I think I might have bipolar disorder. But how do I cure bipolar depression?

[DistantOcean]

I will begin by giving a short summary of my experience with depression and psychosis. So basically I have experienced 5-6 psychotic breaks with manic features since I was 18 (26 now) and whilst I became mildly depressed for 1-2 years (ages 18-20) my mood seemed to stabilize to a decent level for a couple of years. Then after a psychotic break, when I was 23, major depression struck me. In the past 3 years I have had two psychotic breaks and during the moments running up to the psychoses plus most of the psychoses themselves I would describe my mood as reasonably well. In-between the depression remained, and particularly the last two years have been really dark.

Since 2.5 years I have been put on paliperidone while before that I took Seroquel due to it being an injection instead of pills as during my breaks I pretty much always refuse to take my medication. At the moment I have tried Lithium, Escitalopram (SSRI) and Venlafaxine (as an SSRI and an SNRI). Whilst on a high dose of Venlafaxine, so it functioned as an SNRI, I still became psychotic despite having had a 75mg Paliperidone injection. But the psychosis started in the last week of the monthly depot so it could’ve been that somehow it didn’t work long enough. Since Seroquel is actually quite coincidentally one of the three approved drug treatments for Bipolar depression I want to opt for returning to taking Seroquel instead of the proposed Abilify despite it not being injectable.

Other than this I have tried TMS, a healthy diet, working out frequently, I have had some psychotherapy, one psilocybin experience and have supplemented with Vitamin D, omega’s and vitamin/ mineral complexes. Thusfar none of these methods has even begun to lift my depression. Today I have started a ketogenic diet to see if this will help my mood. Also I am working with a coach doing a combination of mindfulness, meditation and Wim Hof breathing. And I will be supplementing with magnesium.

Other than this there are as far as I know only a few other options besides medication which include ketamine infusion (which unfortunately is extremely difficult to get while being prone to psychosis), fixing my sleeping schedule (chronically oversleeping at the moment), some questionable supplements such as 5-HTP and CBD and ECT (which I see as a last resort). Now I am wondering if I am still missing some treatment options. I am keen to hear what helped in treating your bipolar depression

 

[Zoe1]

you might be a bit obsessed with the medication ?
each combination you try needs a bit of time
to experience how its working for you
is it possible to try to enjoy yourself in between trials ?

I know I'm lucky in that I found the right combination
but I woulnt have known it was working
unless I settled down to some hobbies and interests

 

[boffin1252]

What happens when you get psychotic? What do you do?

 

[Rex Smith]

In the past 3 years I have had two psychotic breaks and during the moments running up to the psychoses plus most of the psychoses themselves I would describe my mood as reasonably well.

There is no cure for bipolar. The fact you had only 2 episodes in 3 years is a great accomplishment. If you're feeling good but still have an occasional episode is what most people try very hard to find.

Maybe bipolar 2 or the third bipolar(unspecified) could go without episodes with medications but never heard of someone with bipolar 1 be free from symptoms with medications. It's the original bipolar diagnosis before other types were introduced that greatly differs from one another.

Personally I hate that the mental health field are so lazy that they have categories like 1, 2, 3, etc. People use the term bipolar but depending on the type could be the difference like apples and oranges. Imagine if personality disorders was categorized 1, 2, 3, 4, 5, etc. But their not and instead have their own names. DSM-5 lists ten specific personality disorders: paranoid, schizoid, schizotypal, antisocial, borderline, histrionic, narcissistic, avoidant, dependent and obsessive-compulsive personality disorder.

My wife worked with a spouse with a husband that had bipolar 1. He stopped taking medications because he felt it wasn't doing anything for him. He committed suicide last year because of his frequent intense episodes and wasn't able to work.

It's a very serious condition with a high suicide risk. Again, don't get your hopes up from different bipolar types. Apples and oranges.

 

[DistantOcean]

What happens when you get psychotic? What do you do?

I suddenly become very creative. I wrote a lot and start experimenting with art (something I usually don't like). In general my depression lifted and I became much more undertaking. During my last episode I felt as though I was telepathically communicating with other people, both those in my direct presence and people who were not physically there. I mostly knew who they were and heard their voices inside of my head having fully fledged conversations with them. I also felt like my stuffed animals were possessed and thought they wanted to possess me next. I felt as though there was a ghost in my room and sometimes felt the presence of diseased family members. I also became paranoid at one point which made me run away from home in the middle of the night to eventually sleep near an abandoned house in the middle of the woods in order to be save from forces or people with bad intentions. I also become quite promiscuous, something which I am normally not. When I laid down on the couch in my basement I even had a vivid hallucination where I saw people silently moving towards what seemed like an underground club. Other than that I've head some illusions of grandure (thinking I was somehow very similar to Albert Einstein). When I'm psychotic I want to stop taking my medication at all cost and I become very suspicious of people's intentions. My thoughts are still pretty coherent during my breaks, from what I read back. I just associate very quickly and quite randomly.