[Crook32]

Right now I am pretty stable which is surprising given what is going on with work. The only problem is I am so tired during the day and wake up early. On the weekends I sleep most of the day. My pdoc said he could reduce some meds but I said with everything going on I didn’t want to take a chance with my stability. Anyone else ever have to make choices like this?

[Under*Over]

Yes. That really is one of my biggest things right now- one of my biggest dilemmas. Both sides feel like a loss in some ways so its hard for me to really definitively stay on one side.

Im leaning more towards medication though. As horrible as it is for me, some of the things that happen to me are really scary- and i really feel that it would be... it would be a fast and hard fall for me if I stopped my medication, and at some point I might not be able to come back from it

I wish you luck with your choice. It really can be difficult, I hope you have people to talk to about it, I hope you have someone who listens.

[Pookyl]

Yes I’ve had to choose. I’m fatter than I’d like to be when I’m stable. When I’m thinner I’m highly sui and unstable.
I choose stability purely for longevity. My family deserves that even if sometimes my care factor is low.

Yes, i chose fat and alive over thin and dead.

[piano97]

There is a balance to be struck. In general, I think it's best to be on as little as possible. I will never take an AP again unless there's no other option, and it will be brief. But I doubt it. I think benzo for sedation if mania gets out of control is the option. They are too dangerous imo and from my experience. It has not been pretty at times, I feel blessed and lucky to have survived a couple of different times, but I did.

APs shorten life span and long-term, significantly lower quality of life. Is there anyone here over age 65? Perhaps, but that's about your end age on APs. I'm not cool with that. Slight hyperbole there but not much.

Epilepsy medication...cool with. For now at least. Low dose benzo...cool with. For now at least. AP....never again. When I briefly went back on for a month, the thoughts I had (that were inserted from it, and perhaps only noticeable because the dose was so low that I didn't have the accompanying coma-esque sedation) were the most dangerous and destructive I've ever had. They were not from me, it was from the medication. It took me a bit to realize it was from the medication, and cleared up shortly after stopping again. I don't regret briefly going back on....I don't think my body had recompensated from stopping several months prior and I needed another round. I do not regret in the slightest coming off of it last fall, even if it nearly led to my end. There is minimal to no clinical evidence that maintenance APs are necessary in bipolar. 1 or 2. Epilepsy medications, yes.
There is clinical evidence and research on that. In acute situations, yes to APs. There is benefit and more than adequate clinical research to show this. But not on maintenance. I know that is a controversial statement to some. But I think what people actually are expressing when they say the can't come off it post acute stage mania and subsequent recovery time, they are actually describing discontinuation syndrome, not a return of symptoms. They are very different. An adequate and well-planned taper mitigates this, alongside CBT and other interventions that are non-pharm. "taper" is not meant to sound quick. The first reduction I made on seroquel was in Feb of 2018. Went completely off in late September, and went to fast at the end. Did not go well. Nearly ended me. But with a lot of help and work (and more seroquel), was able to go back off about 6-7 weeks ago. And will not be returning.

My condition is not changing. My ability to exist and cope with things in spite of it has gradually been though. It is not easy. I do not see it as a 'fight'...'fight' is a negative word and isn't healthy. I see it as a journey. I've had major problem with depression recently since first week of Feb. It seems to be wrapping up. Was not pleasant, was not comfortable, but I made it through. And learned a lot in the process.

I don't see functional and psychosocial recovery happening if on APs. To a limited degree, perhaps. But I'm not interested in 'limited'.

I will backtrack a bit and say that the only reason and way I was able to come off of seroquel, and now stay off, was from being on seroquel. Think on that for a bit. It stopped cycling in its track for a number of months, I think my brain healed somewhat during that time, and allowed me to gain new skills that I'm now able to use to help myself. To best of recollection, I started Seroquel in/around August or September of 2017. Was a game-changer.

The 40 pounds of excess weight was not sustainable to a happy and healthy life. The extreme sedation was not either. I was unaware of that until I had some stable time...but then again, 'stable' is not 'doing well for 8 hours a day' and asleep the rest of it. That truly is not stable at all.

I'm way off subject and rambling, sorry. This may not have helped at all, but I hope it might have.

I have a lot more work to do on things. I'd like to think I'm completely 'fine' now, but I'm not. But I'm way closer to health than I was 12-16 months ago. And way, way, way closer than in the years prior. I had to find the right AP and the right combo. It took years. Once found, I was able to recompensate enough to get back on the journey to health. Which now does not include an AP, nor will it. Stay strong. Is awesome to hear you are holding down a job. Hope to be able to sooner rather than later.

Last thing I will say, and this is only my experience, but the best 'medicine' for me recently to cope through the depression was that I had been walking daily for many months at that point, and tending to hygiene stuff way better for about 6 weeks. Hope to start running again soon. Had started cooking some too in that time. Those things insulated the F out of me, and was able to mostly maintain them. If you've showered daily for 6 weeks, and walked or something else for 6 months straight daily, it's way easy to keep those going even when major depression hits. I doubt it's completely over yet, but am feeling way better this morning and late last evening, and not in a hypo spike kind of way.