Mental Health Advice and suggestions needed for long term mental illness - complex case

[candidsurprise]

Before I start, let me preface this by saying that I have seen many psychiatrists. None of them have any idea what to do with me, but I'm not sure if that is just because I live in the UK where mental health treatment is abysmal.

I suffer from the following conditions:
- Autism spectrum disorder (mild severity)
- Obsessive compulsive disorder (moderate severity)
- Bipolar Disorder Category Not Otherwise Specified (severe)
- Generalised anxiety disorder (moderate severity - although there is some debate on whether the anxiety is a product of the other disorders as opposed to a separate disorder)
- Social phobia (moderate to severe)
- Suspected ADHD and Borderline Personality Disorder; although I feel like the brunt of the ADD symptoms are caused by the issues with bipolar
- Substance use disorder (although this is mostly stabilized now with kratom substitution)

I am currently not able to engage in psychological therapy for any of the comorbid disorders due to the severity of the depression that I have been experiencing for several years. Believe me, I've tried. My depression has mild catatonic features in which I struggle with movement, sometimes stare into space, experience partial mutism, purposeless agitation and repetitive behaviors.

The treatments that I have tried are:

- sertraline (SSRI), which initially triggered my bipolar symptoms that have not gone away since
- tramadol (SNRI), made my bipolar issues much worse, after which I vowed never to try an SRI again
- moclobemide (partial MAOI), helped some of my depression symptoms and some of my social phobia, made my symptoms alternate more wildly and led to panic attacks
- low dose aripiprazole (atypical antipsychotic) - no side effects, but I was only on it for a month and it lost efficacy after a few weeks. Severe discontinuation symptoms.
- bright light therapy - helps my depression but worsens my agitation and purposeless pacing
- rTMS - helps a little bit without any side effects, but very expensive and not enough benefit (I am still doing maintenance sessions for this)
- trimipramine: helps my anhedonia, but not some of the other depressive core symptoms; it worsens my symptom cycling and gives me some agitation and other mild manic symptoms
- diazepam: helps the anxiety but not the depression; I am really scared to become dependant on benzos as I tend to take higher doses sometimes
- agomelatine: not sure if helps with anything other than my circadian rhythm
- Silexan (patented lavender preparation): helps the anxiety slightly without any side effects
- lamotrigine - not sure if it is helping with my baseline depression or not. Certainly not enough even if it is. Seems to help my symptom cycling a bit; insomnia if I take it at night, a sickly weird feeling if I take it in the morning. Either this or
- pramipexole: seemed to help with depression but not enough. I started taking heroin whilst on it so I wonder whether it gave me impulse control issues (as it is known to do), might have caused insomnia at night (can't remember), definitely gave me intolerable nausea. Either this or trimipramine makes me feel numbed out
- mirtazapine: helps with anxiety and OCD somewhat; felt zombified on it and did not like the feeling
- MDMA: helps the depression significantly for weeks afterward; but seemed to worsen my anxiety after, and started feeling
- tianeptine: helped, but I can't take kratom whilst on it (it makes me feel ill) and may have contributed towards agitation
- Esketamine: helps but minimally, tendency to abuse it (although usually not out of control)
- Racemic ketamine: definitely helps with more than one of my conditions, but not enough; tendency to abuse. Can't access it anymore
- Cannabis: a couple of US based medical strains helped massively, but can't access them (for obvious reasons). All strains available in the UK give me anxiety and make my OCD really bad
- high doses of omega 3 fish oil: unknown benefit as I have never taken it alone (certainly not enough if any), unknown side effects
- Acetyl L carnitine - seems to help with motivation and mood a little bit for a few hours, not sure if any side effects
- LSD: can only take low doses otherwise it triggers severe anxiety. No benefit at lower doses except for the hours during which the LSD is active. Maybe makes me hate life a bit less afterwards due to it being pretty cool, but doesn't help any of my symptoms

Currently I am on:

- trimipramine as it has stabilized anhedonia (probably my most crippling symptom)
- esketamine once per week
- Lamotrigine-
- Silexan for anxiety
- High dose Omega 3
- Agomelatine
- Acetyl L carnitine

I'm at a point of feeling completely stuck in this state of mental illness. A basic principle of psychiatry is to treat bipolar disorder before anything else. But I feel trapped since I am terrified of taking more hardcore treatments such as depakote, antipsychotics or lithium. The severity of my depression and social phobia makes me unable to change my life circumstances, to seek a way out of my social isolation or to get intensive psychological therapy. Relationships collapse due to Borderline Personality Disorder. I have an OK income, and I rent my own apartment with government money. They refuse to hospitalise me as I am not acutely suicidal (which is only due to my religious faith). Private rehab is way too expensive. They refuse to give me ECT due to the expense involved for the National Health Service

What do you think that I should do? Currently, kratom and the meds stop me from yearning for death almost 24/7, as I did in the past. I am still completely disabled though, and I suffer every single day, hating life. I have a few ideas about what I could do to help a bit:

- Take really hardcore meds like antipsychotics or lithium; bearing in mind psychiatric meds have usually made me worse and deepened my predicament
- Go to my father's country in the third world and pay for ECT privately
- Sign up to an ongoing clinical trial in London for Vagus Nerve Simulation, which works for some cases of treatment resistant depression. No data on bipolar disorder though
- Fly out to California to get the medical cannabis strain that helps, and then find a way to smuggle it back
- Go the Netherlands where I can retrieve racemic ketamine, and then smuggle it back
- Try some supplemental remedies for OCD
- Take diazepam daily

Most of these options are not practically realistic, some might fuck me even worse, and most do not deal with my main problem which is baseline bipolar disorder.

I would really appreciate any help here, I do not know how long I can last in this state. Thanks for reading.

 

[n3ophy7e]

I really feel for you mate. Comorbid psychiatric illnesses/disorders are really difficult to manage and even harder to live with, as you know. May I ask what is your fear of trying other antipsychotics or lithium?

Also I'm going to move this thread over to our Mental Health forum, as it may receive some better responses there.

 

[December Flower]

Hey I've got ASD with paranoid schizo :/
As a therapist(musical) myself I have to say you are a rare case.

But I need to know: has your condition really been a problem, before people said it was a problem and started giving you drugs?
In my honest opinion, I think antipsychotics are a hoax, and I would never give them to anyone. We don't really know what exactly this stuff does, it's more of a guess for a lot of it - we play around a little with chemical compounds, but do we know what exactly it will do to a specific person? No. I strongly advise to stay away from this stuff, there are a multitude of natural or more harmless substitutes. On the other hand I can count at least a hundred cases where I was personally involved as the musical therapist, where antipsychotics made things worse by A LOT.

And now there's the kicker. I suspect how you feel, as I have ASD myself, but there is one simple answer: There is no cure, no healing, no way to get rid of it. We have to learn to live in our minds. Because nothing will ever truly help, not really, and not permanently. If something does help, it's going to bite you in the ass after some time. Only our own handling of our "illnesses" can lead to true progress, that is my opinion.

Good luck, however you choose to go from here

 

[finitelifeform]

What are you doing to change your life besides subscribing to the notion that everything has to revolve around drugs and current psychiatric models?
What about your social life, is it any good? What about good friends, do you have any? Are you isolated? Have you been isolated for sometime? Do you have a good support network? Do you have goals in life that give you something to work for and somebody to become over time? What is your resilience to things like stress? What are your mental maps like in your mind? How do you deal with things? Do you think these work? If they don't, how could they change? What about your life story and has this been integrated? Are you dots connected so that real change can be made to stop repeating the past? How are you exposing yourself to these issues you face and how is that working out for you? Are you trying to gradually expose yourself to things you feel you cannot do but you know would help if you slowly built up the inner strength to do them? What is your mindset like? Do you see your issues as being permanent and therefore futile to deal with? Or, do you see them as being resolvable purely through your own ability to bring in the reality you want to live in? Do you feel like a victim? What can you do to change that? Have you tried doing more than taking drugs? Such as taking on the challenge of going out into life and dealing with these issues one chunk at a time?

Most change won't come from being a psychiatric patient and having a diagnosis. In fact, no change will happen if being a psychiatric patient and having diagnoses is what it means to be who you are. Any psychiatrist worth their ABCs after their name would attest to this. Psychiatry itself doesn't have the answers to your life. It can give you drugs but if the drugs worked like most people think, we would take them and we would be better and that would be it. Psychiatry cannot push you through the doors you need to walk through. Nobody can do that. The perpetual patient fails to recognize that and their labels become a self-fulfilling prophecy and they become a victim of the system and it's failure to recognize the bigger picture when it comes to what mental illness and health is all about. Sure, drugs can and do work and psychiatry can and does work but it's not EVERYTHING. A psychiatrist is not a magician. We go to doctors and want fixing. We cannot be fixed. And we cannot be fixed if there is always a problem and we believe the doctor will fix it. We are just creating an opportunity to point the blame at something or someone else and put the responsibility we owe to ourselves into the hands of someone else. A doctor cannot live your life for you.

I think sometimes the biggest issues we have in Western society are based on how we have created systems that make us dependent on them while helping to etch away at our own innate resources to deal with issues ourselves, both individually and collectively. We become dependent and then we weaken and we expect answers to drop from the sky. We don't want to use our own innate resources to comprehend our issues and work on dealing with them. Case in point; psychiatry. It's very easy to play the mental illness card and sure, you may be mentally ill and you may need care. At one point does the person ever become separate to this system they give themselves too? A year? 5 years? 10 years? Never. Often people will simply be a product, a patient, of the system for the rest of their life. Continue to take medication that masks over symptoms but they never actually overcome or deal with their issues. That's not liberating. That's not what this is about. It's nice to feel cared for, especially when perhaps you never had that before but that's not where, how or what you should be searching for. The relationship you need and crave deep down is with yourself and you won't find the answers in these settings and/or under these conditions. We all know this. That's why we are longing for something. That's why we search for something.

What is that something? What's it all about? Psychiatry doesn't answer these questions. Meds don't answer these questions. Diagnoses don't answer these questions.
You, on the other hand, do. Which means YOU are the center of these discoveries. YOU are the most important asset and it's through YOU healing, transformation and potential will come from. Others can help. The system can and may help in ways. In the end, you do the work. It's really sad because we have become so lost and we have created elaborate traps to stop us from ever finding our bearings again. We are running from ourselves and we believe that the answers come from the systems that have made us believe they know more about us and what it takes for us to get better and become the humans we want to become more than we do. We have lost our connection to a deeper more meaningful and conducive connection to ourselves, to each other and society as a whole. We have sold ourselves out in order to project our superiority in these fields, at the cutting edge of it all etc. We have sacrificed ourselves while at the same time we are still here living in these bodies with our minds still intact and yet we pretend we can detach all of these parts of ourselves and explain them away in ways that simply deviate from the underlying truths.

The best solution to your issues are to deal with them. Not as a patient, not as a diagnosis, not as a label. Not as a problem, as being broken, as being an illness, something to be fixed.
You need to see yourself beyond all this. You need to take all that and push it to one side and stop creating limitations that will prevent you from finding out who you are and becoming who you are. With all this in front of us, it's no surprise we become our illnesses, we become our diseases. You wouldn't say you are cancer. Why say you are x, y, z diagnosis? If the most important thing is what meds you take in the morning and what mumbo-jumbo your doctors say about your condition, and not the levels to this complex and amazing person you are, well, there is no hope.

There is a time for accepting certain things and a time for acknowledging particular realities that exist in our world. But...
These are NOT the only things nor realities that exist. Life is not psychiatry. Life is not mental illness. Life is not medication. Life is not scientific text-book mumbo-jumbo.
Where is the present felt experience? Where is the integration of your very being and what it means to be alive? Where are the memories, experiences, knowledge, adventures and growth that comes from living a life? You cannot stop living otherwise you become a portrait on the wall, a mere statue. We are not statues. We are not simply the illnesses we have nor the identification with the patient we become, the meds we take, the textbook language we are told to regurgitate in order to believe this forms our identity.

What about everything else? And that everything else is what you want to worry about.
Go out and do the things you thought you could never do. Challenge yourself. You will fall but get back up god dammit. Do NOT let these things define you. The only limits are the ones you set yourself. When you trap yourself in realities that offer little chance to flex and move around and grow, those realities become you. You become those realities. If that is illness, you will become that. If that is disease, you will become that. You ARE NOT that. Let go of the diagnoses, let go of the textbook stuff, let go of the medical models. They can only take you so far and then you have to learn to swim on your own. Find out about the things that these illnesses you say you experience symptoms have you supposedly cannot do very well, and go out and do them. Find ways to cope, challenge yourself, endure stress, endure criticism, endure failure. Build positive and reinforcing mindsets. Build powerful relationships. Be the light you want to see. Be the role model perhaps you may be looking for. And, go out and find role models as well. If you think you struggle being human, find someone who does human'ing better than you. Learn from those who have been there and come back to tell others how to do it. Find what is the core of your existence and embrace it and shout it out from the f*cking rooftops and don't be afraid of being judged. Sometimes you have to say f*ck you to the world and put your cards on the table and know that is more than enough.

Whatever you do, don't simply rely solely on the systems we have in place. Create your own. And then, you will be able to say you weren't defined and instead, you defined yourself. You lived this life and made the best of what you had and you flourished. You became everything you wanted to be, even when you were perhaps told it would never be possible. DO NOT DOUBT YOURSELF. YOU CAN DO THIS. Even if it means being f*cked up, so be it, be f*cked up but do it in style and do it without apologizing.

You have this. The life you want to live is a few steps away from becoming a reality. One step at a time. There will be times when you get pushed back. This is a time for you to regroup, assess and rethink strategy and then go again. We go again some more. And then some more. And then some more. Sooner or later, we will win if we care so much to push that goal into reality. And we will win and style and we will be able to look back and say we did that. And that, my friend, is monumental and puts you on another stratosphere. That makes you great. That makes you a winner. That makes you a survivor. Someone who went out there, did what he/she had to do and then came back with offerings to all those who were just like you when you first started out.

It's hard. Life is hard. I had two families, one biological and one adopted. Both f*cked me over. I am out on here on my own man, literally. I brought myself up and it was through me that I survived and became the person I am today. There was no support. I didn't have role models. I had to find them and then I had to become one. I wasn't going to be a loser, someone who let life get to him. I had to fight, I had to survive, I had to win. I was battling demons that brought me to my knees. I had mental breakdowns as young as 10 years old and because I was so traumatized by the severe child abuse I went through due to my adoptive parents I thought I was the problem, I thought the police would come for ME if I reported my parents. I could have gone to social services but the guilt, the trauma, the invalidation, I felt like a criminal, like I was crazy and needed putting away. My biological family is plagued with issues and the best thing we could have ever had was the best start we needed. Instead, our issues were amplified by the second serving of punishment we were too young to even be aware of or know why we even deserved it. 31 and I am still out here. It's made me so strong, so resilient, so aware, so in tune with things. That's when bad times become blessings and when you thank what you went through because it made you who you are today. I have dealt with mental illness all of my life. The things I have been through in this lifetime and from a young age, I have traveled many many more years than my physical age. But... the biggest thing? I did this for myself. I did this because I deserved this. Will life ever be perfect? No. But I have more than most and that's what is within me that is so strong it lights up rooms. I am always told there is something about me. People are drawn to me. Despite all this, to know life is attracted to me and that I can wish for most things and with work I can get them, knowing I was essentially dumped in the trash at 12 years old because my parents were done with adoption and treated us like dogs for Christmas (they are sociopathic/psychopathic malignant narcissists with other co-morbid mental illnesses, especially my mum) and yet I can be among the best of them and fit in? I can be the center of attention and have people gravitate towards me? To know I am even wanted in the first place? To know I belong? To know that through my experiences I am a role model, a teacher, a guide, a best friend, a life partner with so much to give? Words cannot describe when I think about it how much it means to me. Let's not forget. I did this myself. The journey doesn't stop. For me at least I cannot give up, I cannot give in, I cannot simply lower my guard and think that someone or something else will look after me. I had to be my own therapist, mum, dad, brother, best friend, cook, cleaner, life coach, teacher, guide, partner. I had to be all those things.

And I am telling you, your situation is not who you are.
You might think it is but don't create limits. Don't do that to yourself.
You are worth more than you can ever imagine. And please NEVER forget that. Yes, you, are worth more than you could ever imagine.

You can do this. I believe in you. You have got this.

 

[Shady's Fox]

This is a wide broad range of realms already, I hope you know that you might still got a shot with Ayahuasca.

 

[candidsurprise]

i'm not a doctor but i will give advice based on my experience

i have severe ocd and moderate to severe depression, i do thing (but sorry) that your ocd make you think that you have a lot of illness
if you have one illness you will have a little bit from all other one
as for bipolar its not possible to not know if you have it or not, so based on your post i will talk as you have it
the best for me and for all other med users for ocd is low dose 0.25-1.5mg risperidone (don't upper it will cause the opposite) and 225mg anafranil (balanced very strong SNRI don't take the high dose directly or it might cause serotonin syndrom start 112.5mg then you can upper to 225mg this what i do when i was off it for a few months)
for bipolar depressive episode the best is lamotrigine 200-400mg but don't upper fastly you will die, add 25mg every 2-3 weeks and look at your skin for steven johnson syndrome
let say you get in trouble lamotrigine will instantly act and delete you bad memory which will prevent you from getting depressed. it also cause some sort of physical motivation
for manic phrase of bipolar the good is olanzpine i took it and still taking it, it completely prevent you from getting angry and it used as maintenance for manic bipolar (but it will make ocd worst so you might not take it)
for Autism you need SSRIs which anafranil do the trick it extremely increase my ability to enjoy/and do emotion, love, cuteness, talking, and helping others
as for Generalised anxiety disorder i think it because depression lamotrigine and 0.25mg respiridon and anafranil will kill this for sure
Social phobia its because Autism spectrum disorder
Suspected ADHD and Borderline Personality Disorder
for adhd risperidone will solve the hyperactivity but not attention deficit
for Borderline Personality Disorder i don't know how to help here

for depression/motivation work/do things you already enjoy if any, i enjoy internet so i work in internet.

Thanks for your reply, you do know a lot about these things. Unfortunately I can't take any kind of SRI, which includes SSRIs, SNRIS, anafranil or tramadol. They impacted my brain very badly when I took them, I later learned that this was because I have bipolar and these medications can trigger mixed state bipolar symptoms. I am too afraid to ever try one again due to this, and they are not recommended for use in bipolar disorder unless there is an anti manic mood stabilizer like an antipsychotic or olanzapine.

I am currently on 350mg lamotrigine, and unfortunately it does not seem to be working for me. I suppose my best option now is an antipsychotic, but I am very scared to use them. Many people on this forum say that they cause long term neurodegeneration, and they a proven to cause neurological illnesses like tardive dyskinesia.

 

[candidsurprise]

Hey I've got ASD with paranoid schizo :/
As a therapist(musical) myself I have to say you are a rare case.

But I need to know: has your condition really been a problem, before people said it was a problem and started giving you drugs?
In my honest opinion, I think antipsychotics are a hoax, and I would never give them to anyone. We don't really know what exactly this stuff does, it's more of a guess for a lot of it - we play around a little with chemical compounds, but do we know what exactly it will do to a specific person? No. I strongly advise to stay away from this stuff, there are a multitude of natural or more harmless substitutes. On the other hand I can count at least a hundred cases where I was personally involved as the musical therapist, where antipsychotics made things worse by A LOT.

And now there's the kicker. I suspect how you feel, as I have ASD myself, but there is one simple answer: There is no cure, no healing, no way to get rid of it. We have to learn to live in our minds. Because nothing will ever truly help, not really, and not permanently. If something does help, it's going to bite you in the ass after some time. Only our own handling of our "illnesses" can lead to true progress, that is my opinion.

Good luck, however you choose to go from here

Hi, yes I had all of these conditions before I started on medication. I was disabled by them. However, I am worse now compared with before. For example, I did not have catatonic symptoms, and the generalised anxiety and depression were less severe. Yes, I am finding it very hard to accept the reality that ASD is permanent. There are some medications that improve it a bit, but there is no cure. Personally, I've found that certain drug combinations (like amphetamine + benzo) help it significantly, but I would only be willing to to do this once weekly (or max twice).

 

[Jabberwocky]

Before I start, let me preface this by saying that I have seen many psychiatrists. None of them have any idea what to do with me, but I'm not sure if that is just because I live in the UK where mental health treatment is abysmal.

I suffer from the following conditions:
- Autism spectrum disorder (mild severity)
- Obsessive compulsive disorder (moderate severity)
- Bipolar Disorder Category Not Otherwise Specified (severe)
- Generalised anxiety disorder (moderate severity - although there is some debate on whether the anxiety is a product of the other disorders as opposed to a separate disorder)
- Social phobia (moderate to severe)
- Suspected ADHD and Borderline Personality Disorder; although I feel like the brunt of the ADD symptoms are caused by the issues with bipolar
- Substance use disorder (although this is mostly stabilized now with kratom substitution)

I am currently not able to engage in psychological therapy for any of the comorbid disorders due to the severity of the depression that I have been experiencing for several years. Believe me, I've tried. My depression has mild catatonic features in which I struggle with movement, sometimes stare into space, experience partial mutism, purposeless agitation and repetitive behaviors.

The treatments that I have tried are:

- sertraline (SSRI), which initially triggered my bipolar symptoms that have not gone away since
- tramadol (SNRI), made my bipolar issues much worse, after which I vowed never to try an SRI again
- moclobemide (partial MAOI), helped some of my depression symptoms and some of my social phobia, made my symptoms alternate more wildly and led to panic attacks
- low dose aripiprazole (atypical antipsychotic) - no side effects, but I was only on it for a month and it lost efficacy after a few weeks. Severe discontinuation symptoms.
- bright light therapy - helps my depression but worsens my agitation and purposeless pacing
- rTMS - helps a little bit without any side effects, but very expensive and not enough benefit (I am still doing maintenance sessions for this)
- trimipramine: helps my anhedonia, but not some of the other depressive core symptoms; it worsens my symptom cycling and gives me some agitation and other mild manic symptoms
- diazepam: helps the anxiety but not the depression; I am really scared to become dependant on benzos as I tend to take higher doses sometimes
- agomelatine: not sure if helps with anything other than my circadian rhythm
- Silexan (patented lavender preparation): helps the anxiety slightly without any side effects
- lamotrigine - not sure if it is helping with my baseline depression or not. Certainly not enough even if it is. Seems to help my symptom cycling a bit; insomnia if I take it at night, a sickly weird feeling if I take it in the morning. Either this or
- pramipexole: seemed to help with depression but not enough. I started taking heroin whilst on it so I wonder whether it gave me impulse control issues (as it is known to do), might have caused insomnia at night (can't remember), definitely gave me intolerable nausea. Either this or trimipramine makes me feel numbed out
- mirtazapine: helps with anxiety and OCD somewhat; felt zombified on it and did not like the feeling
- MDMA: helps the depression significantly for weeks afterward; but seemed to worsen my anxiety after, and started feeling
- tianeptine: helped, but I can't take kratom whilst on it (it makes me feel ill) and may have contributed towards agitation
- Esketamine: helps but minimally, tendency to abuse it (although usually not out of control)
- Racemic ketamine: definitely helps with more than one of my conditions, but not enough; tendency to abuse. Can't access it anymore
- Cannabis: a couple of US based medical strains helped massively, but can't access them (for obvious reasons). All strains available in the UK give me anxiety and make my OCD really bad
- high doses of omega 3 fish oil: unknown benefit as I have never taken it alone (certainly not enough if any), unknown side effects
- Acetyl L carnitine - seems to help with motivation and mood a little bit for a few hours, not sure if any side effects
- LSD: can only take low doses otherwise it triggers severe anxiety. No benefit at lower doses except for the hours during which the LSD is active. Maybe makes me hate life a bit less afterwards due to it being pretty cool, but doesn't help any of my symptoms

Currently I am on:

- trimipramine as it has stabilized anhedonia (probably my most crippling symptom)
- esketamine once per week
- Lamotrigine-
- Silexan for anxiety
- High dose Omega 3
- Agomelatine
- Acetyl L carnitine

I'm at a point of feeling completely stuck in this state of mental illness. A basic principle of psychiatry is to treat bipolar disorder before anything else. But I feel trapped since I am terrified of taking more hardcore treatments such as depakote, antipsychotics or lithium. The severity of my depression and social phobia makes me unable to change my life circumstances, to seek a way out of my social isolation or to get intensive psychological therapy. Relationships collapse due to Borderline Personality Disorder. I have an OK income, and I rent my own apartment with government money. They refuse to hospitalise me as I am not acutely suicidal (which is only due to my religious faith). Private rehab is way too expensive. They refuse to give me ECT due to the expense involved for the National Health Service

What do you think that I should do? Currently, kratom and the meds stop me from yearning for death almost 24/7, as I did in the past. I am still completely disabled though, and I suffer every single day, hating life. I have a few ideas about what I could do to help a bit:

- Take really hardcore meds like antipsychotics or lithium; bearing in mind psychiatric meds have usually made me worse and deepened my predicament
- Go to my father's country in the third world and pay for ECT privately
- Sign up to an ongoing clinical trial in London for Vagus Nerve Simulation, which works for some cases of treatment resistant depression. No data on bipolar disorder though
- Fly out to California to get the medical cannabis strain that helps, and then find a way to smuggle it back
- Go the Netherlands where I can retrieve racemic ketamine, and then smuggle it back
- Try some supplemental remedies for OCD
- Take diazepam daily

Most of these options are not practically realistic, some might fuck me even worse, and most do not deal with my main problem which is baseline bipolar disorder.

I would really appreciate any help here, I do not know how long I can last in this state. Thanks for reading.

Hi

I have depression, anxiety, non-organ related psychotic disorder, dissociation and substance abuse problem, as my diagnosis. And OCD, but it is not diagnosed.

I check that my front door is locked. Often. Even if i know it is, because i just checked it. Then i have to check that the oven is not on. And i don't even believe those switches it has, i have to try with my hand that they are cold. And this one is embarrassing as fuck, but i am going to admit it anyway, because otherwise it is harder for me to make my point clear. When i go to bed, i have to twice touch me left toes and twice my right toes. To prevent something bad from happening... Insane, i know.... Sometimes i am just like "Fuck this, not gonna touch my toes, if some shit is going to happen, it happens, and my toes have nothing to do with it" Then i feel anxiety coming, and i do that touching anyway, and then it is easier.

So, what i am trying to say, it is not the OCD as such, which is bad problem. It is the reactions, feelings, and emotions caused by it. It takes me about 15 seconds to check the door. Another 15 to check the oven. Like i don't have 30 seconds? All i have in this world, is time. The toe touching thing takes maybe 5 seconds. I do those things, but i simply refuse to care. I don't think about it anymore, that this is insane, this is sickness, and it has to stop. I simply don't care anymore. Personally, for me, it has helped a lot. I do the OCD shit, but completely ignore it, the mental turbulence it can cause. Just ignore all of it.

 

[December Flower]

Hi, yes I had all of these conditions before I started on medication. I was disabled by them. However, I am worse now compared with before. For example, I did not have catatonic symptoms, and the generalised anxiety and depression were less severe. Yes, I am finding it very hard to accept the reality that ASD is permanent. There are some medications that improve it a bit, but there is no cure. Personally, I've found that certain drug combinations (like amphetamine + benzo) help it significantly, but I would only be willing to to do this once weekly (or max twice).

I warn you to be careful with drugs + ASD, we are not the people who should take drugs, "medication" or otherwise. It can get very bad for us. Also do not get into benzos, once you're hooked it's almost impossible to get off again. Just a fair warning, benzos ruin lives.

However: Have you ever taken MDMA? I used to microdose MDMA for quite some time, and it helped a lot with the Autism. Empathogens can help a LOT with the social aspect of Autism. MDMA has helped me read social cues, read faces, read the tone in voices, and I've gotten very good at it (IRL, not here). It's not going to help with the sensory overloads, nervous ticks, etc, not really, you're going to have those forever
If you decide you want to try MDMA, please be careful, take the lowest of doses(it can easily overwhelm your senses), and only in the presence of someone you trust who isn't high (a therapist/psychologist would be best, so you can combine it with cognitive therapy)

 

[candidsurprise]

I warn you to be careful with drugs + ASD, we are not the people who should take drugs, "medication" or otherwise. It can get very bad for us. Also do not get into benzos, once you're hooked it's almost impossible to get off again. Just a fair warning, benzos ruin lives.

However: Have you ever taken MDMA? I used to microdose MDMA for quite some time, and it helped a lot with the Autism. Empathogens can help a LOT with the social aspect of Autism. MDMA has helped me read social cues, read faces, read the tone in voices, and I've gotten very good at it (IRL, not here). It's not going to help with the sensory overloads, nervous ticks, etc, not really, you're going to have those forever
If you decide you want to try MDMA, please be careful, take the lowest of doses(it can easily overwhelm your senses), and only in the presence of someone you trust who isn't high (a therapist/psychologist would be best, so you can combine it with cognitive therapy)

Thanks, I've taken MDMA many times, and just today I was planning my next roll. It benefits me a lot, but I have an awful comedown from it.

 

[poisongirl]

First off, massive hugs. Things are tough, but it personally makes me happy to see you still trying. Thank you for reaching out for more help.

Both my parents have bipolar type II and have suffered with depression their whole lives. I was diagnosed with borderline personality disorder and bipolar.

I suspect I had ASD as a kid because of all the weird stuff I did, but as I transitioned into my teens and into my twenties (which I'm still in) it got a lot better, and now I'm extremely good at reading people and being functional and social, although it takes a toll on me sometimes.

I've also taken a bunch of stuff for depression, anxiety, and eventually schizo symptoms (mostly hearing voices telling me to kms/other bad things)

Valproic acid was terrible for me (made me stay awake for over 40 hours)
Sertraline also sucked, made me feel like a zombie
Fluoxetine kinda worked for some time, then I came off it cause I was so depressed from life sucking and I guess a bit of teenage rebellion.
I also took Lamotrigine, but it made my cognitive abilities terrible. I had extremely bad memory and couldn't do any math harder than middle school stuff without extreme focus.

Eventually I landed on the combination of drugs that worked the best for me for a really long time, which I started around 2017:
- Fluoxetine (at first 20 then 40 then 60mg, changing depending on how much I needed it)
- Olanzapine 5mg
- Clonazepam 1mg (sometimes 2 a day, but it was because of daily anxiety from university/daily life)
- Ambien 5mg for sleep (I suffer from massive insomnia)
- Risperidone (as needed for any manic episodes or massive anxiety)
- I also took some Lamotrigine (100 -> 50mg) but a doctor cut it in 2019 because it was basically too many different pharmaceuticals, and it was such a small quantity that it probably had no effect on me anymore)

I took these for about 2~3 years. In late 2019 I was only taking Olanzapine 5mg, Fluoxetine 20mg

The doctor under which I had been receiving treatment for around a year told me about the fluoxetine + olanzapine combo, which he told me had been recently brought up in the treatment of bipolar + borderline in the U.S. It might sound extremely scary to hear that, and to be honest, I have no clue about any long-lasting effects of the Risperidone/Olanzapine (both antipsychotics), but they helped me a lot. The Olanzapine daily had the side effect of making me *extremely* sleepy, making me miss a lot of my days at university, and eventually I had to drop out. But it helped me get through the days and eventually I got used to it and became more capable of doing things daily.

I eventually decided I was in a better place mentally (from doing 6 years of continuous therapy and also from fixing my life over the following 3 years), and so I decided I wanted to quit taking meds. I told my doctor, and then I stopped Olanzapine first. The WD was terrible, and lasted a bit short of 2 weeks. I felt like I was gonna pass out at all times, I got brain zaps, and it was extremely hard to even get up from bed, to be honest. But after that, I was free, and was feeling a lot better and happy. Plus, I slept way less so I had more time to be productive. Eventually I stopped taking the Fluoxetine too, and I've been happy. I've been dealing with the BPD and bipolar as it comes and mostly from a better mindset, understanding how my mind works and things I can do to take care of myself when I'm having a worse day (self-care).

I hope that my words helped you, even if a slightest bit, and I hope you find your safety soon, friend!

 

[poisongirl]

Anti psychotics get a lot of hate but some people need them to function normally. I know a guy that gets really fucked up when he stops taking them. It always results in police putting him in a straight jacket and then taking him to the psych ward. Now that he consistently takes his meds, he's got a nice government job and a beautiful girlfriend.

Another guy I know is the same way, he got evicted from a very nice place because he went off his meds and called in a bomb threat then called the cops to tell them why he did it, lol. That wasn't the only incident either, dude was always forgetting or choosing not to take his pills and every single time cops would show up. One time it took 6 of them to get his attention because he was too busy screaming and pounding on his neighbor's walls. Whenever I think of that I laugh because those neighbors happen to be absolute cunts.

So yeah, don't be afraid to try an AP, you never know it may just help you.

I think that's a more severe case than OP. APs aren't only for people like those you mentioned. I was never a threat to myself or others or bonkers off the walls like these guys you're describing, and APs helped me a ton.

But I do agree that at this point, I do suggest trying something. Just be careful and research what you take first -- you don't want to end up taking stuff like invega stuff that stays in your system for 3 months. Risperidone and Olanzapine stops affecting you after less than a week if you're not taking them frequently/for a long time, from my experience.

 

[December Flower]

Thanks, I've taken MDMA many times, and just today I was planning my next roll. It benefits me a lot, but I have an awful comedown from it.

Interesting. I would suggest the microdosed route.
Microdosed(try no more than 10mg, and if best spread doses here and there 1mg 2mg 2mg 5mg or something like that over a couple of hours) there is no comedown per sé, however the positive social effects will remain. For me it was so good that i had issues to stop again, but if you stick to a strict regimen it can be quite beneficial

edit: Even with larger doses taking MDMA in "waves" as i call it helps with the comedown. If you take a bunch of smaller doses spread over say 4 hours instead of one large hit, your comedown will come in much smaller, less "soulcrushing" waves. And in my opinion the "roll" is much better too.

 

[candidsurprise]

First off, massive hugs. Things are tough, but it personally makes me happy to see you still trying. Thank you for reaching out for more help.

Both my parents have bipolar type II and have suffered with depression their whole lives. I was diagnosed with borderline personality disorder and bipolar.

I suspect I had ASD as a kid because of all the weird stuff I did, but as I transitioned into my teens and into my twenties (which I'm still in) it got a lot better, and now I'm extremely good at reading people and being functional and social, although it takes a toll on me sometimes.

I've also taken a bunch of stuff for depression, anxiety, and eventually schizo symptoms (mostly hearing voices telling me to kms/other bad things)

Valproic acid was terrible for me (made me stay awake for over 40 hours)
Sertraline also sucked, made me feel like a zombie
Fluoxetine kinda worked for some time, then I came off it cause I was so depressed from life sucking and I guess a bit of teenage rebellion.
I also took Lamotrigine, but it made my cognitive abilities terrible. I had extremely bad memory and couldn't do any math harder than middle school stuff without extreme focus.

Eventually I landed on the combination of drugs that worked the best for me for a really long time, which I started around 2017:
- Fluoxetine (at first 20 then 40 then 60mg, changing depending on how much I needed it)
- Olanzapine 5mg
- Clonazepam 1mg (sometimes 2 a day, but it was because of daily anxiety from university/daily life)
- Ambien 5mg for sleep (I suffer from massive insomnia)
- Risperidone (as needed for any manic episodes or massive anxiety)
- I also took some Lamotrigine (100 -> 50mg) but a doctor cut it in 2019 because it was basically too many different pharmaceuticals, and it was such a small quantity that it probably had no effect on me anymore)

I took these for about 2~3 years. In late 2019 I was only taking Olanzapine 5mg, Fluoxetine 20mg

The doctor under which I had been receiving treatment for around a year told me about the fluoxetine + olanzapine combo, which he told me had been recently brought up in the treatment of bipolar + borderline in the U.S. It might sound extremely scary to hear that, and to be honest, I have no clue about any long-lasting effects of the Risperidone/Olanzapine (both antipsychotics), but they helped me a lot. The Olanzapine daily had the side effect of making me *extremely* sleepy, making me miss a lot of my days at university, and eventually I had to drop out. But it helped me get through the days and eventually I got used to it and became more capable of doing things daily.

I eventually decided I was in a better place mentally (from doing 6 years of continuous therapy and also from fixing my life over the following 3 years), and so I decided I wanted to quit taking meds. I told my doctor, and then I stopped Olanzapine first. The WD was terrible, and lasted a bit short of 2 weeks. I felt like I was gonna pass out at all times, I got brain zaps, and it was extremely hard to even get up from bed, to be honest. But after that, I was free, and was feeling a lot better and happy. Plus, I slept way less so I had more time to be productive. Eventually I stopped taking the Fluoxetine too, and I've been happy. I've been dealing with the BPD and bipolar as it comes and mostly from a better mindset, understanding how my mind works and things I can do to take care of myself when I'm having a worse day (self-care).

I hope that my words helped you, even if a slightest bit, and I hope you find your safety soon, friend!

Thanks for the post, I'm currently on a combination at the moment: 350mg lamotrigine (increased last week from 200 -> 350) + 75mg trimipramine + a bunch of supplements. I'm also still doing rTMS, which is repetitive transcranial magnetic stimulation - basically a mild form of shock therapy that doesn't have side effects. Now the first decision that I have to try to make is whether to come off either of these drugs. I feel a constant very weird sense of dysphoria in my mind which I had a few years ago when I was on the wrong meds, this makes me believe that it is one of these two drugs causing this. In terms of a logical sequence, the trimipramine med is not supposed to be used in people with bipolar disorder because It is suspected to cause issues like agitation and dysphoria, so I think this may be the cause. Now here is where it gets more tricky, I was on 50mg but then increased it up to 75mg whilst I did the TMS. Some of my vegetative depression symptoms improved over that period, but I don't know which of those two treatments worked. I have tried reducing that med dose before, and I got worse over time during that period, but I had other factors going on at the same time. I really want to lower the trimipramine dose, but I'm so scared of doing so and plunging back into more severe depression. However, I feel like I need to try it in order to get rid of this dysphoria feeling (which in itself is making my quality of life miserable). Do you have any advice on this particular decision?

 

[Jabberwocky]

autism makes us much more sensitive to our surroundings, so i gotta ask.... something happened that gave you all of those symptoms? since your case is complicated, it might be easier to treat if you start from the roots
Jah, u might have to deal with that much longer if u dont address the source of it

 

[December Flower]

autism makes us much more sensitive to our surroundings, so i gotta ask.... something happened that gave you all of those symptoms? since your case is complicated, it might be easier to treat if you start from the roots
Jah, u might have to deal with that much longer if u dont address the source of it

"more sensitive to our surroundings" is the cutest description I have yet heard :D Makes it almost sound nice. I always refer to my surroundings as a sledgehammer that keeps beating information into my head.

Thing is, source is the physical brain, further marred through medication. I'd be extra careful with any step in any direction. Even discontinuing the use of medication and/or drugs OP might be taking could potentially be very dangerous. I see why OP feels stuck..

 

[poisongirl]

Thanks for the post, I'm currently on a combination at the moment: 350mg lamotrigine (increased last week from 200 -> 350) + 75mg trimipramine + a bunch of supplements. I'm also still doing rTMS, which is repetitive transcranial magnetic stimulation - basically a mild form of shock therapy that doesn't have side effects. Now the first decision that I have to try to make is whether to come off either of these drugs. I feel a constant very weird sense of dysphoria in my mind which I had a few years ago when I was on the wrong meds, this makes me believe that it is one of these two drugs causing this. In terms of a logical sequence, the trimipramine med is not supposed to be used in people with bipolar disorder because It is suspected to cause issues like agitation and dysphoria, so I think this may be the cause. Now here is where it gets more tricky, I was on 50mg but then increased it up to 75mg whilst I did the TMS. Some of my vegetative depression symptoms improved over that period, but I don't know which of those two treatments worked. I have tried reducing that med dose before, and I got worse over time during that period, but I had other factors going on at the same time. I really want to lower the trimipramine dose, but I'm so scared of doing so and plunging back into more severe depression. However, I feel like I need to try it in order to get rid of this dysphoria feeling (which in itself is making my quality of life miserable). Do you have any advice on this particular decision?

My advice would be starting therapy if you don't yet...

I agree with the other posters saying you should take less medication. Think about your brain before all this. Do you even remember what it was like? Was it so bad that you couldn't learn to cope by other methods? Maybe one way to get back there it by letting your body heal naturally -- maybe you've been taking so many different meds without any break in between that they're still affecting your body somehow.

I'd suggest following your heart -- if you feel like the trimipramine is what's causing your dysphoria, I'd start lowering that ASAP after informing your doctor. Take it easy, titrate if you need to, and slowly but surely you'll take it less. Trimipramine specifically seems to be very uncommon in treatment for bipolar, and from my internet searches, it was described as "bottom of the barrel". Lamotrigine seems less bad, but IMO you should also try to reduce that.

I'd want you to try taking kavakava pills -- they're natural, easy to get over the internet, and were pretty effective for me. All they do is relax you, they don't have WD as far as I know, especially compared to benzos, and they made me A LOT happier when I took them! I just didn't continue taking them when I lived in Brazil because they costed R$60 which was a lot for me at the time.

And for psych meds recommendation -- I know you're afraid of taking another SSRI and APs, but is it so scary to try Fluoxetine + Olanzapine? I also took Sertraline and it *sucked*. But then I moved to a high dose of Fluoxetine and it really really helped me.

The Olanzapine + Fluoxetine combination has been under study for quite some time for treatment of borderline and bipolar, and Olanzapine, as well as Risperidone and Quetiapine, which also are also atypical antipsychotics I've heard good things about, is definitely not as scary as most other APs that people talk about (typical antipsychotics).

Hope it helps, OP! Sending a hug as well.

 

[candidsurprise]

autism makes us much more sensitive to our surroundings, so i gotta ask.... something happened that gave you all of those symptoms? since your case is complicated, it might be easier to treat if you start from the roots
Jah, u might have to deal with that much longer if u dont address the source of it

Yeah I've had a shit childhood, and too many mental illnesses to ever have decent life circumstances. I can't get into a relationship (rejected at every turn), no friends want to see me after hanging out with me twice, family who invalidate my feelings and trigger anxiety whenever they are present, completely afraid of any social interaction (they make me feel much worse both during and after the interaction). I am severely mentally ill, one of rare cases. I actively yearn for death and would have committed suicide long ago, but I have very firm religious beliefs about suicide leading to hellfire and therefore much greater torment (I've researched the topic for 10 years and this is the only conclusion that I can reach). This is why I resorted to drug use, no desire to live (except out of fear of what's beyond) and complete learned helpnessness. I need to be institutionalized, but the government in my country has destroyed the health service, and private treatment is out of reach for anyone besides the wealthiest.

My advice would be starting therapy if you don't yet...

I agree with the other posters saying you should take less medication. Think about your brain before all this. Do you even remember what it was like? Was it so bad that you couldn't learn to cope by other methods? Maybe one way to get back there it by letting your body heal naturally -- maybe you've been taking so many different meds without any break in between that they're still affecting your body somehow.

I'd suggest following your heart -- if you feel like the trimipramine is what's causing your dysphoria, I'd start lowering that ASAP after informing your doctor. Take it easy, titrate if you need to, and slowly but surely you'll take it less. Trimipramine specifically seems to be very uncommon in treatment for bipolar, and from my internet searches, it was described as "bottom of the barrel". Lamotrigine seems less bad, but IMO you should also try to reduce that.

I'd want you to try taking kavakava pills -- they're natural, easy to get over the internet, and were pretty effective for me. All they do is relax you, they don't have WD as far as I know, especially compared to benzos, and they made me A LOT happier when I took them! I just didn't continue taking them when I lived in Brazil because they costed R$60 which was a lot for me at the time.

And for psych meds recommendation -- I know you're afraid of taking another SSRI and APs, but is it so scary to try Fluoxetine + Olanzapine? I also took Sertraline and it *sucked*. But then I moved to a high dose of Fluoxetine and it really really helped me.

The Olanzapine + Fluoxetine combination has been under study for quite some time for treatment of borderline and bipolar, and Olanzapine, as well as Risperidone and Quetiapine, which also are also atypical antipsychotics I've heard good things about, is definitely not as scary as most other APs that people talk about (typical antipsychotics).

Hope it helps, OP! Sending a hug as well.

Honestly thanks for your suggestions, my posts here will have a bad and negative tone due to how miserable I currently am. I can't do therapy, I have intermittent catatonia and social phobia. Can't leave the house without a drug, the last therapist said that it was pointless due to how I'm just completely unresponsive. I can't go without meds, everytime I drop the dose I become suicidal and my catatonia worsens. Absolutely unbearable. This is not a withdrawal issue, I tested that. It gets worse months after reducing the dose. Thanks for your advice on trimipramine, I suppose I should do that, but I will need to find a substitute. I think at this point, I may have to resort to olanzapine or something similar as I'm not left with many options besides something like opiates. Tried quetiapine and it was absolutely horrible for me, made my depression, dysphoria and anhedonia much worse. The trouble with antipsychotics is that they usually have horrendous side effects long term. Most long term users of antipsychotics that I have spoken to have said that they have done more harm than good. I think the catatonia might be responsible for my treatment resistance. Catatonia is present in 10% of psychiatric patients, and is almost always overlooked and missed unless the person has it severely. The treatment for catatonia is different. The algorithm is benzodiazepines -> ECT -> memantine/amantadine -> valproate/carbamazepine -> olanzapine/aripiprazole. Usually, they say that antipsychotics should be avoided in catatonic patients because they often make the situation worse.

I've been considering kava kava for a while, so that's a good point. It's just so expensive and on welfare benefits due to mental disability, so it is very difficult for me to fund these things.

 

[poisongirl]

I wish I could help more, I really do. Even though we're just strangers, I know firsthand how bad this stuff is, and so I empathize a lot with you.

I would just like you to keep thinking of the things that help and the things that don't. Things that can still bring you some joy, even if small, or at least good memories that you can keep remembering. I think everyone can still revert back to times similar to when they felt happy, and at least for me that thought and those memories kept me going.

Remember too that despite meds being in the same class, they're all still different, and I'm positive that you can find some combination that will help you.

As far as long term AP usage goes: I took Olanzapine for almost 3 years and now I'm a perfectly healthy person. I take Adderall for adhd, lorazepam as needed for anxiety, and Trazodone for sleep, but I can still manage very well without it, and I believe you can get there too. If anything, I can promise you to be here to reply and keep as much company as I can along this journey, and I'm sure others will be glad to give support as well!

 

[candidsurprise]

I wish I could help more, I really do. Even though we're just strangers, I know firsthand how bad this stuff is, and so I empathize a lot with you.

I would just like you to keep thinking of the things that help and the things that don't. Things that can still bring you some joy, even if small, or at least good memories that you can keep remembering. I think everyone can still revert back to times similar to when they felt happy, and at least for me that thought and those memories kept me going.

Remember too that despite meds being in the same class, they're all still different, and I'm positive that you can find some combination that will help you.

As far as long term AP usage goes: I took Olanzapine for almost 3 years and now I'm a perfectly healthy person. I take Adderall for adhd, lorazepam as needed for anxiety, and Trazodone for sleep, but I can still manage very well without it, and I believe you can get there too. If anything, I can promise you to be here to reply and keep as much company as I can along this journey, and I'm sure others will be glad to give support as well!

That would be really nice for me actually, I need some contacts who understand this sheer level of severity. I have some friends with milder mental health issues, but they can never understand why the things that work for them do not work for me. So for example something that I could use help with is gentle encouragement to try certain meds and not to be scared of them, and then we can keep each other updated about med progress. It might be a bit one-sided to start with, but if you (God forbid) relapse then I will try to reciprocate the support as much as I can.

Just a warning though, I am really unstable and have borderline personality disorder. That can lead to me being sometimes very unpleasant to talk to, and I don't want to cause any stress to anybody due to this. I have one female friend with BPD who tolerates it from me, but not many others can.