Mental Health Bipolar getting me down

[Eligiu]

I used to have bipolar type 2 and my psychiatrist told me if I remained medication non compliant it would turn into type 1 as mine was rapid cycling or something idk. Anyway I'd been off mood stabilisers since mid 2019 (as we explored an autism diagnosis and to check if my bipolar had actually been drug induced) and only on lurasidone since early 2020, which worked really well (should have been my first clue, since it's only prescribed for bipolar 1 depression)

In November 2020 I started sleeping far less than normal, only around 5-6 hours a night when my average is 10-12. And I wasn't tired. I suddenly had a burst of energy. I figured I was just coming out of the winter haze and was having a few good weeks. I figured maybe my normal regular 'semi depressed' mood had lifted temporarily.

Restrospectively, all the signs were there. I racked up about $1000 buying tattoos and second hand clothes, having unprotected sex with loads of people (very unusual for me to even have sex at all with loads of people), driving recklessly because I thought I was untouchable, had a massive excess of energy (going to the gym for 2.5-3 hours) and managing to work 70 hour fortnights when my average due to disability is 10. I also got prescribed Ambien to help me sleep which did nothing, and eventually downed 100 klonopin in 2 days without much effect.

Eventually I found out someone I used to he very close to died suddenly, and I felt absolutely nothing. This guy had been a mentor and father figure to me and I couldn't care less. I just didn't give a shit.

Eventually the euphoria made way to irritation and I got into 3 huge arguments with friends (which were all later resolved following me explaining I'd been manic for 3 months and a few days later apologising profusely). They were all more concerned about me being stable again than what I'd done. The moment of realisation came when I went to talk to another friend about these arguments and I just pressure talked straight at him for 2 whole hour's and he couldn't get a single word in. He eventually stopped me and was like 'eli I think you might be manic' and I was like 'i think you're stupid' then dropped him home and went to work. At work I realised he was right, I was manic.

I got dose the fuck out with 100mg Seroquel 3x per day for 14 days and by day 5 the mania started to subside. I went back onto mood stabilisers.

My prior episode was a depression lasting 2-3 months as well, clinical. Sleeping 18 hours a day, only getting out of bed to piss, drink a yoghurt, work a 2 hour shift, and come home. Really shitty. Took me ages to realise what was happening too.

With the NDIS support I'll be getting they'll be making a Positive Behaviour Support Plan and training all my support workers in recognising 'behaviours of concern' which will include recognising early signs of manic or depressive episodes, which I'm hopeful about as I see support workers once a day on average and with everyone doing shift notes, something SHOULD get picked up on.

It's just I realised the other day that I lost 1/4 of my year every year to crippling depression or the false high of a manic episode with disastrous consequences. That's a whole 1/4 of my entire life, gone to mental illness. And it happens even when I'm medicated.

And it's like, I just gotta wait, constantly worried about the next episode. The depression last year idk what triggered it, could have been anything. The manic episode was triggered by a hormonal imbalance. This year's depression was triggered by stimulant withdrawal.

It's just so fucked when I have episodes that aren't even my fault. And I'm so sick of people being like 'we get you you out of the shitty situations you get yourself in to' like dude, how was the hormone imbalance or the prescribed stimulants withdrawal my fault? Sometimes it just happens despite me doing everything right, if I'd been non compliant the whole time I'd agree that my episodes would be super annoying because I'd be contributing to it (even though that is a symptom of bipolar I do have - where once you feel better you think you never had it to begin with and I struggle with it every day).

I just want to be normal. I hate this stupid mental illness and how much it fluctuates because my behaviour during a mood episode ISNT ME but I still cop the blame even when I'm in psychosis and delusional. Even when I do the right thing and admit myself shit is still my fault. I don't like having episodes, it sucks. Bipolar sucks so bad. It just steals your life from you and you can't get it back and you just have to wait for everything to go wrong again.

I thought I'd be so much better now that I take my medication but I'm so bummed out that I still had an episode. How do other people deal with this?

 

[n3ophy7e]

Hey, thanks for sharing all of that with us

With the NDIS support I'll be getting they'll be making a Positive Behaviour Support Plan and training all my support workers in recognising 'behaviours of concern' which will include recognising early signs of manic or depressive episodes, which I'm hopeful about as I see support workers once a day on average and with everyone doing shift notes, something SHOULD get picked up on.

You're in Australia? Me too. We are SO fucking lucky to have the healthcare system that we have. Although it might not feel like it sometimes, in comparison to a lot of other countries, we have it pretty good here. Definitely make the most of what you can get through the NDIS

As for the rest of your post, I'll leave that to others to comment, as I don't have bipolar.

 

[Jabberwocky]

I had Type I BP from the get go and it involved some pretty out there delusional manic episodes before I was diagnosed and medicated. I stayed medication compliant for almost 7 years with a break in the middle. However, there were quite a few developments/changes/trials with medications over that period. I stopped taking my main medication for bipolar about 12 months ago (but did hop back on it for a month or so a while back to deal with what I thought was a crisis).

Looking back I believe undiagnosed BP led me to a range of behaviours over time that set me up for an epic life-crisis (bankruptcy, divorce, unemployment and lots more all raining down on me at once seemingly (to me) out of nowhere. At that point I definitely needed medication to stabilise me. However, talking to my parents recently they wondered if perhaps I’d been ‘stabilised’ for far too long and lost my direction and motivation in life because I was so massively focussed on ‘being well’ and not ‘having another episode’.

I think there is some truth in that. Psychiatry never has a plan to get you off medication for conditions they perceive as neurologically structural in large part and therefore permanent. However, there is emerging evidence that the neuroplastic effects of certain bi-polar meds may change the malignant structures of the brain over time such that certain forms of psychosis (and mania) become far less likely to re-occur even after the medication has been stopped.

I certainly feel that many of the psychiatric issues I had before 7 years of supposedly prophylactic pharmaceutical treatment are no longer there. Consequently I wonder if I could have gotten free of the meds much earlier.

 

[Jerry Atrick]

I used to have bipolar type 2 and my psychiatrist told me if I remained medication non compliant it would turn into type 1 as mine was rapid cycling or something idk. Anyway I'd been off mood stabilisers since mid 2019 (as we explored an autism diagnosis and to check if my bipolar had actually been drug induced) and only on lurasidone since early 2020, which worked really well (should have been my first clue, since it's only prescribed for bipolar 1 depression)

In November 2020 I started sleeping far less than normal, only around 5-6 hours a night when my average is 10-12. And I wasn't tired. I suddenly had a burst of energy. I figured I was just coming out of the winter haze and was having a few good weeks. I figured maybe my normal regular 'semi depressed' mood had lifted temporarily.

Restrospectively, all the signs were there. I racked up about $1000 buying tattoos and second hand clothes, having unprotected sex with loads of people (very unusual for me to even have sex at all with loads of people), driving recklessly because I thought I was untouchable, had a massive excess of energy (going to the gym for 2.5-3 hours) and managing to work 70 hour fortnights when my average due to disability is 10. I also got prescribed Ambien to help me sleep which did nothing, and eventually downed 100 klonopin in 2 days without much effect.

Eventually I found out someone I used to he very close to died suddenly, and I felt absolutely nothing. This guy had been a mentor and father figure to me and I couldn't care less. I just didn't give a shit.

Eventually the euphoria made way to irritation and I got into 3 huge arguments with friends (which were all later resolved following me explaining I'd been manic for 3 months and a few days later apologising profusely). They were all more concerned about me being stable again than what I'd done. The moment of realisation came when I went to talk to another friend about these arguments and I just pressure talked straight at him for 2 whole hour's and he couldn't get a single word in. He eventually stopped me and was like 'eli I think you might be manic' and I was like 'i think you're stupid' then dropped him home and went to work. At work I realised he was right, I was manic.

I got dose the fuck out with 100mg Seroquel 3x per day for 14 days and by day 5 the mania started to subside. I went back onto mood stabilisers.

My prior episode was a depression lasting 2-3 months as well, clinical. Sleeping 18 hours a day, only getting out of bed to piss, drink a yoghurt, work a 2 hour shift, and come home. Really shitty. Took me ages to realise what was happening too.

With the NDIS support I'll be getting they'll be making a Positive Behaviour Support Plan and training all my support workers in recognising 'behaviours of concern' which will include recognising early signs of manic or depressive episodes, which I'm hopeful about as I see support workers once a day on average and with everyone doing shift notes, something SHOULD get picked up on.

It's just I realised the other day that I lost 1/4 of my year every year to crippling depression or the false high of a manic episode with disastrous consequences. That's a whole 1/4 of my entire life, gone to mental illness. And it happens even when I'm medicated.

And it's like, I just gotta wait, constantly worried about the next episode. The depression last year idk what triggered it, could have been anything. The manic episode was triggered by a hormonal imbalance. This year's depression was triggered by stimulant withdrawal.

It's just so fucked when I have episodes that aren't even my fault. And I'm so sick of people being like 'we get you you out of the shitty situations you get yourself in to' like dude, how was the hormone imbalance or the prescribed stimulants withdrawal my fault? Sometimes it just happens despite me doing everything right, if I'd been non compliant the whole time I'd agree that my episodes would be super annoying because I'd be contributing to it (even though that is a symptom of bipolar I do have - where once you feel better you think you never had it to begin with and I struggle with it every day).

I just want to be normal. I hate this stupid mental illness and how much it fluctuates because my behaviour during a mood episode ISNT ME but I still cop the blame even when I'm in psychosis and delusional. Even when I do the right thing and admit myself shit is still my fault. I don't like having episodes, it sucks. Bipolar sucks so bad. It just steals your life from you and you can't get it back and you just have to wait for everything to go wrong again.

I thought I'd be so much better now that I take my medication but I'm so bummed out that I still had an episode. How do other people deal with this?

@Eligiu Hey man, I feel for you and I've been there. I have eventually got the diagnosis of schizoaffective disorder due to a prolonged psychosis, but it started off as a bipolar diagnosis and now I am considered to have both. During my first main manic episode, I got two DWIs and was separately arrested for fighting (self defense) all within 3 months. I was spiraling out of control and driving on a suspended license after my first DWI. Quit my decent full time job to go to a music festival and later on, since I didn't know what was happening to me, attempted suicide. A couple of years later, off meds and manic again, I blew off everyone and lived a homeless lifestyle for a few months, experimenting with harder drugs than I'd previously tried.

During the in between times I would be depressed as hell and sleep like 12 hours a day. Once it got so bad I ended up catatonic where I quit eating and communicating and just lay in bed 24 hours a day as if in a coma. I vaguely remember the experience and it was like being trapped in a glass box where I was aware of things going on around me, but not able to respond or take action.

The best I can say is to take your meds as prescribed and maintain communication with your treatment team. With the help of a series of psychiatrists, I was able to find a couple of medications that leveled out the rollercoaster. No more ups and downs, just a steady paced boring life.

I had Type I BP from the get go and it involved some pretty out there delusional manic episodes before I was diagnosed and medicated. I stayed medication compliant for almost 7 years with a break in the middle. However, there were quite a few developments/changes/trials with medications over that period. I stopped taking my main medication for bipolar about 12 months ago (but did hop back on it for a month or so a while back to deal with what I thought was a crisis).

Looking back I believe undiagnosed BP led me to a range of behaviours over time that set me up for an epic life-crisis (bankruptcy, divorce, unemployment and lots more all raining down on me at once seemingly (to me) out of nowhere. At that point I definitely needed medication to stabilise me. However, talking to my parents recently they wondered if perhaps I’d been ‘stabilised’ for far too long and lost my direction and motivation in life because I was so massively focussed on ‘being well’ and not ‘having another episode’.

I think there is some truth in that. Psychiatry never has a plan to get you off medication for conditions they perceive as neurologically structural in large part and therefore permanent. However, there is emerging evidence that the neuroplastic effects of certain bi-polar meds may change the malignant structures of the brain over time such that certain forms of psychosis (and mania) become far less likely to re-occur even after the medication has been stopped.

I certainly feel that many of the psychiatric issues I had before 7 years of supposedly prophylactic pharmaceutical treatment are no longer there. Consequently I wonder if I could have gotten free of the meds much earlier.

Hey @Perforated, it was a different thread but I think it was you who mentioned a term with which to ask your psychiatrist if he believes in it and if not, to find a new psychiatrist. For the life of me, I can't find the thread and I can't remember the term. I think it had something to do with what you mentioned above, which was that once an anti-psychotic has been effective for a while, the brain adjusts and one can taper off and remain AP free. Was it you who said that? And if so, what was the term you used?

I have an appointment with my psychiatrist next week and I want to ask him about it. Thanks!

 

[Jabberwocky]

Hey @Perforated, it was a different thread but I think it was you who mentioned a term with which to ask your psychiatrist if he believes in it and if not, to find a new psychiatrist. For the life of me, I can't find the thread and I can't remember the term. I think it had something to do with what you mentioned above, which was that once an anti-psychotic has been effective for a while, the brain adjusts and one can taper off and remain AP free. Was it you who said that? And if so, what was the term you used?

I have an appointment with my psychiatrist next week and I want to ask him about it. Thanks!

Hi Jerry. Is the term you are thinking of “neuroplasticity” or maybe “neurogenesis”? They kind of mean the same thing. Basically it is the idea that taking a neuroleptic drug can lead to permanent or semi-permanent changes in the structure of the brain. For example, the new growth, the re-growth, or the death of neurones in specific regions of the brain. There is a lot of evidence that it occurs and as techniques like PET imaging or nuclear imaging. This article gives an overview: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4709757/

This article explains how this is thought to work in the case of Abilify: https://link.springer.com/article/10.1007/s40263-015-0278-3

 

[Eligiu]

Hey, thanks for sharing all of that with us


You're in Australia? Me too. We are SO fucking lucky to have the healthcare system that we have. Although it might not feel like it sometimes, in comparison to a lot of other countries, we have it pretty good here. Definitely make the most of what you can get through the NDIS

As for the rest of your post, I'll leave that to others to comment, as I don't have bipolar.

Thanks for replying. I am grateful to have the NDIS even if my plan isn't anywhere near what it's supposed to be. It's about 50% funded and I also have to officially add my bipolar and complex trauma (which they fucked up last week by giving the NDIA the wrong report which described me on my best day, not my worst day). So my funding should, even just with level 3 autism be around $150,000 a year and that's including the stuff for the positive behaviour support plan, which I can't believe I didn't originally get.

@Eligiu Hey man, I feel for you and I've been there. I have eventually got the diagnosis of schizoaffective disorder due to a prolonged psychosis, but it started off as a bipolar diagnosis and now I am considered to have both. During my first main manic episode, I got two DWIs and was separately arrested for fighting (self defense) all within 3 months. I was spiraling out of control and driving on a suspended license after my first DWI. Quit my decent full time job to go to a music festival and later on, since I didn't know what was happening to me, attempted suicide. A couple of years later, off meds and manic again, I blew off everyone and lived a homeless lifestyle for a few months, experimenting with harder drugs than I'd previously tried.

During the in between times I would be depressed as hell and sleep like 12 hours a day. Once it got so bad I ended up catatonic where I quit eating and communicating and just lay in bed 24 hours a day as if in a coma. I vaguely remember the experience and it was like being trapped in a glass box where I was aware of things going on around me, but not able to respond or take action.

The best I can say is to take your meds as prescribed and maintain communication with your treatment team. With the help of a series of psychiatrists, I was able to find a couple of medications that leveled out the rollercoaster. No more ups and downs, just a steady paced boring life.

Hey @Perforated, it was a different thread but I think it was you who mentioned a term with which to ask your psychiatrist if he believes in it and if not, to find a new psychiatrist. For the life of me, I can't find the thread and I can't remember the term. I think it had something to do with what you mentioned above, which was that once an anti-psychotic has been effective for a while, the brain adjusts and one can taper off and remain AP free. Was it you who said that? And if so, what was the term you used?

I have an appointment with my psychiatrist next week and I want to ask him about it. Thanks!

Yeah when I was depressed/am depressed it's just fucked. I literally cannot do anything at all and I can't function. I'm struggling hard now because my disability employment provider keeps asking me to work more hours and I'm like I CAN'T, I DON'T HAVE THE ENERGY because I'm still massively depressed.

What really shits me is the 'I don't think I'm sick anymore so now I will stop my meds' crap that I always do.

 

[Jerry Atrick]

Hi Jerry. Is the term you are thinking of “neuroplasticity” or maybe “neurogenesis”? They kind of mean the same thing. Basically it is the idea that taking a neuroleptic drug can lead to permanent or semi-permanent changes in the structure of the brain. For example, the new growth, the re-growth, or the death of neurones in specific regions of the brain. There is a lot of evidence that it occurs and as techniques like PET imaging or nuclear imaging. This article gives an overview: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4709757/

This article explains how this is thought to work in the case of Abilify: https://link.springer.com/article/10.1007/s40263-015-0278-3

Who are you and what did you do to Perforated?

Assuming you made a name change. Thanks for the articles, man! I think it was neuroplasticity that I read about on here somewhere recently. I read the Abilify article and am still digesting it. While the article was very informative on a medication I've been taking on maximum dosage for over a decade, I don't recall reading anything about the phenomenon of neuroplasticity (or neurogenesis). The article seemed to focus on all the ways the medication works and why it's unique compared to other APs. All good stuff.

I admit I only skimmed the other article but it seemed to focus on brain injury rather than mental illness or schizophrenia. If I need to I guess I can read the fMRI article more completely in order to triangulate the ideas from both articles. Thanks again for sharing! It's been awhile since I read anything academic-related, so I might read the fMRI article tomorrow.

 

[Jerry Atrick]

What really shits me is the 'I don't think I'm sick anymore so now I will stop my meds' crap that I always do.

^^ That's the exact thinking that used to get me off the rails and eventually back into a psych ward.

The neuroplasticity thing Perforated/Jabberwocky was talking about is interesting but might just be unique to Abilify. He said he was on Abilify for ~7 years and was able to safely taper off due to the changes it made to his brain. It gives hope to people like us who may not want to be on APs forever. If I do consider changing anything about my current medication regimen, I will still only do it under the supervision of a psychiatrist. And if it's not possible or feasible, I have long ago resigned to the fact that I might just have to pop a couple of pills every day for the rest of my life. I'm okay with that.