Living with Bipolar

Thanks for the tips. My husband is trying to keep me moving rather than festering under the duvet. Ruminating round in circles is just such a bugger. I don't want my brain to do it, but it's doing it anyway.

What is medical support through PALS? I know what you mean about anxiety about interacting with medical people.

It’s a shame the nhs mental health services are so overstretched they can’t provide basics to people who really need it.
if you are looking at private then priory is a good shout - it’s 300 ish for an initial consult which can be face to face or zoom then 180 for follow ups. X

I’m feeling a bit better thanks - I’ve been trying to keep really busy. Mostly it’s morning anxiety that’s bothering me as I wake up full of dread which isn’t very nice. And I’ve got a bad stomach but I think that’s the stress - got diarrhoea several times per day at the minute which is not nice 😖
got all the paperwork through yesterday for my new house so Ive signed the contract which means probably not long till I will be moving out. It’s scary thought but I think it will do me good to start my new way of living rather than being like a cuckoo in the nest!

8 pm and the anxiety finally stops. I'm going to do a jigsaw puzzle with DC and tomorrow I'm going to the library to get something mindless to read. Might restart the Agatha Christie's as a gentle whodunit seems like a plan

I love Agatha Christie!

The films are so easy to watch - my favourite is death on the Nile with Peter Ustinov- the cast is amazing! I’ve seen it so many times

I'm still really struggling. They've held my job open for me to change my mind and in a way it's making it harder. My thoughts are really bad. I can't see a way forward.

I think them holding the job shows they really value you xx
i know how you are feeling, more or less, obviously we all have different circumstances etc but I have had some real problems recently with the depression.
try and take each day bit by bit, if you can get a med review then it will be worth looking at that side of things. I hope today is a bit better for you and if it isn’t and you are feeling bad then I would ring crisis team. I’ve just been under them and they said they would rather people got in touch sooner than when they literally can’t cope anymore as they are still there to support you if you are having difficulties. They’ve changed the name in some areas to home based early intervention or something like that as the word crisis implies you have to be at the absolute end of your tether before you contact them and that is absolutely not the case xx

Thanks @MarmadukeM . I did contact the crisis team and we upped my quetiapine over the weekend. Which has taken the edge off, just a bit.

Ah I’m really pleased that you did and that it’s helped a bit xxx

Just Wondering if anyone on here has advice on altering medication to try and help depression? I have bipolar and have been on Aripiprazole, sertraline and propranolol for the last two years. Have been stable in that time but for the past 3 months I’ve been in a depression which I just can’t shake.

Am making an appointment with the crisis team on Monday as I’ve realised the depression isn’t shifting using my usual techniques (mainly mindfulness and swimming).

Part of the problem is the flattening out of emotions caused by the aripiprazole - I am grateful not to peak into manic highs but feel like I need a bit of a mood lift iykwim?

Am sick of feeling depressed and just want to stop feeling exhausted all the time.

Any advice gratefully received.

@hoodiemassive I struggle more with depression than mania but struggled with antidepressants in the past

I don't have experience of your medication but have been in your position more than once

One time I was being treated for severe depression and psychosis. The depression was treatment resistant and I ended up on a lot of meds and at one point 2 antidepressants. Once the severe depression and psychosis has improved I found myself stuck at moderate depression and quite emotionally blunted. I was on 800mg of quetiapine because of the psychosis and to prevent all the antidepressants sending me manic. They lowered my quetiapine to 600mg which is historical been the dose I have needed for depressive episodes and that helped.

Other times they have played with the antidepressants. In one episode they went with mirtazapine as it's a less activating antidepressants and the sedation side effects can help with sleep and reduce the risk of switching to mania so you might get away with lower doses of mood stabilisers/antipsychotics. At the moment I'm in a depressive episode but also have pretty bad fatigue due to some physical stuff that is going on. I'm on a low dose of mirtazapine at night and a higher dose of venlafaxine in the morning in addition to the long standing quetiapine. They are hoping that the venlafaxine will give me that bit of drive alongside the mirtazapine which is the only antidepressant that I have tolerated and found beneficial. They have fiddled with my quetiapine dose to see if that helps but only gone up to 650 mg.

Questions I would have for the psychiatrist

• would a minor tweak to the aripipriazole dose help?
• is the dose of sertraline optimal?
• is sertraline the right antidepressants?

Other suggestions to discuss therapy and activity based support.

I'm in a similar place. Mood is still quite low, physical health is still quiet rubbish. I'm waiting on therapy, I was 8th in the queue and I'm now 6th so hopefully that will come up soon.
For the physical health stuff I'm awaiting an appointment with an endocrinologist. I've been doing some reading and I have suggestions of things to try but I know that they can't be implemented in primary practice until blood work shows a problem. Rapidly approaching the summer holidays which was when all the physical health stuff started and yesterday was 5 years since my admission to the mother and baby unit with my daughter. It's hard that I'm in a similar position with my second.

I’ve been tinkering about with my meds (under psychiatry) for about 10
months. I do think the mood stabilisers (I’m on quetiapine) can flatten you as they are sedating. I’m on trazodone as well at the minute, it’s been going ok but I’m under a lot of stress at the moment as marriage has ended and am moving out in next few weeks and shitting myself about it all tbh. I think it does sound like @Superscientist said, maybe look at dose of mood stabiliser and see if the sertraline is doing the trick (doesn’t sound like it is really). It’s a shame there aren’t any guarantees with antidepressants that they will help or not and you have to go a few weeks on them to give them a fair shot. I don’t have any proper advice sadly but I think a discussion is a great starting point, see what your options are. There aren’t any life events that could be contributing are there? X

@Superscientistthey are good questions which I didn’t think of! The Aripiprazole works really well for the manic highs but I feel like the sertraline isn’t doing its job any more for the depression. I can’t go up to 200mg as I tried that a couple of years ago and it sent me really manic and I am still cringing with how I behaved on it. The one good thing to come from the last high I had was it keeps me on the Aripiprazole even though it blunts my emotions in a way I really dislike.

Sounds like you have a lot going on after having a baby - it is such an upheaval and having bipolar is a full time struggle in itself plus other health worries. Sending you a hug if it helps xx

@MarmadukeMI am in a good place atm which I’m grateful for and my life is stable having been a mess for quite a few years. It is frustrating that I seem unable to just enjoy the calm and security but that is the bipolar I guess. I have been on sertraline for 15 years so maybe I have become resistant to it.

I’m sorry you are under such stress and wish you all the best with moving out. Keep posting here if it helps xx

Sorry to post again - called the MH team and they will discuss my case this week then offer me an appointment.

I just want to stop feeling this depressed. Feel like I can’t cope with everyday life, every task feels like a mountain.

What can I do to feel a bit better while I wait for my bipolar meds to be changed? Is there anything that worked for you guys as an interim measure? I am desperate to feel better and to stop wanting to stay in bed and sleep.

@TopsyTurvyDaysthat actually made me laugh - I learnt to drive in a car that had a choke and it was a tricky bugger to get right! Will brief DH when he’s home so he can be my choke.

My friend invited me for a walk and I turned it down but I will rearrange for this week. My friend is a powerhouse of energy and maybe some will rub off on me (even a bit of energy would be amazing right now).

I hope this episode does end it has been so long since I felt any joy and motivation…I just feel so bipolar poorly right now. Sorry to be such a depressive drain in my posts.