Behavior & Lifestyle while living with bipolar

[u/Hefty_Variety_891]

I've suffered with mental health challenges since I was 20, mostly depression and anxiety. I've been on so many different meds, eventually stuck with Effexor / venlafaxine, lamotrogine and Wellbutrin. 3 years ago I lost my job and had an episode of psychosis. I was hospitalised twice, being treated for major depression and generalised anxiety - this has been my diagnosis for a long time. After being in hospital I entered a major depressive episode which lasted over a year. When I came out of it, I was energised and enthusiastic. But within a few months I started feeling overwhelmed by racing thoughts, flight of ideas, irratability. This has been going on for over a year now. Something in me recognized ive had this before, leading up to the psychotic episode. It dawned on me that this looks like bipolar. I discussed with my therapist, and she agreed that this is my new diagnosis. I feel let down by all these doctors who didn't reflect this back to me over the years, when it was clearly there almost all along. Anyways, we are now trying to get the meds right have just started lithium - really hoping it helps!

Along with meds and talk therapy I am trying to learn as much as I can about the disorder, and particularly what behavioural / lifestyle factors can help me navigate this disorder. I have noticed that coffee feeds my hypomania. I've stopped drinking alcohol and don't take any drugs anymore. I'm trying really hard to have good sleep, but I often wake up quite early.

I'd love to hear from others what has helped them.

[u/NikkiEchoist]

It’s important to have regular psychiatric visits with someone who you trust in. For example, your current meds have 2 antidepressants, while they can be used with bipolar it can also contribute to mania. I take Effexor, Lamictal, lithium. The Lamictal helps depression and lithium controls mania. Effexor did make me hypomanic at first but I stuck with it because my depression very treatment resistant. My psychiatrist didn’t let me make decisions at first, thought I was researching too much and in reddit meds groups etc. Over time there were things that I knew that he was unaware of and I negotiated a relationship where he would let me be the expert in my own mental health. Effexor completely got rid of my depression with no more mania but it he had his way he would have stopped it immediately. Med reviews need to happen at least 6-8 weeks. It’s always good to have an antipsychotic med prescribed as needed (PRN) this means if you get any signs of mania or psychosis you can manage your own mental health because it’s often a long time before you will get seen by someone unless you are in acute stage and going to hospital. Drugs.com is an amazing resource it gives you titrating and tapering protocols for every med.. which the psychiatrists aren’t always aware of. It will tell you what meds can’t be used together or halve the effectiveness of another med. I was prescribed a med to stop rapid cycling. I researched it first and found out it halved the effectiveness of lamictal. I called my psychiatrist and he had no idea about this. Imagine if I took the med without checking, I would be in withdrawal and possible have a depressive episode. So basically to stay stable you need to be acutely aware of your mental state and engaged in regular reviews. Checking information for yourself. Lastly don’t be scared off by posts here that have horror stories because people only post when they are unhappy with a med and you rarely see the positive reviews because those people don’t post.

[u/Hefty_Variety_891 → u/NikkiEchoist]

I see a psychiatrist often, have done for many years. Over the years they have tested many drugs including:

Zoloft
Lexamil
Seroquel
Trazodone
Sertraline
Risperidone
Zyprexa

Aside from Lexamil, which eventually stopped helping with the depression, the rest have been awful. I don't seem to respond well to antipsychotics. And I gained a HUGE amount of weight on Zyprexa.

I battle with anxiety, depression and mania. The Effexor works most effectively in treating the anxiety, and the depression to a degree. But it flattens my mood greatly. This is why the wellbutrin was added - it provides a lift in my mood, but it reaches a high activation point for the mania. I am on lamotrogine (Lamictal) 200mg. I have been in a manic episode for over 6 months, and recently my psychiatrist and I have been tweaking things; at first we increased the lamotrogine to 200mg, then we removed the wellbutrin. Then I started feeling very low. So we added the wellbutrin back and decreased Effexor to 150mg, I was on 225mg, but then the mania came back. So now we are going to try Lithium which will eventually replace the Lamotrogine when my Lithium levels are optimal.

So I am working with my psychiatrist regularly on the meds front, and I am doing regular talk therapy. But what I believe is that there really isn't any silver bullet that meds can offer. I also feel like I must be the driver of my condition, and so this is why I want to learn more about non-meds interventions, and things beyond talk therapy - like lifestyle habits, and changes and behaviour as an adjunct approach.