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Underdog21

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Mar 26, 2021
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Oxford
Hi all,

I have been diagnosed with bipolar affecttive disored (it doesn't say whther it 1 or 2) and put on lithium. I am also taking an antipsychotic. Recently some of my symptoms came back such as suicidal thoughts, agitation and low mood. The NHS psychiatrist said they cannot give me an anti-depressant(because might go manic) nor increase the lithium (i've been getting side effects such as stomach problems and dizziness from lithium). Instead they suggested increasing my anti-psychotic which I am not a big fan of. I know people here are not doctors but do you think increasing the anti-psychotic is a solution? Should I seek a second opinion? Thanks!
 
2

2Much2Feel

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Hey, Underdog. I'm really sorry you're going through this. It does sound like a good idea to get a second opinion, as you are not getting better it sounds like. Also sounds like bipolar I if they are concerned about mania, but I obviously am no expert.

I don't know anything about anti-psychotics, so can't help there, but I do know from my own experience that I've been put on meds that made me far worse, and given diagnoses that weren't correct, so yes, a second opinion could be key. The right shrink and the right med can make all the difference. In any case, good you reached out here. I'm sure there are others who can relate and offer good advice. Totally get the suicidal thoughts, etc., and it can be hell. But there is help out there. They may have given you the wrong diagnosis and meds...
 
U

Underdog21

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Joined
Mar 26, 2021
Messages
89
Location
Oxford
Hey, Underdog. I'm really sorry you're going through this. It does sound like a good idea to get a second opinion, as you are not getting better it sounds like. Also sounds like bipolar I if they are concerned about mania, but I obviously am no expert.

I don't know anything about anti-psychotics, so can't help there, but I do know from my own experience that I've been put on meds that made me far worse, and given diagnoses that weren't correct, so yes, a second opinion could be key. The right shrink and the right med can make all the difference. In any case, good you reached out here. I'm sure there are others who can relate and offer good advice. Totally get the suicidal thoughts, etc., and it can be hell. But there is help out there. They may have given you the wrong diagnosis and meds...
Hi SeattleBP1,

Thank you for your kind words. I do feel pretty hopeless and like I am not getting any help from the doctors.
 
Wishbone

Wishbone

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They've actually done away with the Bipolar 1 & 2 labels and go with the ICD-10 "Bipolar Affective Disorder" and then they add on what episode you are in at the time whenever you present for any reason, so don't worry about that part too much, I think they're basically treating things on a case by case basis and if you've had certain things in your history then they will be monitored more closely.
You're not going to get antidepressants and you wouldn't want them either with your history. Lithium will take a little while longer to kick in, it's still early days for you, so that will require patience. If they suggest the higher antipsychotic route then I would go with it if you want to get out of depression. I know I read just the other day about them being used to do just that. It doesn't have to be a long-term solution either, so don't think of it as you being stuck on that dose never to return.
 
2

2Much2Feel

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Hi SeattleBP1,

Thank you for your kind words. I do feel pretty hopeless and like I am not getting any help from the doctors.
That seems to be true for a lot of us. It can take a long time to find a doctor worth going to. If you can switch, it can help so much. I've seen so many, finally found my old doctor again and he is helping a lot. Obviously I'm still not doing great, but not falling apart anymore and am starting to get more done. Things do feel pretty hopeless right now, overwhelming time. But hang on, I have been through this a million times, and it is a state that will pass. Do you have spirituality in your life at all?
 
U

Underdog21

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Joined
Mar 26, 2021
Messages
89
Location
Oxford
They've actually done away with the Bipolar 1 & 2 labels and go with the ICD-10 "Bipolar Affective Disorder" and then they add on what episode you are in at the time whenever you present for any reason, so don't worry about that part too much, I think they're basically treating things on a case by case basis and if you've had certain things in your history then they will be monitored more closely.
You're not going to get antidepressants and you wouldn't want them either with your history. Lithium will take a little while longer to kick in, it's still early days for you, so that will require patience. If they suggest the higher antipsychotic route then I would go with it if you want to get out of depression. I know I read just the other day about them being used to do just that. It doesn't have to be a long-term solution either, so don't think of it as you being stuck on that dose never to return.
Hi Wishbone,

Thank you so much for the advice and encouragement. I feel a bit better just having read your comment.
 
U

Underdog21

Well-known member
Joined
Mar 26, 2021
Messages
89
Location
Oxford
That seems to be true for a lot of us. It can take a long time to find a doctor worth going to. If you can switch, it can help so much. I've seen so many, finally found my old doctor again and he is helping a lot. Obviously I'm still not doing great, but not falling apart anymore and am starting to get more done. Things do feel pretty hopeless right now, overwhelming time. But hang on, I have been through this a million times, and it is a state that will pass. Do you have spirituality in your life at all?
Hi,

I am christian but I am not very active. When I feel good I read the Bible once in a while. If that's what you meant.
 
Wishbone

Wishbone

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No worries my friend. One thing you could try is asking about a possible change from Risperidone to Quetiapine. Apparently the latter has more of an antidepressant effect. I remember asking you about irritability and the Risperidone and you saying no to that so they shouldn't have any specific reason to want to keep you on Risperidone versus Quetiapine as they're fairly similar in their action, it's just that Risperidone seems to have a slightly better acute anti-manic/psychosis effect, from what I've read anyway.
I found this study which is pretty hefty
If you aren't aware of it already just use ctrl+F to find mentions of specific drugs within the paper. About half the way down is an area of interest regarding anti-depressant effects of various drugs, but you can search for anything - or read the whole thing if you like!
 
Wishbone

Wishbone

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And there's a part in there that says:

"Lithium occupies a particularly important place in the management of bipolar I disorder. Thus, the strongest evidence among medicines that are often referred to as mood stabilisers for bipolar I disorder is still for lithium. Lithium certainly prevents relapse to mania and depression."

So remind yourself of this part too. It's well-established and has far more research behind it than anything else. It doesn't work for everyone because we don't all have the same pattern of illness, but you've got to at least give it the time to act, and if you feel it hasn't done enough after 6-9 months or so, then maybe Lithium isn't right for you, as it wasn't for me.
But remember also that there is a difference between keeping moods stable and getting rid of an episode. If you're in the midst of an episode the treatment doesn't work as well to get you out, which is why inpatient treatment is usually something like Olanzapine short-term, then they work on getting you stable with something else. So have faith that when this episode passes (and it's possibly only here because Lithium hasn't built it's walls yet) that next time those walls will be tough enough to repel the attack.
 
U

Underdog21

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Joined
Mar 26, 2021
Messages
89
Location
Oxford
And there's a part in there that says:

"Lithium occupies a particularly important place in the management of bipolar I disorder. Thus, the strongest evidence among medicines that are often referred to as mood stabilisers for bipolar I disorder is still for lithium. Lithium certainly prevents relapse to mania and depression."

So remind yourself of this part too. It's well-established and has far more research behind it than anything else. It doesn't work for everyone because we don't all have the same pattern of illness, but you've got to at least give it the time to act, and if you feel it hasn't done enough after 6-9 months or so, then maybe Lithium isn't right for you, as it wasn't for me.
But remember also that there is a difference between keeping moods stable and getting rid of an episode. If you're in the midst of an episode the treatment doesn't work as well to get you out, which is why inpatient treatment is usually something like Olanzapine short-term, then they work on getting you stable with something else. So have faith that when this episode passes (and it's possibly only here because Lithium hasn't built it's walls yet) that next time those walls will be tough enough to repel the attack.
Hi Wishbone,

Thank you so much for your help. I can tell you are very helpful and you are a valuable member of this forum.
 
JessisMe

JessisMe

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Hi there I am diagnosed with Bipolar one and also take Lithium as well as an antipsychotic. I experience depression also and I take Lamotrigine for that which does help some. You might ask about it to see what your doctor thinks and whether it would be an option for you. xo, j
 
U

Underdog21

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Joined
Mar 26, 2021
Messages
89
Location
Oxford
Hi there I am diagnosed with Bipolar one and also take Lithium as well as an antipsychotic. I experience depression also and I take Lamotrigine for that which does help some. You might ask about it to see what your doctor thinks and whether it would be an option for you. xo, j
Hi JessisMe,

The only problem is that seeing an NHS psychiatrist ( I live in England) takes a while. I barely spoke to a doctor yesterday after making numerous calls for three weeks. I told her I don't want my anti-psychotic increased but her attitude was take it or leave it.
 
JessisMe

JessisMe

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Hi JessisMe,

The only problem is that seeing an NHS psychiatrist ( I live in England) takes a while. I barely spoke to a doctor yesterday after making numerous calls for three weeks. I told her I don't want my anti-psychotic increased but her attitude was take it or leave it.
What a bummer, that doesn’t sound very helpful. Is she at all open to prescribing new meds that might address the depression more directly?
 
U

Underdog21

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Joined
Mar 26, 2021
Messages
89
Location
Oxford
What a bummer, that doesn’t sound very helpful. Is she at all open to prescribing new meds that might address the depression more directly?
Here in England you never stick with one doctor. For some reason they all leave/move on. Yesterday for the 20th time I spoke to a different doctor who I felt was not the best. If I want to get in touch with them I have to wait several weeks and make numerous phone calls to intermediaries before I actually speak to a psychiatrist. I am honestly to tired and drained of energy from the depression to even go through process again.
 
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