[bevet02]

A little background for me is I have been through a ton of meds and diagnosis but, currently it somewhere between Treatment resistant depression (With GAD, SAD, PTSD, Depersonalization disorder) or bipolar 2. The confusing part is I only notice hypo-manic symptoms is when I take anti-depressants alone.

I’m on 150mg Luvox and 200mg Seroquel right now which seems to help a lot with my anxiety and a little for my depression. I still feel occasionally the ‘High’ feeling come through which is strange, as it says the Seroquel is supposed to help with bipolar.

All I can say is about having a bipolar 2 “mixed state” diagnosis is that I feel the high/euphoria but just really agitated and depressed / wanting to crawl out of my skin. No real desire to do anything. To me personally, it doesn’t compare to what I have read people with bipolar 2 would go through.

My first medication I took was Prozac and spent 4 months like that not knowing any better. All the rest of the meds did the same. I have been reading that people can be on a bipolar spectrum. Things like Cychlothima / Bipolar 3 / SSRI- Induced mania/ hypomania. So just wondering can anyone relate to having these symptoms only when given an anti-depressant?

My base mood while off medications is being in a real deep depression / constant suicidal ideation / Horrible anxiety and agitation. Besides all that I have been trying to see if I can try another mood stabilizer when I see my new doctor. I was on Lamictal by itself and it didn’t help (300mg). Can’t take Lithium unfortunately due to thyroid problems. Hoping to try Depakote and switch to a different anti-depressant that would help more with the depression.

Not sure if anyone can help me understand about if even a mood-stabilizer is the proper way to go. Let’s say I get to switch to Depakote and Prozac, if I can tolerate Depakote will it make the anti-depressant work like it would normally?

It just doesn’t make sense to me how it could take my mood that was high/euphoric/agitated on a SSRI and turn it to something that I should be feeling, compared to someone who could just tolerate an anti-depressant alone. (Can it really be that simple?)

It feels like I don’t really have much left besides upping the Seroquel (Don’t feel like I can handle much more) or just trying another mood stabilizer. Anyways, if you got this far, I appreciate any help. Thanks

Originally Posted by bevet02

I feel the high/euphoria ... wanting to crawl out of my skin.

You are dealing with a lot of issues and from my POV the treatment resistant depression (I do not have this) must be the worst.

I just wanted to say, when I have been prescribed antidepressants at too high of a dose--it pushes me into mania and I will wake up in the middle of the night feeling antzy and like something is crawling through my skin. I need antidepressants but I have to take very low doses (I am fortunate that low doses do ward off my depression). Not sure what you can do about your situation--have you discussed this feeling with your doctor?

And by the way--Welcome to PC!!!

[Sunflower123]

I’m sorry you are struggling. I don’t have any advice (I take an antidepressant with a mood stabilizer) but I wanted to give you a warm welcome to PC. I hope you find this forum to be beneficial.

Hopefully your doctor will have some additional ideas. They will know better than me.

Seroquel (I take Seroquel XR) is actually very helpful for all types of my episodes. I am currently on 500 mg and take up to 600 mg usually. I'm not sure what you mean by not being able to take more than 200 mg. For many, more than 200 mg is more helpful. According to stated average doses on most drug websites, 300 mg is the usual dose for bipolar depression and 400 to 800 mg for bipolar mania or mixed states. Of course that can be higher or lower for some people. The body adjusts for most people. If your doctor suggests an increase I wouldn't dread it. If after some time a higher dose did more harm than good that's another story. Higher doses don't necessarily sedate more than lower, but I've read (and experienced) that higher doses of Seroquel work more as a moodstabilizer than lower doses. When I've needed a Seroquel XR dose change, changes as low as 50 mg up or down (or more often 100 mg up or down) did make a clear difference for me.

[MickeyCheeky]

I'm so sorry you're struggling, bevet02 I agree about talking with your doctor about this and see how it goes from there. Hopefully that will help you. Trying another mood stabilizer may be a good idea. Please try to hang on and don't give up. Things will get better at some point, I'm sure of that. Let us know how it goes. I'm so sorry you have to deal with this

[bevet02]

I think I'm just scared with going up a higher dose of Seroquel because of how it might affect my Depersonalization disorder. But if a higher dose could be less sedating, that could be a plus. Mentally I felt really "slow" prior to being on a anti-psychotic. I'll talk to my doctor and see about going up a higher dose if possible. thanks for the help

Originally Posted by BirdDancer

Hopefully your doctor will have some additional ideas. They will know better than me.

Seroquel (I take Seroquel XR) is actually very helpful for all types of my episodes. I am currently on 500 mg and take up to 600 mg usually. I'm not sure what you mean by not being able to take more than 200 mg. For many, more than 200 mg is more helpful. According to stated average doses on most drug websites, 300 mg is the usual dose for bipolar depression and 400 to 800 mg for bipolar mania or mixed states. Of course that can be higher or lower for some people. The body adjusts for most people. If your doctor suggests an increase I wouldn't dread it. If after some time a higher dose did more harm than good that's another story. Higher doses don't necessarily sedate more than lower, but I've read (and experienced) that higher doses of Seroquel work more as a moodstabilizer than lower doses. When I've needed a Seroquel XR dose change, changes as low as 50 mg up or down (or more often 100 mg up or down) did make a clear difference for me.

[Blueberrybook]

I take the regular release Seroquel. When I'm stable, it's at around 300 mg. When I'm having manicky symptoms, they push it up. But I am on the mood stabilizer too, Lamictal. I was on the Lamictal alone for awhile then got very manic, and it was decided, nope, it wasn't bipolar II, it was bipolar I, and I was put on Seroquel. But the pdoc tried me on the extended release version first, and it was awful for me. I was so tired, I just wanted to sleep all day (not even necessarily from being depressed, just very sleepy). I'm on Seroquel 500 mg, but it's making me too tired; called my pdoc, we are going to try 450 mg. I was a 400 mg but leaning toward the manicky side of mixed, I guess?

[jaysmotogp]

Sorry to hear of your long struggles.
I was in a very similar situation to yours about six months ago. Treatment resistant and going hypomanic on ADs'. Then i switched Pdocs, he decided BP2, he put me on lithium right away to stabilize the moods.
Then we retried the AD and it went much better that time. It wasnt until then that i felt like the ADs were doing what theyre supposed to for me.
It took me a long time to understand that i had to cut off the highs with the lithium to prevent the deep lows

[bevet02]

BP 1 sounds even more frustrating. I'll definitely make a suggestion about trying to get the Seroquel up to 300mg to atleast see how I do on it. I hope that you get your seroquel dose figured out soon too.

Originally Posted by Blueberrybook

I take the regular release Seroquel. When I'm stable, it's at around 300 mg. When I'm having manicky symptoms, they push it up. But I am on the mood stabilizer too, Lamictal. I was on the Lamictal alone for awhile then got very manic, and it was decided, nope, it wasn't bipolar II, it was bipolar I, and I was put on Seroquel. But the pdoc tried me on the extended release version first, and it was awful for me. I was so tired, I just wanted to sleep all day (not even necessarily from being depressed, just very sleepy). I'm on Seroquel 500 mg, but it's making me too tired; called my pdoc, we are going to try 450 mg. I was a 400 mg but leaning toward the manicky side of mixed, I guess?

[bevet02]

Happy that you were able to get stable on the new meds. Maybe my new doctor will have a better opinion on taking Lithium with thyroid issues. I just never got a chance to ask why unfortunately. That does give me hope that I'm getting close to a right med combo. Thanks

Originally Posted by jaysmotogp

Sorry to hear of your long struggles.
I was in a very similar situation to yours about six months ago. Treatment resistant and going hypomanic on ADs'. Then i switched Pdocs, he decided BP2, he put me on lithium right away to stabilize the moods.
Then we retried the AD and it went much better that time. It wasnt until then that i felt like the ADs were doing what theyre supposed to for me.
It took me a long time to understand that i had to cut off the highs with the lithium to prevent the deep lows