Trying to conceive - need meds advice!

(Sorry in advance for any TMI)

My husband and I are trying for our first baby, I am 37 yo and he is 35. I have been on 200mg Lamictal for a few years now (as well as Lexapro which I am still on for time being). Have been off seroquel for a while. Diagnosed as BP-2 but I am really uncertain of that diagnosis. I suspect hormones and moods are at odds.

I tapered over 1 month down to 100mg where I am at present. It is already apparent that things are not good. I used to suffer from "rage" attacks, which subsided for a while this year finally.. only to rear its ugly face already 2-3 times in the past mo. I did notice that the moods were almost exactly timed with major hormone flux related to my monthly cycle (hence my suspicion i may have hormone/pmdd possibly pcos..). I also suffered a chemical preg last month, as I have been monitoring closely and had a faint + just before my P started. We just started trying.

I am working with a new Psych NP since we just moved as well. She is very good and open minded. I have stayed on Lexapro 10mg, and am wondering if that is contributing to my attacks. As when I started on Prozac a few years ago, it was very activating to me, and that is what i mostly suffer from. Being over active, 'mania'ish, rage/anxiety attacks, yelling, breaking stuff. Exhaustion the next day & depression which usually lifts on its own in a day or two.

The reason i suspect hormones at play is exactly the say time of the month (just before my Ov) last mo, I freaked out on my DH, and again, this month. (perhaps full moon didn't help). :/

Now that we are trying for a family, we are both on edge re: my moods. I understand his concerns. Last night my freak out related to his concern about me eating Ice cream religiously. Last night, i did not. And then when i mentioned wanting some, he mentioned that he was proud of me for not having any. Well, that triggered a massive over-reaction on my part, which concluded in me breaking a glass on the counter, and lots of nonsense drama. It affects every bit of my being. Thankfully I dont have to work out of the house today. I am so exhausted.

Yet, the thought of having a child is so exciting to me, i have been waiting and waiting and want this to be right I am going off the meds for this baby. I want to do all I can. I do not want to be on Lamictal during pregnancy. That is something DH and I both agree upon as well as my NP.

Its very hard as I was doing really well this year.. I am not going to get too discouraged. I am just frustrated, feel like an outsider, worry I might not be a great mom b/c of my moods. On a positive, I see how I am doing something about all this, vs my parents/mom who have mental illness (i greatly suspect) and did not take any action.. i am getting help, i have a team, and a wonderful therapist.

I was reading an article which struck a chord: Hormone Imbalance, Not Bipolar Link: https://www.psychologytoday.com/blog...polar-disorder and am wondering if I might try this approach which mentioned Wellbutrin helping in the cycle. Perhaps this is the wrong forum for this question- but if any ladies here found relief for hormones w/ Welbutrin? I believe this is also safer during Pregnancy.

thank you for any info. sorry if this is all over the place, i am not exactly very fit this morning.

Is there a way you can go to intensive out patient program or partial hospitalization program? That way you can learn coping skills to deal with your mood swings no matter what the cause is.

If you suspect an organic cause to the mood swings I would ask your doctor for a test for if your thyroid is okay, minerals and vitamin intake is adequate etc. They really should have tested this before the diagnosis.

However, an alternative is that your hormones make the disorder worse. Which I've found to be the case. I've switched to birth control that skips my period and have been happier for it. I still have symptoms (sometimes terrible) though and they are consistent with my disorder but the flux of hormones isn't in the mix. I've heard that when some people get pregnant they are more stable than they were before, you may find this. Just be aware that postpartum may be really challenging. As far as going off medication, a doctor is the best one to help with that. Some people choose to stay on more mild medications with pregnancy as well that are not known for serious birth defects, which is an option.

Many moms with bipolar are great ones, but many also really struggle. I think that people even without the disorder have the same thoughts of feeling like maybe they wouldn't be a good mom. It's pretty normal but you know who you are deep down and you know if you can do this, which it sounds like you think you can. Good luck to you both!

Your OB and NP need to work together to safely manage your BP while pregnant, So seeing a OB Before you are pregnant is really important

Mood shifts can be Bipolar , sure... But mood shifts happen with hormones and sometimes just because it can or you have a right to explode.

I didnt know I had Bipolar when I was pregnant.... that was 20+ something years ago , I was just diagnosed at age 43 ( 50 now) My Daughter has Bp 1 ... I felt guilty for a long time but she finally drilled it into my head that I am not to blame and she loves her life even with the Bipolar part...

Good luck on your Baby journey

Thank you for your input, tonight began awful itching so the withdrawal is real! I haven’t had this since going off Seroquel.
I will try to make an appt with OB- since we just moved to the area I’m still trying to find a good one with a hospital somewhere close to me. I have appointments with therapist and and P coming up in the next week. Fingers crossed!