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Re: BTW,what the heck of bobbles? SUMMER2002

Posted by BarbaraCat on August 22, 2003, at 12:10:03

In reply to Re: BTW,what the heck of bobbles?, posted by SUMMER2002 on August 21, 2003, at 18:23:16

Welcome, Patricia Summer,
Yuck, it's so hard to know how to treat a depression when you've got other complications, like a probable BPII dx. You might want to get "Why your depression isn't getting better" by Michael Bartos, MD for alot of good info on bipolar issues and depression. There are so many variables, with diet, hormones, all kinds of things playing into mood. However, if you're on Lamictal only, that could be a problem. You're on a dose that is considered high for some people and might need to balance it with a more mellow mood stabilizer. For me, that's been lithium. There are others that supposedly work similarly, like Depakote, but I don't have experience with them and am very happy to remain on lithium. Lithium is primarily known for anti-mania, but is a mild antidepressant, an augmentor of other meds, and is even neuroprotective and suspected of increasing the density of neuron connections.

In my experience, stress is the biggest culprit in mood disorders and can bring on anything from a hypomanic to full blown mania episode on down to a depression or mixed state. So many different stressors to choose from, environmental, financial, family, work, social, on and on. I believe that Lamictal alone is destabilizing and agitating and can predispose one to anxiety and stress. That's been my experience of it and I've learned that I need lithium along with lamictal. I've tried one without the other and alone they didn't work, but together they work wonderfully. I take 600mg lithium and 125mg lamictal. Lithium at 600mg is a relatively very low dose and well below my therapeutic window. I do this for thyroid problems as well as allowing me to skirt around the edge of hypomania and not get too emotionally blunted. This is sometimes productive and sometimes uncomfortable but works well in general. Also, lamictal and lithium seem to be synergistic so you need less of each to do the job.

I tried testing both 'just to see'. I have hypothyroidism and it was getting worse because lithium unfortunately displaces thryoid hormone in the thyroid gland. So I cut back on lithium and tried to go with lamictal only. I felt awful - distracted, depressed, irritable, overly sensitive, doom. I knew I was getting into trouble when I was coming home with palletts of plants from Freddie's, Costco, anywhere, and they'd sit in the sun and wither cause I couldn't get it together to dig the required holes. Then I'd thrash about consumed with guilt and self loathing and exhausted futility - even on lamictal! Within 1 week of restarting lithium I smoothed out. I did a test of tapering off lamictal, just to see if I really needed it, and a different sort of depression came on. More like the slowed, sludgy, mirky kind. I seem to need both, and I've heard that lithium and lamictal are 'a match made in heaven' for bipolar depression. I've mainly been severely depressed, but have been definitely manic which can be very fun and productive but quickly deteriorates into disorganization and then depression which ran the gamut from slowed and deadened to agitated and panicky. The agitated mania and despairing depressions were more frequently beginning to merge into each other as bipolar mixed states which is unbelievably nightmarish. I'm 52 years old and this is not uncommon with untreated bipolar as one gets older. I've only come into lithium and lamictal treatment in the past 2 years and even though I've had major and huge stressors in that time period, I can stand it and my life is my own again. Many people have a gut reaction against lithium and the stigma around it (jeeze, lithium, that must mean I'm really crazy!). I know I did and I still don't mention I'm taking it outside of my 'in the know' circle of friends. I'm so glad I overcame my prejudices and fear around it because it's been a lifesaver. Good luck and keep posting here. We have a lovely and very helpful little group going in this thread and I hope it continues. Happy bobbling! - Barbara


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poster:BarbaraCat thread:9730
URL: http://www.dr-bob.org/babble/20030818/msgs/253106.html