Mental Health Drug abuse and "bipolar disorders"

[It's a baby!]

For those of you who have had serious manic/mixed episodes associated with drug use, did you ever reach a point where you "recovered" with abstinence, say 5+ years with no serious episode and no lithium/depakote/etc?

I've had two "manic breaks". The first one was precipitated by lots of psychedelics and weed. Then I was fine for two or three years but did go back to smoking pot, rationalizing that I only went crazy because I was doing all sorts of other crazy drugs. After two years or so of daily pot use I had a second "manic psychosis". That was three years ago and I've been on lithium ever since. Now I've been trying to stay sober and curious whether I'm actually permanently "unstable" or not.

I know this is not at all an uncommon or special experience. I'm curious what the course has been like for other people with similar stories and I know there are a lot like that here.

I can't find any research that would answer this question. Certainly marijuana use is heavily associated with mania (~1/3 of first episode manic patients test positive for it) and people with a bipolar dx who abstain from substances fare better than those who don't but how common is it for someone with real "bipolar episodes" in the context of pot smoking to make a full recovery from abstaining? How many of them have a "real" mental illness and how many of them are just vulnerable to mania in that context? 60% of people with this diagnosis have a history of serious alcohol problems, 50% problems with different drugs. How many of those people would still have episodes if they could abstain? How often is it the case that substance use just happens to coincide with, or is the trigger for, a mental illness that would have developed anyway, and how often is it that people only experience true "bipolar" episodes when they're using drugs or alcohol every day?

OFC I'm not talking about staying up with a buddy smoking ice for days and seeing shadow people, more about people who are basically normal and functioning but smoke pot and/or drink every day, maybe dabble in other drugs sometimes, and then become manic, the mania lasting for weeks or months and even persisting long after cessation of substance use

 

[Ftmbeachboyz]

My girlfriend gets manic bad no sleep then sycosis

 

[Ftmbeachboyz]

Off lith not a good idea

 

[It's a baby!]

Off lith not a good idea

It's definitely not something you can decide to stop taking suddenly. That might well precipitate a manic episode in anyone. AFAIK the only study of putting "normal" subjects on lithium and withdrawing them only lasted six weeks, but I've read about case studies of epileptics having manic episodes after withdrawing from their meds, which are also used as mood stabilizers.

It does seem to be a common progression though: someone has mania as a young person often with drugs and lots of stress involved, gets put on lithium, goes off of it and becomes more manic than ever due to the drug w/d effect, and then gets told "See? You really need to take this stuff!"

 

[Mafioso]

I'm going to move this thread over to mental health, as it's about mental disorders and their medications.

 

[AlphaMethylPhenyl]

With a proper taper, this sort of thing can be avoided.

Way back when, I went cold turkey from lithium and had no issues to speak of.

Ime, the worst side effect was loss of short-term memory. That said, lithium is both unique (the "gold standard" of mood stabilizers) and can damage the kidneys/liver. This means that if you've been on it a while and it starts to really hurt your organs, you'll have to go off of it despite no real substitute in terms of mechanism. But I had no such issue, and most don't.

 

[Jabberwocky]

My episodes were never induced by drugs. In fact, my mania was actually suppressed when I smoked weed.

Of course it can be a trigger, though. But often times people start doing drugs when they are in a stressful situation already, which may likely be the real trigger, if they in fact have BD.

I am on lamictal and vraylar and haven't had an episode in 2 years.

 

[cosmic charlie]

I've had bi-polar since I was a teenager and it's been a thorn in my side ever since. Been on Lamictal for many years and it definetly helps because when I'm off it I shortly go manic or extremely depressed to the point it's a danger to my safety. And to answer your question, yes I use drugs on a daily basis. Been addicted to opioids for the majority of my life and habitually use Cannabis. Also take psychedelics on a weekly or bi-weekly basis.

Does it make the situation worse, not in my opinion. I was still batshit crazy at times when I was sober in prison for a few years. I find tripping to pull me out of the depression very quickly, pretty much instantly. But it has triggered a manic state a few times where I would stop sleeping for a week and drive my girlfriend up the wall. But I refuse to stop using drugs until my heart stops beating. I've been in a love affair with psychedelics for 20 years and like I said it helps more than hurts.

The down states are more common for me and I'll burst into tears at the slightest thing. Start having suicidal ideation and whatnot. But taking the Lamictal helps me so much and I can never try and come off it because it gets so bad, I've promised her i never will again. I used to be on Lithium and Depekote at different times also and stopped taking them because of all the health risks.

The opioids help keep me calm and sort of numb and hence I've always been drawn to them. I actually stopped the Cannabis this past week tho because it started giving me terrible anxiety and i was truly abusing the plant. But I'm in a period of heavy psychedelic use right now and been tripping every week for months. I'm also feeling really well for the most part but had to reduce my hours at work because I started getting very stressed and could sense I was on the verge of snapping. I personally feel that if I continue with the medication i will be fine, but I could just be lying to myself cause I'm a drug addict who refuses to let go.

I'm miserable when I don't get high. Psychedelics pulled me from the brink. It's a roll of the dice for sure and could have the opposite effect on people. My mental illness got much worse in my 20's. Which is also when I began pushing the limits of the psychedelic experience. Could that be related, who knows. Bur deep in my heart I feel like they heal me and I'll continue on my path of transcendence to higher levels of consciousness. I'm in no way promoting people that suffer with bi-polar to do drugs, just sharing my own personal experience.

 

[It's a baby!]

I've had bi-polar since I was a teenager and it's been a thorn in my side ever since. Been on Lamictal for many years and it definetly helps because when I'm off it I shortly go manic or extremely depressed to the point it's a danger to my safety. And to answer your question, yes I use drugs on a daily basis. Been addicted to opioids for the majority of my life and habitually use Cannabis. Also take psychedelics on a weekly or bi-weekly basis.

Does it make the situation worse, not in my opinion. I was still batshit crazy at times when I was sober in prison for a few years. I find tripping to pull me out of the depression very quickly, pretty much instantly. But it has triggered a manic state a few times where I would stop sleeping for a week and drive my girlfriend up the wall. But I refuse to stop using drugs until my heart stops beating. I've been in a love affair with psychedelics for 20 years and like I said it helps more than hurts.

The down states are more common for me and I'll burst into tears at the slightest thing. Start having suicidal ideation and whatnot. But taking the Lamictal helps me so much and I can never try and come off it because it gets so bad, I've promised her i never will again. I used to be on Lithium and Depekote at different times also and stopped taking them because of all the health risks.

The opioids help keep me calm and sort of numb and hence I've always been drawn to them. I actually stopped the Cannabis this past week tho because it started giving me terrible anxiety and i was truly abusing the plant. But I'm in a period of heavy psychedelic use right now and been tripping every week for months. I'm also feeling really well for the most part but had to reduce my hours at work because I started getting very stressed and could sense I was on the verge of snapping. I personally feel that if I continue with the medication i will be fine, but I could just be lying to myself cause I'm a drug addict who refuses to let go.

I'm miserable when I don't get high. Psychedelics pulled me from the brink. It's a roll of the dice for sure and could have the opposite effect on people. My mental illness got much worse in my 20's. Which is also when I began pushing the limits of the psychedelic experience. Could that be related, who knows. Bur deep in my heart I feel like they heal me and I'll continue on my path of transcendence to higher levels of consciousness. I'm in no way promoting people that suffer with bi-polar to do drugs, just sharing my own personal experience.

Thanks for sharing your experience. It doesn't sound extremely dissimilar to mine though I'm scared to trip and probably won't ever again, and ever since my first mania I've had more ups than downs. So far I haven't gotten high or drunk in several months but the springtime crazy is definitely kicking in like normal. It's times like this that I actually feel lithium, it pulls me back when I've gone a night without sleep or feel like things are really flying high, as opposed to spiraling totally out of control as has happened when I wasn't on any meds and ended up in the hospital.

Of all the drugs I've done I've found opiates the most "useful" for mania. They'll get me to sleep 9-10 hours easily and often interrupt the cycle entirely for a week or even a month just by inducing such good sleep.

This is the first time I've had a psych episode and not at least used alcohol to calm down and sleep. Should be interesting (will it be crazier? Will it be less crazy? How will I sleep? etc) But now that it's kicked in and I've satisfied myself that I do, in fact, have a "psych problem" that will probably continue to crop up throughout my life whether or not I get high and drunk I'll probably check out of the thread.

FWIW for any fellow "crazy people" I think lithium has a worse reputation than it deserves. It's a powerful drug but there is a massive variation in its effects at different doses. The difference between a dose that's neurotoxic, a dose that's stabilizing but has deleterious effects on cognition and personality, an effective dose where you'll still have some cycling but be able to function and not feel like you're "on meds", and an ineffective dose is very very small. The difference between each of those "steps" on the lithium staircase is only about 200mg of carbonate for me. Serum concentrations matter a lot: 1.2+mmol/L is risking toxicity, 0.8-1.2 mmol/L is noticeably blunting for me, 0.6-0.8 is the sweet spot, and I hope that with sobriety/lifestyle changes I can get down to 0.4-0.6. I was very lucky to land a resident psychiatrist at a public pauper hospital willing to do this sort of fine-tuning as many psychiatrists IME would not have given a crap and would have tried to convince me to take more meds rather than fewer... I also like that it's a natural mineral. Any manic depressive worth his "salt" sometimes thinks he's some sort of shaman/mystic/witch/prophet. The Taoist alchemists used toxic minerals like stibinium, antimony, cinnabar, and lead to alter their consciousness all the time, so why not lithium? And I wouldn't want anyone to think that I think that there's anything wrong with using street drugs and alcohol, either, necessarily, I'm just experimenting with sobriety for my own reasons, to see what my brain is like with nothing but a little lithium caffeine and nicotine in it.

I once read a naturalistic study of the records of 500 Iowa manic depressives from the 1930s and 40s, when most were treated only with barbiturates or nothing at at all. 15% committed suicide and 20% died while institutionalized of mania - cardiovascular collapse from constant motion and agitation and sleep deprivation for weeks and months and sometimes years. I don't think everyone who has this diagnosis needs to take meds for their entire lives but I'm glad there are somewhat effective mood stabilizers out there now.

 

[Hezman94]

If i take a tiny dose of uppers it sends me irritable manic, was up for 30hours off 100mg amphetamine of street most people take like .3 ,5, i even took diazepam 40mg and that only stopped the anxiety.
And makes e get horrible violent thougts , cannabis helps me better whe i microdose, opiates help but the withdrawal not worth it and i feel its took away most my interests