I think also dulls me quite a bit as well.Do any of you, once 'stabilized' as much as you can be, feel 'great' much of the time? Or, like me, feel great for short bursts of mild hypomania and feel dull and stupid and mildly depressed most of the time?
I would like to be able to say I feel 'great!'. Period. Is that a possibility???
Thanks so much for all of your thoughts. It's good to talk to others like me. Sometimes it's so lonely dealing with this and I feel whiney because I'm so sensitive to everything that happens around me. Most people just go about their day without their mood being in the way.
Posted by SLS on May 23, 2005, at 9:43:34
In reply to thank you everybody, posted by holymama on May 23, 2005, at 8:34:51
Lithium is most likely the culprit. It usually is. It flattens mood and robs people of creativity. I would make it a project to find another mood stabilizer. I might try Trileptal first if I were in your position.
Perhaps you could first add the prospective mood-stabilizer at therapeutic dosages and then taper the lithium. If you relapse, you add back the lithium and try again with another drug.
Depakote
Trileptal
Lamictal
Zyprexa
SeroquelIt would be nice if Abilify were to be sufficient as a mood-stabilizer. It does not cause weight gain and is usually a rather clean drug after the startup anxiety disappears (usually a week or two). There just isn't enough data yet as to its efficacy.
- Scott
Posted by HappyGirl on May 24, 2005, at 0:45:59
In reply to thank you everybody, posted by holymama on May 23, 2005, at 8:34:51
Hi:
>>> Do any of you, once 'stabilized' as much as you can be, feel 'great' much of the time? Or, like me, feel great for short bursts of mild hypomania and feel dull and stupid and mildly depressed most of the time? <<<--- In my case, as my pdoc. saying that I've been stabilized since mid to late 2004, after a 'long' and 'hard' battle/challege that took me almost 'long' 6 years, believe it or not. During 'those' unstable years, I never dreamed about any of Bp stabilization, rather I spent a lot of time searching for 'right' med. combo. along with aboundant readings over the Internet and literatures regarding Bp illnesses.
In regard to the 'current' state, some days, I still feel mildly 'depressed,'... a desire of sleep until mid-morning, particularly after some 'stressful' events. Then, probably if you're sufferring from some 'serious' illnesses, not only Bp also other ailments, there is NO such word of 'perfect' days. But, this is just my opinion/view through my own 'personal' experience along with others'. However, I definitely can say that I feel MUCH better and TRULY happier than before, in my unstable state. In other words, stabilization does not happen without a right med. combo. For me, the med. combo. is as important as daily meals. In regard to 'med. reductiction, I truly hope this happen since one of meds. often causes me 'heart-burn' and other uneasy feelings. But, as of today, I plan to stick with it.
As for your med. combo. above, ... have you ever tried an increased dosage of WB XL, 300 mg.? The WB, in general, giving me mostly 'energy' and 'concentration.' Then, just to increase WB XL dosage might help you, but as Scott suggesting, Abilify might be a good choice. However, it sounds to me like your Bp is milder form, ... more likely Bp III(3)/Cyclothemia(?) as reading your med. list. If that's the case, you may not consider about any A.P., rather some AD, like Cymbalta or newer form of SSRIs? But, since I'm allergic to any of SSRIs, I can not able to direct you in this regard.
The best thing for you now, ... at your next pdoc.'s appt., talk to your pdoc. regarding your 'mildly' depressive symptoms.
H.G.
Posted by holymama on May 24, 2005, at 10:18:20
In reply to Re: thank you everybody » holymama, posted by HappyGirl on May 24, 2005, at 0:45:59
A lot of what all of you have said rings true for me. I too am happy being 'stablized', but spend a lot of my time in a mild groggy 'drugged' state. Sometimes I burst out in a very clear and wonderful hypomania when my brain is sharp and I am inspired and creative and feel wonderful and full of energy. It is then that I can see my full potential and so have a hard time feeling so much less so much of the time.
I saw my pdoc and asked if I could cut back on my lithium (from 600 to 450). She also talked about increasing my paxil, no mention of increasing my wellbutrin or starting another drug. I feel overmedicated, so I want to cut back rather than add meds, but I know that this might lead me to become more unstable. This is a risk I'll take right now.
I'm really curious though -- is any medicated bipolar person out there feeling 'great'??
~~Autumn~~
Posted by Ritch on May 24, 2005, at 12:11:04
In reply to Re: thank you everybody, posted by holymama on May 24, 2005, at 10:18:20
> A lot of what all of you have said rings true for me. I too am happy being 'stablized', but spend a lot of my time in a mild groggy 'drugged' state. Sometimes I burst out in a very clear and wonderful hypomania when my brain is sharp and I am inspired and creative and feel wonderful and full of energy. It is then that I can see my full potential and so have a hard time feeling so much less so much of the time.
> I saw my pdoc and asked if I could cut back on my lithium (from 600 to 450). She also talked about increasing my paxil, no mention of increasing my wellbutrin or starting another drug. I feel overmedicated, so I want to cut back rather than add meds, but I know that this might lead me to become more unstable. This is a risk I'll take right now.
> I'm really curious though -- is any medicated bipolar person out there feeling 'great'??
> ~~Autumn~~
Hi, I'm taking depakote as a mood stabilizer and I also feel similar to what you say about.. "mild groggy 'drugged' state". I've been on lithium and it did the same thing. The easiest thing to do would be a slight dose reduction of the lithium. I knew a BPI whose pdoc had him on 1200mg/day of lithium for several months and he was really dazed out. The pdoc asked him if he wanted to "get a little high", but he didn't want to reduce the dose. So, I think that pdocs are willing to drop the meds a little if you are feeling too flat. As far as feeling "great" goes.. I *do* feel great (for two-seven days every 2-3 weeks give or take). Sometimes it is a "Tony the Tiger" cartoonish hypomanic great!, but there are some days where I just feel good about things-unagitated, not negative. Those days I like better. Hope this helps some..
Posted by stresser on May 24, 2005, at 22:49:39
In reply to Re: feeling great » holymama, posted by Ritch on May 24, 2005, at 12:11:04
I have days when I feel really good, and get that creative, sharp, focused mind. The past few days I have had the opposite, and not been able to think as well, and feeling a little more depressed, with no change in medication at all. I am forgetting things, and not feeling like my I had been feeling for the past month or two. I don't know how to explain it, and wish I could for some of you. -L
Posted by Ritch on May 24, 2005, at 23:18:01
In reply to Re: feeling great, posted by stresser on May 24, 2005, at 22:49:39
> I have days when I feel really good, and get that creative, sharp, focused mind. The past few days I have had the opposite, and not been able to think as well, and feeling a little more depressed, with no change in medication at all. I am forgetting things, and not feeling like my I had been feeling for the past month or two. I don't know how to explain it, and wish I could for some of you. -L
I go through those cycles too. I don't mind having "cyclical ADD spells", so long as when I'm down I don't feel miserable, but just stupid.
Posted by holymama on May 25, 2005, at 8:16:42
In reply to Re: feeling great » stresser, posted by Ritch on May 24, 2005, at 23:18:01
I'm not so sure that I don't mind. I'm in graduate school, and it sure is challenging when I go through weeks of stupidity.
But I have to agree with my doctor -- 'at least you are functional'. She's right. My mood swings are much milder and I can at least function through them without quitting jobs and going into the hospital.
But mental health care sure has a long way to go if the best we can aspire to be is 'functional'.
I'm in graduate school for mental health counseling. I'm sick of letting the system push me around. I want to be a part of it.
Posted by stresser on May 26, 2005, at 21:04:04
In reply to Re: feeling great, posted by holymama on May 25, 2005, at 8:16:42
Good for you! You have been on the other side of that chair, so to speak! I think someone like you would be the best at Mental Health Counseling, because you have been there yourself. That's what it takes, and I have been told that by several doctor's, myself. Go get 'em! -L
Posted by holymama on May 27, 2005, at 6:03:20
In reply to Re: feeling great, posted by stresser on May 26, 2005, at 21:04:04
Thank you! An extra plus to studying counseling is that it makes me try harder to be healthy. I know that I have to be a role model for others who are struggling with the same things that I am struggling with. When I feel low and self-destructive, that idea is something that keeps me going. After all, if I can't do it, how can I expect any of my clients to do it??
Posted by stresser on May 29, 2005, at 20:58:04
In reply to Re: feeling great » stresser, posted by holymama on May 27, 2005, at 6:03:20
You have figured it out on your own! Congrat's! You're on the road to being a compassionate, and caring therapist, who DOES understand. Don't you wish you could advertise that part? I have to say, that from what I have read from your posts, you know what to do. Now...do we ask YOU questions about medications and problems on Dr. Bob's other boards? -L
Posted by holymama on May 30, 2005, at 3:56:33
In reply to Re: feeling great » holymama, posted by stresser on May 29, 2005, at 20:58:04
Thanks L -- that's encouraging. There are days when I'm sure I'll be a kick-*ss counselor, and depressed days when I can't do anything right. If only I could 1. figure out how to work on a manic-depressive's schedule (take long sick leaves every few months??) or 2. get more stable on my medications.
You sure can pick at my brain on this board and other boards...I'm happy to share what I'm learning. I'm only two classes into the degree however, and learning how to manage a mental illness myself. I'm sure over the next 4/5 years (how long it will most likely take me to get the degree with 3 kids and working part-time as well) I'll get better -- as a source of knowledge and as a healthy role model.
I'm sorry to hear, L, that you're feeling a little low. Isn't it strange how our brains click in and out of it so fast. I'm the opposite right now -- I've gone from depressed to manic overnight. I had a change in meds and now I have redecorated my entire house, spent quite a few hundred dollars in plants/craft idtems/pillows/rugs/garden benches/ etc...and slept for two hours last night. THis was all done in a 24 hour period and I'm up again for the day, ready to go again. I've got to come up with a plan to come down a little bit...
~~Autumn~~
Posted by stresser on May 31, 2005, at 13:00:04
In reply to Re: feeling great » stresser, posted by holymama on May 30, 2005, at 3:56:33
I'm sure you will get there! My moods fluctuate daily, and the meds really help. I'm fine today, and I'm thinking PMS had a lot to do with it! Zoloft comes in quite handy!-L
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