[PlanningtoLive]

I have a serious problem here and am running out of time, so I thought that I would ask all of you for your input.

For those who don't know me, I am bipolar II, major depression recurrent and borderline personality disorder. I am married (if you can call it that - it leaves a lot to be desired) with one absolutely wonderful son who means the world to me.

I was unstable for a long time, tried to OD in 2004 (almost succeeded) and had a brief stint back in the psych ward in Dec. of 05 to try to get my act together - a respite, my pdoc called it. I have finally gotten most of the major symptoms under control with a good mix of meds: Geodon, Abilify and Lexapro. All except the depression.

The last few months at work have been hell for me. This is the first job that I have been at for any length of time (one year now) and lately I have been taking "sick time" days off because I can't get myself going to get into work. I have been majorly suicidal, enough that my pdoc and I communicate by phone as well as email regularly.

He just upped my dosages of all my meds, which has seemed to help somewhat with the suicide thoughts. See I knew I needed to get into the hospital because I wasn't safe anywhere else for sure. I get no support, no nothing from my husband at home, just alot of verbal abuse and other stuff. The only saving grace is my son who is ten.

Anyway, work has noticed that I am not as "reliable" anymore with all this time off, but I reassured them that I was going into the hospital soon and would be okay. I worked it out where I'd get 4 days off without losing any pay since all my sick time has been used up. This business has been really good to me since I started there - held a food drive for me when we were short on food at home plus gave me a gift card to the local grocery store - plus promoted me in Dec. and my most recent review was excellent.

My problem is whether I should still go into the hospital. I can still barely get myself up and into work although most of the other things are better with the med increases. If I do go in, maybe they can evaluate the Lexapro and change it to something else or I'll learn something during group session. I've also had to start taking Clonazepam just so I can go to work and stay there. I've been having severe anxiety attacks while I'm there and the Clonzepam helps (.5mg. but I take 5 or more per work day just to hang in there). I'm thinking that a change in job would be good but I don't dislike my work, not consciously anyway.

The flip side is my son. I could take the 4 days and stay home, just relax and see if that helps any concerning work. If I go, my son will miss me terribly and I'm not sure my husband will bring him up to see me (the hospital is about 45 minutes away) let alone what he'll tell him about me.

So......................what do I do? Go for 4 days or just stay at home?

Sorry for the long post.

Thanks in advance for any and all replies.

Mary Alice

[SleepsWithButterFlies]

If your PDOC or T leans towards you going in I woild but otherwise ,...ask for more anti anxiety meds for work...thats JMO

HUGS and best wishes on whatever you do

[PlanningtoLive]

Thanks, Sleeps. It's getting worse at work, I lost my lunch today and the meds I took with it.........<sigh>

[DaveyJones]

Sorry to hear things aren't well with you...it is so hard when you are trying to do your best, and your employer does everything they can to help, but you still feel yourself sliding down. I can truly sympathize with you. If you can be admitted to a hospital without being suicidal it might not be a bad idea...I notice that you are not taking one of the "proven" mood stabilizers...I got no relief from depression until I started taking lithium a few months ago. Now I take lithium and Lamictal but no SSRI's. My mood is better and much more stable than it has been in years.

I hope you get some relief soon, I know the hell you are going through

Hugs,
DJ

[lenjan]

Mary Alice, I know how you feel about the hospital, but I would lean toward going -- when you least feel like being there is when you need it the most, or at least that's how it works for me.

It would only be for a few days, and it sounds like it would do you a world of good.

Holler if you need me.

Love, Candy

[PlanningtoLive]

hey DJ, would they substitute lithium for the Lexapro? Lamictal caused a major rash and that was stopped. I was on lithium before, but it's been awhile.

Thanks for the concern. Only ppl that have been there understand.

Mary Alice

[PlanningtoLive]

Always there when I need you, Candy............thank you. Maybe a few days wouldn't be bad, I'm just worried about my son and the repercussions of my leaving.

You are so busy yourself, but if I need a sounding board, I'll call.

Mary Alice

[cherybery]

I think you should go in if your pdoc is all for it. And if you do decide sit down with your son prior to going in and have a talk with him. As far as work goes I totally understand. I actually started a thread about keeping a job. I think if you have something from your pdoc stating the time off you need there is nothing they can really do about it since you are following medical advice. Also, mindset yourself that in order for you to be the best at your job you need to take the time to take care of yourself. A good employer will understand.
Cher

you know.

I say go.

heck, worse comes to worse bring a couple of good books or somethin to while away your time and you can also look at it as a little bit of escape time.

I think sometimes the hospital is not that bad, for this reason

[Rebound]

I'm sorry you're having so much trouble. I can't honestly say which I think you should do. I have mercifully not been hospitalized, but the idea terrifies me.

On the other hand, I can see how a few days of having others to take care of you and where your only responsibility is to do what you can to feel better, would be a really nice change from going to work and losing your lunch. All in all, i think if you want to keep your job the hospital sounds like a very good idea. The last time I felt that badly about work I just stuck it out as best I could until they let me go. I was having anxiety attacks all the time by then. It might be worthwhile even if you elect to change jobs.

No matter what you decide to do, I wish you all the best. I know how heart-thumping, clammy-skinned, caffeine shakey, brain squeezing, pulse-pounding, terror inducing - panic/anxiety attacks really suck. I'm all for anything that helps.

[DaveyJones]

Hey, Mary Alice...

Too bad about Lamictal...it's really good for Bipolar II depression...I think the consensus is that you shouldn't take antidepressants like (Lexapro) without a mood stabilizer. That's what the doc is using Geodon and Abilify for...but if they are not working, it's time to look at alternatives.

Do you know why they took you off of lithium? It is still the "gold standard" for mood stabilizers. I just believe that too many BPII's are treated more like depression than bipolar, kind of a natural tendency, because we're depressed. It works for some, but like I said before, I feel so much better since I got rid of my antidepressants in favor of mood stabilizers.

DJ

[PlanningtoLive]

Hi Cher - that's how I am looking at it. I need to take care of myself so that I'll be around. Like I mentioned, I took 2 days at the end of one week and 2 days the beginning of the next week - that way I have 4 days in a row and I don't lose any money that way.

[PlanningtoLive]

hey Rainbowzz..........seems the odds are running in favor of me going. The 29th is fast approaching.

This hospital is really nice too. The ppl care and they have group too, I think.

[PlanningtoLive]

It's not so bad if you go in on your own, but if you end up there, then it's not so good. I'm really hoping something will make this anxiety more managable. I've never had something this bad before and I'm afraid it would be any job, not just this one.

This job is not difficult at all for me, a little stressful sometimes, but not hard. Thanks for the empathy, Rebound. It's always nice to know that someone else understands.

[PlanningtoLive]

Hey DJ, I asked my pdoc about the lithium change, and he said he'd definitely consider it. Although the higher dosage has only been a couple of weeks and he says the full effect hits about 8 weeks, I know the Lexapro is not doing its job. The Geodon and Abilify are doing great though.

At one point, I was on all kinds of different meds. I've tried Paxel, Celexa, Prozac, Effexor, etc. plus Lithium. It was awhile ago, so I'm not sure why we switched off of it.

[Rebound]

Well, I hope that things get better for you. It sounds like your doctor is willing to listen to you regarding your meds and that helps.

Most of the medications mentioned in this thread are unfamilar to me. Aside from a slew of anti-depressants which I finally convinced my doctor to give up on all together, I haven't been on too many. Not that I am complaining, mind you. But I often wonder what my options are.

[DaveyJones]

Trying a bunch of different meds is pretty much par for the course...I would be willing to bet that in your case (like mine) the antidepressants are the cause of your problems. It seems counterintuitive, but in many folks AD's wind up having the opposite effect, making you cycle into depression. that's probably why you were switched off the lithium...you were takinig it with antidepressants that kept you cycling...the doctor thinks it isn't doing the job, when it's the AD's that kept you sick. Perhaps you could try lithium, Geodon and/or Abilify in some combination if things don't get better in a few weeks.

I know I sound like a broken record on this, but there is research to back it up, and it has sure proved to work in my own case.

Here is a link to an article by Dr. Nassir Ghaemi of Harvard on the topic: http://www.ncbi.nlm.nih.gov/entrez/q..._uids=14636365

and one to an article by Dr. Jim Phelps: http://www.psycheducation.org/bipolar/controversy.htm

Hope you're up for a little "light reading!"

DJ

[lenjan]

DJ, I've been reading your posts, and I'd like to point out that not all BP2's can take mood stabilizers. The whole class is out for me because the Lamictal caused a physical illness that nearly killed me. I miss it, but recommending mood stabilizers as a cure-all isn't possible for everyone.

Candy

[PlanningtoLive]

Problem is I've been on way too many different ones. I went to a doc once who had me on nine different meds. I didn't know what was going on around. I realized he was a pill pusher and changed to having my T prescribe my meds. What a difference!

[PlanningtoLive]

That's what I'm leaning towards - lithium, Geodon and Abilify. The Lexapro did work for awhile, but something has gone seriously wrong and I'm definitely getting worse.

[PlanningtoLive]

Thanks for the concern, Candy. I read DJ's articles and they do back up what he says, but everyone is different.

I know I was on lithium, I just wish I could remember why I was taken off of it.

[DaveyJones]

Hi, Candybear!

You're right to point out that pretty much nobody can take every medication out there. That said, however, the fact that you have a reaction to Lamictal doesn't mean that you can't take either of the proven mood stabilizers, Depakote and lithium carbonate. These three drugs are not related, and the Lamictal rash is exclusive to Lamictal. And as far as treatment of BP2 goes, the problem is that most of us present with symptoms of depression, which, naturally enough, are then treated with antidepressants, which can cause several problems for anyone with bipolar disorder, among them mania or hypomania as well as overall cycling. I wound up a lot more depressed and unstable after years of AD's, and research shows that to be the case for many people.

That said, with your other medical problems, I would think you have to be exceedingly careful about what you take. While there are broad outlines for treatment, everyone is different, and treatment must be tailored to the individual.


DJ

[lenjan]

I didn't get the rash, I got aplastic anemia. My bone marrow stopped producing cells almost completely, and I nearly died twice, once from the anemia and once from a heart attack. I have been told by a biopsychiatrist, one specializing in psych med management and interaction, that I can no longer take mood stabilizers of any kind.

Depakote was the first one I ever tried, btw, and the side effects were so horrendous that I begged to be taken off it.

Candy

[EJ711]

Candybear,

Tomorrow's your birthday right?

That is so shocking about the side effects you had!!! I am so glad you are still here.

Hugs,

EJ

[lenjan]

Yup, tomorrow's my birthday, but since my home Internet access got cut off (hard to pay a $140 bill with $5 to your name), I won't be able to be around. I'll catch up Monday, though.