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Susan Ivy
Susan Ivy, Nurse (RN)
Category: Health
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Experience:  BSN, MSN, CNS
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How do I find a balance of meds for Bipolarism II and mania,

Resolved Question:

How do I find a balance of meds for Bipolarism II and mania, my biggest concern are the intense, horrible, scary panic/anxiety attacks
Submitted: 7 years ago.
Category: Health
Expert:  Susan Ivy replied 7 years ago.
Hello rebelly,

Thank you for writing to JustAnswer Health with your concern.

It can take some time to get the proper "cocktail" of medication for this disorder. Although it is not commonly known by the general public, intense panic attacks are often seen in those with bipolar disorder.

Is your current regimen a new one? If so, I would hold on for a longer period of time to see how it works for you. Lamictal can be quite helpful in Bipolar II, but must be started out at a low dose and gradually increased, otherwise the side effect of skin rashes may develop.

It is important to keep the line of communication as open as possible with your Psychiatrist or CNS regarding your medications. You also have to continue in your patience. If this regimen does not work, there are options such as Lithium or Clozaril. It will also be very helpful, if you are not already, do make use of certain therapeutic techniques, such as cognitive-behavioral therapy, Emotions anonymous or Bipolar support groups, and journaling of moods. Regulation of sleep and maintaining a constant daily schedule can also be much more assistive in mood regulation for Bipolar individuals than in the general population.

This non-profit website also has excellent information self-help with mood dysregulation. See:
Customer: replied 7 years ago.

When I read the word Lithium I begin to cry immediately and almost go into a panic attack because I don't understand Why i feel this way and why I'm so scared and sad and what is wrong with me that I would need something like that. I have been on the regiman for at least a yr, why do things get better, then worse, why is there only anxiety or apathy, no in between, I don't want to have to take anything. Is it common to abruptly stop meds because you are trying to find yourself and not loathe myself? My last Dr. put me on Klonopin and Seraquil, then took the Klonopin away and want me to take the

seraquil during the day, this scares me and I have recently stopped it, Im so sorry to just go on I just feel that happiness is the absence of anxiety and that I will never have that

Expert:  Susan Ivy replied 7 years ago.
I am sorry that you are so distraught. I do understand though, and know how difficult this can be. I do hope you go to the web site I gave you above because there is wonderful information as well as tips that will help you.

It can be helpful for you to know that some of the worlds most creative and successful people have bipolar disorder. Sometimes those that experience difficulties end up having much more appreciation for life. The ones that remain successful though tend to continue to treat their illness and have regular check ups with their doctor.

You do need to understand though that this is a biological disorder, a disease like diabetes or any other disease where you must take your medication. This is what I meant by keeping the lines of communication open with your doctor. Instead of stopping your medication you must talk to your doctor about whatever side effect that it is that is bothersome to you. You must also know that sometimes you must wait up to 3 months to get the optimum effects, and if you stop too early, you will disrupt the whole process. At the same time, again you must communicate to your doctor if there are side effects that are intolerable, so that the doctor can adjust the dose.

It is true that it can take some years to get the right medication combination that will work the best for you.

It is common for those Bipolar individuals that are frequently in the hospital to stop their medications abruptly. And those that do this usually have a worsening progression of the disease and may incur more debilitation and progression of the disease, than the individuals that do not go on and off of medications. Studies have been done that prove this.

Again, although this is a biological disorder and you will have to continue medication and close monitoring by your physician, once you do get to a stable state, you will likely be high functioning and have a life span that is normal. But as stated above, for those that do not comply with the medication regimen, there is most often a progressive worsening of the disorder and shorter life span.

Besides the medications, involving yourself in the support groups and learning how to track your moods and regulate your sleep can help you .... in fact if you do these things you may not need as high as a dose of medication as you will if you are not learning how to maintain a schedule, get adequate rest, and use techniques to decrease your anxiety. Finding an outlet such as exercise or a creative out let can also help. If you do something that you really enjoy or are good at when you feel the anxiousness, often you can turn this energy into something that will be much more productive.

This can be a very difficulty thing to live with, but it does not half to be; remember there are other diseases that could be even worse. At least you have a very good chance to become stabilized and to live a normal life, as long as you follow your daily medication and schedule - similar to how a diabetic must take their medication and follow a schedule of meals and snacks.
Customer: replied 7 years ago.
I definately know about giving medication a chance to take effect, in your opinion, should I continue the Seraquil to help me sleep and is there anything I can do or take, other than keeping journals, breathing techniques, meditation, etc, believe me I don't want to feel this way, contrary to what some may think. It is just that I am harming myself when these panic attacks occur and I get in such a state sometimes I don't even remember things I have done and said, and I can't lose another person in my life. You mentioned Lamictal, I currently take 300mg a day, should I increase? My Dr in Oklahoma suggests I take a Seraquil during the day, but that scares me. I am in California where there is a better acceptance of this condition and am just trying to find some relief but feel like I'm falling back into a deep depression
Expert:  Susan Ivy replied 7 years ago.
It is important that you follow with a doctor that can evaluate you in person. Really doctors in any state should be up on the current treatment. Seroquel can be a wonderful treatment for anxiety. This is something you can try if your doctor is allowing you to take it as needed -- and if it makes you too drowsy cut back or only take it at night. You should never increase a medication like lamictal without your doctor being aware, and also knowing the exact doses and times of everything else you take.

There is a log more that you can do besides breathing techniques and meditation, there are things you need to do to regulate your schedule and if you look at all the information for bipolar on the link I gave you you will find more about this. By journaling I was not referring to just writing free form, but writing down moods and schedules related to the times you are taking your medications and sleeping.
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