No change... whatsoever :/

I really don't know if I'm looking for some opinions or just moaning here. I'll write it down and I suppose we'll see. I'll keep this as brief as possible, and I'm using bipolar terms in my history for ease of description. Weight losses/gains approximate.

I was diagnosed Bipolar nearly a year ago. I'm 36.

I had trouble with depression from my early teens. Forward to late teens and was heavily into binge drinking. Quit drinking, then became hypomanic, lost 70lb, then became manic/delusional (got the really embarrassing scars), then crashed into a serious, long lasting depression. Put on 84lb.

Gradually climbed out of that, then got some short bursts of hypomania and lost 70lb. Double suicide in the family (which just confused things), still high, became manic, delusional, dangerous to myself and promiscuous. Crashed to depression. Put on 84lb.

There were a couple of mini-cycles of hypomania followed by depressions (but I could still work) with attendant weight losses/gains of around 45lbs. No delusions.

After a short period of long-lasting mild depression, had a few bursts of hypomania again and lost 70lb, before becoming manic, delusional, promiscuous and dangerous to myself again. Crashed to depression, and put on around 90lb.

So, there I am, depressed, and after being referred for the nth time to see a counsellor, I decided I'd get to the bottom of these depressions (I always thought I was "better" when I was hypomanic/manic). With the help of the counsellor, I went back through my history and created a timeline, explored old diary entries where I made specific reference to missing the "high" and being on a rollercoaster (news to me, even though I wrote it myself), and realised it might not be as simple as mere depressions.

Together we pieced it together, I went to my GP, got referred to a psychiatrist, and was diagnosed. Ok. Or so I thought.

And I know I shouldn't discount life experiences, especially over the past couple of years. I really know I shouldn't... but... I really got to know my cycle. I graphed it myself. I can see it right now in front of me going back twenty years. Some of those cycles are devoid of triggers as far as I can see, especially the big ones.

Now I am medicated, and supported, and... been stuck in a severe depression for nearly two whole years. I keep waiting for a burst of hypomania that never comes. I stopped taking Depakote in the hope that something will change. I've never had such a sustained lack of energy. I was never particularly adherent with AD's before, now I am, and it just seems to be having the opposite effect to that intended.

My mood... my mood is just what it is. It's feeding off the lack of energy in a neverending circle. I just can't climb out of this one, and I want to, just because armed with what I know, the next cycle might not be so detrimental. There are things in place, and with just a little energy, I can learn to manage so that perhaps I don't go all the way down ever again. But it never comes.

I don't know what I'm doing wrong. The cycle has stopped dead, leaving me in this place, and who can live like this? No one. If it weren't for my mother supporting me I'd be dead by now or be sleeping rough on the streets with no hope.

Please, something change...

Can anyone relate to this? Does anyone have any idea what is going wrong/keeping me here? I'm so lost.

Hey, Charlie_J!!

Depakote is a mood stabilizer, usually given with anti-depressants to keep them from pushing us over into mania or hypo-mania. Is Depakote all you were prescribed?

Hey Roadrunner! *hugs*

Yep... been tried on Fluoxentine (again), then Sertraline, then Venlafaxine, which I'm currently on. Went gradually right up to maximum dose of fluoxetine, and sertraline. No change. Now on 150mg of Venlafaxine, but there's an option of taking it up to 225mg according to my psyche. So far.. no change.

I haven't been taking the Depakote. The fact that nothing's shifting depression-wise makes it a bit surplus to requirement atm.

The last time we changed my Antidepressant, the psychiatrist was in two minds between Venlafaxine and Olanzipine (sp?), but he thought Olanzipine would make me even more of a zombie.

How are you doing lately? Haven't spoke to you in ages.

seem to have my meds worked out (ty, Universe )
spinal cord being crushed by arthritic disks--acupuncture to the rescue,
+ had to get rid of beloved truck because of it ... managing tho
Most else the same I think ...

maybe they need to try you on a completely different class of anti-depressants ...
have you been on Cymbalta yet?

Sorry about your truck... have you still got something you can get around in?

Back sounds painful too. I really hope it gets easier, RR.

As for the meds... Venlafaxine is the first SNRI I've tried, all the others have been SSRI's. Been on it for at least three months now. So far nothing.

I wish I could try something completely different. It doesn't seem like anything in this family of drugs is helping. I tried bupropion on a stop smoking course once, and that made me mildly hypomanic. I keep wondering if I can request to come off SSRI/SNRI type drugs completely and try some of the older MAOIs.

They're changing my psychiatrist now, as well as my CPN, so I don't know who I'll be seeing. I guess I'll see what kind of doctor they are before I make any "requests".

Have you tried Lamictal? It's a mood stabilizer that works better with depressions rather than mania. It seems a lot of people take it and have had success with it.

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000957/

It takes a while to work the dosage up to where you'd actually feel something but it's worth a shot.

Then again, changing drugs is one thing... but why is the depression so long-lasting this time? I've got evidence in front of me. It's definitely over a year longer than my last major depression already, and it's the longest major depressive episode I've ever had. The drugs can't be making it last... can they?

Last year, with my diagnosis, I was a person whose life had been severely disrupted by tragedy and genetic mental illness, but who was moving forward.

Now, I'm a perfect mental health patient. Reliant, helpless, and hopeless... with no end in sight. It's almost as it, by going the way of figuring out what was happening to my moods, I've made some kind of horrible mistake.

*firmly squashes down immediate conspiracy thought regarding pharmaceutical companies*

Damn... now I've thoughtlessly overdosed on kitkats. *sighs*

Hi confused... and thank you...

I've only ever been prescribed Depakote as a mood stabiliser. I've no prejudice against that one, just that the thing it's there to prevent has thus far deigned to make any kind of appearance.

Once in a while I'll have a day - one day - where my energy levels go up, something like maybe once in every couple of months. Those days I use to fight with the garden. Then they're gone.

Maybe it's me. Maybe I should be adherent with the mood stabiliser so that the energy of those days becomes spread out, thereby lifting the depression enough for the anti-depressant to do its job.

Maybe I'll try that.

Honestly, a combination of medication and a new outlook on life helped me.

Medication helps my tendency to be overly emotional and has helped with dealing with anxiety. My outlook prevents me from thinking too much about my diagnosis in my everyday functions. I know I have a "mental illness" but I simply don't think about it unless it's brought up.

A person with diabetes remembers to take their insulin and make check-ups to get blood work etcetc. They don't associate every part of their day with the illness. They do think about it when they eat, and when they need to take blood samples. The problem with MI is the feelings aren't confined to one situation. All of your interactions with the world produces some response in you. The system doesn't really help because you end up feeling "helpless and hopeless." It isn't until you decide that you want a partnership with your doctors that the relationship shifts and you gain more confidence in yourself. It becomes easier to believe that you're a capable human being.

If you're still seeing a T, I'd recommend going over ways to take back your identity outside of the mental health world. A T can help you explore, AND they can also help you with asserting yourself. It's a really good and often safe place for clients to practice real world skills that they may/may not have had because x,y, and z happened in their life.

sorry XDD I didn't see your reply

Hi again confused...

I think I might have given the wrong impression in a previous post.

I'm in a depression that has lasted longer than any others previously, a depression that leaves me with negligible mental capacity, and means I physically cannot function. At the moment I really couldn't care less about emotional responses. They come and go, and they will get better if I can just raise the energy to pursue the things that will help.

I have a small part time job of six hours a week that I'm determined to keep and am scraping by just barely managing to do the work required because I know it helps my mental health. I attend all of the appointments I can, and go to all the places I am supposed to go... if I can.

Ideally, I want to be able to attend work, go to the lifeskills class I have once per week, attend a subsidised gym I've been referred to three or four times a week, attend appointments with my doctor, psychiatrist, CPN, grief counsellor and a therapist. I also want to attend the appointments deemed necessary by the jobcentre people.

But... I'm not getting enough of a reprieve from the depression to do all of that, and the point I mean to make is that before, without self-knowledge, without drugs, without treatment or support of any kind - I absolutely did better. I may have been unstable, but compared to this, I was better on the whole.

The worst thing about being depressed for this long is that I sense something changing in my brain. I mean, I've experienced a lack of concentration and memory problems with depression before, but now it just seems like parts of my intellect are dying, and I can't be sure they're going to come back. I feel... brain damaged in a way.

*shrugs*

eta: The reason I posted is because while I suspected it, this morning I got out the timeline I painstakingly constructed, and it's there in front of me in black and white. I'm not imagining that it's longer. It is longer, so much so that it's a drastically recognisable and measurable change to my mood cycle prior to treatment.

hope things get better for you....

hugs

I think I'll try being adherent with both the AD's and the mood stabiliser for a couple of months.

Then, if that doesn't work, I think I'm going to ask my GP about getting referred for ECT. I just don't know what else to do.

I can't get referred to it through the CMHT, because my CPN told me it's a hospital thing, rather than a mental health one (how weird is that?).

to all.

incomprehensibly

Charlie, from your thread I gather that you are somewhat controlled by your insurance company which directs you about what you may and may not do. That's a tragedy.

I wish that you would consider seeing an allergy specialist, Charlie. There may be
problems with severe allergies that have been unrecognized for years. Help in that area might be something that can start you on a road to recovery.

I would at least try that before going in for electric shock treatments.

Along with an inherited genetic problem that causes bipolar illness, we often (some of us) may have an inherited allergy gene that wreaks havoc with our feeing tones.

You may be amazed at what can be determined by those inclusive tests.

I would suggest that you might consider seeing an allergist, particularly if you have cravings for any kinds of foods or problems with high histamine levels (in allergies) or if you have addictions of any type.

Take care of yourself, please.

Why dont you ask to change the mood stabilizer if you dont feel depakote is working?

Making a goal and routine you can't currently accomplish wont help either. You have to break it down to very small baby steps. Like, "I will go outside and sit on my patio" or even, "I will leave my bedroom and make myself cereal" These goals aren't difficult for a person who isn't depressed, but can be so agonizing for those who are. It is a huge accomplishment to even see your health team and you should be proud of yourself. If you see a t, talk about those baby steps. You cant just go to the gym 4x a week without feeling overwhelmed. Going outside for a 10-15 min walk may seem silly but its a stepping stone.

I think you should ask for the ect now. Even if you dont get the ect, youd give the message that you want to be well.

Unfortunately, I am not surprised that your depressions are getting worse over the years. This is common. Depression (and in particular bipolar depression) is sort of a progressive disease. It is common that the first few depressive episodes are more mild and triggered by difficult life events. As time goes on, the episodes tend to be more severe, longer, and not triggered by anything.

As someone who has struggled to find a good med combo over the years, one thing I have found helpful is to bring a type written chart of meds I have taken, when, and their positive and negative effects. Sure this info is likely in your chart somewhere, but doc's sometimes don't take time to read carefully etc. It helps to do some of their work for them.

I know it is easy to get discouraged. I experienced one depression that lasted for years until I hit on the right drug for me (Abilify). It can get better. Keep fighting.

Best,
EJ

P.S., I see you are in the UK. Do they have TMS there? That might be a better option than ECT.

EJ

Thanks for your reply. I'm not fettered by an insurance company, but by the NHS. I've recently heard the term "throwing services at things" for the first time, and while it wasn't used in a bad context, I can imagine it being used that way by others in control of budgets.

Hi again, Confused... I think the mood stabiliser might well be working. Mood stabilisers control manic symptoms rather than depression, and I'm really far away from mania being a problem now. I stopped the Depakote in the hope that a long overdue burst of hypomania might kick in, then I could get back on the stabiliser sharpish so that the Antidepressants I'm taking could do their job and put me on the road to recovery.

Hey Eliza... thank you for the reply. The med chart thing is a really good idea! I'll get on with that on Excel, then print it off.

What is TMS?

I've actually found a UK based research study for which I'm a perfect candidate. They want to study differences in memory loss between people who receive ordinary ECT, and those who are injected with a small amount of Ketamine along with/in place of the other anaesthesic drugs.

I'm going to write to her to see if I can be included in that, I think.

cheers, all...

xx

Quick info on TMS:

http://en.wikipedia.org/wiki/Transcr...ic_stimulation

Gotta run,
EJ

Buprion made you slightly hypomanic, why not try it now with a mood stabby?

Hi Charlie J,

Wow, your experience takes the cake! I am sorry it has been such an ordeal. I know that medications work differently for everybody, so it is hard to compare. My experience thus far with a mood stabilizer is that I am stuck in depression continuously........ no hypomania. I am on lamictal and was also on abilify at the same time. I am also taking venlafaxine as my antidepressant and the only thing I think it does is help with anxiety control. Like you, I am so sick of the depressed state that I recently asked to go back to an old med that used to work, Paxil. So I am keeping my fingers crossed but will be very disappointed if there is no effect.
I can completely identify with you in terms of stuck in depression.............

That's what I thought when I was going through the first few months after I was diagnosed---maybe I was better off BEFORE I started trying all these new meds? Of course, I'd conveniently forgotten what a hot mess I was when I first sat down on my psychiatrist's sofa, as well as all the other crazy stuff I'd done throughout my UNmedicated life.......all I could think of was how much more unstable I'd felt since starting the drugs.

Now, with the right 'cocktail', my moods are no longer in charge of me. It took four different meds to get my BP under control, but it's happened and life is good again. It will be for you as well; just try to be patient with your meds and your doctor. It really does get better!

Thanks so much for the link, Eliza. It seems an interesting thing, but after trying to find it here, I don't think they do it.

I've actually thought of that myself, and have asked my doctor if there is any chance of him prescribing it for that reason. Trouble is, here it's only ever prescribed as a stop smoking aid.

I then asked to be referred to the stop smoking program, got my letter through and talked to them, and they told me where they are in the middle of a town not too far from me... but...

Smoking is sometimes the only thing that makes life a little easier. I don't drink, or do (illicit) drugs. And they test your breath there. I don't think I could count on them to continue with the bupropion if it was clear I wasn't stopping, and maybe they wouldn't give it to me at all, given that I'm already prescribed an SNRI for bipolar. *sighs*

The only other option then is to buy off one of these dodgy internet places, and I'm not that crazy... hey! I'm not that crazy! (me = 1 Bipolar = 0)

Hi Blue Poppy, and thank you. I'm really sorry you're going through that same stuck in depression thing - I know how crap it is. I wish I had something to suggest. If I do find that something works, I'll definitely let you know so that you can think about it for yourself.

I really glad things are better for you now, BipolaRNurse. I don't feel UNstable now, rather I feel stabilised into a living death where nothing lifts and nothing changes, but I also think you've hit the nail on the head a bit. I mean, if the alternative is rushing around like an overexcited whippet while everyone else looks on in amusement, getting in ever more dangerous situations and believing I'm invincible, all the while making certain that the next crash to depression will be deeper and bleaker - is that really better? No... it really isn't.

Thank you.

To all: Sorry it's taken me a while to reply to these comments. I've had some real trouble staying awake and appear to have completely forgotten what day it is.

Somebody mentioned Abilify. A few years ago my Pdoc put me on Abilify and it gave me energy I hadn't had in years. But when I went into another deep depression it stopped working.

Others have had good results on it. Unfortunately I went to get this and Seroquel refilled and it was so expensive I couldn't afford it. He finally got me the generic Seroquel and took me off the Abilify.

The abilify worked good for me for a few months. Wishing you well to find the right cocktail for you.