Hello, I have schizoaffective bipolar type and take a large dose of Lamictal to control the bipolar side. We are just now getting it to a therapeutic level, since my bipolar type was just diagnosed in March. Prior to that, my previous practitioner was treating depressive type, which of course does not require nearly the level of mood stabilizer as I actually need. Lamictal can only be raised by 50 mg every two weeks, so it's been a long transition period for me.

The easiest way to explain my answer to your question is that often, it's when you're wondering if it's actually doing anything that you can tell that it really is. I keep a mood tracker, which I recommend if you don't already (Depakote has a great one online that I adapted into Excel). I can see trends where I am either in the steady mood category, or only one level off from steady. Not very or significantly manic or depressed, and thankfully, it's been about two weeks since I had a mixed state episode, which directly coincides with my last med increase.

These meds are there to give us stability. When we have it, we often don't appreciate it for what it is. We just feel like we can't explain how we are doing - and when dealing with bipolar, that's a GOOD thing! It means we're not living in the extremes like we have been. But that's what we're so used to, we start getting sometimes distressed when we're not in the status quo. I know when I first went to Lamictal 250 mg, I started feeling very flat and I briefly went back to 200 because I was so freaked out by not having racing thoughts all the time. I thought it was too much medication, but my psych nurse confirmed that what happened means the meds are actually working. I had become so used to hypomania that I panicked when normal changed. But hypomania is not normal, right? It had been for me for almost two years though.

I know I will have bumps up and down again, but the Lamictal should minimize those and keep them from hitting such big extremes. Those are those times like you said when you know it's not working. No med is going to be perfect though, our brain chemistry won't ever be perfect. But it's those days when I sometimes ask myself what the meds are actually doing, that I know I am on the right track to getting where I need to be. Steady mood check marks on the mood tracker. Isn't it nice to have quiet in your head more often? That's the meds. 🙂