From my experience meds can take 2-6 weeks to kick in, and it takes time to stabilize after you've quit drinking.
Talk to your pdoc. Sometimes there's some other stuff going on that they can figure out. I've had pdocs who helped me troubleshoot my meds, I was pretty frank with my docs, including with what other stuff I might be doing (ie actual amounts of alcohol I was drinking, not what I should tell him because I didn't want to be judged, they see all kinds of shit, they don't judge). Weird stuff happens, some meds or dosages increased a craving for alcohol for me, and adjusting my meds it fixed that problem.
One of the issues I had was that I want results NOW. And would want to make drastic changes, which basically is like throwing a giant rock in the pond and expecting the water to settle right away. Incremental changes work better. It's really hard to do when you're in extreme pain. That's usually when the DBT techniques and ice comes in handy till you can stabilize.
Talking to a therapist also helped me figure out how to reduce the stressors in my life to help decrease the emotional shitstorms that result from it. There have been times where I thought I was between a rock and a hard place with an impossible decision, and a therapist helped me see that I did actually have options. That was a huge relief. For some reason pdocs are shit at the emotional part of therapy, therapists are way better.
Have you ever read: Marbles by Ellen Forney? She talks about her journey with bipolar and meds, she went through a lot of med adjustments and crisis in between, a lot of it rang true for me also. It's a graphic novel, so if you can't concentrate well, it's a pretty easy read (I was very thankful for that at the time).
There's a continuum from schizophrenia to schizoaffective disorder to bipolar disorder to unipolar depression. Bipolar disorder, especially bipolar I (that's the one with full blown manias) is closer to the schizophrenia side than the depression side. It's mostly genetic (like schizophrenia), it's got a pretty even gender balance (like schizophrenia), it doesn't respond well to talk therapy without medication (like schizophrenia). There are a lot more genetic links between bipolar and schizophrenia than you might think.
Bipolar depression is different from unipolar depression. It's more likely to be agitated, with lots of pacing and irritability, and it's more likely to have psychotic features (hallucinations and delusions). So, you can see a little bit of the manic features even when the person is depressed. That probably plays a big role in why antipsychotics and antimanic agents are effective.
Another possibility is that bipolar depression is caused by mania. Either the practical effects of the mania are overwhelming (you lost your job, you lost your money, etc.) or you're exhausted by the mania (not sleeping, lots of high-risk behaviors) and that throws you into depression. Either way, preventing the mania prevents the depression.
The final reason is that dopamine plays a role in mood. When we think of mood, we usually think of serotonin, but actually most neurotransmitters have some effect on mood. Antipsychotics blockade dopamine receptors in an area of the brain that is involved in higher-order thinking. We know that weakening activity in that region helps with excessive worry and obsessive thoughts. Some depressed people really struggle with something called "rumination" - thinking over and over about the same thing without making any progress. It makes sense that turning the volume down on that region would help with rumination too.
Where to read about bipolar vs. unipolar...depends on what level of information you're looking for. A good starting place is the graphic novel / memoir Marbles.
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This book here really helped me understand more and helped me feel seen!
Not sure if this is what she wants to hear.. but man if someone would have told me this years ago my life would have been hella easier.
The mania and depression will take a long time to even out with medication. Some meds are not for everyone and some doses can be too much or too little. I’d give the med like 3 months to fully judge its effect. The key is to find something that you can function with.. keep a job.. manage your relationships.. and doesn’t have a million side effects. If you are in the art world, Antipsychotics can effect your creativity. Mood stabilizers are fine in my experience but if you are experiencing psychosis and delusions I’d recommend the antipsychotic for some amount of time until your symptoms have evened out, Then judge if you need an antipsychotic from there. You will however need a mood stabilizer. It took me many years of trying different medications to find the right combination and doses for me. You can’t give up. If you don’t want to do it for yourself, do it for those who love you. It is very painful for them to watch you going through this.
Being bipolar is something where you just feel the world more than the average individual. In the art world that’s awesome! Most creative types suffer from bipolar and it takes years for them to realize they can’t be productive without treatment or by hiring someone else to just manage their lives for them. Normal brains, typically experience emotion that caps off at a certain level. For bipolars ours exceeds that cap to the point where we feel amazing one minute and perhaps the next— absolutely miserable. I’ve cried in bed for weeks on end and I’ve had the back of my head hurt so much that I felt someone whacked me with a baseball bat.
The mania can put you in situations where you can really embarrass yourself, Believe you are capable of things beyond your reach and later, regret some of your decisions. If you can try to not make a fool of yourself over social media. The over confidence is hard to deal with because you are totally capable of doing amazing things but you have to keep yourself grounded in knowing what’s realistic and how to get there reasonably.
I recommend a therapist to speed up your process if you are having delusional thinking. They can help you get out of your head and see things for as they are.
Please avoid drinking and smoking pot more than like one night a week on meds, and if you can even less than that. They will slow down your progress and lower the effects of medication. Pot will make you depressed imo.
Most importantly, listen and trust your SO. He has been amazing, working very hard to learn about our condition, and really loves you. He wants to see you happy and fully reaching your potential. He can be an invaluable resource for you as someone who can see what’s going on from the outside and has the best intentions to help you.
I recommend this book
DM me anytime!
I recently read Marbles: Mania, Depression, Michelangelo, and Me by Ellen Forney which I really enjoyed. She is a cartoonist and wrote a graphic novel depicting her struggle to accept her diagnosis at age 30 even though bipolar disorder was clearly affecting her life. I liked it a lot because it was funny and really focused on her thought process which was interesting, though it is aimed a broader audience so there is a lot of introductory stuff that someone with the disorder would already know.
Unholy Ghost: Writers on Depression is also quite good. It's a collection of something like 25 essays about depression/bipolar disorder. They didn't all click with me, but the ones that did hit really hard and I keep going back to them. I also like that there is a variety of perspectives. It is mostly written by people with mental illnesses, but there are a couple of times where you finish one essay and the next one is written by that person's husband or sister. Another example, they have the story of a woman who decided to continue her medication through pregnancy and one who stopped, and both have the opportunity to explain their decision and the consequences.
I really loved Marbles!