Crestfallen :(

Shakti, I'm really glad that your appointment went well and I hope that the risperidone works really well. I find it really settles me down when my brain is flipping out all over the place, and it helps me to get good sleep, everything is better with good sleep
Write as often as you need to if things get hard with your partner away. We are all here for you.
Do you have crisis phone lines you can call to chat with some one when things get bad? Are there friends or family that you can call?
Give your special dog a hug from me and I hope you feel better soon.

Thanks everyone for their input towards me too.
I'm not sure how substantial the price difference between generic and brand name is here, nor the issues with generic not being accurate enough copies. The pdoc did say she was happy with the generic - trust me, if I get a dud batch and freak out, there will be all hell to pay.

Innerzone - it was strange; yesterday pdoc asks me if I ever have OK/normal episodes. My answer: I just don't know what normal is anymore.

Yesterday I was bouncy , talkative and happy - normal or hypomanic?
In hindsight, I'd say hypomanic, as I've been dropped badly today, teetering on the edge. And I have a bloody headache too.

I'm the same way. Years ago when I was first diagnosed with bipolar, I was in the hospital for depression/self-injury. They decided to try me on lithium, and an hour after I took it I was running around the ward! I couldn't sit still or stop talking. Then, it leveled off and really worked for me. I haven't heard of the study you mentioned that lithium is bad for Bipolar II, ultra-ultra-rapid cycling. That's the kind I have (my moods can flip in the same day, sometimes a few times), and lithium worked great for me. I actually felt happy, without being numb, and I lost my desire to drink, because I didn't need it to numb my emotions anymore! Lithium was truly a life-saver for me. Unfortunately, my doctor won't put me on it now, because she said it interacts with my rheumatoid arthritis meds and can be bad for my liver. So, I'm on Seroquel, which I also felt the day after I took it. I went from depressed to ultra-cycling the next day, to irritably manic the next, then leveled off on the third day.

It's great that you have a caring doctor. As the other posters said, don't take the nurse's attitude personally (I know it's hard- we tend to take everything personally!) She may have just been having a bad day that had nothing to do with you. And if she was irritated with you, so what? That's what they get paid for! Look at it this way- if you went to a store repeatedly because you needed more things than you originally thought, would you feel guilty? Of course not- so don't feel like you're "bothering" your doctor- you're giving her business!

I'm BP 1, but I think it's just not ideal for rapid cyclers or mixed states. But I'm not a doc, so I don't know. I'm glad my doc identified that my supposed mixed states were mostly just mania. Maybe I'll get some Lithium, after all. Well, when this combo peters out. So far so good, but you never know with tomorrow coming and all....

The nurse was very kind and contrite when I called to cancel the appt. I think I just took it wrong, considering the state I was in. We chatted at the appt and she was just as nice as always. But you hit on something--I feel like I'm bothering my doctor. Five appts in one month now, I believe. My memory is full of holes so I might be wrong on the number but it's four or five. And I have another next week to discuss how the risperidone is working and increase it, if needed. Anyway, I guess you are right. Well, I KNOW you are right--I should not feel like I'm bugging her. She's getting paid either way, plus all these visits about bipolar in the 2 months (I went several times in the first month, too) that she's been my primary care doctor, she's seen a lot of my bipolar and is really in my corner about disability. So, bonus. But I need to be less reticent about going to the doctor and care less about feeling embarrassed that they see me there so much.

I also always feel like I'm bugging my pdoc or T - So you are not alone in this.
I think you need to try be positive and really hope this med combo is the one for you

Stuff them. Keep pushing, you have nothing to be embarrrassed about.

On the Lithium, still hold that in the back of your mind because I have found that different psychiatrists give me different Bipolar dx's, ie I or II and that can affect their overall dx and the medications that can be on offer for you. As you alluded to, Lithium helps reduce the highs and I am also on Lamictal, which helps with the lows - and also heaps of other meds. Even gettting the mania for only a day or two can have you rapid cycling and then of course the terrible and dangerous Major Bipolar Depressions.

Just on SSRI's, I am only of those Beepers for whom SSRI's are contraindicated. They shot me up into hypomania and mania again and again over many years and then escalated the whole cycle including mixed states and rapid cycling and the terrible depression - endless. After 6 years of this (and not knowing I was being mis-medicated) I tried to take my life and nearly died (I survived just by a whisker).

I'm not syaing SSRI's are contraindicated for you, they are an integral part of many Beepers meds mixes, but it's just something useful to know, if you do end up seeing them escalting you into hypomania an d mania.

I've been on almost every anti-dep out there. SSRIs are a nightmare for me. Haven't taken any in probably 4 years and I'd definitely never take them again. SSRIs should never be used for any bipolar without an accompanying mood stabilizer. Many (but of course not all) bipolars have a difficult time with them. For me, though, they just increase my anxiety, caused panic attack, ROCKETED me in mania, and then after the mania ended just did nothing at all other than cause anxiety attacks, anxiety, and terrifyingly bad catatonic depression (my ex-husband even dressed me a few times, for example).

At any rate, I like the combo I'm on at the the moment: Lamictal/Wellbutrin/Risperidone/Klonopin. I realize Lithium is a choice still now after seeing my doctor, so when/if this combo craps out on me, that's probably next. If that doesn't work I'm probably requesting ECT, though I'm not set on it yet. I know a lot of people have reservations about it, but I have none. These meds make me as dumb as ECT ever would, and the "remission" rate with ECT is quite high. As for my diagnosis, there is absolutely no way on this earth anyone would diagnose me as BP 2. There's no question at all that I'm BP 1.

WendyAussie, my experience was much like yours. For several years doctors just saw the depression and shoved anti-deps at me, which caused rather extreme mania in me, which dropped me afterwards into DEEP depression, and the rapid cycling started up (anti-deps when used wrong in bipolars can cause or worsen rapid cycling) and it was all downhill from there. Add in mixed states. Then toss in a few psychotic breaks that just started this year and yikes. I would NEVER take an SSRI again. Actually I've had problems with all anti-deps that don't deal with norepinephren and/or dopamine reuptake inhibition. They just don't like me and I hate them.

The addition of the Risperidone seems to have made a dramatic difference. Whether it will last or not....we'll see.

At this point, I'm pretty much willing to try anything. ya know? But hopefully I'm onto something that is working this time. If not, back to the ol' drawing board.

Wow, that is totally my story with SSRI's too. I think it is important to talk about this issue on these boards - I didn't know about this phenomenon and it swept everything from my life anf then nearly my life. And I was on mood stabilisers most of those years I was on SSRI's but I still had those terrible effects. I'd do ECT if it came to it - even with all the stuff that can happen.