mood stabilizers

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They said I want to stay out as much as possible, that it's a very horrible place to be, I wouldn't want to be there.

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Consider this. Did you think they would actually encourage you to want to go there? I don't think so. I think of it this way (its somewhat applicable).

When I get sick...I get SICK. I put off going to the doctor for as long as possible. Last Christmas, I put it off until my husband physically MADE me go. Put me in the car and wouldn't let me out. I ended up with not only strep, but pneumonia. Had I gone in earlier, things wouldn't have escalated that far.

AG - Every hospital is different. The one in my area is a state facility, and it's really nice. It's big enough that they are able to have separate units for various levels of illness. So, people who are acting out, are not housed with people who are depressed and vulnerable.

If I were in your shoes, I would call my local NAMI. Tell them you are considering hospitalization, but would like to talk to someone who has been an in-patient at that particular hospital. I'm sure they'd hook you up with a volunteer (Sometimes former patients even volunteer at the state hospitals to help transition new patients). So, you could talk to someone who has been there, and get the real scoop.

Additionally, sometimes medical hospitals will keep psych patients for extended periods to stabilize meds. Find out which hospitals in the area might do this by asking NAMI as well.

Take care. emmy

Thanks for the suggestion, I'll check that out but not looking for any extended stay anywhere. Nope, not gonna happen, must be done as out-patient only.

i wont go to a psych hospital either... i just know everyone has a different opinion on it...
i dont know if i suggested this to you before (bad memory due too all the meds)
when im feeling suicidal or at the end of my rope, sometimes i just hang out somewhere i know i will be safe.
for me, its wandering around the hospital (not a psych hospital)
or refilling prescriptions to just interact with other people....
also been going to a pool hall and getting to become comfortable there....
its a good thing to just try to go where your heart tells you (dont listen to where the "disorder" tells you to go)
for me its the pool hall and the hospital, for you, its somewhere...
just think of one thing you enjoy, just one, and "move" toward that one thing.
but thats just my wierd state of mind talking...
im just trying to help.
(extending a hand to you... )

Actually that's not weird at all ccl. My T suggested the same thing to me today during my appt, divert my attention before I get to the point of being suicidal to hopefully avoid it. Next time I'm on the down cycle I'll have to give it a try. Thanks for your suggestions and help. Very much appreciated. I'm glad to see you're making some positive changes in your life. It's really paying off.

Since I'm a psychiatrist maybe I'll put my 2 cents in here. The drugs we call "mood stabilizers" are actually anti-manic drugs. Most of them don't help the depression of bipolar disorder, they simply keep you from having a manic episode. The newest one, Lamictal, is the first to actually help the depressive episodes which are much more common in bipolar. So Lamictal is really the only true 'mood stabilizer'. Anti-psychotics are very good at treating manic episodes too, and generally require less bloodwork with less risk of serious side effects. Europe uses anti-psychotics to treat mania, and I suspect the US will too eventually.

Allow me to get on my soapbox for a moment on bipolar disorder. In the last 5-6 years the diagnosis of bipolar has skyrocketed. I believe this is due to all of the advertising appearing in the psychiatric literature and all the research funded by drug companies when they figured out that their antipsychotics were useful for bipolar instead of just for schizophrenia (and they are). However, 95% of the time when someone comes into my office thinking or having been diagnosed with bipolar disorder they don't have it. Usually they have a personality disorder, frequently borderline personality disorder, and the rapid sudden shifts in mood (day to day, or even hour to hour) are mistaken as bipolar. True bipolar is an illness where a person spends most of their time with a normal or depressed mood and only has a 'manic' episode once or twice a year for several weeks at a time. Most of the people I see who have been misdiagnosed (or mis-self-diagnosed) have unstable moods almost every day. Childhood trauma is almost always found in their histories as well as frequent suicide attempts, stormy interpersonal relationships, phobias of abandonment, etc.

However, despite the misdiagnosis of bipolar, 'mood stabilizers' and antipsychotics are very helpful in these folks. This is because these medications significantly blunt the impulsivity in personality disorders. Violent rages, cutting, spur of the moment indiscretions are dramatically reduced. I routinely use an antidepressant and a low dose newer antipsychotic (usually the smallest dose made or even 1/2 of that) with great success in my borderline patients. In fact in one of my patients with borderline personality disorder and bulimia, a low dose of Abilify dramactically controlled her rage AND her vomiting. I like working with borderline personality disorders, but unfortunately many psychiatrists do not. Some even refuse to see them. Although medication is very useful, it is never enough by itself. Psychotherapy (often for years) is necessary to ease the pain and try and undue the trauma. www.mhsanctuary.com/borderline is a wonderful resource that tells you more about this disorder. Also you should check out www.needymeds.com - this is a one-stop resource that contains information on all the patient assistance programs available to patients for free meds. They explain the program in a straight-forward way, and usually have the applications for the programs you can print off online. Since the antipsychotics can cost over $400 a month, if you can get them for free through the program this is a great deal!

Are you suggesting that I'm BPD and not BP2? I was sent by my first therapist to a psychiatric institute for testing for BPD and was at that time diagnosed with BP2 instead. I did *several* written tests which took hours and a verbal interview with a pdoc. Before I was originally put on my first mood stabilizer, Depakote, I was rapid-cycling at least 30 times a day. Now my rapid cycling can change every few hours, days or sometimes longer although rarely. I don't very often have a hypomanic episode. Depression is what I normally experience and when my cycle changes, the depression goes to the depths of the abyss leaving me in a very suicidal state. I'm getting very tired and scared of getting like that I want desperately to avoid it if at all possible. If you've read this entire thread, and I'm assuming you did, then you already know I'm on ADs but I don't think they are helping me like they used to. My Effexor XR used to be much higher than it is now but was lowered due to side effects. My pdoc refuses to increase it again fearing it will trigger a hypomanic episode, which seems to be her main concern IMHO. I can't seem to get through to her how very dangerous my depressive cycles can be and I feel she is playing Russian Roulette with my life. I understand her reasoning for not wanting to increase my ADs but I wasn't triggered before so I don't think I would be if she increased it again back to where it was and see if I can tolerate the side effects. I am in therapy and starting a new group therapy for cognitive therapy. I just finished a group therapy just prior to Christmas for Bi-Polar. So, I'm not just looking at this from a meds point a view and expecting them to be the be all and end all of my rapid cycling. I'm not sure why you are giving me info on BPD unless you are suggesting that I have been wrongly diagnosed. As I said, I've gone through extensive testing to be diagnosed with Bi-Polar 2, PTSD, Anxiety and SAD. Could you please clarify your reasoning for the info you provided and what your opinions are on increasing my ADs.

Since I don't know you, it's not my place to diagnosis. However the definition of rapid-cycling is more than 4 episodes *a year*. It sounds like you may cycle at least several times a month. If you truly had bipolar my thought is that it would be well under control by now. Mania is a fairly straightforward thing to treat and people respond fairly quickly in a predictable way. However, if we assume you truly are bipolar, there is no reason you can't be on an effective dose of an anti-depressant, you just also have to be taking a mood stabilizer at the same time. We have people on high doses of antidepressants with mood stabilizers everyday and it sounds like you could use a higher AD dose. The Tegretol, Klonopin and Xanax should serve to protect you from mania (provided you are on an effective dose - easily checked with a blood level for Tegretol). My apologies if I offended you.

I was wondering if the same applies to the "skyrocketing" diagnosing kids with ADD/ADHD, as far as many not really having this disorder, and that the true percentage is smaller than what we have been made to believe from all the stuff we read or hear.
Also, I have seen cases when I worked in a school system a few years back, that many kids were being labeled with the DX and given the meds from their GP's, I personally, and may be wrong for saying this, feel a pdoc, not a gp should be the person to make the evaluation of the child's state. I believe this disorder exists as well as other disorders, but personally I think the DX is overkill by now. I've witnessed and even had a young mom come to me about her daughter and ask, "do you think if she is on Ritalin she'll behave?" I told her Ritalin is not the answer, the child was NOT ADD, she needed some consistancy at home, the teacher I worked with who was near retirement, knew of her mom's sour marriage and this was contributing to the child's poor behaviour.
My sister-in-law is a R.N. she has said she has never seen such a rash (figure of speach) of scripts for ADD meds being sent to school, she says it is like a long line of kids coming in at lunch time for meds. she also knows of docs that write the scripts to appease the parents, not even having the child evaluated.
It saddens me when people with marital, or other problems become eager and desperate for some sort of "substitute" for what a child really needs.
Okay I rambled on enough, and probably to an obnoxious extent, ha!ha!
Thanks for reading this

DE

Hey Doc, as you know we are ppl not text book cases here , we're here for support, not evaluation
Angie

I think I must be one of the BPs that the doc is talking about. I'm on Lamictal and a small dosage AD....I cannot tell you what my life was like before these meds. I had talked to medical docs for years.....asking for something else to help me and they poo-pooed me.....now I went to a psychiatrist and the first thing she said was she wanted to do something differently. About three or four times yearly, I get so low that I scare all around me. My mood now is "normal" and I feel so much better. My dose of Lamictal is very small and I am so thankful that I am taking it. I found the information that the doctor posted to be extremely interesting. Thanks.....Pat

I like Lamictal the best so far
I'm down 150mg's since last summer, and still alright.
Wish you well

DE

I do not see anything in his/her's reply that indicates he or she is evaluating anyone, just offering info.
Sorry, that you feel that way, maybe I'm misreading or have been mislead?
The pdoc. here also apologized if his or her info offended anyone.
I'm sure and hope all has been with good intentions.
Please take care,

DE

i was mis-dx'ed bipolar and did the med thing for 2 1/2 yrs and felt no better...felt worse. brother is true bipolar. it's all so confusing. i went to a dr for help, and got the wrong kind due to a generalization of my symptoms. when he put me on a strong AD that gave me hypo-manic like symptoms, he assumed bipolar...that began my 2 1/2 years of what i call "nothingness".

meds are a necessary and life saving thing. i was just one of those where they took my quality of life away due to mis'dx.

i so wish everyone on the med journey well. i'm watching my brother with this and it's a hard road, but so far beneficial

love to all,

Epilum is my mood stabilizer, is used also to treat people who have epilepsy, but works with bipolar to. Can't take Effexor without it, I just go high. Co's am not high {to happy} or low {to sad} and cruisin along in between, guess Epilum must work.

Kezzz

Kimmy,

I am so glad you made this post. I have been dealing with mis-diagnoses for the last 10-12 until three years ago when they finally pinned down I am in-fact bi-polar. The last four years have been (for lack of better term) Hell, with the new meds, the dosage changing, the other symptoms themselves, and changing of the dx.

As many of you know (thru chat) I recently sought a 2nd opinion because I didn't feel my pdoc was listening to me when I was TELLING him I was getting manic. In some cases, SSRI's/AD's (like Paxil CR) can cause manic symptoms/episodes (this is straight from family doc of 15yrs). Yeah, put myself in the hands of a professional, and he screws me up even more by throwing me into a manic state for 4 months.

My new pdoc has excellent credentials and (shock) he actually listened to ME, not what was on a piece of paper. I'm not thrilled about Lithium, but I am going to do whatever it takes to get back to being myself again.

I agree with you, the meds are necessary, but another thing to remember is you have to have the will to want to get well again, and therapy is ALWAYS a plus.

Every person is going to react to every med differently, just bear that in mind.

Jenn