I spent nearly 3 weeks this time in a mixed state. It was hell. I was tired but not. I couldn’t sleep no matter how much I wanted it and my brain would not shut off. It was racing thoughts and then obsessing about having racing thoughts thrown in with some obsessing about a thought that would get caught up in my brain. I was angry all the time and felt that nobody could finish a sentence fast enough and just wished they would shut up instead so I didn’t have to wait to hear it. When I’m in this, I am greatly, many times smarter than everyone else and everyone else has an IQ of a compromised person. All but me, are all stupid, dumb, and idiots. My irritability is like a force field around me. I have dark, so dark thoughts and energy, energy, surging energy. My skin feels like it’s electric. The sensation is so bad, I want to claw it off. I have so many things I want to do and absolutely need to do and need to do urgently. I have no choice. Sleep is torturous. I’m up for two or three days and collapse on one, only to wake up every two to three hours and have difficulty going back to sleep. I saw no end to the hell and started thinking of ways I could get out.
I could end it. I was both glad and disappointed that there wasn’t a gun in the house. I reflected on the collection of pills I have in my meds drawer. The car wasn’t in the driveway so I didn’t have keys to go ram it into a concrete wall. Just before these things became too overwhelming for me to control, I called my psychiatrist one more time to try to get straightened out.
I had been taking an SSRI. Once, in an inpatient stay for a severely suicidal mixed episode, my doctor there told me to never ever go back onto an SSRI. It was a complete, no questions asked direction – Do Not Ever Take An SSRI Again.
I was seeing a different psychiatrist than my current one last year. During a depression, he removed my Wellbutrin XL (which was the best AD I’d ever been on) and replaced it with Trintellix, full dose and gave me 30 mg of Adderal in addition to the Vyvanse I’m on and also increased my Vyvanse by 10 mg. About 7 months later, I broke and had a manic episode. He only took away the Adderal. About 8 months after that, fast forward – here we are now. I break down and have a hellish mixed episode that I am actually surprised didn’t put me in the hospital. I’m with a new dr at this time.
My psychiatrist made good med changes, although at the time, I thought he was just messing around and full of BS. He took me off of Trintellix (SSRI, don’t let anyone lie to you and tell you it’s just a modulator because that IS bullshit) and dropped my Vyvanse by 10 mg and added gabapentin for anxiety and to help slow me down and sleep. I asked about Wellbutrin XL because I’m terrified of my depressions and do not want to be set up to go there. He said he wants to see if I can manage on just four of my current meds, that already includes Latuda for depression and mood stabilization. He’s hoping I won’t need an AD at all. Me, too.
A week later, after med changes, I am feeling so much better. My doctor did know what the was doing! Even though it took a few miserable days after the med changes to make a difference, they worked and again, I feel so much better. I’m out of my mixed episode and recently found by adding one more medication – the magic potion for a whole night’s sleep.
I’m sure there will be another time when bipolar comes out and throws a fit or sequesters me to the deep pit of depression but I’ve learned that I can at least trust my doctors judgement now.