Posted by Ponder on October 22, 2002, at 21:49:47
In reply to Re: Lucid Description » Ponder, posted by BarbaraCat on October 22, 2002, at 20:34:29
> Hi Ponder,
> Yes, taking a benzo prophylactically seems to be the key in heading off a mixed state. I definitely think that anxiety is the trigger that sets off the whole cascade for me. I too used to sail through anxious situations and was very much an adventurous spirit who relished the 'aliveness' in dicey situations. I was confident of my ability to find a way through or out of any thing. Even though I was going through depressions during this time, I wasn't the scaredy cat I've since become.
>
> Sometimes I think that the bipolar manifested itself more black and white back then and my high times were bordering on mania and my depressions were the standard variety. Now the spectrum has blurred toward the middle and anxiety has become excrutiating and debilitating. The reason I don't think it's one of the anxiety disorders is because of the sheer violence and terror in the black hole. My fears become very vivid and fueled by the mixed states nightmarish quality. I used to wonder if it was a schizoid disorder, but it's too cyclical and besides, Lamictal seems to be doing the trick.
>
> Hopefully a respite from psychic trauma courtesy of the right meds will reset the fear circuits and allow me to rediscover that sense of adventure, faith, and self confidence.
>
> Please tell me your experience with mixed states. Sometimes I feel pretty alone and kinda weird with this dx. - Barbara
Barbara,
I, too, used to have better definition between states. My euthymic and hypomanic times allowed me to make up for lost (depressive) time, thereby making it possible to sustain a demanding career. As the years went by with no effective treatment in sight, the illness progressed--more frequent bouts of debilitating depression, more anxiety and irritability, much less time feeling decent at all.A few years ago, I was put on Effexor. This drug, without a mood stabilizer, was the death of my career. I felt better for awhile, then the horrible mixed states--the restlessness, irritability, need to dominate every business meeting, getting unreasonably angry with people, getting fixated on a specific point and holding up the progression of a meeting by harping on it, pacing, pouting, crying, complaining -- all this from someone who had earned an exemplary leadership award the year before for positive leadership and role modeling!
After awhile, more OCD-like symptoms emerged making me feel even more driven and out of control. The whole damned thing finally came crashing down so hard, I couldn't think straight enough to do laundry. I was terrified and overwhelmed in just going to the grocery store, had trouble leaving the house at all. Through in a series of earthquakes and 9-11 and my memories of that period of my life are a seamless black sphere.
Extended medical leave turned into long-term disability. I got admitted to a study protocol at a major university for severe treatment-resistant bipolar depression. Finally, like you, I found some relief in Lamictal. I take it in combination with Wellbutrin. I am much better than I was, but it is still a struggle to stay healthy. Recently, because my hair is falling out and because I was having a recurrence of depressive symptoms, I got disgusted with everything. Seems that when things go south, doctors always want to add something. Pretty soon you've got 6 different components to your treatment and there is no way to tell what's working and what isn't. Some days nothing seems to be working. So, I recently reduced my WB dose from 400 mg/day to 300 and reduced my Lamictal from 150 mg to 125. I have a bottle of Topamax on the counter which I still haven't worked up the courage to try -- scared of the "dumbing" effect and the psychomotor slowing that so many people on this board have experienced.
I also take vitamins, fish oils, zinc, selenium, biotin. I exercise an hour and a half a day, use a light box, do yoga --jeesh, it's nearly a full time job just doing all the stuff that's supposed to help!
Do you also experience "loss of insight" when your illness worsens? I look back on the last year of my career and can't believe I didn't realize something awful was happening. I just kept taking the Effexor and getting worse. I'd call my shrink and he would tell me to increase the dose. I did not recognize the mixed states for what they were and would complain to him about depression because I felt like heck, so he would just up the dose. What a horrible downward spiral I was in!
Anyway, I don't know if I answered your question or am just rambling on. I appreciate your observations and insights and hope to hear more.
poster:Ponder
thread:31636
URL: http://www.dr-bob.org/babble/20021019/msgs/124784.html