Anyone with Bipolar spectrum disorders?

I'm not sure which antidepressant you were on, but according to studies I found on PubMed, some bipolar patients "flip" on them. They dive into depressions rather than having them alleviated. It appears to have happened to me. In my case it was Effexor, and one of the studies I read showed that the active ingredient in it (venlafaxine) is particularly tied to this outcome. I'm fairly certain this happened to me, and as a result, I'm off antidepressants altogether and tapering onto Lamictal now. That's a different class of medication altogether.

I'm pretty new to the diagnosis as well. I found this tool online (I linked it above as well), and it's been really helpful in tracking each day and seeing patterns.
https://insights.emoodtracker.com/login
I've had one episode since I started it, and I have info for the days leading up to it, information of a sort that I've never had before. I've allowed both my counselor and psychiatrist to access my account as well so they can see what's going on as well.

Above all else, it has me paying closer attention than I ever have before. I was in a soft manic phase last week, recognized it, was on the lookout for a possible flip, did flip, saw it hitting, recognized the depression setting in just as I'd recognized the mania, and was able to take steps that kept it at bay. It took the better part of two days fighting it off, but I did. The previous episode, before I started the program, slipped over me without my knowing, I was just borderline suicidal again, and that time I made some poorly thought out decisions. This time I saw it as it set in. Whether I will next time I have no idea, but just catching it this once, for the first time, felt like a small victory. It's definitely worth looking at and seeing if it's helpful for you.

Hello @itchyd,

I'm glad that you said in your post, "I'll only offer commiseration and not advice." It sounds as if you have had some tough experiences in your attempts to deal with mental health issues. It is very difficult to deal with medications as well as the disorder itself. As I read your profile (https://connect.mayoclinic.org/member/00-d961381f32ce0525356818/), I see that you are a Navy vet, a retired electrical engineer and that you are a recovering alcoholic. All of these accomplishments are something to be proud of.

Your comments about medications used for bipolar disorder are, as you probably know, not everyone's experience. Lots of people can be helped by these very meds that you have mentioned. It is not helpful to generalize your experience to everyone in the community. Does that make sense?

That said, what are you doing right now to deal with your bipolar disorder?

While it might be easy to blame the psychiatrists, and medications, I'm wondering what you are doing to help yourself. Are you considering finding a new therapist, a new medication, a new psychiatrist? There are professionals who, if you let them know of your history and frustrations might try to help you. Can you try that?

Hi Teresa,

Thanks for your thoughtful comments. Although it may not be helpful to cast a wide net of aspersions at the psychiatric community, I feel I need to express my feelings in an honest manner. I've been through the ringer and think that I can fairly blame some, though certainly not all, of my problems on the failings of members of that group. I won't bore you with the gory details, but jobs were lost and a promising career was derailed.

The one clear advantage of being forced out to pasture early has been the ability to experiment, per se, with my mental hygiene. Not being under the extreme pressure of having to perform at a high level in stressful circumstances to stay employed has allowed me to, against the advice of my handlers, shelve the psych drugs that were ruining my health, both mental and physical.

I'm currently being provided for via the VA Healthcare system. They're maybe a little better at the brain game than my previous handlers were: they are old pros at dealing with PTSD and other mind dilemmas that have some similarities with BP.

Thanks again for your caring words.

Regards.

You are most welcome, @itchyd. After my last post, I was thinking about more ways you might be able to help yourself. Have you ever considered attending a support group? Perhaps the VA offers support groups, but if they don't, I'd like to suggest an organization called NAMI. NAMI has support groups throughout the country. If you would like to give it a try, here is a link to their website where you can find information about a group nearby,
https://www.nami.org/Support-Education/Support-Group
There is value in support groups where you can share with others who are experiencing similar problems. You can learn something about what has helped them in terms of medications, lifestyle changes and even good therapists who have helped them.

If you've never kept a journal (or if you already journal), I'd encourage you to join the Connect discussion titled, Journaling the Write Stuff for You. Here is the link to that group,
https://connect.mayoclinic.org/discussion/journaling-the-write-stuff-for-you/
In this group you will find others who are working through their physical and emotional struggles through writing on a regular basis. I'd encourage you to, at the very least, read the posts in that group.

I look forward to hearing from you as you continue this healing journey. It is not an easy road to travel, but well worth the trip!

Hi Teresa,

My one experience with NAMI was not a positive one.

I will take your other suggestions under advisement.

Thanks again.

Itchy

I have been on more anti-depressants than I can remember, but among those I've had prescribed to me, in addition to Seroquel, are: Celexa, Lexapro, Wellbutrin, Prozac, Cymbalta. It was Cymbalta that triggered the mania which got my diagnosis modified from depression to bipolar. After the new diagnosis I was on a mood stabilizer, Abilify, which worked, but had akathesia as a side effect, which was miserable. Beta blockers helped alleviate the akathesia, but it was still a deal breaker. By far my worst experience was with Cymbalta. Much of the experience with Cymbalta I cannot remember, I think I have blocked off that memory - too difficult to relive. I also developed tinnitus when I abruptly stopped Cymbalta, and still have it years later.

It's fascinating to me how different people respond differently to the same medication. My experience with Abilify was it flattened me out. Like it stripped me of my entire personality. Left me kind of emotionally catatonic, except it didn't stop a major depressive cycle. After first reducing the dosage, my psychiatrist took me off of it entirely for this reason. On the other hand, a lot of people here have had very good luck with Abilify, judging by comments on the varied bipolar forums. One person felt they had finally gotten themself back thanks to it. Why your condition is so resistant to medication I do not know, but I've found since my diagnosis that this is an art, not a science. There is science behind the different drugs, but ultimately finding each person's best options seems to be a lot of trial and error. Meanwhile you're stuck going up and down with crazy extremes. It can be discouraging.

Again, I'm finding that in my case, using the mood tracker I linked and getting into therapy have been the biggest help. I'm finally articulating this thing I've lived with all my life. I'm hoping I can understand it better.

I have bipolar 1 with mixed features. And anxiety/PTSD. I take risperidone and lamotrigine, and was recently hospitalized for a depressed episode brought on by stress from work mostly. Though I am on leave. I've struggled with meds and the Genesight testing showed most SSRI's aren't a good option and when on them, I haven't done well. Sometimes I use supplements to augment my mainstream treatment (NOT to replace it by any means). I like B-complex, vitamin C, and probiotics mostly. And I try to identify food triggers (fast food) and attempt to avoid them, but when depressed, I don't want to cook. It's a vicious cycle. I'm wondering if it's time to go back on Pristiq as I did okay on it before.

The mood tracking program I linked (here it is again: https://insights.emoodtracker.com/login) has been very helpful for me. I'm seeing this more and more, almost on a daily basis. Getting all this data to work with and figure out what might lead up to depressive events is something I never had before (prior to my diagnosis, I'm unsure that I even realized I could be helped). Along with the daily mood tracking, I'm keeping notes in it as well, and can go back and look at the ups and downs, check the notes to see what was going on that day, and compare it to more recent or current moods. It has me paying closer attention than I ever have before, and it's paid off. For the first time, back in March, I was able to see a depressive cycle coming on, and was able to fight it off. It wasn't easy and it took the better part of two days, but I held my ground. It felt like a victory.

I had just started lamotrigine when that last wave hit. It was low dosage, as you have to ease into it, so it wasn't at treatment level yet. Now I'm up to full dosage, I've been seeing a therapist weekly, logging everything in the program I linked, and getting exercise. I haven't logged depression since April 13, and that was a mild depression that passed relatively quickly. I was looking at the graph and realized that before I sought help (only a few months ago), lasting this long without a deep depression accompanied by suicidal ideations was unimaginable.

I got off Effexor in early March. It seems to have done a number on me. There's a paper on PubMed cautioning against treating bipolar 2 patients with antidepressants, and Effexor is singled out by name as especially problematic. If you're on an antidepressant and still suffering depression, ask your doctor if a medication switch might be a good idea. After reading the paper, I'm convinced at this point that the drug was flipping me upside down and kicking me into deep cycle depression. My psychiatrist thinks this might have been the case, and the paper shows that it happens to a small but significant number of bipolar patients. I've been on a generally upward trajectory since I got off of it. I do believe that this is significant.

I'm unsure how much of my better mood is tied to getting off of Effexor, how much is tied to the lamotrigine, what role the mood tracking program plays, how much therapy is helping, and if spring daylight is lifting my mood (it absolutely did not do this last year). What I do know is that I've felt better overall than I have in years. I'm not calling it the new normal yet, but it feels good to feel normal, even if it's just for now (hopefully not).

I cannot recommend the mood tracking program enough. It's free, and after a couple of months, you have a lot of data to work with. You can see on the graph where your moods have gone on a daily basis, and in the notes, along with discussions of what moods I was feeling and my thoughts on why they might have occurred, I've kept a nutritional log. I need to log exercise as well. It's really helpful and worth giving a try.

I hope this helps.