[xRavenx]

When it comes to depressive episodes, how long did your longest one last?

I used to cycle more rapidly, but this depressive phase that I am in right now has been going on since September. Maybe a little bit of mixed mood in between, but mostly depression. Maybe my patterns are becoming more seasonal, but I'm really not sure. It is getting more and more difficult for me. It is exhausting that I am not responding to meds at the pace that I have been hoping for.

I cannot take antidepressants or even Wellbutrin, or it throws me into mania or a terrible mixed state with psychotic features. I experience a mild response on certain antipsychotics, especially when increased, but the side effects become problematic if the dose is too high. In the past, high dose Seroquel was somewhat helpful. I'm maxed out on Lamictal. There's definitely more medications out there that I haven't tried yet though. Right now, I am on Lamictal, Seroquel, Klonopin, and Latuda. Maybe something needs to be either increased or changed entirely.
This is getting so frustrating....I'm like, when is this going to stop? I know there's no exact answer to this. I just feel so defeated.

Hmm... I'm surprised Latuda isn't helping with your depression since it seems to help a lot of people (although admittedly, it didn't help me either, so you're not the only one)...

I am on Rexulti and it is used for treating psychosis and MDD. I have found it immensely helpful with depression. So, that could be an option for you if you're willing to give a different antipsychotic a shot. You know, focus on APs that treat depression.

Some people with BP have been depressed for years, so I guess you can technically be depressed for a while. HOWEVER(!), some people have a lot of luck with Mirapex. I just can't guarantee you won't become manic on it because I don't know much about it, but it is not an AD or an AP, so you could read up on that.

If you have changed your Seroquel dose around September, it is possible seroquel is making you depressed. I know I became heavily depressed on seroquel when my dose was too high for my body to handle. Plus, benzos like klonopin are documented to cause depression in a decent chunk of people who take them long term, so I don't know if klonopin is making you depressed, but it's one of those things that can happen and might take months or even years before it causes depression, kinda like TD.

Hi xRavenx. I'm sorry to read that you are still depressed. bluebicyle's observation about Seroquel might be something to explore with your doctor. When I am getting pure depressed with a lot of fatigue (or just stable with a lot of fatigue), my psychiatrist lowers my Seroquel XR. If I am getting manic or agitated/mixed, he often increases it with good results. I don't know what dose of Seroquel you take, but I have read that the maintenance dose to curb depression is often lower than the maintenance dose to curb mania or as a prophylaxis.

My longest pure depression was likely around a year. Maybe longer, if you add lower level depression. That was abnormal for me, since previous pure depressions usually only lasted weeks, at the longest. I attributed the long length of my worst to being "a crash" from years of mania and mania with mixed features. My doctors eventually suggested ECT because of the stubbornness of that longest depression, and my propensity to become manic (or manic with mixed features) when antidepressants or stimulant were trialed. I agreed at the second suggestion. It helped, and then made me more responsive to moodstabilizers and antipsychotics again.

[bpcyclist]

So sorry you are struggling with all this, Raven. Longest one for me has been more than a year, but I was not being aggressively treated then. Wellbutrin has worked best for me, along with lithium. Interesting, you experience, as my shrink, who has been in practice about 20 years, was just telling me he has never seen a case of Wellbutrin causing mania in a bipolar patient. I guess everyone is a bit different.

Sending you support. Please don't be hard on yourself. You are doing the best you can. It will turn around.

[xRavenx]

Originally Posted by bluebicycle

Hmm... I'm surprised Latuda isn't helping with your depression since it seems to help a lot of people (although admittedly, it didn't help me either, so you're not the only one)...

I am on Rexulti and it is used for treating psychosis and MDD. I have found it immensely helpful with depression. So, that could be an option for you if you're willing to give a different antipsychotic a shot. You know, focus on APs that treat depression.

Some people with BP have been depressed for years, so I guess you can technically be depressed for a while. HOWEVER(!), some people have a lot of luck with Mirapex. I just can't guarantee you won't become manic on it because I don't know much about it, but it is not an AD or an AP, so you could read up on that.

If you have changed your Seroquel dose around September, it is possible seroquel is making you depressed. I know I became heavily depressed on seroquel when my dose was too high for my body to handle. Plus, benzos like klonopin are documented to cause depression in a decent chunk of people who take them long term, so I don't know if klonopin is making you depressed, but it's one of those things that can happen and might take months or even years before it causes depression, kinda like TD.

Thank you. Actually, I might have written this up in a confusing way...
when my Seroquel was higher, I was less depressed, just more tired. My Seroquel was actually decreased when Latuda was added. I think it comes down to whenever something is actually helping the depression, I get side effects. My pdoc was thinking about Rexulti at the time, but I was mixed, and she wanted to treat the manic symptoms, so she steered away from that. I guess I will just have to wait and see what she suggests. Klonopin I've been on for years and years, but it's technically a PRN. I never tried Mirapex... I should look into that.

[xRavenx]

Originally Posted by BirdDancer

Hi xRavenx. I'm sorry to read that you are still depressed. bluebicyle's observation about Seroquel might be something to explore with your doctor. When I am getting pure depressed with a lot of fatigue (or just stable with a lot of fatigue), my psychiatrist lowers my Seroquel XR. If I am getting manic or agitated/mixed, he often increases it with good results. I don't know what dose of Seroquel you take, but I have read that the maintenance dose to curb depression is often lower than the maintenance dose to curb mania or as a prophylaxis.

My longest pure depression was likely around a year. Maybe longer, if you add lower level depression. That was abnormal for me, since previous pure depressions usually only lasted weeks, at the longest. I attributed the long length of my worst to being "a crash" from years of mania and mania with mixed features. My doctors eventually suggested ECT because of the stubbornness of that longest depression, and my propensity to become manic (or manic with mixed features) when antidepressants or stimulant were trialed. I agreed at the second suggestion. It helped, and then made me more responsive to moodstabilizers and antipsychotics again.

Thank you. I'm glad you found something that helped.
I am starting to wonder if maybe both my mood stabilizer and antipsychotic combination needs to be changed. My pdoc also raises and lowers Seroquel dose, based on symptoms. Right now, I'm only on 200 mg. I was on 800 mg in the past. Maybe I need something in the middle... I'll need to ask my pdoc.

[xRavenx]

Originally Posted by bpcyclist

So sorry you are struggling with all this, Raven. Longest one for me has been more than a year, but I was not being aggressively treated then. Wellbutrin has worked best for me, along with lithium. Interesting, you experience, as my shrink, who has been in practice about 20 years, was just telling me he has never seen a case of Wellbutrin causing mania in a bipolar patient. I guess everyone is a bit different.

Sending you support. Please don't be hard on yourself. You are doing the best you can. It will turn around.

Thank you. I'm glad Wellbutrin worked well for you. I've never been on Lithium and wonder if maybe it would help me more than Lamictal.

[bpcyclist]

Originally Posted by xRavenx

Thank you. I'm glad Wellbutrin worked well for you. I've never been on Lithium and wonder if maybe it would help me more than Lamictal.

Noone ever talks about it for depression, but overall, it has been a huge help for my depression. I have been on over 50 meds, most before I tried, finally, lithium.

[*Beth*]

I'm so sorry, Raven. 5 months is a long time. (My depressions are generally short; mixed states very long.)