breaking through.

before diagnosed, my episodes were seasonal.

after diagnosed and put on lithium, it all stopped.

now that I'm on lamictal, which doc says is more for depression while lithium is more combatting mania, I keep "breaking through" to hypomania. idk whether it's the progression of the illness or the med change, but some days I am actually triggered by stress.

stress never used to trigger me. it was purely seasonal.

now when I "break through" I take a seroquel and the next day I'm fine.

how often do u break into hypomania? and if you take PRNs to clear it up does it subside?
is it because the illness gets worse, even when treated?
how often do u change meds?

I breakthrough as you are describing it seasonally and in stress as well. I escalate VERY quickly sometimes so I have to jump on anything my treatment team, family, or I notice. Sometimes a boost in my seroquel and a temporary addition of klonapin is enough to dumb it down but just before spring last year for instance, we caught it in what I would consider quickly enough but it still escalated to mania and I almost ended up hospitalized. It was triggered by major stress...my job. That is a stress that I finally, like literally today have decided I canÂ’t return to because I canÂ’t keep having breakdowns. IÂ’m putting in my resignation on Monday.

I have had no manic episodes since starting lithium. The only times I broke through were when I stopped it. Lamictal didn't do a whole lot for my crushing depression, for some reason. I know it works great for a lot of people. Have you talked to your pdoc? Maybe some tweaking needs to be considered. Hang in there!! You'' figure it out.

Saucygirl, I am similar to you and cashart in terms of stress and seasonal triggers. Sometimes I am even triggered by "positive" stressors. Also like you both, I have a lot of breakthrough hypomanias. I have a long history of full blown mania, as well, but between family and mental health team (like cashart's) and improved insight, my hypomanias/manias are now often caught early, which is important.

I absolutely use prn medications in the case of breakthrough hypomanias and manias. You can see them in my signature below. Also, if my hypomanias/manias continue despite, my psychiatrist raises my base Seroquel XR dose, but sometimes the prn use doesn't always necessitate that. I think that those of us who do have frequent hypomanias/manias benefit greatly from the use of prns.

My medication cocktails did change a lot during the worst years of my bipolar illness, but not as much these past 8 years. In fact, I have been able to have some meds in a previously behemoth cocktail removed. These last few years, only my Seroquel XR dose is manipulated, although the starter dose of Latuda was added maybe 7 months ago. My psychiatrist hasn't changed my Latuda because it likely wouldn't be as effective for mania control as my Seroquel XR.

If hypomania breakthrough is an issue for you now, please discuss that with your doctor. Maybe one of your medications is activating, or something else?

thanks everyone. yeah seasonal for sure, and then stress more of a trigger now that ive been diagnosed for a while, prob because of the illness progression.

yeah I broke through when my vraylar wasn't refilled for 3 days, then this spring so we increased lamictal to 400, and again recently even on lamictal 400 because I was stressed.

luckily they have just lasted a day or so because Seroquel knocked them out. it wasn't even very noticeable it was just like I drank coffee and immediately was like "wow this is way too much energy".

Good for you! Your health is most important. Without it, everything else falls by the wayside.

Thank you! I actually did it!