Mental Health Diagnosed with bipolar II and need info/advice

[FluidLink]

I'm a 20 year old guy and I've just recently been diagnosed with bipolar II and I have no idea whatsoever if that's the correct diagnosis for me. I have extremely sparse contact with my psychiatrist (once every two months) and haven't been able to get in contact with a psychologist at all. This is a byproduct of me living in a country with a somewhat crippled mental health system, but nevermind that, I've got the internet to help me. 8)

I'm currently taking Litarex (Lithium) 6mmol 1/day (half morning, half evening, to be increased to 2/day) and Venlafaxine 75mg (probably better known as Effexor). I'm switching from Fluoxetine (Prozac) 25mg. I also take 25mg Seroquel for sleep and have now for a while.

I've always been prone to (what I've been told is) hypomania when on antidepressives but never really veered that deep into depression, I've felt like crap and wanted to die for a couple of days here and there and had anxiety issues since I was a kid but I've never considered myself depressed as such. I've been having some mild delusional thinking I guess with constantly thinking my girlfriend is fucking around behind my back (which is bullcrap) but I'm not sure if this is a delusion or obsession or some other fun mental quirk. Anyway she knows I have issues and we're working on it.

So I have a bunch of questions that I was hoping you'd have opinions on / answers to and since I don't want to bore you to death, here's a list with short sentences instead of a huge paragraph for each one. If you need more info or something I'll answer you then and just append it to this post.

1. I used to smoke weed most weekends. I stopped about 2 months ago because I had a really bad bout of paranoia (thought my girlfriend was cheating on me and everyone knew) while high at a party and realized being high hadn't been fun for a while. Will I fuck shit up if I smoke again? (I'm fine with not smoking if that's what it takes to get better)
   
2. What about psychedelics? I've tried a low-dose mushroom trip and that was fun but ever since then I've had a very light case of visual snow, along with sometimes feeling uncomfortable looking at repeating patterns. Is this the time to accept that I'll never be a psychonaut?
   
3. Do you think telling my boss what's going on is a good idea? He's understanding and such but I'm not sure if this will colour his perception. I work as a programmer at a two-man consulting company.
   
4. When should I expect to feel better? How good am I going to feel? Is the anxiety going to go away?
5. I never thought of myself as depressed, isn't that necessary for a bipolar II diagnosis?

I realize that this probably is way too long for anybody to want to read it so here's a
TL;DR: 20m, doc says I have bipolar, put me on meds, I don't know what to do next. Questions in list above.

 

[exists]

1. I used to smoke weed most weekends. I stopped about 2 months ago because I had a really bad bout of paranoia (thought my girlfriend was cheating on me and everyone knew) while high at a party and realized being high hadn't been fun for a while. Will I fuck shit up if I smoke again? (I'm fine with not smoking if that's what it takes to get better)

It would be best if you got your paranoia under control before toking up again. I was forced to quit smoking for 3 years a while back, and during that I time I decided not to care if people were talking behind my back or not. Since then, I have had some intense periods of anxiety and paranoia whilst high on cannabis, but it was because I was smoking way too much on top of drinking alcohol. So you'll never be "in the clear" again, but it doesn't mean you have to abstain from mj forever.

I've found that the best way to avoid pot-induced unpleasantness (short of not toking up at all) is simply to take smaller hits over a longer period of time, when I'm safe at home and not already anxious. There's no rule that says you have to take big hits in order to get high. Taking huge hits makes titrating your dose much more difficult, the high more unpredictable. By taking smaller hits over a period of several hours, you ramp up the high slowly and thus become more able to deal with things as they come, instead of being overwhelmed all at once. Besides that, slow-toking simply produces more euphoria.

So I'd take it very easy. Start small, and if things aren't going well, stop. Find an alternative if you must. Build up your dreaming abilities or something.

Maybe somebody else will chime in to address your other questions.

I hope everything works out for you; keep us updated!

 

[paranoid android]

If you get paranoia and get delusional i would stay away from Cannabis for awile until you get that well under control. It's not worth possibly fueling your illness all for some ganja atleast in my opinion. As for your diagnoses of bipolar 2 delusional thinking and paranoia fit more into bipolar 1 or as is the case with me bipolar NOS with some psychotic features. Most people don't seem to fit into one of the nice little categories anyway so i wouldn't worry about the diagnoses so much as opposed to getting better. But you don't have to get really severe major depression to be diagnosed bipolar 2 and people with hypomania as opposed to full blown mania or mixed states fit into bipolar 2.

Have you talked to your shrink at all about your paranoia and delusional thinking? If you haven't i would bring it up first thing when you see him/her again. The sooner you get that treated the better.

 

[a dream]

(this post is heavy on my personal experience - hope you don't mind)

You say you don't currently have access to a psychologist - can you talk to a therapist, someone without a PhD but still qualified to help? I see a therapist and she only has a masters degree.

What are your current drugs doing for you / how well are they working? What's your history with antidepressant drugs? If you say you aren't very depressed, how did you get started on antidepressants? I highly recommend you research the drugs you're on and read the experiences of others; I've had a few problems in my life that I learned were caused by drug side effects; the professionals didn't figure it out, and I wouldn't have figured out on my own had I not done a lot of research.

I've had pretty bad depression for a long time, and am diagnosed with bipolar I according to my medical records, but the only real (hypo)mania I've had was induced by antidepressants (SSRIs Lexapro, Zoloft, and SNRI Effexor). I don't feel the bipolar diagnosis is correct at all, but I believe bipolar II might be more appropriate. Ultimately it's just a line in a medical record, and all I really care about is getting effective treatment. However, one study has shown that antidepressant-induced mania is similar to bipolar disorder.

I used to smoke weed most weekends. I stopped about 2 months ago because I had a really bad bout of paranoia (thought my girlfriend was cheating on me and everyone knew) while high at a party and realized being high hadn't been fun for a while. Will I fuck shit up if I smoke again? (I'm fine with not smoking if that's what it takes to get better)

This happens to some people. I recommend being careful and avoiding cannabis until you're feeling better. I haven't tried to smoke weed for three months due to one experience with a panic attack/high heart rate. I tried again about a month ago and had the same reaction, even though I was in a much better state of mind - luckily I had Xanax on hand.

Were you on the psych meds when you had the bad weed experience?

What about psychedelics? I've tried a low-dose mushroom trip and that was fun but ever since then I've had a very light case of visual snow, along with sometimes feeling uncomfortable looking at repeating patterns. Is this the time to accept that I'll never be a psychonaut?

Now is definitely not the time to try psychedelics. Fluoxetine or venlafaxine will minimize the effects, and it doesn't seem like you're in the right state of mind for them. I think many people would suggest that those with mental health issues should avoid psychedelics; that hasn't stopped me, but most of my psychedelic experiences since starting treatment for depression haven't been that great.

Do you think telling my boss what's going on is a good idea? He's understanding and such but I'm not sure if this will colour his perception. I work as a programmer at a two-man consulting company.

I think it's a bad idea to tell an employer any details about mental health issues. Many people don't understand mental health very well, and your boss might not have a good idea of what "bipolar" actually means. Where I am, people are protected against discrimination at work due to health issues as long as they are capable of doing their job, but laws may vary. If your work performance is impacted, I recommend starting by just explaining you have a health issue, and you might consider asking for a note/letter from a doctor explaining that you are receiving treatment. However, the relationship you have with your boss is probably different than that of an employee of a bigger company.

I work at a big company and missed a lot of work last year due to depression, and was performing poorly for a few months, and I just explained it to my boss as a "health issue". I offered multiple times to provide documentation, and he said he didn't need any. About a month in to the worst of the depression, he said that if I wasn't doing better in two months that I'd need to consider options such as reduced working hours/disability. I got better, but if I hadn't I would have been able to go on short-term disability and my job would be protected. I think my boss might have figured out that I was depressed, though, since I told him I started getting panic attacks after working two 60 hour weeks in a row, and then started having performance issues due to depression.

When should I expect to feel better? How good am I going to feel? Is the anxiety going to go away?

It's hard to tell. Different people respond differently to treatment. If you find a good combination of drugs, you could feel better in weeks. How you will feel will depend on the medications you are taking and how well they work for you. I'd expect fluoxetine to reduce anxiety, but I'd guess venlafaxine could potentially increase anxiety due to its NRI effects. (previous sentence is just a guess!) Not sure for lithium and Seroquel.

I never thought of myself as depressed, isn't that necessary for a bipolar II diagnosis?

In my opinion the bipolar diagnosis is sometimes applied inappropriately, as I think it's been lazily applied to me.

 

[RobotRipping]

if you aren't regularly depressed and are just prone to hypomania why did you see a psych in the first place?

if it's that you feel mentally unstable then definitely no cannabis for you and i'd certainly avoid psychedelics. From how you describe things you don't' sound like you have bipolar ii but i guess it's impossible for me to say over the internet.

I think i could better answer your questions especially regarding psych use and telling your bosses about your issues, if i knew why you sought out a psychiatrist in the first place.

Just from your post, you just sound a tiny bit insecure which can be fixed without meds no problem. The cannabis just increased that sense of insecurity and led to paranoia, very common and can be fixed by tying up the issues with feeling insecure or inadequate or having low confidence. I had the same problem for a while but i got over it and smoke cannabis without issues now (tho it's not like it used to be).

 

[8ball1234]

Do you feel numb?
like your not depressed but numb to life and unmotivated with little to no energy?
And do you oversleep?
These are signs of depression without the oh i feel so sad and depressed type of depression.

The anxiety could not go away if the meds don't help you. It didn't for me on several different treatments until I was prescribed klonopin which has helped.

I wouldn't smoke weed it increases anxiety and IME stopping it has lowered my overall level of anxiety although I was a daily smoker.

Taking psychedelics is a bad Idea unless ur in a good state of mind trust me from expierence being in a bad state of mind and using psychedelics is a horrible experience and I don't wish that anyone goes through it.