I don't know whats happening to me -- mixed state Bipolar

So I have been getting treatment for about a year. When I started I was diagnosed with depression, put on Prozac of 20MG and it went from there. Now on 80MG of Prozac, 1600MG a day of Neurontin, Adderall & Risperidone (which I am not taking).

I am all over the place now -- depression, anger at times with paranoia to feeling relaxed & focused while on medications. On the other hand I have a $#%^ temporary job that I drive 60 miles to (each way), own a business absentee which is burning thru most of the revenue each week, owe a huge amount in credit cards and now overdue taxes, have no friends (because I am convinced everyone hates me and judges me). I have destroyed my career partially from getting fired from virtually every job, gettting caught in lies on my Resume and burning bridges with recruiters.. I can feel great at point in the day and then totally hate life and everyone.

I am totally dependent on Adderall. I didn't take any for two days -- I felt like crap --- all day I was worried that the pharmacy wouldn't have any. I saw the psyc doc for all of 5 minutes, got the script for Adderall and one for Risperidone (which I should be taking but not) drove to the pharmacy (they had it) and took the full daily dose at one at 6pm (3 tabs).

At this point, I think I am just going to wait until this position ends (probably mid december) and then try to address this with another doctor in my insurance network.

I'm sorry to hear that you're going through this. I will move your post to the Bipolar Forum, and leave a Shadow Thread here, so you can gain the support of both forums.

It's very important that you take your meds according to the doctor's instructions.

It certainly sounds like you are going through it and could do with a bit of a sort out. What is it about the risperidone that is stopping you from taking it? I think it would be worth letting the Dr know as then they can prescribe an alterntaive that might work a lot better for you. FWIW I hated risperidone but it can be effective and it might be that you need to be on something that has similar properties but a different side effect profile. Anyhow welcome to the forum, I hope we can help support you here

Cracked

As someone who is diagnosed as having both mixed state and rapid cycling bipolar and who enjoys his stimulants abit too much at times i can certainly relate to the hell that bipolar+stimulant abuse can be. I have never taken adderall but i have taken alot of Dexedrine in the past. If i only took a lowish dose of Dextroamphetamine i was fine and it actually helped my bipolar. However when i abused it it made my lowest lows a horror show. I have stayed up for 4 days and nights on Dexedrine and by day 3 i always ended up as pretty much psychotic. My moods would be all over the place and i was very volatile to say the least. I would end up seeing the shadow people as they are called by day 3 and amphetamines in high doses tend to just amplify whatever mood i am in good or bad.

Crashing is the worst and even though Dextroamphetamine is much smoother then the other amphetamine salts that make up adderall by day 4 you are approaching meth comedown status. I always go into a deep pit of depression that can hang around for a week or more after unless i take another drug to combat that. Amphetamines act mostly as Dopamine agonist's which means they cause your neurotransmitters to produce more dopamine as well as norepinephrine. When you stop taking a amphetamine after taking it for a long time or taking alot of it you are left with less dopamine then you had before. Since dopamine plays a major factor in mood this is one of the reasons amphetamine comedowns can be so hellish. I didn't find them to be nearly as hellish as IV coke or crack comedowns but that's a whole other league of misery. So i would highly recommend taking your adderall as prescribed. I know that is way easier said then done but even if you need someone to help you it would be worth it.

Prozac like all SSRI's can cause mixed states as well. If anything Prozac is going to ave a worse effect on your mood then aderrall will especially when you are not taking a mood stabilizer or a anti-psychotic that works for you. Giving a mood stabilizer/anti-manic drug along with any anti-depressant especially SSRI's and other serotonic anti-depressants is pretty much a golden rule if the person has bipolar disorder. I would not count the neurontin as a mood stabilizer as studies have shown that it actually performs worse then placebo. I take 3200mg's of neurontin a day for neuropathic pain and it does absolutely nothing for my moods except maybe add abit to my depression. I can understand why you don't want to take the risperidone as it is a pretty unpleasant drug to some people (though if you are in a mixed state you don't get the zombie effect nearly as much) but there are many alternatives to risperidone that act in the same manner with less side effects. Olanzapine (zyprexa) Quetiapine (seroquel), abilify and others are all newer atypical anti-psychotics then risperidone with more favorable side effects profiles. All the same i didn't feel any side effects from risperidone at all until i took 2mg's and then i got the sucky side effects.

I would seriously recommend going back to your doctor and just telling them that the current med regimen is not working. I bused to get hellish mixed states alot but now i pretty much never get them . So trust me things can get better.

Sorry to hear you're going through this. Your depressions sound exactly like mine.

I've burned friendships and jobs/references several times going through that crap. And school. The paranoia is the worst, though, and you should really try and talk it through with a psychologist/counselor. I get to feeling like everyone hates me and is judging me, but in all likelihood it's not true. Sometimes it's worse than that, but I'll just leave it at that. And it's funny about the stimulants, too. How just too much caffeine (in my case) can make the world turn black and it precipitates this crap.

It's much easier to say than to do, but you can tell yourself that those are paranoid thoughts and they're not real. You may need someone to talk to to help you see what's real and what's not because you can't do it on your own when you're going through it, I know. It's a leap of faith, I know. Being asked to just believe that people really aren't out to hurt you kind of feels like you're being asked to jump off of a 10 story building into an invisible net that's just a few feet over the edge that you can't see. If that makes any sense. :/