I can really identify with how you said your "pain fogs the glass." I've often felt like I'm separated from everyone else around me, even the ones who love me, by these glass walls. People can see in, and what they see looks okay, but when I look out, nothing is really right. It's all distorted and the world is wrong, and no matter how I try to get out, I can't break the glass, it gets harder and harder to see out, and these horrible thoughts of depression get louder and louder with nowhere to run. And the whole time, from the outside, everyone else just sees something totally different than what my reality is.

You asked what the therapeutic dose of Lamictal is: it's 200mg. I started Lamictal/Lamotrigine myself just under three weeks ago because the Wellbutrin Xl I've been on for a year has stopped being effective. As soon as I started Lamictal, it was like the floor fell out from under me with my depression, and that was just at 25mg. I'm on day #3 of 100mg, and so far it's been this rollercoaster of very unpleasant, violent suicidal thoughts just running through my head, especially very weird ones I've never had before, every day. Also been having very weird, disturbing dreams almost every night. Before I started taking it, I had suicidal thoughts, but they maybe were a few times a month. Nothing like this.

A few days ago, it suddenly dawned on me that I had a very easy way out, a box of fentanyl leftover from an injury I had four years ago. If you don't happen to know, fentanyl is an extremely strong opiate painkiller, one you absolutely cannot take unless you already have an opiate tolerance. I was prescribed it after having taking 60-80mg a day of oxycodone for months for a herniated disc and still being in pain. Fentanyl helped me then, but basically, if I were to use it now, I would stop breathing.

As soon as I realized all this, my rational mind knew I needed to throw it away, but my depressed mind wouldn't let me. My depressed mind kept telling me to keep it, because if things get too hard, then it would be so easy to just to put on those patches and never wake up. I battled very hard with whether or not I would tell anyone about this... I always tell my pdoc/tdoc about my suicidal thoughts, but this was something... more. So yesterday, I told a close friend about it, and how it bothered me that I couldn't throw it away. She thanked me for telling her, then said if I couldn't throw it away, then give it to her. I said I would think about it.

Today, I told my tdoc about all of this, and how it really bothered me that there was this part of me that wouldn't let me throw it away. She very plainly told me that she did not give a f*** WHY I didn't want to throw it away, because it was completely irrational, coming from my depression, and very likely coming from starting new medication. She reminded me that I was in a very vulnerable state right now starting a new medication, that I'm not even at the the therapeutic dose of Lamictal yet, and that there was no reason to have anything around me that could hurt me if I became so vulnerable that I lost control when my feelings changing for the better are just right around the corner.

At the same time—and this is what really mattered—she told me that all my thoughts were real, that my feelings were real, and that I had no control over feeling them. And she validated the fact that that is truly terrifying. Thoughts you can't control? Seriously, what the hell, that's unbelievably scary. My depression and possibly medication are filling my head with irrational thoughts, and when I sit back and look at them, I KNOW they're aren't rational. I KNOW that I should throw it away. That doesn't make feeling like I should keep the fentanyl any less real, and it doesn't invalidate that these very real suicidal thoughts keep running through my head. What matters is the fact that I can identify them as irrational, because that means I can now choose a constructive behavior that actually helps me.

I'm sharing all this with you because I just want you to know that feeling suicidal just isn't rational, at all, but it happens, and many times, it happens A LOT. It might seem rational, but it's not, they really are just these terrible lies over which you have no control from coming into your head. But you DO have control over what you do with them, even when these thoughts really make you believe that you are powerless and helpless against them. None of that is true. You have to keep telling yourself that these thoughts aren't rational or true.

I'm also sharing this with you so you know that you aren't alone. I'm struggling too right now, and I haven't struggled this hard since that close call I talked about in my last post. I haven't even had the strength to admit to my husband how I've been feeling because I don't know how he would handle it. And all in the face of what should be an objectively "great time" in my life. I'm in my last semester of undergrad, I'm graduating with honors, I'm planning to go to graduate school, I just quit a horrible job I hated and started one that I love... yet these absolutely horrendous thoughts fill my mind. It's utter madness, but my thoughts are uncontrollable...but they're just thoughts. My behavior is what's real. It's what I do with my thoughts that counts, and the same goes for you too. No matter what kind of truly horrible thoughts fill my head, I still can choose to do the opposite, and so can you.

I'm sorry to hear it's so difficult for you to get regular help because of distance and finances. I'm really sorry to hear that you feel you can't trust your doctor... I know that makes things even worse. (I once had a psychiatrist for couples therapy asking after two sessions if we were ready to "fly free" when that now-ex was physically abusing me. That made me doubt all psychiatrists/psychologists for years afterwards.) All of that makes a horrible situation feel even more hopeless.

If you tell your doctor how you really feel though, chances are he might either change your medicine completely or have you increase the dose to get to therapeutic levels faster so it can actually start helping you. With this medicine, as long as you haven't developed the dreaded rash from it, those are really the only two acceptable answers you should be getting from your doctor when you have urges this strong. Otherwise, you really need to find another doctor who will take you seriously.

You really aren't alone though. If for any reason you feel like you can't take it anymore, and you feel like you can't call anyone or tell anyone about it for any reason or get to somewhere safe, or you feel like you're out of options because of money or distance or anything, please just know you can call the suicide hotline at 1-800-273-TALK anytime 24/7.

Above all, I just wish and hope that this helps you remember that you're not alone and that you can beat this. You CAN and I'm really betting that you WILL. Your life does NOT have to end this way, and there's absolutely no rational good reason why it should. Just like I have absolutely no rational good reason why I should keep a box of fentanyl "just in case." I'm going to throw it away. I wish that you can throw away your plans too and hang on.

These illnesses we have are not our fault and they take us on long, twisted, f***ed up paths sometimes, but one of the things that's helped me hold on so long is believing that if I can even help one person by sharing what I've been through, then all of it will have been worth it. I am just going to believe with everything I got that that one person ends up being you. Please hold on and just don't give up. BP II is the worst because of how much time we spend in depression, but there are so many people who have been saved from it once they've found the right medication. You and I both just need to get there, one day at a time. It will happen. I'm not going to give up and you don't have to either.

I want to thank you too, because your post and replying to it made me realize how serious my own thoughts were and how much I was in denial about them. It's incredibly brave of you to post what you did here, and even though you didn't mean to, you ended up helping someone because of it. I hope that helps you see that your life is worth living, because you helped me, and I honestly can't say I know what I would have done in the next few weeks without the wake up call. Thank you, so, so much for that. Please keep being strong.