For now, we are positing that most of my psychosis has its roots in often unrecognized mania-mixed stuff. Current thinking is that that percolating mania spins up my psychosis occasionally. So, addressing the mania is critical as well as, of course, going after the psychosis proper.

So, in you, this notion that stabilizing your 'mood' could prevent your psychosis is quite clever, far as I am concerned. Do you have some degree of as yet clinically unappreciated and stealthy mood dysregulation? Sneaky mixed stuff-anxiety? Perhaps you should apply that big brain and its exquisite organizational acumen to attack that. If I was required to venture a guess, I might go with, 'possibly. Probably.' It is an endlessly crafty and subterraneanly sneaky illness.so difficult to identify when it is operating...

The problem with lamictal is that it is a depression med and you do not seem to have psychotic depression. So, it would not be my choice for you.

I cannot speak to Geodon as have not been on it. But been on many APs.

If you go this route, my choice for you would be Abilify or Rexulti. In my opinion, they are the most thoughtfully designed atypicals and have minimal SE usually. You cannot afford SE w your insane life responsibilities. Abilify is not a szr med, but those all have waaaay more SE. There is reason they call it Depressakote...

Just if I were in your shoes, I wld start Abilify. My goal wld be to eliminate the psychosis, as it is scary, painful, injures our brains, and can be lethal due to impaired judgment. I was on the highest dose for 12 yrs before I had a single adverse event.

Fern, I think you have some serious thinking to do. Go back to childhood. Review relationships. Review school and job performance. I know you are a star. But that is not a bipolar vaccine.it is a legit risk factor. Van Gogh. Einstein, probably. Could go on all week.

Sketch it out. Review your psychotic episodes. Every single detail about the weeks leading up to them. What were the stressors and their severity? Family issues. The endocrine situation, as in, do these episodes both occur at the same time in your cycle? Sleep. All supplements, meds, caffeine, alcohol, recreational meds-drugs. What were the dates and days? Same time of month? Were pets ill. Are you a current events junky. Compulsive or obsessive or ruminative issues. Thoughts occasionally that you, yourself, find odd or a tad off or frightening or confusing. I went through a period where every time I was on a 2nd or 3rd floor with a patio, the thought of pushing someone off would not leave me alone. Negative symptoms. Motivation. Fatigue. Anhedonia or limited joy capacity. Memory, data processing, language, hearing, or vision issues.

Do you like tense or dark or heavy books and films. Exercise. How much puter time and what specific type prior to episodes. Triggering of known trauma. Is it possible you have unappreciated additional trauma. Diet soda is a massive NMDA antagonist--drink it?

Travel prior to episodes. What was the nature of your day and evening exposure to light and what kind of light. Light can cause psychosis all by itself. Stressful or charged dreams. Fear in your life, real or imagined. What about shame and guilt.

That is a start. This is what I look at on my life.

Hus and love!!!!!