GreenFlameTiger

February 22, 2017

Well here I am again. Another year long hiatus from posting. This time more than a year. Why is it that I have been posting so infrequently? Now I know why.

I have recently listened to the abridged audio books of First Things First, The Seven Habits of Highly Effective People and The Eigth Habit all by Dr. Stephen R. Covey. They have taught me to put first things first. They opened my eyes to the fact that I was spending almost all of my time in Quadrant 4, things that are not urgent and not important.

I have self diagnosed video game addiction. Until about three weeks ago, almost all of my thoughts and energy went into video games. I have known for years now that my freedom is the most important thing in my life. So why did I spend all that time with video games? Because I was addicted. I've been playing video games since I could hold a controller. Among my very first memories are playing video games. Not only are they very entertaining but they provided me with a distraction. Goals to achieve that I believed were ACHIEVABLE.
I am SO, SO grateful that I realize now that I have this addiction. I would have spent my entire life in fantasty worlds that ultimately pale in comparison to the real world. I'm not saying that there is no place for video games. I am saying that any kind of addiction is dangerous. It could have just as easily been a movie or tv addiction. The point is I have energy now for what really matters.

So you are going to be seeing a lot more of me as long as there are people who need my help. I want to help people who are going through what I'm going through.

On my journey of tapering, I am still on my first of three medications. I am currently taking 0.38 mg of Olanzapine, sometimes bumping it up to 0.42 mg when I need to. I am AMAZED at how much I am growing: mentally, physically and spiritually. I am so grateful for everything.
Please feel free to ask me any questions. I am going to check this thread every day if I possibly can and reply right away. No more perfectionism so that I can write mini essays. If I'm in a down cycle please forgive what I imagine will be shorter perhaps less inspired posts. But this time I WILL POST!

Many Blessings,
GFT

February 23, 2017

Well, here I am for my daily check! I would like to add that lowering the dose of the Olanzapine has been incredibly helpful as well. I will likely start feeling quite tired in about a month and when that happens it's time to lower the dose in this beautiful micro taper! I wish everyone a tremendous GOOD LUCK!

February 23, 2017

Thanks for coming back to update us!

It's great that you've "tuned in" to your symptoms so much that you know what getting increasingly tired means for you.

Keep letting us know how it's going for you.

February 24, 2017

Thanks scallywag! I'm glad you guys haven't made me walk the plank!

February 25, 2017

Well, that would be my job, being a scallywag and all. :lol: You're safe ... for now.

February 25, 2017

March 1, 2017

Well, I've been checking this thread every day. I am not going to post every day of course unless I get a question every day. If I do get a question then I will make my best efforts to answer it ASAP.

I've changed my notification settings. Being e-mailed that I've received a reply was turned off! So I've turned basically everything on and saved it.

I hope everyone has a stellar day and a marvelous March.

GFT

March 9, 2017

What I want to talk about today is down cycles.

As someone with Bipolar I experience regular down cycles. Lately they happen about once every 7-9 days. They last for about 6 days. This is a big improvement since before the down cycles would last for weeks sometimes. I find that when I start exercising again that means I'm out of the down cycle. The down cycle zaps my energy and I find it more and more difficult to work out.

These down cycles also have one big downside. They screw up my sleep schedule. I can't keep up with my obligations when it happens and so I have to stay up to do them. I need even more sleep not less so I sleep in past my anchor time. Then I'm not tired until later, so I fall asleep past my bed time and eventually I end up living in the endless night (Being awake during the night and sleeping during the day).

So. I have an impassioned plea/question. HOW DO I END THE DOWN CYCLES?! Is it even possible for someone with Bipolar? I suppose I just have to continue with this taper and pray that eventually my brain will stop zapping my energy once every 7-9 days. This is huge because these down cycles are preventing me from having any friends or participating in any activities outside of the house. The plans I have made in the past have always been thwarted by my extremely irregular sleep schedule. And so I feel like I have 0 friends since I don't see anyone except my family. They prevent me from participating in any activities outside of the house because it robs me of my motivation. Logically, I suppose when I'm not in a down cycle and my sleep schedule just happens to be good; when the stars align I can leave the house and do things. But this is so unpredictable that I feel so deflated to even try. What's the use in putting in time to make friends or engage in activities if I can only see them or do them when everything aligns perfectly? Is that even a good idea considering that both friends and activities require regular interaction? I find that anything worthwhile in life requires consistency.

So I am rather stumped. Thankfully I have an amazing family that I live with. Thanks to my teachers such as: Eckhart Tolle, Rhonda Byrne and Stephen Covey to name a few, I have a strong spiritual life. I can sort of see how the zen monks could live in a cave for so long. But I feel dissatisfied. If we are to call spirituality Yin, then I feel like if all you have is Yin you kind of get to the point where you wonder, why am I even here? I feel at peace but I'd be even more at peace if I just rejoined the formless dimension. If we are to call the world of form Yang, then I have very little Yang in my life. I want to experience more. I'm still tired a lot of the time but I'm getting more and more ready to start having a life.

So any thoughts? Anyone here with Bipolar that has conquered down cycles? Thanks for listening, er I mean reading all of this.

Best wishes,

GFT

P.S. I just found this list of Bipolar apps thanks to a good ol' Google search. http://www.healthline.com/health/bipolar-disorder/top-iphone-android-apps#1

Bipolar Disorder Connect sounds promising since it's a community of people with Bipolar. Also I should get back to tracking my moods like I used to. More accuracy sounds like a good idea instead of relying on the ol' noggin.

Argh! Bipolar Disorder Connect is now a thing of the past! But their website https://surveys.alliancehealth.com/bipolardisorder-connect

links to a few promising resources such as Bipolar Support.org which has their own forums.

March 27, 2017

I thought I would share this documentary called CrazyWise. It is incredibly relevant. It conveys my perspective very succinctly.

https://vimeo.com/201079582/37ea6dd390

I believe it will only be available to watch for free until tomorrow.

December 4, 2017

I am going to be seeing a psychiatrist in one week. I have not had a psychiatrist for about three years. I am quite uncertain as to whether this is a good idea or not. But I am fed up with feeling so numb in the head. I am unable to think clearly and quickly. I am completely unproductive. I am unable to hold a job or to study. I do things at about a third or fourth of the pace of the people I observe around me. Most importantly this numbness I feel in my head robs my moment to moment experience of life.

I have been tapering Olanzapine since 2013. I've had one manic episode in 2014 and I ended up in the hospital where my dose was raised to 5 mg. My previous psychiatrist never came in to see me my entire stay and that further solidified my lack of faith in psychiatrists. That and my 13 years of experience with psychiatrists up to that point. So I never made another appointment and haven't seen one since.

Since then I have been continuing to taper the Olanzapine on my own with my family. I had another manic episode in 2015 but for the first time in my life I didn't end up in the hospital from a true manic episode. I am still very proud of the progress made. I've gotten the Olanzapine down from the 5 mg in 2014 to 0.4167 mg. I am struggling to get it lower than this.

That being said I think I could get it lower but only if I go even slower than I have been. And I've had it. It would be one thing if I was fully functional or even reasonably functional. Some relief of this crippling numbness. Then I wouldn't mind it. But since I can't even hold a job or study... I can't put my life on hold like this.

Do you guys have any advice? This feels like a pretty important point in my life. I have a friend with Bipolar 1 like myself who was on the same combination of drugs as I am taking (I am uncertain about the dose he was taking): Lithium, Lamotrigine and Olanzapine (see my signature) and his psychiatrist switched him to an Abilify injection once a month and he's now fully functional. He's doing a full course load at university and he has a part time job.

I've read some horror stories on this forum about Abilify so I am so unsure as to what to do. I would deeply appreciate any advice you can give. Thank you.

P.S. I plan to add the taper formula I've been using. My math skills are poor and along with my numbness, I had my brother help me create the formula using a template found on these forums. I suspect that I may be using too little liquid (30 ml) which means the smallest amount I can measure with my oral syringe is a larger increment than if I were to use more liquid. That being said unless I am incorrect I've been going at a sixth of a 0.1 mg a week rate which I've seen on this forum. They said it was a micro taper. I am currently holding the dose at 0.4167 mg.

December 6, 2017

This is the taper formula I've been using. This was when I was at the dose of 0.625 mg. Since then I haven't bothered writing out the formula. I've just been recording the ml. So I am now taking 5 ml which as I calculated previously is 0.4167 mg.

2 x 2.5 mg tablet = 5 mg

87.5% of 5 mg = 4.375 mg

5 mg - 4.375 mg = 0.625 mg (desired dosage)

2 tablets. 0.625 mg + 0 mg = 0.625 mg

0.625 mg desired taper of single tablet.

30 ml of water to dissolve 2.5 mg tablet

30/2.5 = 12 times ratio to create a 2.5 mg solution in 30 ml of water

2.5 mg to 0.625 mg of solution

0.625 mg x 12 = 7.5 ml

Out of the 30 ml solution, I pipette 7.5 ml for a dosage of 0.625 mg.

December 9, 2017

Hello, GreenFlameTiger.

Very good to hear you managed your manic episode without going to the hospital. Congratulations on minimizing the olanzapine. The less you take of that, the less the risk of the very serious adverse effects.

The numb feeling you have in your head may very well be due to the lithium and lamotrigine you're taking, more likely the lithium.

Since you're having difficulty tapering olanzapine, if I were you, I might hold on reducing it for now and consider reducing lithium or lamotrigine.

I hope this new psychiatrist is supportive of your minimizing your drug burden. At the very least, the doctor should order tests for renal function, serum electrolytes, and thyroid function. These need to be monitored when taking lithium, especially when you're taking a drug cocktail.

(It may be easier to calculate a ataper by adding 50mL water to a 2.5mg tablet, yielding .05mg of the drug per milliliter. For a dose of 0.4167mg, you would take 8.334mL.)

December 12, 2017

Thank you SO much Alto for the response! I truly appreciate it. You're awesome!

I ended up canceling the appointment for various reasons. One of which is I couldn't find any reviews for the doctor. I prefer to see someone well reviewed.

I ask my GP to order blood tests for my lithium level and thyroid function. I'm almost positive serum electrolytes are included but I can check. I actually get my blood tested about once a year I'd say. I know that's not the best. It should be at least every six months right? I better check when my last test was...

50 ml of water is such a great idea, thank you. My plan now is to try tapering the Olanzapine once per week again but at a smaller increment than before. Before I was going down by 0.2 ml a week of that 30 ml solution. I don't remember what that is in mg and I don't have time to do the math right now (I'm not very good at math at the moment). So this time I will go down by maybe half that amount using the 50 ml solution. If that doesn't work out I will try as you suggest tapering the lithium. I think my family will be more concerned about me tapering the lithium than the lamotrigine though since the lithium is seen as the foundation of my treatment. Do you think it would be safe to do so and a better choice than the lamotrigine?

Thanks again Alto. You're a true beacon of hope for us out here surviving antidepressants.

March 28, 2018

Update!

I saw my new psychiatrist today. He is the first psychiatrist I have seen in four years. The conclusion of the appointment is as follows:

1. Increase the Lithium back up to 900 mg. I've been taking 891.6 mg. He said that Lithium is the drug with the most evidence for preventing mania and reducing depressive symptoms. So maintaining the Lithium for now is the plan.

2. Remove Olanzapine entirely. I've been taking 0.37 mg and he told me at this point it's not doing anything. He did say it may be helping me sleep but that's it.

3. Begin to taper the Lamotrigine. He initially suggested a reduction of 25 mg down to 75 mg. Upon hesitance on my mom's part and I am now grateful for that, he suggested 10% per week.

I am going to be starting these changes today. I was wondering what you guys think? @Altostrata Alto you wrote on this page: Lamictal to calm post-continuation withdrawal symptoms

"They also don't understand the hypersensitivity issues and insist on doses that are far too high to accomplish what we want -- to support the nervous system in healing instead of inducing yet another drug-dominated state."

Is Lamictal particularly good for healing the nervous system? If it is, is it a good idea for me to be tapering it at all? I would say that my dose of 100 mg is probably on the drug dominated state side rather than the healing side. You were mentioning doses of the likes of 2 mg.

So do you think this is a good plan? I'm hoping that the Lamotrigine tablet dissolves easily. Tonight will be my first night. Thank you guys in advance for your input. God Bless.

March 28, 2018

4 hours ago, GreenFlameTiger said:

he told me at this point [0.37mg olanzapine is] not doing anything. He did say it may be helping me sleep but that's it.

Helping you sleep is pretty important, isn't it?

What symptoms did you ask the new psychiatrist to help you with?

We do not recommend changing more than one drug at once, so you can see what happens when you make the change. For example, if you drop olanzapine, reduce lamotrigine, and increase lithium all at the same time, and then you can't sleep, which drug change broke your sleep?

Or what if you have a manic episode, which drug change triggered that?

The best psychiatrists would not suggest making more than one change at a time. I am worried about this new doctor's advice. If I were you, I'd politely but firmly tell him you'd feel a lot more comfortable making one change and seeing how that works for a month.

It may be time for you to go off olanzapine and see what happens. I cannot see why he would insist you take 900mg rather than 891.6 mg lithium right now, there's not much difference between them. If all goes well when you're off olanzapine for a month, you may wish to increase the lithium to 900mg then. (Your doctor seems to have a lot of faith in lithium, I suggest this only if you want to take his recommendations about it.)

If all is stable for a month after increasing lithium to 900mg, I might reduce lamotrigine by 10% per month rather than 10% per week, keep everything nice and stable.

On 2/22/2017 at 9:37 AM, GreenFlameTiger said:

So you are going to be seeing a lot more of me as long as there are people who need my help. I want to help people who are going through what I'm going through.

That would be wonderful, GFT. You have a warm, gentle online presence.

March 28, 2018

Thank you very much for the reply Alto. = )

I really appreciate your advice. I have weighed it with my own thoughts, I have prayed on it and I have decided that I am going to continue with the plan my new psychiatrist has laid out. I have a good feeling about it. One could say I am being over eager or jumping the gun but the way I see it is as long as I can get my sleep then I'll be okay. So if I find I have trouble sleeping I'll increase the Lamotrigine back up to 100 mg. If I still have trouble sleeping I will add back the Olanzapine. And then if I still do, I seriously doubt this will be the case, I will lower the Lithium back down to 891.6 mg. Please correct me if I'm wrong but I think it's unlikely that a smaller dose of Lithium would help me sleep. I slept last night for close to 8 hours. So, so far so good.

I have grown incredibly weary of my situation and since I feel the risks are minimal, seeing as I can raise the dose of any or all at the drop of a hat, I feel the risk is worth it. And the systematic raising of the dose of each medication would help identify which medication is helping me sleep as well.

The symptom I asked my new psychiatrist to help me with is the symptom called my life. As I've written in this thread I am currently not working or studying. I find that most of my days are what I call maintenance days. I do my hygeine, I eat, I do basic chores like cleaning the kitchen, I workout for about an hour and a half if I feel up to it and then I sleep. That's about all I can handle. I feel like my life has been on hold for 17 years. Symptoms I told him about include: a feeling of numbness in the head, fogginess, cycling from a down cycle (increased sleep, more depressed mood, up during the night and sleeping during day) to an up cyle (more energy, better mood, up during the day more, more active) about every 7 to 10 days. I feel like the numbness and fogginess inhibits the healthy and natural functioning of my brain. I find I have trouble with processing things, planning a day, making decisions. I think it's why I can for the most part only handle maintenance days, and why I can't work or study along with my disrupted and completely irregular sleep schedule.

A regular sleep schedule is something my new psychiatrist strongly stressed as well. Dr. Jordan Peterson, who I am a big fan of also says the same thing.

Now that I think about it some more, I am tempted to increase the Lamotrigine back up to 100 mg and just see what removing the Olanzapine will do. I think I will keep the increase of the Lithium because it's such a negligible difference and doing the taper of it is time-consuming and it tastes disgusting even with almond milk. XP I'll see how it goes with the original plan and take it from there.

Quote

On 2/22/2017 at 9:37 AM, GreenFlameTiger said:

So you are going to be seeing a lot more of me as long as there are people who need my help. I want to help people who are going through what I'm going through.

That would be wonderful, GFT. You have a warm, gentle online presence.

Thank you so much Alto. I recall when I wrote that. I was waiting for replies or inquiries. But I received none aside from the sweet encouragement of a certain scallywag. ;D I suppose it would be better if I were to peruse the forums and look for topics that I could help with? As I said before my days are so cramped with nothing, lol as it is that in my inefficient state I don't know how often I will get around to posting. But I will see what I can do. This post alone has taken me about an hour to write.

Thank you again Alto. You're awesome.

March 29, 2018

You're awesome your own self, GFT. Please do visit with others in their Intro topics.

On 3/28/2018 at 8:26 AM, GreenFlameTiger said:

Symptoms I told him about include: a feeling of numbness in the head, fogginess, cycling from a down cycle (increased sleep, more depressed mood, up during the night and sleeping during day) to an up cyle (more energy, better mood, up during the day more, more active) about every 7 to 10 days. I feel like the numbness and fogginess inhibits the healthy and natural functioning of my brain. I find I have trouble with processing things, planning a day, making decisions.

Those symptoms may very well be the effect of the mix of drugs you're on.

As you're so close to going off olanzapine, you may wish to focus on tapering off it now. Also, YES, definitely set a regular sleep schedule. This could be the key to keeping your nervous system stable. Please keep daily notes about your symptoms, when you take your drugs, and their dosages, along with your sleep schedule. This can help you learn a lot about what works and what doesn't.

I would not count on increased lamotrigine to help you sleep. Does it make you sleepy now? What time of day do you take it? Lamotrigine is one of those things where a little bit has one effect while a higher dose can have a completely different effect, even a paradoxical effect. That means if it makes you sleepy now, a higher dose might keep you awake. (The "sweet spot" differs for everyone, which is why physicians find it so difficult to use.)

Remember, our mutual aim is to keep you out of the hospital. If you panic when hearing voices and go to the hospital, you will be re-medicated. We want to keep you calm as we remove the drugs that are clouding your life.

March 30, 2018

Just a quick update. Thanks to you Alto, I’ve raised the dose of Lamotrigine tonight back to 100 mg. I was feeling weird sensations in the frontal lobes of my brain and while I was sleeping, I wasn’t sleeping all that well. I think you’re right that one drug at a time is the best way to go. Tapering is sort of like walking a tight rope. You’ve got to go slow and steady. If you rush you’ll end up falling. It’s just hard when you’ve been walking the tight rope of psychiatric drugs for 17 years. God bless you Altostrata.

March 30, 2018

For the past two nights I’ve noticed erectile dysfunction. I normally have very strong erections. I’ve read that psychiatric drugs can cause this. I thought that less psychiatric drugs would make it better (not that it needed it) not worst. But I suppose it’s not that simple. I hope this remedies itself with time.

March 30, 2018

Don't worry about it. Please keep slow and steady with the drugs.

May 18, 2021

Wow, it’s been a while. Three years. I read a few of the last few posts. Your support has been invaluable. Thank you SO MUCH.

Thankfully, to the Lord Jesus Christ I am now at 325 mg of Lithium. THAT. IS. IT.

It’s AMAZING! 🤸🏻‍♂️🎊🎉 💕🕊🎉✝️❤️♾ I am so incredibly grateful to be where I am now. The last three years have been a crazy journey and I am very eager to share and help people with the experience that I have.

I would say the two biggest things that have helped me are:

1. Jesus Christ

2. Waking Up by Sam Harris (Meditation app)

I started meditating to the meditation app Waking Up by Sam Harris in June 2019. This in itself has been a journey and back in January something happened that made me believe that it was incompatible with Christianity. So I stopped and switched to a Christian meditation.

But then recently I was oscillating in my faith and on April 29^th, 2021 at the advice of my psychiatrist the dose of Lithium was raised to 450 mg and I took 11.25 of Zopiclone to sleep. My mother and psychiatrist became concerned by the fact that I was losing my faith and then regaining it multiple times. That’s the reason for the raise of the dose. For my birthday soon after, I asked for one thing, permission to lose and regain my faith as many times as I need to. An infinite number of times. As long as I take care of my responsibilities, am kind and respectful then whether or not I have faith is irrelevant at least to them.

This raise of dose was extremely traumatic for me. I was surprised since I didn’t think it was that big of a raise, although it is about a 50% increase and it floored me. I had trouble walking around the house, I felt streaks of pain in my brain and pain on the surface of my heart. Thankfully, my brother advocated for me when I requested to lower the dose back to 325 mg and the next day April 30^th, I did.

For the following 11 days I thought I had permanent brain damage. I had trouble thinking, speaking as I used to. My brain felt incredibly slow and clunky. Then on the day before Mother’s day, May 8^th I began meditating to the Waking Up app again. I had stopped listening to it around the end of January so it had been a while. It truly helped me get through this. Then on May the 11^th, I remember I was moaning in pain from the sensations in my brain while cleaning the kitchen. I meditated to Waking Up as I have been every day since May 8th and I felt true oneness. I watched Smash bros Ultimate videos to relax while I took breaks from cleaning. Strangely enough, staying up for 24 hours, eating very healthy food, including smoothie with flax oil, and organic dark chocolate… helped to heal me.

I would love to go into detail in the future about my nutrition and my sleep since both are so crucial. I will say for sleep, that my psychiatrist was suggesting that I take Zopiclone to sleep every night for two weeks. But after what happened when my dose was increased to 450 mg I became very hesitant to take anything to make my brain feel at all the way it felt. I am so grateful that I am blessed with circumstances that allow me to sleep as much as I need to and whenever I need to. So that’s what I have been doing and now my schedule is getting back to normal without any sleep medication. I woke up naturally at around 8:30 am today and I prayed to the Psalms and the Prayer Process outlined in Hearing God by Matthew Kelly first thing in the morning. Then after breakfast I did my 20 minute daily meditation on the Waking UP app. I feel great. Centered on Jesus Christ.

I was describing the sensation that mediating to Waking UP brings to a friend recently. “Being able to be the witness of whatever is appearing in consciousness, to in fact be that consciousness is truly liberating. To be the space in which the body appears, thoughts, emotions... consciousness no longer has a center. Usually people experience their center as behind their eyes or maybe their spine but consciousness actually has no center.” This feeling really is incredibly liberating. And then I believe that believing in Jesus Christ as my Lord and savior keeps out the sin. In fact on August the 3^rd, 2020 I wrote this:

“On August 2nd the Lord saved me after I woke up. He lifted the demon on his shoulder and took him away. I am saved. And I know, know he is real.

You should have felt it yourself. The presence of the malevolent presence as I told Diana about was so real. Super real. Almost to the hospital. My trajectory was.

And today I’ve felt so much better. Holy Spirit infused! With the demon gone🐳☺️ meditation, walk with mama, conversation with Diana, watching Despicable me 2, listening to Happy by Pharrell Williams, he is faithful, mass with mama so incredible. Just an amazing day. The absence of the demon and the complete presence of God.

Because I’m happy, clap your hands if you feel that happiness is the truth!

Because I’m happy, clap your hands if you feel that, that’s what you want to do!

🎶 🤸🏻‍♂️”

Well, that’s about all I wanted to say for now. I am more than happy to go into all the practical sides, exactly how much I tapered down by, at what rate etc. I will be working on my signature to reflect the current reality of 325 mg of Lithium! WOOOoohHHOO!!

God Bless you all.

P.S. The erectile dysfunction remedied itself shortly after that post on March 30^th, 2018. Altostrata was right to say not to worry about it. I definitely don’t have any problems there! Thank God! Thank you Jesus!

May 18, 2021

Good to hear, @GreenFlameTiger

How do you feel compared to when you were taking lithium, lamotrigine, and olanzapine?

May 20, 2021

For the past two nights I've been sleeping for only six hours a night. Yesterday I felt fine but today I am incredibly tired. I've been getting to bed at around 2 am and I have been waking up spontaneously at around 8:30 am. According to a book called The Power of When by Michael Breus everyone has a chronotype. I've done the test and it says that I am a lion. The optimal time for lions to sleep is at 10 pm and to be up at 5:30 am. In my experience I really do get a much better nights sleep if I sleep before midnight.

@Altostrata I am feeling very tired but I will answer the question to the best of my abilities.

On 5/18/2021 at 4:48 PM, Altostrata said:

Good to hear, @GreenFlameTiger

How do you feel compared to when you were taking lithium, lamotrigine, and olanzapine?

The best way I could answer this question would be to review my journal entries and records. But off the top of my head I would say one big difference is the amount of sleep I need. Back in those days I would often sleep for 12 or 13 hours a day at least during a down cycle. Now, on most days I sleep for 7 to 9 hours a day. I see that as a big improvement.

But I want to be honest. Honesty and humility are two character traits I deeply admire and aim for. My life is far from perfect. I still don't have a job. I still am not studying. I still don't even know how to drive. I still am a person with a disability. I've had a birthday recently and I turned 35. I've been struggling with this illness, with these medications for 20 years. Sometimes I feel deeply and profoundly depressed and sad that my life is as it is. I feel like I've lost my teens and twenties. I haven't experienced so many things that I wanted to have experienced by now. And I don't see my life changing all that much. I am still so dependent on my family, on the government. I am feeling tired and perhaps my mood is low today. I think the key is I need to accept where I am in life. To make the best of my situation and to follow Christ. To help people the best I can with whatever gifts I happen to have.

There are days where I feel a lot clearer and better than I do today. I often feel like I am many people. Not in a multiple personality (Dissociative identity disorder) way but because my energy and moods can change overnight and to a large degree. Consistency is so incredibly important in life and it is perhaps the most elusive quality for me to grasp. I read The Slight Edge by Jeff Olson and now I'm sarcastically thinking, good luck to me!

Sorry. I'm hoping after a good nights sleep I will be more optimistic. I'm still glad I posted because it's probably a lot healthier that you guys get to see all sides of me and the reality of my life. God bless you.

P.S. I reread yesterday's post and that is a perfect example! Yesterday I was in a much better mood. Maybe I just need sleep...

May 20, 2021

You sound like a normal person. You've spent a long time in a different life. Now you have to make a new life.

May 22, 2021

Thank you @Altostrata for your kind reply. I am doing my best to make a new life. Uniting my life to Christ. Abiding in Him. He went through the very worst so if I can be a little Christ, I can live this life with grace.

My taper rates:

I tapered/weaned off the Olanzapine first, then the Lamotrigine and finally the Lithium. I will edit this and add the first two later. For now I will start with the Lithium. To anyone: Please feel free to ask me any questions you may have. My prayer is that at the very least my life can be of some help to others going through this.

Lithium

My psychiatrist wrote me a prescription for custom Lithium capsules. I had them compounded at a local pharmacy. The cost came to about $1 CAD per capsule. The commercial capsules here in Canada are 300 mg and 150 mg and are covered. I ordered 100 mg, 75 mg, 50 mg and 25 mg capsules to make it as cost effective as possible for the various doses combining them with the commercial capsules.

I began my Lithium taper on January 31^st, 2020. At 21:13 I dropped to 850 mg of Lithium.

February 7^th, 2020 21:18 I dropped to 800 mg.

February 14^th, 2020 21:24 I dropped to 750 mg.

February 21^st, 2020 21:36 I dropped to 700 mg.

March 1^st, 2020 22:21 I dropped to 650 mg.

March 8^th, 2020 23:45 I dropped to 600 mg.

April 4^th, 2020 23:42 I dropped to 550 mg.

April 12^th, 2020 03:30 I dropped to 500 mg.

April 22^nd, 2020 01:33 I dropped to 450 mg.

June 6^th, 2020 01:21 I dropped to 425 mg.

June 22^nd, 2020 22:45 I dropped to 400 mg.

July 15^th, 2020 22:47 I dropped to 375 mg.

July 29^th, 2020 01:00 I dropped to 350 mg.

Sept 3^rd, 2020 02:07 I dropped to 325 mg.

Sept 14^th, 2020 23:54 I dropped to 300 mg.

Nov 3^rd, 2020 23:49 I dropped to 275 mg.

Nov 7^th, 2020 20:55 I dropped to 300 mg.

Nov 17^th, 2020 20:30 I raised to 375 mg.

Jan 11^th, 2021 23:30 I dropped to 350 mg.

Jan 12^th, 2021 22:58 I raised to 375 mg.

Feb 12^th, 2021 22:55 I dropped to 350 mg.

March 26h, 2021 20:00 I dropped to 325 mg.

April 17^th, 2021 23:00 I dropped to 300 mg.

April 28^th, 2021 05:07 I raised to 325 mg.

April 29^th, 2021 21:22 I raised the dose to 450 mg.

April 30^th, 2021 22:41 I dropped the dose to 325 mg and have maintained this dose to today May 21^st, 2021

I thought I would include this note I made in case it helps anyone.

“I may have double dosed on the 20th so I skipped this day. No more taking pills straight from the bottle. Always take Lithium from a weekly pill organizer. Double dosing Lithium is no joke. If you are ever unsure always skip the dose. And my pharmacist said I did perfect. If you double dose skip for one day to give your liver a rest. I also added two teaspoons of lemon juice in my morning smoothie every day and ate lots of oranges and clementines and fruit. Focus on the citrus to cleanse the liver.”

May 22, 2021

@GreenFlameTiger I respect your determination, but you may be tapering lithium too fast with reductions that are too large, that's why you find you need to correctively updose. Overall, this sets you back in minimizing lithium.

Lithium has a half-life of 18-36 hours. This means it will take 4-8 days for any dosage change to fully take effect. You should allow extra time to subjectively assess the outcome of a reduction. This is why we recommend monthly reductions.

A reduction of 25mg is not very large (3%) when you're taking 850mg, but it's larger (more than 8%) compared to 300mg. From your history, it appears you might do better with 12.5mg decreases.

Since you've recently gone off olanzapine and lamotrigine, your system may still be wobbly as you taper lithium, which is why you might need to reduce by smaller amounts. There is no need to rush on this, you've done an amazing job going off drugs so far. You may consider getting down to minimal or no lithium as a long-term project.

May 26, 2021

@Altostrata Thank you Alto, I agree with you. When and if I do decide to decrease the dose I will ask for a 12.5 mg decrease. That would mean I would need to ask for a prescription for 12.5 mg capsules.

My psychiatrist asked me to get a Lithium level. He said that he would like my Lithium level to be at a minimum of 0.3 mmol/L. That sounds reasonable to me. What do you consider as minimal Lithium?

May 26, 2021

What your psychiatrist thinks is that you need a particular level of lithium for therapeutic effect, whatever that means to him and you.

We don't aspire to treat psychiatric conditions and do not have any such measurement. Your minimum effective level is the level at which you believe your symptoms are controlled. It may be 0.3 mmol/L, it may be higher, it may be lower. If you don't need lithium to control your symptoms, this may be zero.

You've done such a good job of minimizing your drugs, I'd leave it to you to judge how much lithium controls your original symptoms.

June 16, 2021

I did blood work last week and the results came in.

My TSH is <0.01

I have hyperthyroidism. I read that Lithium decreases production of T₄ and T₃ and commonly causes hypothyroidism. More rarely, lithium causes hyperthyroidism due to thyroiditis.

Over these past twenty years I've been hypothyroid and hyperthyroid. When I was hypothyroid I remember taking pig hormone. When I was hyperthyroid I saw an endocrinologist and he told me to simply stop taking fish oil. Lower the iodine in my diet. It went away. I was on a lot more medication back then. I believe 900 mg Lithium, 100 mg Lamotrigine and 5 mg of Olanzapine. Now at just 350 mg of Lithium it's back.

Today I stopped eating eggs and himalayan salt. I'm hoping that will lower my iodine levels.

I'm experiencing all of these symptoms:

an irregular or rapid heartbeat (Except this one. Uncertain if I have an irregular or rapid heartbeat. My resting heart rate is 70 beats per minute)
muscle weakness
nervousness or irritability
difficulty sleeping
frequent bowel movements or diarrhea
weight loss
changes in mood

I thought they had to do with bipolar (changes in mood, nervousness, irritability) but maybe hyperthyroidism is at the root.

My GP has prescribed me Tapazole (Generic name: Methimazole). I would rather treat this with natural means and not take more pharmaceuticals. Do y'all have any advice? Thank you so much Alto for all of your support.

September 14, 2022

Wow, it's been a very long time since I have posted.

I have been off all medications since July 24th, 2021. It's been a very tumultous year. For three months I was doing quite well, although perhaps hypomanic. Then I got Covid and had a crash. And since then I've been very up and down. I still haven't been hospitalized for a manic episode since 2015 which is a big accomplishment. Heck being medication free for a year is a big accomplishment for me. But I'm having a hard time now. I seem to need the perfect amount of sleep and to go out and see people or I have a terrible day. I feel very off in the head sometimes. My psychiatrist said I can't feel my brain so I wonder if what I'm feeling is my sinuses? I have a cat and cat allergies and nasal rinse about three times a day. He also mentioned how people can have a distorted map of their bodies and feel sensations in their brain when it's really not in the brain?

I am considering taking Abilify. My psychiatrist thinks 10 mg is the lowest I can start with. He said that I can try it for a month, even up to three months and I will be able to stop the medication fairly easily. Is this true?

Thank you for your time. I'd be happy to go into this past year in more detail at a later time.

GreenFlameTiger - Bipolar taper off all meds

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