Hey everyone—I’m new here and wanted to introduce myself. I’ve been diagnosed with Bipolar I, GAD (with obsessive-compulsive tendencies) and symptoms of PTSD (not enough to qualify for a diagnosis anymore, thanks to EMDR). I was diagnosed 4 years ago, when I was 18, and I’m still going back and forth between acceptance and denial (and everything that comes along with that).

I’m in my last year of college, and this is a particularly stressful time, as it’s finals week and I have a few papers to write. I went off my medication for bipolar in September (Latuda monotherapy; topamax for headaches, though it may have had an effect on my mood) but stayed on Gabapentin for anxiety. I’ve been on and off meds for the last four years (I have an issue with compliance) and always feel stable for a month or two right after going off, but then things get wild. I was using alcohol and various drugs pretty excessively this semester, and had a chemical health evaluation that resulted in a recommendation for residential treatment. Financially, this is the worst time of the year to enter a facility that is so costly, so I’m trying things on my own—24 days clean and sober now.

The last month, I’ve been riding an increasingly intense high. Minimal sleep, elevated/expansive/euphoric moods, everything must be done now (and it must be a masterpiece), increased libido and careless spending (I haven’t bought anything too expensive, just video games and books that I can’t afford), lots of thinking which leads to lots of talking (speed-talking is my forte), mild hallucinations (mostly at night, of the hypnagogic sort, mostly pleasant; but also during the day I think people are all around in the corners of my eyes but they’re not, etc.), people tell me I’m paranoid, and things just overall seem very special and purposeful. In the last week, irritability/agitation has been appearing. I wake up and am usually irritable for an hour or two before things go back to being great, but the irritability can also be pervasive. I guess I’m just afraid of going into a mixed episode, as I have a history of those and was hospitalized for it last fall.

I’m considering going back on meds (my rational mind tells me to do it, but I’m getting a lot of stuff done and don’t necessarily want it to end). I see my pdoc on Monday to talk about options, many of which I’ve exhausted—but there’s still enough left to try. She has tended to push AP monotherapy, but I had the cognitive side effects that I usually get from AP’s. Lithium didn’t work for me (really bad physical side effects—though I would try it again) but I don’t know why she’s not suggesting mood stabilizers. I’ve only tried Lamictal (which felt like a sugar pill for me) and Topamax.

Is an AP mono therapy effective for any of you? Has anyone tried Saphris (she’s considering that)? Or had problems with lithium but had it work a second time around?

Thanks for reading (or skimming) this long introductory message. I’m excited to be a part of this forum!