This is kind of word vomit... I mostly want to get my feelings out...

I struggle with med compliance -- a lot. I think this is in part due to my rejection of my diagnoses. Does anyone else have med compliance issues (or have you had them in the past)? How did you talk to your therapist about it?

Sure, you can say, "Well, why not break down everything into individual problems and symptoms? Depression, anxiety, poor concentration, etc.. That will help." Actually, no, it does not. For starters, there are different types of depression. To name a few: regular depression, major depression, dysthymia, and bipolar depression. If you have bipolar depression, you need a mood stabilizer and/or antipsychotic at the bare minimum, and possibly an antidepressant on top of that. But if you have any other type of depression and you're not prone to psychosis, you can just use an antidepressant (unless you have treatment-resistant depression).

So if I'm being treated for bipolar depression, I'm on Seroquel XR, Lamictal, and Lexapro. But what if I just have regular depression? Then I only need the Lexapro. I can ditch the other 2 meds and save myself a whole lot of money (and save myself the brain damage caused by long-term use of Seroquel and Lamictal).

This is what I go thru literally everyday. On top of that, sometimes I'm just flat out lazy, I feel I don't need anything, "it's too much effort for very little reward", I think none of my medications work, my pdoc is prescribing me Rx's I don't need to make money off me, etc. etc.. I'm always coming up with an excuse.

I don't think I've ever been med compliant for more than 1-2 months at a time. Not even joking. This is what it's been like for me ever since I sought help 1.5 years ago. (And I don't know if this matters, but I'm 25.) And just recently, I've been non compliant and now I'm suffering from psychosis!

I've started to discuss this lack of compliance in therapy, but I feel we've only scratched the surface. Does anyone have any advice from personal experience? Or does anyone have any suggestions on what I could do? I'm self sabotaging.

[ruh roh]

I used to take a lot of medication for depression and then bipolar. I played a big role in deciding types of medications and dosages as part of my pdoc sessions--it was just how things were handled. If I wanted to cut back or stop taking something, I did that, and emailed pdoc to let her know and to explain why.

So I guess I don't see it as compliance or non-compliance. I talked things over with the pdoc and asked questions, then said I needed to think about it, which they knew meant included going online and researching.

I rarely sought advice from a therapist about medication, or felt the need to account for what I was taking in terms of compliance or non-compliance, but I would let them know if I stopped or cut back and why. It wasn't up for debate.

[Argonautomobile]

I think, "This is ********. There's nothing wrong with me" Almost every morning when I pop open my pill minder. Then I take them anyway. It becomes habit after a while.

I don't have a P-doc, just a PCP I have seen exactly twice in two years and avoid like the plague. So I talk to my T about it sometimes. He's careful not to step outside his area of expertise, but it can be helpful sometimes to talk to him about it.

I'm glad you're talking to your T about this and I hope you can find a solution that works for you.

[unaluna]

Wow, the way you describe it, blue, its like a mathematics story problem. The train leaves the station, i cut up an apple - ?? I dont really know what i have. Ive read the lists, you must have 5 of these 9 criteria - yeah aside from it seems to me like 5 of the 9 criteria are THE SAME across all the diagnoseses, yes i DO have at least 5!

My dr tried one med (prozac), then a few months later we tried another (topamax) That was good until a major life event and i started xanax. Then i got off xanax. Then a while later we added wellbutrin. Then another major life change and i went off wellbutrin. I dont think you can start and stop these meds all willy-nilly, the rumor is that they dont work or they dont work the same after youve stopped and restarted. Plus they often take time to build up?

My advice would be to sloooow down. But thats easy for me to say, i tend to live life in the slow lane.

[BudFox]

Are you required to take the drugs for some reason? If not, I don't understand the meaning of compliance as you are using it. Isn't it up to you? And if the drugs aren't helping, isn't that justification for not taking them?

BTW, according to my reading pretty much all psych drugs damage the brain. And they don't treat any known disorder. Did the psychosis start recently?

[ScarletPimpernel]

Just a comment: you can have major depression and still be on a mood stabilizer and an antipsychotic. I am. Both help. The antipsychotic is for SUI and SI thoughts. I'm not saying everyone needs this combo or that it works for everyone, but it does work for some. And for me, it took a long time to find the right combo and it still needs some tweaking. I spent 4 years in my 20's trying different combos of meds. Some worked for a little while, but in the end they stopped working. It's really difficult sometimes getting the right meds.

[Victoria'smom]

You know my lack of compliance. Everything from " This tastes nasty to this isn't working to I just forget" I've had it out with my share of mental health professionals. Specifically about forced compliance/hospitalization. One of my T's said it's inhuman to people with mental illness not give them a decent quality of life. So it's more about your quality of life then anything else. Are you safe? Are you struggling? Can this help you? You don't have to promise to take it forever. Just until you see your T/pdoc next time discuss your concerns and agree/disagree to take it until next appointment.

[annielovesbacon]

I struggle with med compliance but in the opposite way. I have severe anxiety and every time my pdoc prescribes a new medicine, I think "this is bullsh-t, this doesn't work" and then instead of taking them as prescribed I take a lot more so I can get high.

Originally Posted by bluebicycle

This is kind of word vomit... I mostly want to get my feelings out...

I struggle with med compliance -- a lot. I think this is in part due to my rejection of my diagnoses. Does anyone else have med compliance issues (or have you had them in the past)? How did you talk to your therapist about it?

Sure, you can say, "Well, why not break down everything into individual problems and symptoms? Depression, anxiety, poor concentration, etc.. That will help." Actually, no, it does not. For starters, there are different types of depression. To name a few: regular depression, major depression, dysthymia, and bipolar depression. If you have bipolar depression, you need a mood stabilizer and/or antipsychotic at the bare minimum, and possibly an antidepressant on top of that. But if you have any other type of depression and you're not prone to psychosis, you can just use an antidepressant (unless you have treatment-resistant depression).

So if I'm being treated for bipolar depression, I'm on Seroquel XR, Lamictal, and Lexapro. But what if I just have regular depression? Then I only need the Lexapro. I can ditch the other 2 meds and save myself a whole lot of money (and save myself the brain damage caused by long-term use of Seroquel and Lamictal).

This is what I go thru literally everyday. On top of that, sometimes I'm just flat out lazy, I feel I don't need anything, "it's too much effort for very little reward", I think none of my medications work, my pdoc is prescribing me Rx's I don't need to make money off me, etc. etc.. I'm always coming up with an excuse.

I don't think I've ever been med compliant for more than 1-2 months at a time. Not even joking. This is what it's been like for me ever since I sought help 1.5 years ago. (And I don't know if this matters, but I'm 25.) And just recently, I've been non compliant and now I'm suffering from psychosis!

I've started to discuss this lack of compliance in therapy, but I feel we've only scratched the surface. Does anyone have any advice from personal experience? Or does anyone have any suggestions on what I could do? I'm self sabotaging.

I think this is a fairly typical struggle many with mental health issues have.
I hope you can continue to dig at it with your T.

Good luck.

Bluebicycle, the level of serious psychosis you have been experiencing goes far beyond depression which is why you need antipsychotics at this point, but stopping them abruptly along with your problem with adderall is creating additional instability. It is going to take serious compliance with your meds before you will even begin to be able to figure out what works, but so far you haven't even begun to do that, and the more you mess with your meds and abuse the adderall, the less likely it will be you find any stability.

This is a common problem in bipolar disorder particularly. One sure fire way to render therapy virtually useless is to be so unstable so constantly that your thoughts are so disordered that therapy just ends up being about med/episodal crises (putting out fires) instead of being able to actually work on underlying issues.

You have to get honest with your pdoc about your meds so he knows everything you are taking and not taking. You have to make that decision that you want to find stability more than you want the chaos that your non-compliance is giving you.

[nottrustin]

Blue you pretty much describe me perfectly. I loathe taking medications and I always have. However, I also know that I need them up have an internal struggle every day. So I was seeing skipping every few days. I do tell Pdoc and T. T asks her clients that she knows takes medications if there have been any changes. Not because it is her expertise but she knows that changes can effect moods. When I am asked by them I can't lie.

While neither of them like when I stop taking medications they are supportive. They know the struggle I go through. I am getting better with when I am taking a break from them recognizing when my mood is slipping and when I noticed the change I start taking them again . In the past though I would wait until I was really depressed before restarting. Another reason I will stop taking them is the first couple of days that I do I actually have a increase in energy.

Sometimes I don't take my message because I just forget to until it is to late. To help I downloaded and app that reminds me every morning at the same time to take them. It has a feature that allows me to snooze the notification if I am not in the position to take them at that time. I can also choose to skip them. I am more compliant because I hate hitting skip. But I still hate taking them

[captgut]

I hate taking meds. Because I don't need them.
He calls me mad and want to treat me because it's his job.
Diagnosis is just a word invented by people from here.
Life is very difficult for me, but it's because of life, not because of me.
I promised I try new meds and started taking it, but I think I'll stop it again

[Favorite Jeans]

a couple of questions:

1) What is scary to you about getting well and how do you benefit from being ill? This might shed some light on your motivation to self-sabotage.

2) When you say that your pdoc is just trying to make a buck and doesn't care about your wellbeing—is that your illness (or excuses) at work or is that your true feeling about them? If that is your true feeling, maybe try to find a new pdoc.

[Erebos]

Don't care if they called crazy, not bothered by taking meds it's just another altered stAte of reality. If it means I can remember more days with loved ones and those around me aren't constantly afraid of what they are. Coming home to, so be it.
There is more in my life than just me.

Besides if they aren't medicating me, then I just resort to substance abuse. What's that about?
Even I am not deluded enough to pretend there is a difference.
Their legal concoctions may well have long term effects, but then so will the shyt I chuck down my throat in the name of self medicating.

If I was on my own it might be different.

But I chose not to be,

Originally Posted by Favorite Jeans

a couple of questions:

1) What is scary to you about getting well and how do you benefit from being ill? This might shed some light on your motivation to self-sabotage.

2) When you say that your pdoc is just trying to make a buck and doesn't care about your wellbeing—is that your illness (or excuses) at work or is that your true feeling about them? If that is your true feeling, maybe try to find a new pdoc.

1) Mostly I'm scared of what I'm putting into my body. "Do I need it? Is it going to damage my brain?" etc etc..

I don't think I benefit from being ill, but sometimes I wonder if my medications are making me worse. I mean, ever since I started medication, my depressions have been growing worse and worse. I'm not sure if my meds are doing this or if it's the natural progression of my illness (or if since starting medications that I've become more aware of my symptoms), but sometimes I'm convinced my medications are making me worse.

2) I'm not sure. Maybe it is my illness talking, but I know that sometimes my illness tricks me. I honestly go back and forth between "my pdoc is trying to make me feel better" and "my pdoc wants my money". I just confuse myself and I don't know what I want or believe. It's a constant battle.

Originally Posted by lolagrace

Bluebicycle, the level of serious psychosis you have been experiencing goes far beyond depression which is why you need antipsychotics at this point, but stopping them abruptly along with your problem with adderall is creating additional instability. It is going to take serious compliance with your meds before you will even begin to be able to figure out what works, but so far you haven't even begun to do that, and the more you mess with your meds and abuse the adderall, the less likely it will be you find any stability.

This is a common problem in bipolar disorder particularly. One sure fire way to render therapy virtually useless is to be so unstable so constantly that your thoughts are so disordered that therapy just ends up being about med/episodal crises (putting out fires) instead of being able to actually work on underlying issues.

You have to get honest with your pdoc about your meds so he knows everything you are taking and not taking. You have to make that decision that you want to find stability more than you want the chaos that your non-compliance is giving you.

I'm just confusing myself.

I quickly found out that stopping an antipsychotic cold turkey can induce psychosis on its own. So was the psychosis a result of that, or was it the result of a combination of Adderall and withdrawal? That I don't know.

So, all that said, do I really need an antipsychotic? If the psychosis was only caused by withdrawal, then I would say the answer could be "no". But if the psychosis was the result of a combination of both things, then yes, an antipsychotic is likely necessary. That's what I'm going thru right now.

I guess I'm scared of being honest with my pdoc. He knows already that I'm not so compliant with meds because I've admitted to him in the past when I stopped meds cold turkey or when I took doses I wasn't supposed to take.

I don't know why I'm being so difficult.

I don't want therapy to be all about meds, so you're right that I need to be more compliant with meds.

[Favorite Jeans]

Originally Posted by bluebicycle

1) Mostly I'm scared of what I'm putting into my body. "Do I need it? Is it going to damage my brain?" etc etc..

I don't think I benefit from being ill, but sometimes I wonder if my medications are making me worse. I mean, ever since I started medication, my depressions have been growing worse and worse. I'm not sure if my meds are doing this or if it's the natural progression of my illness (or if since starting medications that I've become more aware of my symptoms), but sometimes I'm convinced my medications are making me worse.

2) I'm not sure. Maybe it is my illness talking, but I know that sometimes my illness tricks me. I honestly go back and forth between "my pdoc is trying to make me feel better" and "my pdoc wants my money". I just confuse myself and I don't know what I want or believe. It's a constant battle.

What if you go in and just lay it all out for pdoc:

"I have a hard time trusting the meds and a hard time trusting you. I worry about the side effects and long term effects of these meds. I also know that I'm ill and don't like how that feels. I need to feel like we're working together on this. I need you to slow down and explain stuff to me [or whatever you need]. I also would prefer if you could help me be on as few medications as possible. Of the three meds I'm on, which would you say is most crucial? Can we meet more regularly because I don't feel that stable right now?"

If they don't receive this well, that is a sign of someone who isn't the right pdoc for you now. If they are able to hear you and appear to be doing their best to meet you where you are, consider how you could follow your med plan better. Would a dosette or a timer help?

It is likely frustrating for the doctor for a patient to be uber skeptical about the proposed treatment plan (esp on the grounds that meds are toxic) if the patient is not seriously pursuing other avenues to wellness. So you know, the substance use issues, the physical activity plan, the meditation, the talk therapy, the community involvement, the healthy eating.... It would show a lot of commitment (and make it easier to negotiate) if you were hard at work on those things.

[BudFox]

Originally Posted by bluebicycle

1) Mostly I'm scared of what I'm putting into my body. "Do I need it? Is it going to damage my brain?" etc etc..

I don't think I benefit from being ill, but sometimes I wonder if my medications are making me worse. I mean, ever since I started medication, my depressions have been growing worse and worse. I'm not sure if my meds are doing this or if it's the natural progression of my illness (or if since starting medications that I've become more aware of my symptoms), but sometimes I'm convinced my medications are making me worse.

2) I'm not sure. Maybe it is my illness talking, but I know that sometimes my illness tricks me. I honestly go back and forth between "my pdoc is trying to make me feel better" and "my pdoc wants my money". I just confuse myself and I don't know what I want or believe. It's a constant battle.

From my perspective, you are asking the right questions. There is ample evidence that long term use of psych drugs correlates with worsening depression, increasing disability, and with mental disorders shifting from episodic to chronic. They alter normal brain function. That is what they do.

Based on my reading though, stopping any drug abruptly is dangerous and can make symptoms worse. But that does not mean that stopping is the wrong decision. Might mean a carefully managed taper is needed. Not giving advice, just sharing what I know.

If you are worse on meds than off, wouldn't that be the most relevant piece of evidence to guide decision making?

This graphic speaks volumes:
https://www.madinamerica.com/wp-cont.../04/Harrow.jpg

I wonder if you have a medication phobia, which often comes with OCD. You said yourself you make excuses-could that be due to a medication phobia? Do you have phobias in general? Usually people with phobias have more than one. Are you also scared to take vitamins and supplements too? If you are, then maybe it isn't self-sabotage but related to your anxiety that manifests as a phobia. If that is the case, you could address the phobia in therapy to help with getting on a regular medication regime.

As some may have already pointed out, you really do have to stay on a medication for at least 4 weeks (some longer) to see if it works. (as a side note-I think the clinical term non-compliant is offensive and should not be used when clients can't tolerate side effects or medications, and that seems to be the case with you, at least in part).

Also, I do not think this is all your fault. I don't agree with the prescribing of multiple medications at once while searching for something effective (unless you are too unstable or a benzo is used as a second one until the first kicks in) as there's no way in heck you can isolate what is effective and what side effects (both good and bad) come from which drug. Maybe you have already started this way, but I thought it was important to point out.

"Well, why not break down everything into individual problems and symptoms? Depression, anxiety, poor concentration, etc.

Medications usually target symptoms, not diagnosis, this is true, but to see what's effective, the most contributing symptom gets addressed first, so it's the opposite of what you have written. Start at the most contributing culprit then work down.

Bipolar can be used as a sort of bucket diagnosis for people who have various mood dysregulation schemas, but if a bipolar mood instability is in fact the culprit, then your psychiatrist could isolate Lamictal (or Lithium)-give that a try for how long your psychiatrist requires-4 to 6 weeks or whatever it is. Then assess how you feel/your symptoms and see what, if anything, needs added on. S/he should monitor you closely during this time.

So, all that said, do I really need an antipsychotic?

People don't necessarily need to take antipsychotics for psychosis if the mood stabilizer will suffice. If the mood stabilizer works for psychosis, you might be able to avoid the antipsychotics.

And ADD medications can contribute to psychosis-especially if you take more than prescribed. (very overly simplified here but antipsychotics block dopamine; ADD medications promote dopamine). One of the major ER visit reasons for mental health across the US is ADD medication induced psychosis. Did you take more than prescribed, to experiment maybe?

Taking too many at once really makes it difficult to treat effectively, which seems to be a common thing for people in your situation. You'll never know what is doing what by taking all at once. I'd back up and start with one, start over. So, if your psychiatrist addresses the primary problem/symptoms with just one medication then s/he can work in steps to address the rest. If it's mood instability that progresses to psychosis or bipolar depression-start with the mood stabilizer. But you HAVE to stay on it as long as your doctor prescribes to see if it will work.

If the mood stabilizer ends up taking care of the mood instability and psychosis, but makes you feel too down or sleepy, you could later add on Wellbutrin. Wellbutrin could help with the ADD like symptoms too. Mood stabilizers can help with the anxiety, which will help with the concentration; on the other hand, some can worsen it. But concentration issues do not usually call for a ADD drug, as in addition to mania/hypomania from bipolar, depression and anxiety can be the biggest cause for focus and concentration problems. Figuring this out will of course help you minimize drugs used.

I also don't agree with doctors in general that use more than 2-3 at a time in the long run. I think that's doctor laziness for not finding the best one before adding and adding, and no one has studied the effects of these medication combinations in tandem with one another.

Your issues are similar to some on my father's side of the family. My other personal experience is that my last 3 psychiatrists have been just prescribing me what I ask for, which involves my own trial and error. I've finally settled on something on a temporary basis. After being in the system for 10 years, you may get to the point where you can pick your own medications too and your doctors will trust your judgment. But you have to at least stick with something first that works for the most part--slow down and level out.

So please try to stick with the mood stabilizer for at least 4 weeks or however long your doctor thinks, one that will prevent psychosis! And like I said before, you might be able to avoid the antipsychotics if the mood stabilizer works, which is what you want, but you have to give it a chance!

Tell your doctor, too, about your experimentation. My long-term psychiatrist said everyone does. And after him, I've told my subsequent psychiatrists that I quit one and started another in between appts, etc. I was scared to tell them too, but that helped them allow me to have more influence in the choices, then eventually make my own.

With you, they may not be too happy because you have psychosis, but try to be honest and say it's because this is not working. But i really think you should quit doing this, perhaps address a phobia if that is related, but tell your psychiatrist that taking all these drugs at once is not working, and ask if you could perhaps start over because you are serious about where you need to be, but it's not working this way. If the drugs make you worse, it's really not a matter of 'just' the side effects. I really don't think it's all your fault.

Originally Posted by Favorite Jeans

What if you go in and just lay it all out for pdoc:

"I have a hard time trusting the meds and a hard time trusting you. I worry about the side effects and long term effects of these meds. I also know that I'm ill and don't like how that feels. I need to feel like we're working together on this. I need you to slow down and explain stuff to me [or whatever you need]. I also would prefer if you could help me be on as few medications as possible. Of the three meds I'm on, which would you say is most crucial? Can we meet more regularly because I don't feel that stable right now?"

If they don't receive this well, that is a sign of someone who isn't the right pdoc for you now. If they are able to hear you and appear to be doing their best to meet you where you are, consider how you could follow your med plan better. Would a dosette or a timer help?

It is likely frustrating for the doctor for a patient to be uber skeptical about the proposed treatment plan (esp on the grounds that meds are toxic) if the patient is not seriously pursuing other avenues to wellness. So you know, the substance use issues, the physical activity plan, the meditation, the talk therapy, the community involvement, the healthy eating.... It would show a lot of commitment (and make it easier to negotiate) if you were hard at work on those things.

Yeah, I could say that. I never really thought about that.

My pdoc doesn't think I'm stable either, but he doesn't know much about my non compliance. I'm just deathly afraid of him terminating with me because he thinks I'm a lost cause

He does know that I'm in therapy and doing the best I can in that respect. He's asked me a couple of times, "how is therapy going?" Then I usually tell him that it's going well for me, but I don't really elaborate on that.

Originally Posted by Skies

I wonder if you have a medication phobia, which often comes with OCD. You said yourself you make excuses-could that be due to a medication phobia? Do you have phobias in general? Usually people with phobias have more than one. Are you also scared to take vitamins and supplements too? If you are, then maybe it isn't self-sabotage but related to your anxiety that manifests as a phobia. If that is the case, you could address the phobia in therapy to help with getting on a regular medication regime.

I have an OCD Dx, technically, but only 2 of the 4 opinions I have say I have OCD.

It's sort of a phobia, I guess, since I'm not so comfortable taking medications

Originally Posted by Skies

As some may have already pointed out, you really do have to stay on a medication for at least 4 weeks (some longer) to see if it works. (as a side note-I think the clinical term non-compliant is offensive and should not be used when clients can't tolerate side effects or medications, and that seems to be the case with you, at least in part).

Also, I do not think this is all your fault. I don't agree with the prescribing of multiple medications at once while searching for something effective (unless you are too unstable or a benzo is used as a second one until the first kicks in) as there's no way in heck you can isolate what is effective and what side effects (both good and bad) come from which drug. Maybe you have already started this way, but I thought it was important to point out.

Medications usually target symptoms, not diagnosis, this is true, but to see what's effective, the most contributing symptom gets addressed first, so it's the opposite of what you have written. Start at the most contributing culprit then work down.

Bipolar can be used as a sort of bucket diagnosis for people who have various mood dysregulation schemas, but if a bipolar mood instability is in fact the culprit, then your psychiatrist could isolate Lamictal (or Lithium)-give that a try for how long your psychiatrist requires-4 to 6 weeks or whatever it is. Then assess how you feel/your symptoms and see what, if anything, needs added on. S/he should monitor you closely during this time.

Yeah. Started with Lexapro. Added an antipsychotic when my pdoc claims I became manic. Then when I became depressed, I started on a mood stabilizer. Then one by one changed antipsychotics, making sure to select ones that also targeted depression (first Latuda, then Abilify, then Seroquel)

We never tried out multiple medications at once. We always made sure to do everything one by one (for reasons you said).

Originally Posted by Skies

People don't necessarily need to take antipsychotics for psychosis if the mood stabilizer will suffice. If the mood stabilizer works for psychosis, you might be able to avoid the antipsychotics.

And ADD medications can contribute to psychosis-especially if you take more than prescribed. (very overly simplified here but antipsychotics block dopamine; ADD medications promote dopamine). One of the major ER visit reasons for mental health across the US is ADD medication induced psychosis. Did you take more than prescribed, to experiment maybe?

I was prescribed 20mg Adderall XR. Only took the 20mg dose.

First time I did it, I was on Lexapro, Latuda, and Lamictal. (Or maybe it was Abilify instead of Latuda... I don't remember.) Pdoc claims I became hypomanic.

This time, I went off all meds, *then* took Adderall.

Originally Posted by Skies

Taking too many at once really makes it difficult to treat effectively, which seems to be a common thing for people in your situation. You'll never know what is doing what by taking all at once. I'd back up and start with one, start over. So, if your psychiatrist addresses the primary problem/symptoms with just one medication then s/he can work in steps to address the rest. If it's mood instability that progresses to psychosis or bipolar depression-start with the mood stabilizer. But you HAVE to stay on it as long as your doctor prescribes to see if it will work.

If the mood stabilizer ends up taking care of the mood instability and psychosis, but makes you feel too down or sleepy, you could later add on Wellbutrin. Wellbutrin could help with the ADD like symptoms too. Mood stabilizers can help with the anxiety, which will help with the concentration; on the other hand, some can worsen it. But concentration issues do not usually call for a ADD drug, as in addition to mania/hypomania from bipolar, depression and anxiety can be the biggest cause for focus and concentration problems. Figuring this out will of course help you minimize drugs used.

I also don't agree with doctors in general that use more than 2-3 at a time in the long run. I think that's doctor laziness for not finding the best one before adding and adding, and no one has studied the effects of these medication combinations in tandem with one another.

Your issues are similar to some on my father's side of the family. My other personal experience is that my last 3 psychiatrists have been just prescribing me what I ask for, which involves my own trial and error. I've finally settled on something on a temporary basis. After being in the system for 10 years, you may get to the point where you can pick your own medications too and your doctors will trust your judgment. But you have to at least stick with something first that works for the most part--slow down and level out.

So please try to stick with the mood stabilizer for at least 4 weeks or however long your doctor thinks, one that will prevent psychosis! And like I said before, you might be able to avoid the antipsychotics if the mood stabilizer works, which is what you want, but you have to give it a chance!

Tell your doctor, too, about your experimentation. My long-term psychiatrist said everyone does. And after him, I've told my subsequent psychiatrists that I quit one and started another in between appts, etc. I was scared to tell them too, but that helped them allow me to have more influence in the choices, then eventually make my own.

With you, they may not be too happy because you have psychosis, but try to be honest and say it's because this is not working. But i really think you should quit doing this, perhaps address a phobia if that is related, but tell your psychiatrist that taking all these drugs at once is not working, and ask if you could perhaps start over because you are serious about where you need to be, but it's not working this way. If the drugs make you worse, it's really not a matter of 'just' the side effects. I really don't think it's all your fault.

In thinking about this a little more, my pdoc *has* asked me in the past if I had a particular antipsychotic that I wanted to take. Maybe he did that because I was non compliant and he thought I'd be more compliant if I chose my own meds. I'm not sure. I could be over analyzing and making assumptions.

I've thought about asking for Wellbutrin because I'm aware of the ADHD thing and Wellbutrin, but my pdoc won't even let me boost my Lexapro dosage because he claims it made me manic. So idk if he'd even be willing to give Wellbutrin a go, but in all fairness, I've never asked.

I'm a bit afraid to start all over, mostly (because as you said) I've been non compliant and haven't given them a chance to work. I just don't know what I want anymore. I'm honestly confusing myself

[BudFox]

I would be careful about the idea that antipsychotics are "targeting depression" or "treating psychosis". As far as I know, there is zero evidence for that. What they do apparently is produce a general tranquilizing effect. And they come with great risk.

I AM med compliant but I question taking them regularly. Perhaps now more on account I feel okay. I struggle not to fall in the trap of 'I'm okay so I don't need my meds' thinking. Now, it has suddenly occured to me that my practise might be entirely different if I had to pay for my medication. I only pay $2 per fill. I suppose if I did have to pay for my drugs I would probably be thinking more about whether I could get away without doing so.