Mental Health Bipolar 2 & ADD

[T1gersxjaw]

Hello, Bluelight!
I recently remembered my password, and had some important questions.

Firstly, some backstory:
I am a 19 year old freshman in college. I had a pretty rough high school experience, really characterized by struggles with mental illness.
I have been on the majority of SSRI's available, anti psychotics such as Latuda and Abilify, Lithium, SNRI's--the point I'm making is I've been on quite a few medications.
I am diagnosed bipolar 2, although I am not entirely certain about this diagnosis. Frankly, sometimes I agree with it, sometimes I don't. It's tough because of the substance abuse mixed in throughout the years, potentially affecting the way medications would work, I guess. The drugs I was abusing were for the most part prescription meds, with some fairly heavy daily xanax use at my worst.
After things essentially climaxed my junior-senior year of highschool, I found myself in an inpatient facility, and eventually was put on a regiment consisting of Latuda, Lithium, Effexor, Klonopin, and Ambien.

I stabilized, even though I felt like a zombie, and things have improved somewhat since.
I am now thousands of miles away from my home, and have no parents to bust me over drug use.
I use my klonopin as directed, because without it, I am a walking entity of anxiety.
I have experimented with adderall, vyvanse, dexedrine, etc. and have found that in combination with my anxiety meds, I function very well.
I had been tested many years ago for ADD, and the results as I recall were 'inconclusive,' my pscyh saying it could be 50/50 so I was put on concerta. That was around the time the climax happened, and I was taken off it for abusing it.

If I find that I function very well on 20-40mg vyvanse, and .5-1mg Klonopin, are there psychs out there who prescribe the combination, with a bipolar 2 diagnosis?
I have heard conflicting things about whether or not psychs will even prescribe it.

Thanks for the help, and I apologize if the post is a little disorganized.

 

[silverwheel]

What's your mania like? That's the real difference between Bipolars 1 and 2 - if you've had a true manic episode that last for longer than 7 consecutive days, then you're Bipolar 1. Bipolar 2's don't have that degree of mania, and tend to cycle more rapidly.

Don't go into a doctor requesting specific meds, especially if you have a history of abusing prescription drugs. Since there's some substance abuse mixed in with your bipolar and possible ADD, a doctor who specializes in Dual Diagnoses would be the best place to start. They would be good at treating both aspects, and will likely want to have you on something that doesn't have much abuse potential. Share your experiences and what's worked/not worked (always best to be truthful about your experience), but don't go in expecting to get a specific combination. Not to mention that some of your previous meds may work much better without substance abuse mixed into the picture. The heavy xanax use can definitely negate whatever benefit you might have gotten from your previous prescriptions.

Now that you're far away from home, do you trust yourself to stay away from substance abuse? It's okay if you don't, just be honest about where you are with that question.

 

[T1gersxjaw]

Hi silverwheel,

Thank you for the quick response!

I do not get bad mania. That's why I'm still a bit unsure of the diagnosis.
When my doctors explained Bipolar 2 to me, they explained to me what hypomania is--and after reading into it more, it only added to my confusion.
I have never had what I would perceive as a full blown manic episode. I have pretty severe insomnia, and have more of an artistic personality, and I do often go through very creative periods where I function on low sleep, but it has never seemed to be really severe. The only time I have experienced anything close was a week I was under heavy stress and could not sleep at all, and talked much faster, read more, wrote more, etc. but... that was in combination with some tramadol.

Frankly, I feel like I've fucked myself over, over the years. In regards to the cycling, I believe the reason I was slapped with the BP2 diagnosis was because I go through long, long periods of severe depression. That has always been the main issue. I am aware that many mental health problems have overlapping symptoms, and I sometimes feel it could be multiple things. The anxiety and depression have been crippling at times, though. I was homeschooled for a period of time and put it in a hospital.

When I was admitted inpatient, I gave them a pretty complete list of my substance abuse. I have never been addicted to a drug, but the list was pretty extensive, for my age at least, and they recommended a rehab center. My parents disagreed with this and gave me another chance, and I was also put on the plethora of medications that were mentioned above, and I never had to go. I moved away to college and am still currently on 1mg of Klonopin, 10mg ambien, and 600mg gabapentin 4 times a day.

I have done really well not abusing my klonopin, and no longer want to ever take xanax again. I am not a fan of stimulants, aside from cocaine on a rare occasion, and a low dose of vyvanse is not something I'd be worried for, for myself. But my psych would most likely be skeptical.
My biggest issue currently, if I'm properly medicated, is motivation. Being a freshman in college, I've done well, but it's mainly been a lot of cramming and procrastination. Luckily, I've pulled it off for now, but I fear for the future.

I guess I'm really wondering,
1. Are doctors willing to prescribe ADD medicine to somebody who is biploar 2? I know it can induce mania, so I'm wondering if any doctors even do that.
and 2. I am still considering switching medicine and trying something new, but the vast, vast majority of medicines I have tried have either not helped, or negatively affected my life. I am hesitant to try and switch things up, because klonopin has really been a gift from god for my anxiety. It allows me to function. Is there any good ways to approach a doctor about this? Should I see a new psychiatrist?

Thank you, sorry for the lengthy post

T1gersxjaw

 

[silverwheel]

It sure sounds like you're a bipolar 2. Bipolar 2's often only get diagnoses after multiple episodes because, in its depths, it's often indistinguishable from regular style severe depression (this is why bipolar 2's have a much higher suicide rate than the 1's - we usually don't get properly diagnosed at first because real mania is much more recognizable).

I honestly can't answer the first question because I don't know you and what you go through. A lot of it depends on getting a firm diagnosis one way or the other regarding ADD. The procrastination/cramming cycle probably has more to do with bipolar than possible ADD. And you're right that it's probably not a sustainable way of going through college. As for the second question, be honest that the klonopin helps you a lot, and you're not sure about the other two. I just don't want you to get labeled as a drug-seeker, so don't be pushy about it. Some doctors will be willing to give you an honest chance, and some may not.

To what degree does the ambien and the gabapentin help you? I found out the hard way that I'm severely allergic to gabapentin, so I only know of it in the most abstract sense. It's possible that your anxiety may improve with something that helps your sleep. Seroquel and Remeron are two medicines that can possibly help with both. I'm prone to severe sleep disturbances from my fibromyalgia, and Remeron has been a wonder drug for me on that front - not just getting to sleep, but good REM sleep. Since you're being good with the Klonopin, I doubt that a doctor would immediately want to get you off of that, but he/she may want to try you on something that may make the Kpin not necessary, so be open to that if it gets recommended.

 

[Mmp85]

Some doctors are more liberal about medication. If you have a psychiatrist that really listens to you and isn't just there to write scripts they're more likely to work with you.
I'm bipolar 1 which is the more manic side and also ADD and take Adderal. Which I'm sure a lot of doctors wouldn't do but but my doctor understands how hard it would be to work and function if I couldn't focus and well I need to be able to work and function so I don't go all bipolar nuts.

 

[Mmp85]

Although as a disclaimer I was diagnosed ADD before the bipolar so they knew my reaction to ADD meds and knew I had a history.