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Old Mar 18, 2016, 04:00 PM
Icare dixit's Avatar
Icare dixit Icare dixit is offline
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Member Since: Feb 2016
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I've always dealt with a lot of dense/mixed cycling between longer mania, post-mania/severe and mild episodes of depression. Pretty much continuous cycling.

I wouldn't suggest antidepressants. Atypical antipsychotics will do what e.g. SSRIs do and they counterbalance some of negative effects they can induce. They go beyond that to be antipsychotic, which in the context of mood can be like weathering the storm with an oil tanker instead of a canoe: longer cycles and more moderate.

For monotherapy I would suggest aripiprazole (Abilify or generics), because it is a bit more "activating" than e.g. olanzapine or quetiapine.

But I wouldn't suggest monotherapy. Since depression is your main problem I would without hesitation suggest lamotrigine as mood stabiliser, to calm the storm itself. It is like taking your oil tanker out on the ocean instead of the sea: you might go up, but not equally far down (I don't know whether this analogy has any footing in reality, but I like to think that that's something that separates oceans from seas).

The antipsychotic should therefore counterbalance that a bit (having two meds working against each other is always good: just tune your doses). I would therefore not use aripiprazole, but something like olanzapine or quetiapine.

I hope this might help. I am no doctor so that should help.

A professor is not per se more experienced than a clinician, age difference or not, most likely not if his research area is not BP or includes BP, or he doesn't himself have a psychotic disorder (always nice to have) very much like BP or BP. Some scientists know very much about other fields and/or are also very much involved in clinical work, others not so much.

Personally I would go for the professor but I may be very much biased. As already mentioned, just let your current psychiatrist know about the second opinion and ask whether one contacts the other. For you the clinician may be more interesting. You also just have to relate as human beings.

Go for the one that tries to understand you, but also doesn't hold back.

Hope it all works out fine.
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Mania kills cells. Brain cells die. Memories become more reduced conceptually, making more efficient use of limited means. Memories shape our reality. Our memories are more or less split in two by abstractions, conceptual reductions. Mood states with memories, concepts, attached. Memories of pain and those of joy. It causes instability, changeability. Fearing that will leave an emptiness between pain and joy and a greater divide.
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Thanks for this!
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