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But I'm Still Bipolar, Right?


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#1 butterfly854

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Posted 30 July 2014 - 07:53 PM

So the title is sarcastic, but I am confused about something. I was (finally) diagnosed 8 years ago with bipolar 2. Since then I've been on Lamictal, cymbalta and generic ritalin. From all the reading and research I've done it seems unlikely I will ever be able to function without meds and this is something I accept because I know how the alternative feels. I am currently bead counting to wean off cymbalta, which my doc recommended since it can cause mania and I recently had a hypomanic episode. After doing lots of reading here and elsewhere I am glad to be getting off the cymbalta… . BUT, isnt my brain chemistry still "off"?? I will stay on the lamictal, which is a mood stabilizer, but I wonder if that will be enough? I would like not to have to start another anti-depression med, because then whats the point on stopping cymbalta? ?

Does anyone have bpd2 that can give me advice ? Is a mood stabilizer typically enough? I would ask my doc, but due to insurance I had to switch and don't really like the new one. :/

#2 FiveNotions

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Posted 30 July 2014 - 08:05 PM

Hi Butterfly, this question is way out of my experience/knowledge range, but I'll do some research. We've got several other folks here who, I believe, also have bipolar, so let's hope they turn up to help out.


#3 brzghoff

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Posted 30 July 2014 - 11:20 PM

So the title is sarcastic, but I am confused about something. I was (finally) diagnosed 8 years ago with bipolar 2. Since then I've been on Lamictal, cymbalta and generic ritalin. From all the reading and research I've done it seems unlikely I will ever be able to function without meds and this is something I accept because I know how the alternative feels. I am currently bead counting to wean off cymbalta, which my doc recommended since it can cause mania and I recently had a hypomanic episode. After doing lots of reading here and elsewhere I am glad to be getting off the cymbalta… . BUT, isnt my brain chemistry still "off"?? I will stay on the lamictal, which is a mood stabilizer, but I wonder if that will be enough? I would like not to have to start another anti-depression med, because then whats the point on stopping cymbalta? ?

Does anyone have bpd2 that can give me advice ? Is a mood stabilizer typically enough? I would ask my doc, but due to insurance I had to switch and don't really like the new one. :/

 

i do but f you have a history of mood swings i can't recommend staying on or getting off C - you definitely need to have an anti-d strategy with your doctor, a psychiatrist you like and trust. 

 

i have an "official" diagnosis of bp 2 and am also on lamictal. have been for ten years, i went on it and the C at the same time (previously on effexor and depakote). i quit the C 11 weeks ago after a fast taper. i want off all the meds, but the C the most so that's where i've made my move for now. the lamictal can wait.

 

as for your situation i can't say if a mood stabilizer is enough. do your swings tend to depression or mania? those who are truly bi polar ( i have serious doubts about me - as does my therp) then you need to tread lightly. while anti-d's without a mood stabilizer definitely promote mania, coming off C can also do it. sounds like the C did it to you while on the lamictal. definitely stay on the lamictal. if its "enough" or not is between you and a p-doc you trust. as for your brain being "off" not sure what you mean - since it seems your doc is encouraging you to get off C he will hopefully keep an eye on whether you need to get on something else or not. its hard to tell the source of depression while weaning off an anti-d, is it withdrawal or the actual depression returning? it takes time to really know. coming off C is way easier if you are transitioning to another anti-d, but that is between you and your doc - if you trust him. 

 

for me getting off C has been rough, for the first month and a half or so it was a lot of physical stuff, joint and muscle pain - lots - serious gastro issues, nausea, the runs, etc, confusion, tinnitus ( i have it anyway-lots of loud music in my life). mental issues kicked in early on but didn't get serious until i'd been off for a couple weeks and is now all that really remains - primarily anxiety, serious at times. its enough to drive me to the point where i wonder if i should give up and go back on, but then i get a clue and realize that i am doing the right thing for me. i started going to my therapist again while i've been in withdrawal mode and he is my voice of reason. cognitive skills are essential to deal with the anxiety

 

in my case, i think the bp 2 label is the result of a mental disorder du jour diagnosis. if anything, i may have ADD, but that's another disorder du jour. therapy is what has helped me the most in my 18 year mental health journey. i've done so well for so many years on the meds that while skeptical, my p-doc was cool about me wanting to wean off the C but had no suggestions about how. he is clueless. i'm switching p-docs . if he knew what i have been going through he'd tell me i need to be on it, that withdrawal only last a couple weeks it must be depression, yadda yadda yadda ad nauseum . 

 

all the best to you. good support here.


#4 FiveNotions

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Posted 31 July 2014 - 08:19 AM

Brzghoff, thank you for sharing all that about bipolar and your own experiences with it and the meds ... I'm beginning to think that / wonder if, there are certain commonalities in the Cymbalta weaning process depending on why we were put on it in the first place .... anxiety, depression, bipolar, fibro and/or other types of pain, etc .... this forum is a gold mine of experience and information on questions like this ...

 

I had a wonderful, brilliant secretary years ago who had bipolar ... what "type" I don't know ... but she ended up on abilify ... with great success ... which was sort of ironic, because I was on the team of lawyers who did the legal work (visas etc) to allow Otsuka, the co. that developed it, to move their team of scientists and drug dev. managers/executives around the world to lead the project (it was being carried out in Europe, Asia, Canada and the US simultaneously, and coordinated from here in the US) .......... we used to joke that the least the company could do would be to give my secretary a lifetime free supply of the stuff ....

 

Is abilify still used for bipolar?


#5 butterfly854

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Posted 31 July 2014 - 09:42 AM

Yes, Abilify is still used.  I have been on it briefly twice, but it caused me to have high blood pressure so I was taken off it.  I am confident in my diagnosis of bipolar 2 since it fits me to a T.  Bipolar 2 is more depression based with episode of hypomania.  Prior to my diagnosis I was always just treated for depression, which explains why I wasn't stabilizing.  Lamictal has really helped even me out a bit.  However, (and I've read this here as well) I sometimes feel like I don't have enough emotions, just blah blah all the time.  I'm hoping by stopping Cymbalta that will help but not push me over the edge. :) 

 

I guess time will tell....    Thanks for the support!


#6 brzghoff

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Posted 31 July 2014 - 10:07 AM

 

my understanding with abilify is that as butterfly indicated, it is used as an adjunct to your regular anti-d. however, i've never taken it. a bp 2 diagnosis can be made for a depression leaning mood disorder with less frequent swings to hypo mania, but the term is also applied to moods that swing more often toward the hypo mania spectrum. bp 2 differs from bp 1 in that the "onesies" have full blown manic episodes that can totally destroy a life and border on a psychotic episode. those are the ones you hear about most often. when bp 2 swings towards the depressive range more often, then lamictal and/or abilify are often the go-to drugs, paired with an anti-d. lamictal is also used like abilify for hard to treat depression mood disorders. my doc chose the C not because he thought it was a good choice to treat bp 2 depression, but because it was number one on the hit parade of anti-d's in 2004. it was a drug reps high-commission dream ticket. 

 

butterfly, does the C also cause high BP for you? all snri's are known for that. i had to go on a high dose of benicar, and i still had problems controlling mine, it would spike to 180/100 sometimes. now that i am off the C, i was moved to a low dose of a lower strength BP med, losartan. since then i have been able to go off it as well. i was getting very dizzy thinking it was the C withdrawal but my blood pressure came in as low as 88/60, so my doc said its fine to go off, just monitor it for now. its now around 110/75 - with no drugs. in other words, if i hadn't been diligent in monitoring my BP i could have gotten a stroke on cymbalta. 

 

also, i have always known that anxiety can cause low blood pressure. reason being is that when you develop anxiety, your heat rate goes up and your pressure drops to compensate. however, i have now learned that the reverse is also true. low blood pressure can lead to anxiety! not only did i have that suspicion, i researched it and found that can happen as well. i wonder if that was complicating my withdrawal anxiety as well. i've only been off the BP med for a couple days now and i am feeling better - but its too early to tell if that was causing it, or even if i can stay off the BP meds in the long run. 


#7 butterfly854

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Posted 31 July 2014 - 10:20 AM

Hi brzhoff,

 

I have been on Cymbalta for 8 years since I was about 25.  Before that I never really monitored my BP, but I do know it is a little higher than preferably, but I've not needed to be on meds for it.  When I was also taking Abilify it really did help me but obviously wasn't worth the risk of stroke or anything.  Since I have always been more depressed than anything (seldom, sporadic bouts of hypomania) I was leery of weaning off Cymbalta before now.  I feel like I am at a reasonably good place right now and want to give it a try before fall/winter when I usually fall into a funk.  (On another note, I highly recommend light therapy during winter- it helps tremendously!)  Ultimately I am hoping the Lamictal will suffice in keeping my depression and mania at bay while still allowing me enough "real" emotion.  I am tired of being tired! 

 

So now that you are off Cymbalta and still on Lamictal do you feel like you will even out with your anxiety, etc?  Or perhaps need something additional besides the Lamictal?


#8 brzghoff

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Posted 31 July 2014 - 02:36 PM

 

butterfly,

 

i've only been off the C for 11 weeks. it is too soon to tell how much the anxiety will "even out" my goal is to never go back on any more drugs, and hopefully someday get off lamictal too. i want OFF! in my case i honestly think the bp2 is a bogus diagnosis. i had a lazy p-doc who just wanted to write 'scrips and go onto his next patient. i think my issues stemmed from "irrational" thinking i developed due to various household stressors growing up. nothing hugely traumatic, dad gone for a year at a time to vietnam on several different tours of duty and the surrounding stress on my mom with three young girls  - stuff like that. i had 3 therapists before finding a good one, i've been seeing #4 for ten years, although not at all the last two until a month ago. i've seen him twice again and will next week also. his method is the "original" form of cognitive behavioral therapy called rational emotive behavioral therapy - or REBT. you learn to challenge your thinking - those things that we tell ourselves for which we have no evidence - such as something is so horrible that we can't stand it - for instance money problems, which causes the anxiety. just why is it so horrible? what evidence do i have that money problems are so horrible or that i can't "stand it"? its tough to make ends meet and it would be better if i had more money coming in, but its not killing me.  that kind of thing. anxiety is learned and can be un-learned. i also learn strategies such as focusing on my breath and the sounds, smells and sights around me. mindful activities can also keep the anxiety down. it doesn't come all at once, i have to practice all the time, but it is starting to come naturally to me as i struggle through this anxiety which i truly believe to be temporary as it has reared its head again as result of the changes to my system created by cymbalta. now that i am off , its up to me to "fill in the gaps" so to speak. i never had these cognitive "skills" before therapy and the drugs, so i've never had a chance to implement them in a drug free setting. that's my goal. 





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