Passion, I went into the hospital ONLY for a chronic suicidal depressed episode. (lasting 5 months) I was not at all manic. I was in a manic episode during the summer then crashed from one day to the next into a severe depressed episode. When i crashed into the depression in Sept. i ended up missing 2 therapy appts at the crap clinic i used to go to, so they dropped me out of no where with a letter in the mail. Result: no more meds. I was on effexor, lamictal and topomax at high doses. Luckily i had enough to wean myself off slowly so as to not experience the withdrawal symptoms. I never intended to go off meds or stop receiving care. They have a strict policy at this clinic that if you miss 3 appts, you get dropped. It was the new 20 something yr. old therapist i just started seeing that closed my case. The idiots at this clinic didn't realize that it takes 4-6 weeks to get into another local clinic. By then, i was so crippled by the depression and became house bound that i no longer cared or was in a proper mind frame to find help. I just kept telling myself, when the depression episode passes, i'll go and find a new clinic etc. I was in that state where even making a phone call was insurmountable. Anyway, after a few months of depression hell, i attempted suicide for the first time. Was taken to a local crap hospital, put on wellbutrin, topomax, lamitcal and i can't remember what else. I think it was the lamictal that started to bring me out of it because i consider the other 2 meds useless. Anyway, i believe they released me prematurely because one week later, the depressive symptoms hit me again. I started going to another clinic referred by the hospital, but the dr. there seemed like he just got out of med school and inexperienced. The idiot took me off lamictal because i told him my acne was coming back---he thought it was a rash...i explained i was on lamictal for yrs before this and that it was acne and not a rash. Anyway, as my depression worsened, he kept changing my anti-depressants and i had to keep starting from scratch. I ended up back in the same hole and feeling suicidal again and a friend suggested i leave the county and go to another hospital. Thank god i did because the care there was 10,000 times better.

Sorry for the long story...but to answer your question: Yes, the lithium alone was what lifted the depressive symptoms which i didn't expect since it's often given for manic states even though it's, of course, a mood stabilizer which works for both. I was very surprised when the doc there wanted to take me off anti-depressants and not give me any at all. She even took me off trammadol which i was taking to sleep since it had AD properties. Keep in mind, i've been on AD's with a mood stabilizer for all these yrs. since diagnosed, but she was really against AD's for bipolars and believed it was the reason it keeps us going up and down,(more so than usual) not to mention the potential side effects such as anxiety etc. I've read about the manic-switch prior to this and met another person with bp whose pdoc agreed was of the same mind set as my pdoc at hospital, but i just found it hard to believe that a mood stabilizer alone would lift my depression, but it actually did and my depression was pretty severe.

So far it's been about a month since i was released from the hospital and other than a pms moment, i've had no depression at all. Only thing i'm struggling with is the fatigue side effect which really sucks since it psychologically reminds me of a dep. episode, but this is only physical, not chemical. Hopefully the lamictal that my new pdoc prescribed will counteract this side effect---which is what he said would happen as he ups the dose.

Thankfully i'm no longer in a conveyor belt clinic as i have been for all these yrs. I was able to get a private doc thanx to the doc at the hospital who called in a favor. I live in NJ and if you have both medicare and medicaid like i do, it's virtually impossible to find a private pdoc that will take my insurance. So i'm sooooooooooo very thankful for that. Makes a huge difference. Only challenge now will be to find a therapist which i haven't had much success with since the ones at the clinics in my area were a joke.

p.s. and yes!!!! regarding your question about sleep. I've had erratic sleep patterns as long as i can remember. (no natural rhythm) Lately my sleep patterns seem to be normal so far. I wonder if it was the AD's that caused it. Dunno.... we'll see in time.