[Shakti]

I've been counting down the days until August 10 when I was going to get actual psychiatric services and psych/med eval and it was what was holding me up through all these mixed state episodes and the constant underlying depression.

I just got a call from them saying my appt was canceled because the person I was going to be seeing has decided to no longer do new intake for the time being. I expressed (very calmly and politely) that this was a huge setback for be because my meds are not working at all. She manages to get me a tentative appt for early Sept, but will get back to me to let me know for sure. That's at least a whole month extra. A whole extra month of this ****ing HELL.

So I called my GP directly after and explained the situation. I've already seen my GP three times this month and they got me in today to discuss my meds all crapping out. This will be the fourth visit. In just a couple weeks. The nurse who set up the appointment sounded annoyed with me. And I normally don't go to the doctor much at all...but I didn't know what else to do. But I was there twice last week and yesterday. This is just ****ing humiliating. I'm embarrassed and sad and upset and I feel desperate.

I'm sobbing as I'm writing this, but not melting down. What's the point? But it doesn't help that my partner is out of town for work for the week.

They got me in for 3 this afternoon. I'm embarrassed to show my face. They must think I'm a drama queen and a hypochondriac. I don't even want to go. Maybe I should just switch doctors. I hate this.

On top of it, there's no way I'm getting Lithium. I'm an ultra ultra rapid cycler with mainly mixed states (with some definite aspects of psychosis) and deep deep depression (that also has some aspects of psychosis at times). I do not struggle with just plain mania. I get mania, sometimes happy, usually terrifying, but it's so short--a day or less usually. I've been on medline and pubmed for a few days researching this and it turns out my "flavor" is "largely untreatable due to resistance to nearly all medications." Lithium is not at all recommended for ultra rapid cyclers with primarily mixed states. And my depression has been resistant to every anti-dep (with mood stabilizers of course) I've tried and it turns out that that's the norm for my particular kind of BP. I don't know what I'll eventually get put on. But for today I guess I just need a booster anti-dep. And either way, I get to adjust to new meds and then in Sept adjust again to new meds. They don't give lithium to my kind of BP. I don't know why I was so hopeful about it, but I guess I needed some blind optimism for once. Much of the research I've read has expressed how difficult and sometimes impossible to treat with any expectation of "normality."

I'm so sad right now. So frustrated. I need help. I need this to let up just a bit. And my GP told me she's so glad to hand over my med management to a psychiatric unit....and now I'm taking this complicated flavor of bipolar right back to her and I don't think she knows what to do with it.

Please encourage me. Or something. I'm so discouraged. It's always wait wait wait and nothing ever works. It's getting harder to have hope. I'm in a "normal" (whatever that is) mood today, but this is making my mind wobble. It could be triggering and it might end up being triggering. But I'm alone with no one at all in person to talk to, lean on, or to support me or encourage me or hold me while I cry. I wish my partner was here.

It was so embarrassing calling for the appt today with my GP. They really sounded annoyed and I think they think I'm a hypochondriac, but I'm not. I'm sick. Sick almost to death. Literally. (I know people will say not to be embarrassed, but I am and I will be, so don't bother--I wouldn't have been if I didn't hear the annoyance seeping from her voice. I mean, hell, I was JUST there yesterday.)

Maybe my doc will give me new meds and a miracle will happen. What a stupid stupid stupid idea. A miracle. There are no ****ing miracles.


I need to stop crying and go shower. I want this to go away.

If they offered me ECT I'd do it in a heartbeat. NO questions asked. I've researched it a lot and I don't even care about the possible consequences. I'll do anything to make this better. Anything.

[Shakti]

And if they offered me hospitalization today (for the first time ever, despite my practically begging for that sort of help), I can't go because my partner is out of the state until Thursday and I will have no one to look after my (handicapped and very much special needs) dog.



Should I just go off meds altogether? I know it sounds like a bad idea, but if I still cycle exactly the same way on them and off of them, why bother?

[rartemis]

Your doing the right thing Shakti by seeing your doctor. Writing down your concerns and the situation may help, so you have it to refer to when your in the office. You may want to ask your doctor if there are other places you can go besides the place that cancelled your appointment. There may be other options.

[rartemis]

Originally Posted by Shakti

Should I just go off meds altogether? I know it sounds like a bad idea, but if I still cycle exactly the same way on them and off of them, why bother?

This is the depression talking. May be safer to stay on and see what your doc and you come up with this afternoon.

[Shakti]

I don't feel depressed, though. Just so frustrated and exhausted by the non-stop cycling. But maybe I am depressed...it all happens to me so fast I can't keep up and sometimes don't know I'm in an episode until I'm well into it. But I was feeling fine today. Just good. Not too good. Just good.

I called the dr office to cancel and explained why. The nurse who sounded annoyed now sounded concerned and encouraged me to come in. I was trying not to cry, but she said, "You deserve to feel good and you sound upset" and I did start crying. She told me to come in anyway if I felt up to it and to at least talk with her, even if no med changes happened....she said I need to at least stay connected in times like this. I know she's right. I'm just so damn embarrassed.

[Shakti]

Maybe I could try adding abilify? I'm just so desperate.... This is awful.

I wonder if abilify will make me fat... You know what....I don't even care if it does.

[Perna]

Originally Posted by Shakti

I know people will say not to be embarrassed, but I am and I will be, so don't bother--I wouldn't have been if I didn't hear the annoyance seeping from her voice.

I won't bother fighting over your embarrassment, you obviously want to be embarrassed so be it but I would like to point out a few other scenarios?

The person on the phone just before you called was a real pain in the a%& and the appointment maker is lousy with her own emotions so let her annoyance at that person seep out at you.

The other desk clerk was trying to get her attention while she was on the phone with you and distracting her and she didn't like that one bit and was really annoyed. . . at the other clerk.

She got up on the wrong side of the bed this morning and doesn't have a dog to kick.

She is an annoying person and doesn't realize how annoying she can be.

It wasn't the doctor was it? Why would anyone else "care" who called on the phone and made an appointment? One appointment person is pretty much like another appointment person. Yes, you do need to be worked into a too busy schedule but that it's too busy is their problem/fault, not yours. They're annoyed at working anyone in, doesn't matter if it's you or the next person who calls with an emergency.

I hope your doctor can think of something today to help you weather the wait and/or that your partner is coming home soon to hold and comfort you and thinking about that moment will give you some comfort now.

Oh Shakti!!!!!!!!!!!!! I read your post and just started crying.... I soooooo feel for you!!!!!! You KNOW I do. Words are failing me. I so wish I could teleport to where you are and just be there for you and hold you. For real. In real life. I hardly know what to say.

It will happen, but the rug being pulled out when you've worked so very very hard for this and hit so many roadblocks... there probably isn't even a word that quite captures it (though crestfallen is a very good one!)... the true depth of it in the palpable sense. Some might read this and think I'm being negative, but that's not at all the case. Just want you to know that I truly do feel your pain, and if there's ANYTHING I can do to help ease it, you know I will. Please feel completely free to PM me, ok?

(I also need to say that I think it is really stinky of them to clearly not have thought this through very well. If she feels she needed to make the decision not to take new, fine, but she should make it and THEN not make appointments! Not after! Good grief.)

[blueoctober]

Originally Posted by Shakti

And if they offered me hospitalization today (for the first time ever, despite my practically begging for that sort of help), I can't go because my partner is out of the state until Thursday and I will have no one to look after my (handicapped and very much special needs) dog.



Should I just go off meds altogether? I know it sounds like a bad idea, but if I still cycle exactly the same way on them and off of them, why bother?

Sorry you are going through this Shatki. There are options for your dog. Do you have a regular veterinarian that you use, because they often do boarding as well. Alternatively you could ask for a recommendation for a professional dog sitter.

It's completely up to you on what to do with the meds, but I wouldn't recommend stopping them. There may be awful withdrawals symptoms and most times it's advisable to taper off slowly.

I agree with Perna, you will never know why the receptionist was annoyed and either way that's her issue not yours, so don't own it. I had a break down in my GP's office prior to being diagnosed and I was sooooo embarrassed to go back, but I did and I was glad that I did. At least your GP knows your history etc. Keep us posted.

[Shakti]

So, I went to the appointment. My doctor is very nice...I just feel like a burden going so often, but she always sets me at ease.

I printed out my lights off, lights on, yadda yadda post (but edited in word where I removed the part about taking less meds and not telling her...hehe). She actually asked to read it and slowly and carefully read the whole thing. I've never had a doctor take that kind of actual interest or time before. I could tell when she was done that she really got it. She said she was sorry I had to experience that so much in my life and gave me quite a few options (in addition to telling me that while it had characteristics of a mixed state and probably overlapped a bit, that was mania....it's just that that's my particular flavor of mania. And after the appointment I'm feeling a bit too good, expansive, and creative and just good. Probably flirting with hypomania, but these constant cycles....it's why we go to doctors.

Anyway, I mentioned to her that I wanted to try Tegretol, Risperidone, and abilify. She agreed that all three would be beneficial, but said she wanted to change one thing at a time (which is obviously smarter). She also mentioned that Lithium is probably actually ideal for me. I just never thought I had mania. It just tuns out my mania is scary and weird and delusional. We agreed I'd continue with the meds I'm on now (Wellbutrin and Lamictal) and add Risperidone (for mania and mixed states and rapid cycling) for now. I have to go back in a week and we'll go from there. That's one good thing about my rapid cycling--I can know in a week if I've been stable. Sad, actually, but in my benefit right now. Anyway, I'm going to take my Lamictal and Wellbutrin at the original doses.

The other option is that she could refer me to a mental health inpatient crisis center (at any time that I feel I need it) where I'd stay a week and then do a daytime kind of thing for another week or two (but be home at night). It's intended to figure out the situation/illness in the person, get them stable on meds, and see how it goes for a few weeks. Then I'd continue with the psych people in Sept.

So we'll see how it goes. I'm feeling good, tough. I didn't meltdown, I've been rational about all of this, filled my prescription, came home and I'm eating strawberries. And I feel like I can be patient.

I hope Risperidone doesn't make me fat.

[Perna]

I'm really glad your doctor listened and offered some ideas and hope for you to feel better!

[blueoctober]

That sounds like a great plan Shakti!

[Bat Mom]

Hi Shakti. I'm glad you have such a nice doctor. And I'm really glad that your latest post finds you in a better place. You are going to find the right treatment. It might be this one, it might be the next, or it could be several more down the road but the time will come. Just keep trying. I believe, you need to keep believing too.

You are doing the right thing! Keep doing it!

Oh yea yea yea Shakti!!!! I'm glad it went so well at your appointment today. She sounds like a very good doctor indeed!! And yea for options! It sounds like you've put together a great gameplan! I'm soooo glad!!!
Strawberries, yum!

[Trippin2.0]

I'm sorry things have been so rough on you, but at the same time glad that you now have options and a way forward.

Good Luck Shakti.

[sugahorse1]

Yay for you.
Well done - it took a lot of strength for you to get this far!
If you are sick, there is no place for embarassment, so please don't ever contemplate feeling embarassed again.
Your GP sounds like a really nice doctor.
I think going inpatient may be useful if you fall back into the deep hole. In the mean-time, I hope things work out fine for you!
Why do you have to wait until Sep to see the psychiatric unit?
Is it a state one, or is this the earliest and private practitioner is available?

I'm starting on Lamical and may add Wellbutrin therafter (one drug at a time); hoping I have a better experience than you.

[Shakti]

Originally Posted by sugahorse

Yay for you.
Well done - it took a lot of strength for you to get this far!
If you are sick, there is no place for embarassment, so please don't ever contemplate feeling embarassed again.
Your GP sounds like a really nice doctor.
I think going inpatient may be useful if you fall back into the deep hole. In the mean-time, I hope things work out fine for you!
Why do you have to wait until Sep to see the psychiatric unit?
Is it a state one, or is this the earliest and private practitioner is available?

I'm starting on Lamical and may add Wellbutrin therafter (one drug at a time); hoping I have a better experience than you.

I have to wait because it's a whole health insurance mess. I live in a state that has universal health care. Basically, if you live here you can get insurance through employer or if not employed or disabled or in any other situation you apply through the state. They let you know then what you are eligible for. My insurance is fully subsidized and when they responded, I had five or six different insurance providers to pick from. I chose the one that best met my needs...but as we all know, mental health care is just not given enough attention. Ok, so within my insurance provider they have a separate group that handles all mental health services, so I have to use them for my insurance to cover it. Or I can see my GP or whatever. In general I have great insurance and I love it--it's free for me and I pay $1-$3 for a month prescription (unless it's a brand name they just won't cover at all...grrr...but that's not very many). That's all I have to pay for (and after really never having access to doctors or medical treatment or even health insurance before, this feel like a dream of some sort). So anyway, once I got here I had to go through this intake process with the organization who provides mental health/psych services for my insurance provider. Turned out there was a waiting list, so I went on it, and in the meantime, to stay on the list, I have to see (really just to touch base with) my assigned social worker/therapist. We don't do therapy. We just touch base every few weeks and make sure everything is ok. And it's all in the same hospital, so my GP, the soc worker, and my eventual pdoc can all work together with the meds etc. SO (this is a long story, eh?) I got a call saying I was off the list and had an appt Aug 10. Then it got canceled and now the early sept thing. But I got a call today and I'm in with a pdoc On Aug 31. Pretty much earliest available. So that's the deal with the psych appt stuff.

As for the Lamictal/Wellbutrin combo, I really truly do think it worked wonders for me for a while. I swear by the brand name, though, and I think the reason it's no longer really working for me is because I've been mostly on the generic with a few months here and there of the real thing. There's such a difference (in my opinion) that I think it just hurt me more than helped. I should have just been consistent with either the generic or brand. Wellbutrin is a med I LOVE!!!! It's activating and gave me energy. And it WORKED. None of the usual anti-deps work for me--my issue seems to be dopamine. But I've been on it for two years so maybe it's just petered out? Either way, the combo worked very well for me. Until it didn't (probably for reasons mentioned above). I'm still on both of them...we're just slowly tweaking to see what is working and what isn't.

[sugahorse1]

I won't be getting the brand name Lamictin, but the generic, so hoping it will work as well as the brand name...???

[Shakti]

There seems to be a lotof buzz about this one particular drug having a crappy generic. One of the reasons (so says my pharmacist when I threw a fit one day...er....I just admitted I threw a fit at the pharmacy...oh well...whatever) is that various manufacturers make the generic and the formula for all of them varies a LOT. This includes the amount of the active ingredient (which here in the U.S. can be with a certain range of the brand name but doesn't have to be exact; the difference can be pretty significant) and the inactive ingredients like fillers etc. Some months the generic works fine and some months I know I got a dud batch. I have not heard of this with any other meds at all, but this is even getting noticed by medical professionals now. But this may be a U.S. thing....maybe your laws and whatnot pertaining to generic versus brand are better. Don't worry about it. Just see how it goes. Plenty of people have no problem with the generic....and my body truly does act strangely with chemicals, so I'm very sensitive to it, I think.

I'm sure it will be fine! When I first went on Lamictal I was on the generic and it saved my freaking life. I went back and looked at the bottles after noticing changes between the brand name and generic this year, and the first few months I was on it it was the same manufacturer, so who knows...

[perpetuallysad]

You have said so much that I want to comment on, but for now I will just tell you about this. I am on wellbutrin and the generic doesn't work for me and I cannot afford the huge prescription costs, so I found this program called bridges to access that glasko-smith kline has that gives me the meds for free. I get a huge *** bottle of them every three months and each year I just have to reapply (its a pretty short form and you just have to have a script from your doc for a year's supply). It was very easy to apply for and even though we aren't "poor" I do qualify for the med for free. You should really try applying for it. They give you the meds even if you have insurance and just cannot afford the prescription costs or copay costs... I know drug companies are evil but this program is really helpful to me.

The link is:
http://www.patientassistance.com/pro...mithkline-168/

[Shakti]

I'm not sure if it is just me feeling "normal" or slightly hypomanic (I HOPE it is the former and not the latter), but today I have been super productive, feeling like my old self, just feeling normal and with normal energy....but maybe slightly too good? Or maybe I just don't remember feeling good in a way that is not illness-related in so long, but last night I took my first Risperidone (1 mg). I've learned not to burst out in song and flowers every time a med makes me feel great right away since it's usually a fluke...or maybe Murphy's Law is just particularly focused on me. I can always feel the effects of meds right away--I've never had that "it may take up to 6-8 weeks or more before you will feel the effect or know if it works." Anyway, I sure did sleep well last night. Now I know why the bottle said take at bedtime.

I've been SO productive today. That makes me worry it's hypomania, but I also remember before bipolar I was generally very productive every day, so we'll see. One day of any med is too early to tell of course.

I worry a bit though because I also take flexeril (muscle relaxer for severe back/neck/shoulder pain) and klonopin for anxiety and panic attacks. They're all sedatives (and also make my immediate short term memory foggy when I take them at night), so even though I have a strictly timed med schedule I stick to (I set my cell phone alarm to go off 6 times a day, between meds and supps like multi-vitamins and omega 3s) I've started writing down any flexeril or klonopin I take each day (since they are not normal scheduled meds and just taken as needed) after 5 pm. I tend to go to sleep around 11, so I figure 6 hours between them would avoid interactions. They were all ok'd by my doctor, of course, but Flexeril is powerful stuff and so is Risperidone and I'd not want to take them together--too much sedative, especially with my weird heart rate issues lately. It scares me. Less so with Klonopin and Risperidone, but still...better safe than sorry.

Anyway, I'll end this little ramble right here.

[Shakti]

Originally Posted by perpetuallysad

I am on wellbutrin and the generic doesn't work for me and I cannot afford the huge prescription costs, so I found this program called bridges to access that glasko-smith kline has that gives me the meds for free. I get a huge *** bottle of them every three months and each year I just have to reapply (its a pretty short form and you just have to have a script from your doc for a year's supply). It was very easy to apply for and even though we aren't "poor" I do qualify for the med for free. You should really try applying for it. They give you the meds even if you have insurance and just cannot afford the prescription costs or copay costs... I know drug companies are evil but this program is really helpful to me.

The link is:
http://www.patientassistance.com/pro...mithkline-168/

I'm not sure who your post was directed at (sorry), so if my comments are off, that's why.

This same assistance program (or maybe a different one? Pretty sure it was the same one) gave me Pristiq for two years (I applied twice) when I had no insurance at all. At the time the Pristiq/Wellbutrin combo was all that worked for my depression. I didn't do the Wellbutrin assistance thing, although I'm not sure why. I paid out the nose for that one, although after a month or two of paying so much my the pharmacist somehow broke up the med dosage in some way that cut the costs by over half--even though I was getting the same dose each day.

I wish they had that kind of program for Lamictal. They do have a $40 off your monthly prescription for 12 months card they will send you, but given that a month of Lamictal is over $200, it doesn't much matter. I'm resigned now to the generic, but I'm pretty sure I won't be on Lamictal much longer. My doc said that probably Lamictal will go out and Lithium or Tegretol will go in its place. We'll see. This new batch of generic Lamictal I just picked up last week seems to work fine. So weird how it varies so much from batch to batch and manufacturer to manufacturer.

[perpetuallysad]

duh, I guess I misread your post, I thought when you said the thing about the wellbutrin lamaticil combo you meant you were taking it now, but taking the generic wellbutrin. I was just trying to help.

[Shakti]

Originally Posted by perpetuallysad

duh, I guess I misread your post, I thought when you said the thing about the wellbutrin lamaticil combo you meant you were taking it now, but taking the generic wellbutrin. I was just trying to help.

I thought maybe you were talking to Sugahorse. I think we just had a communication breakdown. Crossed brain wires. No worries.

Originally Posted by Shakti

I'm not sure if it is just me feeling "normal" or slightly hypomanic (I HOPE it is the former and not the latter), but today I have been super productive, feeling like my old self, just feeling normal and with normal energy....but maybe slightly too good? Or maybe I just don't remember feeling good in a way that is not illness-related in so long...

This is EXACTLY what I've been wondering too with my latest brain shift! Do I simply not remember normal (I do tend to be pretty darn productive at "normal", just not at all when depressed.) or is it heading toward hypo? I don't *think* so, but only time will really tell. Productive? Yes, but not vibrating or doing 10 things at once, turning every 3 steps as they cascade to mind (of course by then it's pretty well too late! )

Originally Posted by Shakti

I wish they had that kind of program for Lamictal. They do have a $40 off your monthly prescription for 12 months card they will send you, but given that a month of Lamictal is over $200, it doesn't much matter.

Amen to that! It's time for me to pick up a refill. (And actually, thanks! This reminded me to call back. I'd called in the refill yesterday and forgot to mention that I only want to pick up 1/3 of it --it's a 90 day prescription, so do the math if you dare to see why the full refill is so daunting! As in, sure, take half my money in the world right now! ) I really *can't* afford the brand, but am just too damn scared to go generic on that one, especially given all factors going on right now.

I'm soooo glad you're feeling better now, Shakti! -- and fingers crossed that it stays on just the right keel!!!