Deep question, how do you know if meds are working anyway?

okay, so to start with my family doc put me on Prozac several years ago for depression and anxiety. Then when I kept complaining of being depressed on and off and having no energy she added Wellbutrin.

Then my family doc decided that I actually had bipolar disorder and not just depression and sent me to a psychiatrist. At first he thought I was just depressed so he switched the Prozac to Lexapro.

So here's my question, I know the Lexapro is working because If I try to wean the dose down I start having anxiety again. But how do I know if the Wellbutrin is even doing anything?

I alternate with bouts of depression and mania. When I'm depressed I'm still pretty severely depressed and have no energy. The Wellbutrin was added to help give me energy. I have been on it for 2 years now.

I plan to ask my new pdoc this.

My main reason for asking is if it's not really doing anything then I hate to waste money on it you know?

I suggest doing a before and after check list. Include symptoms as well as quality of life. If both pictures have very little or no difference, your meds are ineffective and ultimately a waste of money. Which means you have to re-strategize, try new meds, different therapy, even new coping mechanisms. No point in using meds that are not beneficial.

Also, you can't judge a meds effectiveness based on withdrawl symptoms, its not a very accurate indicator, plus alot of people complain about meds causing the very symptoms they're trying to treat, 2 biggies are depression and anxiety, so you may want to address this with your pdoc too, it may just be the reason you remain depressed.

Hope you figure it out and formulate a health plan that works

Well that is a hard question and mty only answer is ask about getting off of it and see what happens. I know that can be a dangerous trick but I think thats the only way to find out. I wish you best of luck on your journey to find the answer.

What about asking pdoc to tier down the welbutrin and see? Usually that's the only way I know meds are doing something.

It's really hard to tell if meds are working right unless you're in remission or have improved dramatically.

Lex and wellbutrin never worked for me. Well, wellbutrin helped with focus significantly, but didn't solve depression and I believe it made me anxious.

Agree with others that you have to experiment (with pdoc's blessing). With complicated issues, it is easy to wind up on lots of different meds, some of which might not be necessary. I have dropped meds before and discovered that I was fine. The opposite has happened too where I dropped a med and fell apart.

Best,
EJ

I take wellbutrin along with my other meds. I think it helps me with energy and anxiety, but not sure. Several years ago, I took it and it made me very anxious, but not anymore. Maybe I could give it up, but I believe that it helps to keep my appetite down. Most meds push me to put the pounds on, but with wellbutrin I have been able to lose 20 lbs. My cost is only $5 a month for this drug.

All of you who can take Wellbutrin are lucky. It's good for energy and can help you lose a few pounds, as well as work on depression.

I knew it wasn't working for me when I started flying into instantaneous rages and hysterical crying jags---I think it's what finally tipped me over into full-blown bipolar, along with a serious family crisis and the death of a close friend all at the same time. Not that I didn't have BP before, but it came roaring out of its hiding-place when this trifecta of misery sent my world spinning out of control.

The only real way (other than stopping them) to know if meds are doing what they're supposed to is compare how you feel now, versus how you felt when you started. This last year has been a real rollercoaster ride for me, and sometimes I wonder if all this stuff I'm taking is really doing me any good; but then, I look at where I was then and know absolutely that medication was the right choice for me.

You say "deep question" ... So I'll be very honest, the meds weren't working for me. It's a very personal choice. I quit the lithium in November. I felt like I'd rather try to ride the swings than the side effects. I'm not interested at this time in trying more bp meds. It's different for everyone, and a personal choice. I have pdoc appt on Wednesday and not sure what I will tell her. I think everyone says to be totally honest with pdoc, but honestly I trust myself more.... Shrugs, that's where I'm at.

I will say that YOU have to feel it works.

Not your doctors, or your "loved ones". I often feel when reading the comments here and elsewhere that often doctors and family mistake "boring" for "normal".
Some traits are character traits, not illness... for bad and good... and to medicate them is silly, imho...

I think you can be honest AND trust yourself more. I'm not taking this. I feel fine. I'm not going to be talked out of it. I'll call ya if I need ya.

EJ

It's just a little more complicated than this... I want to continue to have my add and anxiety meds, to take as needed which is not every day, I don't abuse them and they help so much. She won't give me those unless I'm on a MS. I disagree so ... It's my body my money I pay her, I think I can have my privacy. If I come down to needing it, I have some lithium on hand and will take it.

It sucks because there is a power play. I remember talking to my T about this and talking about it in group therapy. It would be nice if it were equal power but it isn't usually with patient doctor relationships. They want your trust, and we all mostly know that trust is a two way street or should be.

My first pdoc was much more trusting and open, he had his desk facing and against the wall so that you could sit beside each other and have open communication and conversation. He wanted to get to know you an build a relationship. My other pdoc was very closed, not trusting, didn't listen and interesting he had his desk between him and the patient which seemed to close communication and solidify who was in authority. He did not want to get to know you or build trust. I think he assumed my trust to him should be a given and his trust of me was not important. Ahh sorry but that was something I really noticed between the two of them.

You have to do what feels right for you Blue and you know your pdoc and how she might respond. But I am sorry that you find yourself in that situation.

Thanks Anika, I agree about the power play. They can really make us question ourself, but I really believe in myself, way more now than when I was first handed the dx - that shattered my reality for awhile. And I really thought I had to take all the meds pdoc gave me. But still had the moods, plus side effects. I was honest with her about quitting the wellbutrin at our last visit.

*Possible Trigger*
Same pdoc had my daughter admitted for her 2nd psych stay a couple years ago (cuz she was depressed and cutting). My daughter was 16, and I knew what my daughter was thinking / hoping she could get shot up with a bunch of ativan or something and escape her hurt. I knew it wouldn't go down like that, and that they'd deny her any benzo's while on a 5150 hold. I did not feel a 5150 was a good idea, I wanted to bring my daughter home and stay with her night and day and help her get better. I asked pdoc what if I don't take her to the hospital right now? She said, you can do that, but then I won't provide further treatment. So I gave in, my daughter agreed to go, but when she got there and realized they weren't taking her pain away, she wanted to leave but we were closed in by police, my daughter cried while she had to put on the gown in front of the male cop who wouldn't even turn around while she changed clothes. My calling him a twisted pervert didn't help the situation either. It turned into a 2 week hospital stay at a horrible psych ward 2 hours away, the staff was mean, it just sucked, she just got more depressed. First thing when she got home was lock herself in the bathroom and SI, I busted in and just hugged and hugged her and kissed her scars and we cried and held each other. Eventually now I consider, the experience may have made her stronger, but in a cruel way. So after that, I feel no reason to have to fully trust the pdoc and don't feel obligated to tell her everything. I do think she's a good doctor, but I also think I know more about my spiritual being, and my daughter's that she won't ever understand. So sticking to my right to my privacy. (That's all pretty heavy, I will add trigger icon)

Sorry, sort of straying, back to original topic... My opinion is strong, but I believe bp people are highly intelligent and should be allowed more choice in their treatment than many pdocs want to allow. Our opinion matters just as much as theirs. I think you trust yourself and learn as much as you can about bp and med/non-med treatments to help you figure out if the meds are helping.

Before and after is a good way but if you went in medication in a fit of desperation, like I did, there isn't much of a before list. I quit medication last July and I'm noticing things now that I will note if I decide to go back to them.

I cannot tell that my meds are or are not working. I do not feel any different whether I am taking them or not. That being said, my mother can tell within 3 days if I stop taking them and almost everyone else around me can tell within a week. Even though I don't see the help, others do so I guess that they are working. Is there anyone around you regularly that can give you an honest answer as to their views?