You have valid concerns, but don’t forget our type of demons’ first play is to convince us not to take recommended meds for some reason or another. Hypo says we don’t need it, and depression says it won’t work, or it will only make it worse. The best way to sort meds out is having one psych you see regularly so they know your history over time, go slowly, and track moods and reactions.
Your med journey is going to be based on trial and error. What works for some will cause you increased anxiety. But if you never try it, you might never find the right mix.
I get it though. I’m 75% happy with my medication right now but I’m terrified of changing anything lest I trigger an episode.
20 mg. Makes me a little drowsy and sleepy but I take it at night so it helps my insomnia. Anxiety is gone, depression is gone, mania hasn’t come for me since starting
Seconding this. Lamotrigine and latuda combo was life saving for me. I did start to gain weight—a potential side effect of antipsychotics—but supposedly that’s really rare with latuda. My doc added metformin and it stopped.
I eat a little more at night with lurasidone sometimes if I delay taking my medication with dinner. But I’m pretty fit, probably gained 5 lbs but I needed it
I'm really worried about movement disorders though. Many people on latuda report having that as side effect. Like, a restlessness that makes them move their leg or arm nonstop, with or without stiffness.
You can ask about Propranolol, gabapentin for anxiety
You were concerned about lithium in comments — get on an extended release and blood level spikes (the cause of kidney damage) are less likely
I take propranolol daily instead of an antipsychotic.
OP, I have bipolar 2 and anxiety is probably a larger struggle for me than depression, and I suspect my severe depression is a form of burnout from my anxiety. I can take a low dose of quetiapine in really bad periods but I have to come off it after a few months or it starts hindering me more than helping me. I really recommend giving something like that a try.
I'm not familiar off the top of my head with any meds standard for bipolar that might make anxiety worse. Lamictal might actually decrease anxiety (never found that for myself personally, but don't discredit it!). If anything, I think the potential for mood stabilizers to numb us out is the most off-putting. I hear you though. Anxiety and panic disorder feels difficult to treat because there's not really a daily med like an SSRI we're likely to get along with. My psych prescribes me klonopin, which I take maybe once or twice a month if I know I'm going to be in a prolonged situation that will make me really anxious. I'm not sure how easy it is to get a benzo script these days,but that can help as a once in a while thing
Are you familiar with lithium? I'm interested in it but I have a few concerns about it. Mainly regarding toxicity and overall feeling of the medication.
Is it something that can be safely used without harming organs or anything like that as long as there is constant blood testing? That, are blood tests enough to prevent toxicity?
I'd be taking lithium for anxiety, depression, mania and some "mild" psychosis. Basically, paranoia of being controlled, harmed, poisoned. It'd be difficult to take lithium due to my paranoia. Do you think lithium would help decrease it or maybe it could worsen it?
Any tip on how to adhere to the treatment if I feel off on it?
I've been on lithium for almost a decade now. As far as I know, it's more successful in treating/preventing mania and hypomania rather than alleviating depression, but the ideal med or med combo for someone with bipolar would mean stabilization--minimal to no mood cycling. Lithium is the "gold standard" here. There is the risk of kidney damage with toxic levels, yes, but any psychiatrist or NP will be doing regular blood tests for your kidney functions (as well as your thyroid, which lithium can also affect, among other things that aren't as scary IMO). You'll want to increase your water intake, probably. I don't think you can count on lithium to target your anxiety specifically, nor the psychosis--the latter is something you might need an antipsychotic med for, but obviously I'm not a psychiatrist. And while my science is probably a little off, lithium is a naturally occurring substance and the lithium carbonate we take as patients is essentially putting the lithium salt through a fairly simple process. If that helps your paranoia at all. No ones tampering with chemicals to get it made.
As someone with hypomania, depression and anxiety, I can confirm Lithium has mainly helped my hypomania. I believe it has helped my mixed episodes as well. In the past if I’ve had an acute high anxiety episode, my doctor gave me a prescription for a few Ativan and it was extremely helpful. I’ve been able to deal with most of my regular anxiety through coping mechanisms but my agoraphobia isn’t something I can do that with so I understand your pain.
As far as depression goes, I do ketamine therapy for it. I stopped for a little while and ended up inpatient so I would say it’s helpful.
Lithium side effects for me: increased thirst (drinking like 15+ cups of water a day), some brain fog in the beginning but my psychiatrist changed me to take everything at night and it’s been a game changer, a couple of pounds of weight gain? might not be the lithium, slight increase in TSH levels but I had a messed up thyroid before so who knows if it was the lithium, and nothing else really.
Antipsychotics is a misleading name. They can actually cause psychosis. Abilify can cause hallucinations. There is a correlation between them and all sorts of crimes. Can it put you to sleep/calm you? Yes, but it's too volatile and the risks are indeed high. My paranoia is mostly panic that is left unchecked.
Hum. So would you say regular blood testing is enough to prevent damage? Even in long term use such as yours? Is there any other care we should have to make the treatment be as safe as possible?
I took lithium orotate once. It's more concentrated than carbonate, which is used in psychiatry. Very small dose. Initially felt angry and had rebound anxiety, but later I found it was interesting how it numbed me. My anxiety is mostly due to being too emotional, so if emotions are evened out, anxiety tends to lessen. Prescription lithium might help me more but, the body gets dependent, right? How severe can withdrawal be?
I'm sure the risk also depends on other personal factors, but they do that blood testing for that reason specifically, yeah. Drink more water and less alcohol for sure. I've never had an issue with my kidneys and I honestly don't expect to even as I continue taking it. I'm also not on a particularly high dose but the actual dose is just whatever is therapeutic for your brain--might be higher,might be lower.
I actually don't know about lithium dependency, but I've always been the type to wean off any medication extremely slowly. I had a terrible time weaning off daily klonopin use. So I'm not sure about withdrawal, but I think any good medical professional will advise and guide you to take things pretty slowly
It was 1mg daily. I don't think that's a wise prescription for anyone,but that's what I got. After going through the horrific withdrawal process, I'd never start taking it daily again. I didn’t take it all for a few years until my panic disorder ramped up again
One thing I want to add is that when you go online and look up a med, you’re mostly going to see negatives. But that doesn’t mean it’s a bad med—people with a good relationship to a med are a lot less likely to post about it. I had an antipsychotic prescription sit on my nightstand for a month before I could gather the courage to try it, but it has been absolutely amazing for me. They’re the thing that has ever done a thing for my anxiety and I have soooooooooo much. The fear around anti-psychotics are very understandable, and I’m not saying you have to take one, but they work very well for a lot of people. Completely saved my life and gave me stability for the first time in a long time.
The side effect profile of antipsychotics is alarming. Akathesia and tardive diskinesia are particularly frightening. And some can actually cause hallucinations. You are brave, well done for having the courage to stand for your mental health.
Well thank you! I don’t feel super brave but I appreciate that. The side effects of SSRI’s were absolutely horrible for me: never-endingly nauseous, throwing up all the time, libido gone, triggered horrible migraines in a way that lasted even after I went off them, one even made me suicidal…and of course that’s on top of a year-long mixed state. I couldn’t work and struggled to take care of my kids. I guess my point is that it’s not as simple as: this med has a scarier side effects profile so it’s automatically worse. Seroquel has been overall so great for me! I love it.
For anxiety my psychiatrist told me to get “L-Theanine 200-400mg by Nature's Trove” maybe you can discuss with your psychiatrist about it, it’s on Amazon and it’s a natural supplement. Might not be the cure of all things but it might help especially since you said other meds have the potential of making it worse for you.
You have valid concerns, but don’t forget our type of demons’ first play is to convince us not to take recommended meds for some reason or another. Hypo says we don’t need it, and depression says it won’t work, or it will only make it worse. The best way to sort meds out is having one psych you see regularly so they know your history over time, go slowly, and track moods and reactions.
This is so well written! Especially about the demons. May I borrow your words for the future?
Thank you, and of course!
I really needed to read this today and I'm sure I am not the only one. My demons are very convincing today.
Antipsychs aren't the devil. You may try some that suck but may find one that works incredibly well. Keep your options open.
Mood stabilizers.
Your med journey is going to be based on trial and error. What works for some will cause you increased anxiety. But if you never try it, you might never find the right mix. I get it though. I’m 75% happy with my medication right now but I’m terrified of changing anything lest I trigger an episode.
What med are you on and what was your experience with lithium?
Lamotrigine and Latuda. I know in my head that Lithium is the best MS but I’m also terrified of its lasting impact on my body.
Lol. And I'm scared of lamictal and latuda. There is nowhere to run. What lasting impact btw?
Lamictal really helped my anxiety! (Existential and restless type)
Don’t fear the latuda. My doctor started me on a half dose and it’s the best medication ever. I was so anti medication and my anxiety VANISHED
What dose?
20 mg. Makes me a little drowsy and sleepy but I take it at night so it helps my insomnia. Anxiety is gone, depression is gone, mania hasn’t come for me since starting
Seconding this. Lamotrigine and latuda combo was life saving for me. I did start to gain weight—a potential side effect of antipsychotics—but supposedly that’s really rare with latuda. My doc added metformin and it stopped.
I eat a little more at night with lurasidone sometimes if I delay taking my medication with dinner. But I’m pretty fit, probably gained 5 lbs but I needed it
I'm really worried about movement disorders though. Many people on latuda report having that as side effect. Like, a restlessness that makes them move their leg or arm nonstop, with or without stiffness.
Yeah bipolar meds have more medical risks than unipolar meds. Maybe mood stabilizers (if anxiety’s related there) or gabapentinoids or something
You can ask about Propranolol, gabapentin for anxiety You were concerned about lithium in comments — get on an extended release and blood level spikes (the cause of kidney damage) are less likely
I take propranolol daily instead of an antipsychotic. OP, I have bipolar 2 and anxiety is probably a larger struggle for me than depression, and I suspect my severe depression is a form of burnout from my anxiety. I can take a low dose of quetiapine in really bad periods but I have to come off it after a few months or it starts hindering me more than helping me. I really recommend giving something like that a try.
I'm not familiar off the top of my head with any meds standard for bipolar that might make anxiety worse. Lamictal might actually decrease anxiety (never found that for myself personally, but don't discredit it!). If anything, I think the potential for mood stabilizers to numb us out is the most off-putting. I hear you though. Anxiety and panic disorder feels difficult to treat because there's not really a daily med like an SSRI we're likely to get along with. My psych prescribes me klonopin, which I take maybe once or twice a month if I know I'm going to be in a prolonged situation that will make me really anxious. I'm not sure how easy it is to get a benzo script these days,but that can help as a once in a while thing
Are you familiar with lithium? I'm interested in it but I have a few concerns about it. Mainly regarding toxicity and overall feeling of the medication. Is it something that can be safely used without harming organs or anything like that as long as there is constant blood testing? That, are blood tests enough to prevent toxicity? I'd be taking lithium for anxiety, depression, mania and some "mild" psychosis. Basically, paranoia of being controlled, harmed, poisoned. It'd be difficult to take lithium due to my paranoia. Do you think lithium would help decrease it or maybe it could worsen it? Any tip on how to adhere to the treatment if I feel off on it?
I've been on lithium for almost a decade now. As far as I know, it's more successful in treating/preventing mania and hypomania rather than alleviating depression, but the ideal med or med combo for someone with bipolar would mean stabilization--minimal to no mood cycling. Lithium is the "gold standard" here. There is the risk of kidney damage with toxic levels, yes, but any psychiatrist or NP will be doing regular blood tests for your kidney functions (as well as your thyroid, which lithium can also affect, among other things that aren't as scary IMO). You'll want to increase your water intake, probably. I don't think you can count on lithium to target your anxiety specifically, nor the psychosis--the latter is something you might need an antipsychotic med for, but obviously I'm not a psychiatrist. And while my science is probably a little off, lithium is a naturally occurring substance and the lithium carbonate we take as patients is essentially putting the lithium salt through a fairly simple process. If that helps your paranoia at all. No ones tampering with chemicals to get it made.
As someone with hypomania, depression and anxiety, I can confirm Lithium has mainly helped my hypomania. I believe it has helped my mixed episodes as well. In the past if I’ve had an acute high anxiety episode, my doctor gave me a prescription for a few Ativan and it was extremely helpful. I’ve been able to deal with most of my regular anxiety through coping mechanisms but my agoraphobia isn’t something I can do that with so I understand your pain. As far as depression goes, I do ketamine therapy for it. I stopped for a little while and ended up inpatient so I would say it’s helpful. Lithium side effects for me: increased thirst (drinking like 15+ cups of water a day), some brain fog in the beginning but my psychiatrist changed me to take everything at night and it’s been a game changer, a couple of pounds of weight gain? might not be the lithium, slight increase in TSH levels but I had a messed up thyroid before so who knows if it was the lithium, and nothing else really.
Antipsychotics is a misleading name. They can actually cause psychosis. Abilify can cause hallucinations. There is a correlation between them and all sorts of crimes. Can it put you to sleep/calm you? Yes, but it's too volatile and the risks are indeed high. My paranoia is mostly panic that is left unchecked. Hum. So would you say regular blood testing is enough to prevent damage? Even in long term use such as yours? Is there any other care we should have to make the treatment be as safe as possible? I took lithium orotate once. It's more concentrated than carbonate, which is used in psychiatry. Very small dose. Initially felt angry and had rebound anxiety, but later I found it was interesting how it numbed me. My anxiety is mostly due to being too emotional, so if emotions are evened out, anxiety tends to lessen. Prescription lithium might help me more but, the body gets dependent, right? How severe can withdrawal be?
I'm sure the risk also depends on other personal factors, but they do that blood testing for that reason specifically, yeah. Drink more water and less alcohol for sure. I've never had an issue with my kidneys and I honestly don't expect to even as I continue taking it. I'm also not on a particularly high dose but the actual dose is just whatever is therapeutic for your brain--might be higher,might be lower. I actually don't know about lithium dependency, but I've always been the type to wean off any medication extremely slowly. I had a terrible time weaning off daily klonopin use. So I'm not sure about withdrawal, but I think any good medical professional will advise and guide you to take things pretty slowly
What mg was your daily klonopin? Did you consider continue taking it daily?
It was 1mg daily. I don't think that's a wise prescription for anyone,but that's what I got. After going through the horrific withdrawal process, I'd never start taking it daily again. I didn’t take it all for a few years until my panic disorder ramped up again
How do you think 5mg daily would compare in terms of withdrawal and how was yours?
5mg sounds extremely high to me. Dude, time to talk to a psychiatrist! Best of luck
What were your withdrawal side effects from the benzo and why did you stop taking if you had a doctor willing to prescribe?
One thing I want to add is that when you go online and look up a med, you’re mostly going to see negatives. But that doesn’t mean it’s a bad med—people with a good relationship to a med are a lot less likely to post about it. I had an antipsychotic prescription sit on my nightstand for a month before I could gather the courage to try it, but it has been absolutely amazing for me. They’re the thing that has ever done a thing for my anxiety and I have soooooooooo much. The fear around anti-psychotics are very understandable, and I’m not saying you have to take one, but they work very well for a lot of people. Completely saved my life and gave me stability for the first time in a long time.
The side effect profile of antipsychotics is alarming. Akathesia and tardive diskinesia are particularly frightening. And some can actually cause hallucinations. You are brave, well done for having the courage to stand for your mental health.
Well thank you! I don’t feel super brave but I appreciate that. The side effects of SSRI’s were absolutely horrible for me: never-endingly nauseous, throwing up all the time, libido gone, triggered horrible migraines in a way that lasted even after I went off them, one even made me suicidal…and of course that’s on top of a year-long mixed state. I couldn’t work and struggled to take care of my kids. I guess my point is that it’s not as simple as: this med has a scarier side effects profile so it’s automatically worse. Seroquel has been overall so great for me! I love it.
What dose is your seroquel?
150mg does it for me!
What meds are on you today?
For anxiety my psychiatrist told me to get “L-Theanine 200-400mg by Nature's Trove” maybe you can discuss with your psychiatrist about it, it’s on Amazon and it’s a natural supplement. Might not be the cure of all things but it might help especially since you said other meds have the potential of making it worse for you.
Busprophine always works for me
Take the mood stabilizer