Why am I so stupid?

I apologize in advance if this is too long...

I've been struggling with stimulants because I've been using them to induce hypo/manic episodes, even though I know very well that such episodes (even depressive episodes!) damage the brain. You would think I'd know better by now, but I don't.

I admitted to my therapist yesterday morning that I have an addiction to stimulants, namely the Adderall I was once prescribed. She and I discussed why I had the addiction and what I could do about it. We ultimately came to the joint agreement that I should dispose of my Adderall by giving it back to the pharmacy -- but I just couldn't (can't) bring myself to do it.

We also discussed the issue of med compliance. I said I wasn't compliant with meds. Basically, I'd forget to take them, I wouldn't want to take them, it was "too much effort", etc.. Then she said, "Well, you appear to be rapid cycling, but maybe -- just maybe -- it's because you're not taking your medications as prescribed." I never really thought about that, even though, in hindsight, it was glaringly obvious.

On four separate occasions, I have admitted to my pdoc that I was non-compliant with meds; however, I've been non compliant plenty more than four times. But the four times I've admitted to being non-complaint were: Stopped Latuda cold turkey, stopped Abilify cold turkey, stopped Strattera cold turkey, and forgot "a few times" to take my meds. Each time I admitted to being non-compliant, he said, "You know, you could have caused a mood swing." Again, you think I would have learned.

My pdoc did make me the promise that, once I got stable, we could try stimulants again (since non-stimulants like Strattera weren't working). But I know if I continue to abuse stimulants, I will never get a stimulant again. He will most certainly put information in my file that says I abuse them, and any pdoc I see thereafter will have access to that information.

I really do need the stimulant for my ADHD because my ability to focus is severely impaired, and that impairment is compounded by some of the other meds I'm on (likely Lamictal). It sucks.

I don't remember how med complaint I was when I first took Adderall. However, I do remember that I was "stable" at the time, which is why we agreed to start it in the first place. I think I was on 200mg of Lamictal, 40mg of Latuda, 5mg of Lexapro. (I can't remember if I was on Abilify, though. It was around the time I was stopping Latuda and starting Abilify. Either way, both APs were useless.)

This time, I have hope that my new AP, Seroquel XR, will prevent hypo/mania when I take a stimulant. I just don't want to screw up again by taking a stimulant and becoming unstable again. My Seroquel XR dose isn't therapeutic yet. However, I'm now on 400mg of Lamictal, which I think will help immensely.

Good news is that I've been med complaint for the past 2 weeks (which I'm proud of!). I think the longest I've been compliant is 6 weeks. (Pathetic, I know.) I just don't get why I'm being SO STUPID about all of this. I know better than to be non-complaint.

I can't imagine what my Pdoc would do if I were that way about my meds. And yes you just might get your Adderall taken for good. But you're not the first- nor the last- person to use it to induce mania.

I don't think it's helpful to label oneself as stupid. You can talk about the facts, which you do in the rest of your post. I am a firm believer that there's nothing you can do about "stupid." Not in a derogatory way, but it doesn't allow you to develop a plan of action. Your self-awareness is to be commended; to be able to admit you're non-compliant with your meds. THAT is something you can work on.

My suggestion would be to work on med compliance first, then take on the other things one-by-one. In my experience the only way I've been able to remain stable and make good decisions is when I've been compliant with my med regimen. Once that is in place, I can tell objectively whether or not meds are effective, what side effects they cause, and if making a change might be beneficial. Making hit-or-miss changes doesn't allow your body time to build up the meds in your system, and it doesn't allow for objective assessment of how they're working. Without this information, you're shooting in the dark and shooting yourself in the foot.

Best of luck with getting your compliance under control. If I were you, I would work on that first and put the stimulant consideration on the back burner. It's more important to get the BP under control than it is to get the ADHD under control. You can't do one without the other. The quicker you can get the BP under control, the quicker you can move on to working on the ADHD.

I know what it's like to keep stimulants around, and how seductive they can be. If you committed to your therapist that you'd give them back to the pharmacy, you should probably do that. The two of you decided it would be the best option for you, and you should make your best effort to honor that commitment. I can't tell you what to do with them, but that's what you decided in your moment of honesty and openness with your therapist.

I know very little for certain but one thing I do know is you are far from stupid Blue. I don't know why you abuse meds...I don't know why you aren't compliant....but I do know that it's not a result of your stupidity. Maybe digging and exploring the reasons with your doctor could be helpful. It's easier for doctors to call someone non compliant than it is to take the time to understand why they aren't and address the underlying reasons. That would take more than 15 minutes and it's easier to deny meds or prescribe new one.

I hope you get the answers you seek but I can say with certainty that stupidity is not a trait you possess....nor do I feel that others who are non compliant are so out of ignorance.

Good luck.

The lack of med compliance is concerning.

If managing when/if you take them is difficult, I suggest having your pharmacy blister pack them. I do. That way, if I can't remember if I took them or not it is plainly obvious to me. I also leave myself several notes as reminders.

Gosh, I really enjoyed being hypo/manic but the crashes and fall-out were devastating. As much as I miss the episodes I can't afford - literally financially - to go to that place again.

I recently stopped taking Abilify for the same reason: to induce hypomania. I had been depressed and thought it would bring me 'up.' Not only no luck there, but I also felt 'stupid.' But it's not that. Hypomania itself can be so addictive and it's very hard to think of the consequences when you're so desperate for that -sadly temporary, usually- high. I get it. Don't beat yourself up about it! You're doing the best you can under very difficult circumstances.

Hey blue, you are far from stupid. Med compliance is something many of us struggle with and your self awareness of the stimulate issue is a good thing. I'm glad you talked to your therapist openly about this. Do your best to keep that promise and get rid of them. I'm sorry your having a rough time right now. Hugs!

You're not stupid. You have a disease in your brain. It trips you up.

There's times I don't take meds, or reduce them without the pdoc knowing. Not the best idea, but I know me and at the time the meds were making me climb a wall in anxiety.

Like someone said, get the BP under control. If you're having mood swings, it won't matter if you can focus or not. You're not going to be able to focus anyway.

I think it's understandable that you're struggling with taking the meds to the pharmacy, considering your addiction to them and that you feel they are so effective, but it's harming you. Could you give your meds to your therapist to dispose of?

My lamictal has totally messed with my memory, too. It's so frustrating and very real.

I agree with others. I recommend getting your bipolar under control, putting the stimulant question on the backburner, and then coming back to it when you are stable enough to measure its effects. All this would give you a much better idea regarding the speed of your cycling.

Can you remember how it felt to be stable last time? Like, use the memory to help motivate yourself?

(And also, I did the google search you recommended for the $3 or less seroquel xr. It looked like it was for people without any insurance. Do you have any insurance?)

You're not stupid! That was really brave of you for being honest with your therapist. I second or third what others have said and work on just being med compliant regarding your bp. I would take the adderal to the pharmacy. Just get rid of it. I'd be too scared of taking adderal, lol. I'm afraid I'd go into a psychosis. But just get rid of it. Work on being med compliant for now.

Best of luck!

you are wonderful blue and smart!
I believe you are in part in denial about your bipolar diagnosis.
Talk with your therapist and learn to better cope.
This DBT work book is very good.
bizi

You are not stupid, blue. I've always found your posts to be very insightful and give us things to think about as far as how BP affects us in different ways. You are admitting to having an issue with stimulants, and it takes courage to face this problem. What's most important is that you are starting to address it in order to take better care of yourself. Please don't be so hard on yourself. You have support here.

Blue you are definitely not stupid. You get to travel the world with your computer momojumbo. I think you are being rough to yourself. We all have this disorder that makes us do something we might regret later on. Don't beat yourself up just try to get better.

bump for blue.
(((((HUGS)))))
bizi

I think you're right... but maybe not "in denial"... but more like "I don't believe it."

Like right now, I think the bipolar diagnosis is one huge ploy to let big pharma suck my bank account dry, and they're doing this to millions, if not BILLIONS, of people in secret. I mean, why is 1 out of 6 people in the U.S. on psychiatric medication? And why are bipolar Dx rates increasing? Medications are handed out like candy. And since everyone who has bipolar disorder needs to be on medication for life, it is a very VERY clever ploy. Astra-Zenica and other companies are behind all of this, and I bet they have a secret deal with the government.

None of my meds prevent anything, so everything is fake, the diagnosis and all. It's a lie. I don't think anyone is trying to help me. In fact, they are trying to make me worse, which gives them MORE money. It's kinda like, "well, let's prescribe latuda. oh wait, that causes akathisia? well, looks like you're going to need cogentin too to get rid of that akathisia.. and maybe you'll need an anxiolytic to go with it because you may have anxiety about getting akathisia again." that kind of thing

My pdoc is part of the bigger scheme.

I came in for help with ADHD, and what do i get? They give me antipsychotics and mood stabilizers instead. Huh? Since when do I need an antipsychotic or mood stabilizer?

I haven't been taking any of my medications because I refuse to succumb to the clever ploy. I think the govenrment is coerced to turn a blind eye... or possibly just persuaded... bribed. I mean, in the UK, they have caps on medication costs. In the U.S.? Latuda is like $1300 for 1 month's supply. That's why drs prescribe it. It's $1300 for 30 pills. I mean, why did my pdoc start me on latuda? he coul have started me on seroquel, or... idk.. haldol, abilify. but no, he started me on latuda. He was bribed by big pharma to drug me with something useless, but expensive.

All I need is adderall or something like it, not antipsychotics, mood stabilizers, etc..

Hopefully that makes sense.

I started Adderall again and not been taking my other medications. I instantly feel better.

I hope you'll be ok. I believe they give out too many bp diagnoses too. But I know I have it. If I were to go on adderal I would, I'm quite sure go manic and maybe end up psychotic.

You are not stupid. Whether your in denial about having Bipolar or not.

You have a legit reason as for Big Pharma. I loathe that whole mess but I will scoot my soap box away, for now lol

I also believe that the exploding diagnosis of all kinds Mental Health can be due to the foods we eat now that are full of gawd knows what chemicals.

If the specific word Bipolar is a hurtle for you.... break it down to just treating individual symptoms. Anxiety, sleep issues, racing mind or the depressive end.

From My observation blue.
You rapid cycle on or off meds. I think you will rapid cycle even more off meds.You are the one who said you were addicted to mania that you missed it. well here it comes and be ready for it. I hope you enjoy the ride, roller coaster and all.
good luck my dear we will be here for you when you crash.
(((((HUGS)))))
bizi

Thanks guys. I'm just not sure anymore.

I feel a lot better this morning after taking Adderall and nothing else. I didn't get any sleep, but I feel amazing.

I'm just a bit peeved because I know that my pdoc will not prescribe me more adderall because of what's written in my file.

@Christina: It does help a bit to break down everything into symptoms, but I feel like my meds are useless because I still have all of those symptoms regardless of how many and which kinds of meds I'm on. I mean, I need a higher dose of my AP, but my pdoc won't give it to me because he insists it made me manic the last time. I vehemently disagree.

Blue, maybe it is time for a new psych doctor? A new set of eyes....and ears!
((((HUGS))))
bizi

I have 4 opinions and they all say the same thing. I'm just not getting any better, so I think the Dx is wrong.

How could the dx be wrong?
What else could it be???????
(((((HUGS))))
bizi