Some help? Totally confused.

Last December I was diagnosed with BD1 and gradually worked my way up to 900mg of lithium a day. On the 900mg I felt 100% stable. Everything was going well and my blood level was found to be .84, (not in the range for manic episode prevention but somehow it prevented the mania?). But then I had to switch doctors. I like my new doctor much better, however he raised my lithium to 1200mg a day instead of 900mg. After being on the higher dose for a few weeks I went for the routine blood work and we found that my level had been .74 and I had not done a single thing to lower my levels so that to me is baffling.

But my big question is my mood right now: what the Hell is it? I'm very clearly majorly depressed, I'm rotating between insomnia and hypersomnia, I am pretty much always excessively crying, I'm extremely fatigued, I have days where my mood is very good, not manic, just, well, good but then I am also currently the light switch of anger: any little thing can set me off and I'm suddenly tantrumming like a child; screaming, sobbing, cursing, slamming doors, locking myself away in my room and punching holes in my walls, ect. But just as quick as the anger came on, it goes away.

With all of the listed symptoms, what exactly is my mood? Am I in a certain episode, (mania, hypomanic, normal, depressed, mixed, ect). I see my psychiatrist fairly soon but I would like to know ASAP.

Sounds more mixed or dysphoric mania perhaps. I have dysphoric mania and mixed episodes and I'm an ultradian cycler. Fun. So, I often can't tell what my mood is exactly. Over time and tracking for the past 4 years I've figured out my pattner. I'm pretty much always mixed (yes, that is a thing, actually I discovered.) I don't have "normal" phases. I'm either more depressed or more manic, but always both. My mania isn't has high so it appears more like hypomania, but that's because I'm always depressed at the same time.

Very complicated.

Also, I do very well at 300 mg of lithium. I do not as good at 600 mg and I go into some crazy freak out mode at 1200 mg. I shake like you wouldn't believe and it elevates my racing thoughts. 300 mg is the key for me. I'm very sensitive to meds of all types. So, I know there are guidelines or whatever, but really, I think it is much more complicated than a text book but good luck finding a doctor who gets that.

I am not sure, but that sounds like a more pronounced version of what happens to me when my mania/hypo turns south and becomes dysphoric (mixed). Its like I have all the symptoms of both mania and depression and at any given moment I can feel more of one side than the other, but all sorts of emotions are there wrapped up into one big ball of difficult. My episodes usually stop after about 2 weeks of that feeling so at least I know it doesn't last forever. I hope you feel better soon.

Oh, and like Faerie, I am suuuper med sensitive so I have to take realllllly low dose of lithium 150mg. It does enough to help take the edge off, but doesn't prevent hypo/mania. I am learning what I can to try to temper that on my own, but the symptoms are inevitable so I am learning to ride the wave since I can't medicate to any dose that would actually fully stabilize me.

I want to preface this by saying that I am in no way, shape or form any sort of medical professional, and don't mean to question a doctors rx-

But I know avoiding caffeine is recommended for most people with bipolar, so wouldn't taking amphetamines twice daily be (X) times worse? Could that possibly be a factor?

Of course no one can diagnose you , just our opinions.

It does sound like a "mixed" episode. They in general are hellish. Of course You Pdoc should review your current medications and see if any of them need adjusted. Your Lithium level being up and down is common, My Pdoc has always made sure that I had my blood drawn 9 hours "after" my last dose , so maybe that is an issue.

All the typical advice , regular sleep schedule, diet, avoid caffiene, drink more water ( especially taking lithium) Exercise, Meditation, self ground , etc

Welcome to PC Glad your here !

I agree with the members above---it sounds like a mixed episode, which is pure, unmitigated hell IMHO. I just came through one myself about a month and a half ago, and I hope I never have another like it.

In your shoes, I wouldn't wait until your pdoc appointment to phone him and let him know you're having so much trouble. (Mine gets after me about that, because I tend to play this game of "how much of this crap can I take?") Sometimes they'll call you back and have you adjust your meds, and others they'll want you to come in ASAP. But whatever you do, don't let this mood persist.....over time, repeated episodes do cause brain damage and make the bipolar worse.

BTW, welcome to PC.....we're a pretty supportive bunch, and what one of us hasn't experienced, somebody else has.

Thanks everyone! I've had every episode except a mixed episode so this was my first. I'm starting to come out of it, I think. And I see my pdoc on Monday so hopefully we can sort this out! Thanks for all the insight!