[LiteraryLark]

I'm seeing my new pdoc in two days and I'm trying to figure out how to explain to him my depression. I'm bipolar. Not depressed. I can feel depressed, and severely when I do, but it lasts for a few days to two weeks or more if something does not relieve it. When I feel depressed, it feels like I've always felt that way, even if I was happy the week before. And when I'm depressed, it feels like I'm in a dark abyss where my life is meaningless and hopeless, and because I'm bipolar, I can suddenly be so happy I'm singing and act like I'm never depressed.

So what I am planning on asking my pdoc is, what can I do during those phases when I'm feeling depressed? My previous pdoc told me it's just something I have to live with because anti-depressants trigger the mania, but there's just no way I can keep living with the depression any longer because it sends me into such a dark place where it's not normal depression.

I just watched a commercial for Abilify. They said it's an add-on to the anti-depressant I'm already taking, which I guess could mean the lithium and zyprexa I am taking. When I was in IOP, a nurse told me that I should try different anti-depressants and other solutions to find the right fit for me.

I'd like to find a medication I can take as-needed for when I am feeling depressed, something that will fit with my bipolar and won't trigger manic symptoms. What has worked, what hasn't for you? Thanks.

[optimize990h]

Originally Posted by DrSkipper

I'm seeing my new pdoc in two days and I'm trying to figure out how to explain to him my depression. I'm bipolar. Not depressed. I can feel depressed, and severely when I do, but it lasts for a few days to two weeks or more if something does not relieve it. When I feel depressed, it feels like I've always felt that way, even if I was happy the week before. And when I'm depressed, it feels like I'm in a dark abyss where my life is meaningless and hopeless, and because I'm bipolar, I can suddenly be so happy I'm singing and act like I'm never depressed.

So what I am planning on asking my pdoc is, what can I do during those phases when I'm feeling depressed? My previous pdoc told me it's just something I have to live with because anti-depressants trigger the mania, but there's just no way I can keep living with the depression any longer because it sends me into such a dark place where it's not normal depression.

I just watched a commercial for Abilify. They said it's an add-on to the anti-depressant I'm already taking, which I guess could mean the lithium and zyprexa I am taking. When I was in IOP, a nurse told me that I should try different anti-depressants and other solutions to find the right fit for me.

I'd like to find a medication I can take as-needed for when I am feeling depressed, something that will fit with my bipolar and won't trigger manic symptoms. What has worked, what hasn't for you? Thanks.

Well, the antidepressant, Wellbutrin, is what I am on. It's something that could increase anxiety.

Others should give ideas of the other antidepressants.

The thing about Wellbutrin is that you don' t have wean off it. You can stop and supposed have no effects. Take care.

[usbusi]

I'm on Wellbutrin as well, and Abilify. But I don't think any drugs are designed where you can "pop" one when you are feeling in a mood, as they take a while to kick in. But who knows maybe some people take them like that. They are designed to be daily. I take Abilify to prevent mania, as I was given it first when I was hospitalized the 2nd time. So far two years and no mania. I know what my trigger is now though, too. Wellbutrin is a good anti depressant, but you can read another recent thread or two that shows many people get manic on it. So you should have a good mood stabilizer or anti psychotic ready to fend off the mania in your bloodstream as well. I think most psychiatrists prescribe something to prevent lows and something to prevent highs, to try to sandwich us into the normalcy range. I don't cycle so I'm easy to deal with though I think, tending towards depression all the time. Which the Rx's I take help.

[hamster-bamster]

Originally Posted by DrSkipper

I'm seeing my new pdoc in two days and I'm trying to figure out how to explain to him my depression. I'm bipolar. Not depressed. I can feel depressed, and severely when I do, but it lasts for a few days to two weeks or more if something does not relieve it. When I feel depressed, it feels like I've always felt that way, even if I was happy the week before. And when I'm depressed, it feels like I'm in a dark abyss where my life is meaningless and hopeless, and because I'm bipolar, I can suddenly be so happy I'm singing and act like I'm never depressed.

So what I am planning on asking my pdoc is, what can I do during those phases when I'm feeling depressed? My previous pdoc told me it's just something I have to live with because anti-depressants trigger the mania, but there's just no way I can keep living with the depression any longer because it sends me into such a dark place where it's not normal depression.

I just watched a commercial for Abilify. They said it's an add-on to the anti-depressant I'm already taking, which I guess could mean the lithium and zyprexa I am taking. When I was in IOP, a nurse told me that I should try different anti-depressants and other solutions to find the right fit for me.

I'd like to find a medication I can take as-needed for when I am feeling depressed, something that will fit with my bipolar and won't trigger manic symptoms. What has worked, what hasn't for you? Thanks.

No, Doc, Lithium and Zyprexa are not AD's. Lithium is a true Mood Stabilizer and Zyprexa is an AP. To the best of my knowledge, for Abilify to work, it needs to be an add-on to an existing AD, such as an SSRI. It may be a good route to take, and I assume that taking Abilify will reduce your reliance on Zyprexa because Abilify is a potent AP in its own right. Definitely worth trying.

Lithium protects you from flipping into an AD-induced mania. You can try an AD while on Lithium. Whoever told you you cannot was not informed or too fearful.

[Secretum]

I'm on a medication called "Symbyax", which is simply a combination of Zyprexa, which you''re already on, and Prozac, the most famous SSRI ever. Symbyax is one of two meds approved by the FDA to treat bipolar depression. (The other is Seroquel, which is an atypical antipsychotic with antidepressant qualities.)

The Symbyax has been a miracle drug for me. I'm not depressed, at all. Admittedly, I do run a bit hypomanic most days; the Prozac is probably to blame for that. Maybe if I wasn't on an SSRI, I would be more "stable". One thing I know for sure: between the antidepressant qualities of zyprexa, prozac, and wellbutrin, I have mood swings, but I can deal with them. Without a "destabilizing" SSRI, I would still be having mood swings, and I wouldn't be able to deal with them. That is my opinion regarding the use of antidepressants in the treatment of MY bipolar disorder. take it for what it' s worth.

[hamster-bamster]

I take 10 mg of Prozac - less than Secretum. It works well without causing me to flip into mania.

[cocoabeans]

Lithium has antidepressant effects and is sometimes given to unipolar depressed patients. Zyprexa is given to suicidal people a lot even those who are not psychotic or bipolar. Abilify commercial is just more marketing since lots of antipsychotics used as add ons are now generic like Seroquel and zyprexa, same goes for symbyax with prozac and zyprexa being generic, why save consumers money?

Of course, the commercial creates a lovely belief that the drug will work and placebo effects are still effects.

[~Christina]

I can not take Ad's at all, they flip me into an ugly Mania.. I take Lamictal to help ward off depression ,my Pdoc called it the background drug for depression. Lithium, no side effects for me at all. I refuse to take any AP's for more than a couple days if I really REALLY need it. all my meds are weight neutral which is something I refuse to budge on. I am not a person that can honestly say " ill be ok being fat as long as I'm stable" that does not work with my ED issues.

I hope you find something that works for you. Be very clear with your Doctor about your personal "Do and Don't " list. If this new doctor isnt willing to understand you wants and needs then find another new one..

Good luck

[Trippin2.0]

Have you looked into natural AD's? I read a study that shows this young girl with severe depression, her parents didnt' want her on psychmeds and tried Niacin... according to the study she responded well to it. My brother was so impressed he's started using it. he's a a musician and didn't want to risk his creativity with psychmeds.... I don't speak to him anymore though, so I can't tell if it's still working for him... I agree, be very firm with your pdoc as to what is acceptable to you, best you're on the same page from the get go.

[BipolaRNurse]

I take a very small dose (10 mg) of Celexa every day along with Lamictal. It wasn't quite enough to stop me from slipping into a depression in December, but much of it was situational and cleared up after the holidays were over. The thing that frustrates me is that 10 mg isn't really enough, but 20 tends to switch me into hypomania and my pdoc knows it. So he won't let me take any more than 10 mg (and he really wanted me off the AD entirely, but when we tried that it was a disaster), but he did increase the Lamictal, and that's made a difference.

It really is a crapshoot when you're talking antidepressants and bipolar....some people can be helped by ADs, while others can't even get near them. And what works well for one person can launch another into outer space (Wellbutrin is the only reason why the term "psychotic" is in my medical record). I'm just glad my pdoc is open to prescribing an AD, as reluctant as he is to do so, and as strict as he is with my dosage.

Just for the heck of it---and because I was sliding into my usual seasonal gloom---I asked him recently if I could increase the dose, for the winter only, and his reaction was actually kind of funny: "I know what you want, and NO!!" He knows I love my hypomania just a little too much.

[Br0k3nW1ng3d]

I found that it was useful to give examples of my behavior when I am going manic. The more specific the better outlining any risk taking, elated feelings or thoughts, and what have you. The more you can say in your own words without sounding like a text book will help you prove your case for getting the proper medications. You have to explain how it is making it challenging to function.