I always hit the bottom after a big mania but I don't think it's the APs, I think it's just how I cycle. We can sort of prepare for it but sometimes it is easier than others. Right now crashing is a big risk because I haven't been able to tolerate more than 50% of my AD in 2 months? or so. For a while I was off it, then on 33% and now 50% but so far definitely not ready for more than 50%. So we'll have to hope we catch the downswing in time to get enough AD in my system. My AD is an MAOI which is really, really stimulating (which works well for me most of the time although it means high dose APs) so when I have a bad, sustained mania, it becomes a problem. It's a patch so I've done a lot of scissor work lately. I am not good at remembering episodes, I tend to remember depressions when I was really manic first but I think it usually goes mania=>increased AP and decreased AD==>improvement==>eventually leads to depression, usually a hard crash==>leads to return of full AD dose and sometimes a slightly higher dose although we try to avoid that dose==>several months of working with meds and therapy==>eventual recovery. I'm always mixed through 99% of it but the mania predominates and then the depression predominates although sometimes there will be a depression in the middle of 2 manic periods (I suspect that's happening now) and half the days I won't know what to say I am although looking back I can see.

So far we've barely gotten even extremely high doses of APs to calm me down a little. So they haven't had a chance to be destructive. When I start a 2nd AP next month (latuda) we'll see what happens then.