Hello all. I usually post in the drug sections but I've found solace here on Mental Health so I figured I should share what has helped me. Bipolar 2 here but with ultra-rapid cycling and I'm almost as prone to mixed phases as I am to purely hypomanic ones. I'm also diagnosed with BPD (and a laundry list more) and I think that speeds up the swells and makes them bounce around a lot faster, but that's just my hypothesis.
Like a bunch of other people in this thread I've had good results from Lamotrigine. I was on 250mg/day for a long time but after a particularly bad episode my doctor decided to raise it. I'm on 350mg/day now and I have to say the difference is pretty remarkable. The way it was described to me by another prescibee (I'm making that a word) was that if mood was measured 1-10, 1 being suicidally depressed and 10 being dangerously (hypo)manic; A lot of the meds I've tried (antidepressants, antipsychs) seem to block basically everything except 4, 5 & 6. The Lamotrigine seems to successfully knock out 1 and 10 respectively, but I can still feel all the normal range of emotions between. I do still get full swells occasionally, they just seem to be fewer and farther between, and not quite as dangerous when they happen. I haven't been nearly as self-destructive, though there are other factors at play though*.
The one antipsych I consider an absolute necessity in MY medicine cabinet though is Olanzapine. I prefer it to Quetiapine because it kicks in way faster (under 45min), whereas Quetiapines 1-2 hours leaves more room for danger, but I know that most people prefer Quetiapine.
I almost never use the Olanzapine though. It's only for when I am in a fully hypomanic phase and I realize I've been awake for 40 hours, eaten exactly 1/2 of a sandwich, and still think I'm the smartest person on Earth, or when I'm in a mixed phase and am literally putting together a suicide plan. But in those times it is the ONLY thing that will shut off my brain. I have an Rx for Diazepam, and live in a medical marijuana state, both of which help slow me down during less intense swells, but when shit hits the fan they don't do anything. But 5mg Olanzapine will shut down any suicidal thoughts, any sense of being better than anyone else, and ensure that I NEED to eat and then immediately sleep. I'll take another 2.5mg the next day, and maybe a day or 2 after that just to make sure the cycle fades completely before I take back the reigns myself. Those few days are always a boring blur where I don't get anything done and don't really enjoy anything (trapped between 4-6) but if I was at a 1 or 10 that's what needs to happen.
*I've been practicing DBT a lot and I find it extremely helpful in managing certain lesser symptoms. Specifically "opposite action" helps me be productive during depressive cycles. It's really fucking hard to convince myself to cook dinner when all I want to do is order Chinese food and feel sorry for myself, but as many of you know laziness usually only exacerbates itself in depressive cycles. During hypomanic phases I use mindfulness exercises to try and measure whether or not I actually am hypomanic or just feeling uncharacteristically optimistic. Simply the act of putting a few minutes between impulse and action to consider what my motives are for that action has really helped me catch myself before I make regrettable choices.