I've reached a dead end medication vice

[snowflake231]

So I have bipolar 1. I've been on regiment of medication. I'm going through a mixed episode. My medication is not controlling the symptoms. I can't add any new medication due to allergic reaction. I can't increase the medication I'm on as it would require me taking it in the morning and it knocks me out cold so I would not function at all through the day. What do I do? 

[AuntGlow]

Hello @snowflake231, 

Thank you so much for sharing this update with us. This all sounds very overwhelming and challenging to navigate - there are so many factors at play, aren't there? On this occasion, perhaps more regular strategy/management-based support could help? But I understand that you may not have a lot of space for implementing these things right now... in your opinion, out of the options you have been given, what seems like the best thing to trial? 

I hope someone here can offer some lived experience around this too. In the meantime, I am more than happy to talk things out with you. 💛

[snowflake231]

@AuntGlow thank you. I really don't know what to do. This suxs. I really don't know what I can do. 

[AuntGlow]

It really would suck, I am so sorry you're going through this... do you feel comfortable talking about it further with your psychologist and psychiatrist so you can work out the best plan to trial? 

[snowflake231]

@AuntGlow  

Im happy to talk about it with my doctor but I feel like there isn't much more they can do. I've been taken off antidepressants cause it got me into a mixed episode. I'm already on antipsychotics and I can't increase them without sending me into zombie state and I'm allergic to anticonvulsants. That covers all the meds available for bipolar. 

[Dimity]

Sorry to hear things haven't got any easier @snowflake231 . That's unfortunate re the allergy.

Have you been off the antidepressants very long? It may take a while for your system to adjust, but hopefully the mania component of the mixed state will ease pretty soon. 

I don't know what to suggest re the depression.  I've been relying on behavioural activation when I'm up to it but it hasn't sounded like motivation has been a problem for you. Does social connection help? I think physical activity helps me regulate too.

Are you sleeping any better?

Sorry to be so concrete, I'm just going by my own experience. Another thing I've noticed is that times when I'm mentally unwell usually coincides with other stresses in my life eg work or family stuff and resolving those can help too. Nowadays I factor that into my medication. I've titrated the antipsychotic down but can take more PRN if I'm stressed and not sleeping. That approach helps that zombie feeling. It's worth talking to your psychiatrist as it probably depends on the half-life of the antipsychotic. 

[snowflake231]

@Dimity 

this is my first day off the antidepressant so I still have to wait and see. 

at the moment I don't have any stressors in my life so that is all under control. 

I don't know though. Maybe I should stay on the antidepressant as the mania is still manageable so maybe I can stay in it.  The mania is still better than the depression as the depression makes me non functional. At least with the mania even though not ideal but I'm functioning somewhat. 

I just don't know what to do 

[snowflake231]

So until I speak to the dr on Monday I've decided I won't stop the antidepressant as the depression symptoms make me non functional and they are harder to deal with than the symptoms of mania at the moment. I also decided that I won't increase the antipsychotic because I don't want to take a dose in the morning as it will sedate me too much. I have to be able to drive because I have a 16yo that needs taxiing around. 
so I guess all I can do is ride it out. Hubby is very supportive and is keeping an eye on things. He knows what's going on as he attends my dr appointments with me. 

[Dimity]

That sounds reasonable @snowflake231 it's often a judgement call and it's good you.can rely on your husband and doctor to help monitor and support but it sounds as though things are well under control. Bipolar 1 can be a bit scary because we don't want to revisit past relapses. 

Maybe you can start to relax now you're feeling more confident, and find ways of enjoying yourself. 

[snowflake231]

So I decided that it might be time to look at ECT again. I've had it before, 6 rounds to be exact and it scares me  I hate ECT but that might be my only option. I really don't know what else to do.