Tchi: Don't think I'm bipolar

[Tchi]

Thank you Gold star

You helped find the answer '' Reinstating a little is probably a good idea ''

 

Yes I want to taper !!   Just find the Paxil tough . It's going well with Lithium .

 

I get scared when going into these depressed , suicidal moods .

Need some encouragement .

[Tchi]

My doctor is a resident , well-meaning but inexperienced . She gave me a stern speech '' it's at your risks and perils '' . I know more about tapering than she does  lol

[AliG]

TChi .  It sounds like you have been trying to get off these drugs for a while .  I think you have been doing so well !   I don't know where you learned this , but you have landed in the right place now , for more support / encouragement. & advice. Most doctors are clueless, and don't understand withdrawal .

I'll post a few pertinent links , and you can have a read , and then come back with your questions & can then formulate a tapering plan .

 

Tips for tapering off Paxil (paroxetine)

 

Taking multiple psych drugs? Which drug to taper first?

 

What is withdrawal syndrome?

 

Ali

[brassmonkey]

Hi Tchi-- paxil doesn't like to be rushed when being tapered. The 10% a month that you were doing is within the guidelines we recommend but I have found that it is a bit fast for many people.  For my personal taper I have been doing 10% every 6 weeks and have been fairing pretty well with it.  I found the range of 20mg  to 10mg to go pretty well but once under 10mg I had to start paying more attention to what my body was telling me.  It would be a good idea to hold on the 21mg for several months to let the symptoms settle and stabilize before decreasing any more.  Then try a longer hold between drops.

 

You said that the lithium is doing well.  Are you trying to taper it at the same time as the paxil?  We find it is best to only taper one drug at a time.  It makes it easier to understand where the different symptoms are coming from and do something about them.

 

Depression and suicidal moods are two of the biggest problem symptoms we all get.  They are a manifestation of the drugs and not the real you.  Both of them will pass with time.  There really isn't much that can be done but ignore them and go on about your life in spite of them.  Being afraid of them adds to their power and just makes things worse.  It is a hard thing to learn, but just let them be there and get on with things.  If the suicidal thoughts start to turn into actions like planning methods then it's time to seen outside help, this doesn't happen often but just a heads up to pay attention to our thoughts and actions.

[Tchi]

Thanks Gold star

I have read the links before and it was good to read them again .

 

I taper Lithium and Paxil on different weeks , to make sure I can identify whatever symptoms appear .

This was suggested by a member of this board . I guess I was a bit in a rush   

 

As for the bad thoughts.....it's okay if they don't last too long ( lots of practise ) , but when they get too strong too long , I can't just get over them . Being afraid is a sign something's wrong . I can't afford a psychotherapist at the moment . So I use prayer and meditation .

[AliG]

 

I taper Lithium and Paxil on different weeks , to make sure I can identify whatever symptoms appear .

This was suggested by a member of this board . I guess I was a bit in a rush   

 That's not a great idea , at all . Have a read. See what you think  and come back with any questions or concerns. We can set up a more conducive tapering plan .

 

Taking multiple psych drugs? Which drug to taper first?

 

Ali

[Tchi]

From what I read , I should've tapered Paxil first  , and used Lithium as a brake...

I'm down 38% from Lithium  ( 375 mg ), 30% from Paxil ( today 21mg ).

Maybe the problem comes from there : not enough Lithium ?

 

If so , doctor will be upset if I ask for an increase of Lithium . She tried in the beginning to taper it 30% , too fast .

How much Lithium should I take to balance the Paxil ? 405mg ( 30% ) ? When I was at 420mg , it was fine .

 

Thanks again for the help - it can be confusing

[Altostrata]

Hi, Tchi.

 

I merged your posts into your Intro topic, to have all your history in one place.

 

You're trying to see your house, your mother is ill -- it could very well be these stresses are difficult for you.

 

If I were you, I'd stop tapering everything for the time being, let your system settle down while you deal with your life stresses.

[Tchi]

Hi Altostrata -  You don't mean going back to the original dosage ?

I've been feeling so down ( Paxil down ) , maybe I should up the Lithium a bit ?

[Altostrata]

No, not going back to the original dosage -- stop tapering and let your system stabilize for the time being.

 

It could be that tapering both drugs at the same time has caused some nervous system instability. You need to give it a rest.

 

To go off drugs successfully, you will need to find ways to deal with life stresses other than taking drugs, please see Non-drug techniques to cope with emotional symptoms

[ChessieCat]

Hi TChi,

 

You might find some of these helpful to learn coping techniques:

Audio:  How to Recover from Anxiety - Dr Claire Weekes

 

Resources:  Centre for Clinical Interventions (PDF modules that you can work through, eg:  Depression, Distress Intolerance, Health Anxiety, Low Self-Esteem, Panic Attacks, Perfectionism, Procrastination, Social Anxiety, Worrying)

 

Audio:  First Aid for Panic (4 minutes)
 

CBT Course:  An Introductory Self-Help Course in Cognitive Behaviour Therapy

[Tchi]

Thank you everyone .... I went back from 375 mg to 450mg Lithium + 20 to  21 mg Paxil

Ali made a good point with accelerators and brakes

I appreciate the coping techniques

Now , if I can get rid od that 2-day migraine !

[Altostrata]

Please do not make changes in your drugs for a good long while. The changes are destabilizing.

[Tchi]

No , Strata , I won't .

 

I will keep Lithium at 420mg ( fom 375 for past few weeks - that's when the problems started ) and try again Paxil 20mg ( only one day at 21 ).

 

I appreciate all your input .

[Tchi]

Hi 

I cannot start a new topic , no button . Please help.

 

Very upset . I have been diagnosed with kidney failure after 30 years of lithium.

I've tapered  lithium by 50% on 15 months , am down to 300 mg a day.

also finally have a new real doctor ( as opposed to the residents I saw for 3 years+.

Problem is : a) she wants to me to taper the remaining 300 mg in three months because of the kidneys , whereas I feel I might need another year.

                    she doesn't feel qualified enough with lithium , so she wants to send me to yet another psychiatrist who can prescribe Seroquel as a plan B in case I'm bipolar and go manic.

The same thing happened in june 2015 , when the resident sent me to the psychiatrist because I was successful tapering lithium , he spent 45 mn trying to convince me I was bipolar based on diagnosis dating back 1991 , then he said '' Well , you don't look bipolar , so keep on tapering carefully and slowly ''

This , after I saw a psychiatrist for two years back in 1998 to clear all doubts , the man said I was NOT bipolar , and the GP gave me the prescriptions from then on.

 

This situation is painful , having to be studied under a microscope like a bug , answering questions, rehashing the past  and not be believed . Dealing with often paternalistic , arrogant and linear '' specialists ''.

It makes me nervous and scared . I don't trust most of  them.

 

I told my doctor I wanted to be in charge of my heath , with her help and knowledge . Was distressed , as I didn't see this coming.

she looked at me funny , yet I know she's well intentioned ; she's my mother's GP.

 

I'm scared to taper the rest of the lithium so fast .

I'm scared of taking an anti-psychotic as a plan B. Because  if I taper too fast , there will be withdrawal related depression....and the merry-go-round I'm trying to get off of.

 

Anxiously waiting for your replies .

Thank you

[scallywag]

Tchi - I'm very sorry to learn that you are experiencing kidney failure as a result of your long time on lithium. Your doctor(s) should have been monitoring your liver and kidney function regularly to prevent this.

 

You're in a difficult spot: -- you definitely need to reduce your lithium dose but a fast taper has huge risks. I've asked other moderators to have a look at your situation and weigh in.

[Tchi]

Thank you Scally.

My liver and kidneys were checked regularly .

Kidneys failed suddently , due to an episode of severe dehydration. We did 3 blood and 2 urine tests , which confirmed.

Going for an ultrasound.

Doctor's pharmacologist suggested today that I skip the 150 mg lithium night dose once a week ; then twice a week , and so on. Then do the same for the morning dose.

That's 14 weeks altogether to quit 300 mg daily.

 

Last year , I tried tapering 38% in one shot . Felt very low.

 

Please tell me : how do I create a new post with a new subject ?  I looked , but can only add to this thread.

 

Thank you

[scallywag]

Starting a new topic:

1. If you're asking questions about or updating your own situation, this topic is the right place to post so that all your information is in one place instead of being spread throughout the site in multiple topics in different forums.
    
2. If you want to start a topic about a particular symptom or about a coping technique, please search the site for the symptom or the technique first. You can use any search engine such as google or bing or duckduckgo. Include site:survivingantidepressants.org as a search term in addition to the keyword for the symptom.
    
3. If neither of those situations apply have a look at the different forums listed on the main page. Click on the one that seems most appropriate. On every page of the forum list there's a black button at the top "Start New Topic," click that and you're on your way to a new topic.

[Tchi]

Thanks

Any feedback from the moderators about lithium anf kidney failure ?

[scallywag]

Tchi, the moderators who have more knowledge than I do about such things haven't been on the site much this week. Because your kidney function is damaged, consider a 25% reduction in lithium; it's not as drastic as going cold turkey but will address the toxicity issue faster than a 10% taper.

 

Fast tapering lithium after long-time use poses a high risk of creating "manic" symptoms. Do you have a medical professional you trust to help you manage these?

 

Although you don't want to start another medication, it is an option that may assist you. Once you stabilize on it and after you deal with the kidney issue effectively, you can taper off the "new" medication. It's not a life sentence.

 

Please keep notes on paper of your symptoms and the times of your dose(s). This post has a useful format for a daily log:

Take notes of doses and symptoms.

 

You can post your log of symptoms here in your intro thread, if you'd like.

 

Please let us know how you are doing.

[Tchi]

Thanks a lot . I'm a bit reassured .

 

Even if I'm not bipolar , tapering lithium quickly can send me into a high ?

 

My doctor doesn't feel qualified enough with lithium , so  she wants to send me to yet another psychiatrist who can prescribe Seroquel as a plan B in case I'm bipolar and go manic.

This has made me depressed , because I've been okay with a GP for the past 19 years.

I’m scared that if I go manic because of lithium withdrawal , I’ll be labeled bipolar.

 

At 300mg , I’m already under the therapeutic level , no manic symptoms.

 

Really afraid of what might happen , when the tapering has been going so well since last year .

Afraid to take another medication , but you’re right , I can always taper later .

 

Very grateful for your help Scally.

I’m not just concerned for myself but also for my old mother I care for.

 

Doctor's pharmacologist suggested today that I skip the 150 mg lithium night dose once a week ; then twice a week , and so on. Then do the same for the morning dose.

That's 14 weeks altogether to quit 300 mg daily.

[scallywag]

That is what the prescribing information says -- fast reductions in lithium can cause mania.  Many people have symptoms caused by medications, including mania, it's often how people end up on outrageous and dangerous psych drug "cocktails."

 

First, do not skip doses; your doctor and the pharmacologist don't seem to understand how these drugs work. Skipping doses creates instability which leaves you more likely to have symptoms, including ones labeled "manic." You are much better off to reduce your daily dose than to alternate days on and off medication. It's more work to create a non-standard daily dose but far, far safer.

 

Second, forget about minimum therapeutic dose (MTD); it has no relationship to withdrawal symptoms. Symptoms are most probably caused by changes in dosage not any specific dosage.  For example, I have tapered to well below the MTD for Cymbalta, which I've seen listed as both 20 mg and 30 mg. 7 mg is about 33% of 20 mg and 23% of 30 mg. Regardless of that fact I do sometimes notice mild symptoms appearing after I've decreased. Also, on this site, there are people taking minute amounts, less than 0.5 mg of medication, who experience a flare up of symptoms when they make a reduction to a smaller dose.

[JanCarol]

Hey Tchi - 

 

I'm sorry you are suffering.  That toxicity thing is awful about the lithium.

 

also finally have a new real doctor ( as opposed to the residents I saw for 3 years+.

Problem is : a) she wants to me to taper the remaining 300 mg in three months because of the kidneys , whereas I feel I might need another year.

                      she doesn't feel qualified enough with lithium , so she wants to send me to yet another psychiatrist who can prescribe Seroquel as a plan B in case I'm bipolar and go manic.

 

If your kidneys are in failure, you may need to go faster.

 

Have you ever been full-blown manic before?  

 

Having a Plan B in preparations for mania is a good idea.  It just may not be the one that the doctor wants.  Think of some alternative Plan B's.  

 

I had a conference with my partner and my p-doc, to ensure that she was getting good reporting if I was "high."  Do you have someone in your life who can support you as a third-party observer?  This can soothe the p-doc a bit, if they know they will get accurate, third party information about you getting high.  I asked for Valium, just 3 days of strong Valium, to "knock me down" if I got high.  The p-doc refused (it's an "old drug" and "strong doses" are not advised).  But she did like the conference with my partner, and trusted me more, knowing that he would report if I went manic.  We signed a contract under what conditions he would call her, and she was greatly eased by that.

 

The Seroquel is not the most awful thing they can give you for short term use for mania.  It will knock you down fast, and numb you out.  It is preferable to use it short term, instead of replacing the lithium with it (long term treatment).

 

I’m scared that if I go manic because of lithium withdrawal , I’ll be labeled bipolar.

 

Just to let you know, I did not go manic during my tapering.  Not once, not even close.  Everybody is different.

 

Here's the thing - how you act in doctor's office makes a difference.  If you can breathe, and calm and be still, and quietly describe your withdrawal symptoms in quantitative remarks:  I am sleeping only 4 hours a night, I eat 2 balanced meals a day including meat and veg & fish, I take fish oil, etc.  If you can do this, you are less likely to be diagnosed, and more likely to be reported as drug symptoms.  

 

If, however you bounce up and down in your chair and kick out your feet and raise your voice and insist "It's a drug side effect!" then you are more likely to be diagnosed.

 

This latter is behaviour which I call "behaviour that will get you caught."  The goal is to not get caught.

 

The doctor's Plan B rightfully scares you:

I'm scared of taking an anti-psychotic as a plan B. Because  if I taper too fast , there will be withdrawal related depression....and the merry-go-round I'm trying to get off of.

 

Here's the thing.  The lithium is killing your kidneys.  Unlike the liver, they don't heal so well (I'll have some suggestions on that in a bit).  

 

You have reached the point where it is vitally important to get it out.

 

If you FILL the script for Seroquel - tell us what doses they give you - for just in case - and reassure your doctor - sign a contract like I did - that you will take it if you are getting high.

 

Define with your doctor what is getting high for you:  not sleeping enough, spending too much money, obsessing over what people say, spending too much time on obsessions, etc.

 

Then - fill the script and tell the doctor you will keep it on hand.

 

Determine a quantitative situation under which you will take it.  If you have not slept for 3-5 nights, you might take one.  It is vitally important, when trying to prevent mania, to sleep every night.  I have more anti-mania tips, as well.  I'll try and get them all in today.  

 

Anyhow, depending on the dose, you might take it for 1-3 days, then stop.  Don't give it time to re-organize your brain and neurotransmitters, just take enough of it to "knock you down."    These drugs can be useful, if used appropriately - which is - low dose and short term.

 

But do not be afraid of it as a Plan B.  You may have other Plan A's - your Non-Drug toolkit - that you want to emphasize to your doctor.  I will phone a friend, write a letter, listen to music, take a walk around the block (only at appropriate hours of the day, of course), play a computer game, watch a TV episode - all of these distractions and delays.

 

But if your system is revving, these will only delay the inevitable.  It is possible to live through a manic episode without help - but if you have ever had a manic episode, you realize the wreckage you leave in your wake - hurt friends, bankruptcy, debt, lost jobs, etc.  It's better to prevent the manic episode to begin with!

 

BUT if it gets that far, a Plan B is a very very good idea.  As Scally said:

Although you don't want to start another medication, it is an option that may assist you. Once you stabilize on it and after you deal with the kidney issue effectively, you can taper off the "new" medication. It's not a life sentence.

 

In my experience, once you are below the "therapeutic level" (this is a fictional level, really, determined by drug companies), the chances of a manic episode diminish greatly.

 

However - having that Plan B in place is a good idea - you don't want to wreck your life, and it is reassuring to your doctor that you are placing the well-being of yourself and others, first.

 

Scally's advice about do not skip doses is right on the money.  Every-other day dosing  Lithium is slightly different from other psych drugs, in that it is more about "levels" than it is about specific neurotransmitter fiddling - but still - keep it stable.

 

I was able to get lithium in 2 sizes - once you break it, it is no longer extended release, so take it 2x a day.  I had 450 mg XR, and 250 mg IR.  Between those two tablets, I was able to break into 1/4's and get my doses down.

Overall, I agree that a 25% reduction is a good place to start.  If, in 3 weeks time, that was no problem, we'll take it down another 25%.  If, after 3 weeks, it was hard, we will slow it down - but the goal is to get off it as quickly as possible.

 

Next post:  Preventing mania.

[JanCarol]

OK - more in your toolkit about mania.

 

First of all, can you put stop-gaps on your money?  This is just a precaution.  Make sure you need extra approval, and you can't spend money with the click of a button, or whipping out a credit card.  Lock the credit cards in a safe.  Hide them from yourself, or make them hard to get to (in the jar on the very top shelf & you need a stepladder to get them!)  Make sure that you have to go get the credit card if you are shopping online.  Just put some stop gaps between you and your money.

 

If I have to ask hubby, I won't spend the money.  That's my main stop gap.  I broke my account at ebay.  I left it broken.  If I want something from ebay, I find it, and ask him to get it for me.

 

But - what you really need are some tools for preventing and managing mania.

 

There are 3 things I think most highly of:

 

1.  Get enough sleep.  Every day.  For me, this is between 9-11 hours, if I am struggling with symptoms.  6-8 hours if my mood is more euthymic.  I had an emotional event this week; last night I slept 12!  If you are finding that your sleep is slipping, this is the first thing to take care of.  The Seroquel will be excellent for this.  In low doses, you can manage your sleep, and make sure you do not "ramp up" into 6 hour, then 4 hour, then 2 hour sleep nights, and fly off the handle.  Sleep cycles running shorter is usually the first symptom of a manic episode.

 

2.  Get enough protein.  For me, this is some meat every day.  Vegetable protein is less effective than meat at "holding you down," in my experience, and this is not just my body, but other people I know who have experienced mania.  When my friend is ramping up, I ask:  have you had any protein?

 

3.  Essential fatty acids:  Omega-3 fish oil.  If you can, 4-6 capsules per day, will help keep your nerves lubricated and operating smoothly, and nourish your brain.  Eating fish is even better than fish oil.  I do both, just because I was so afraid of mania - I wanted to cover all the bases!  I was up to 14 capsules of fish, krill, Flax & EPO daily; I now just take 6 of fish and krill oil.

 

There are other things which factor in:

 

1.  Managing blood sugar.  Blood sugar spikes and drops have been interpreted by many doctors as "bipolar disorder."  I got a cheap blood sugar monitor and learned about my blood sugar cycle:

• a - what is my fasting blood sugar first thing in the morning?
• b - what is my blood sugar after a carb meal?
• c - how quickly do I recover from a carb meal?  20 min?  45 min?  longer?
• d - what is my blood sugar after a protein meal?  
• e - what is my blood sugar after a blended (protein, carbs and fats) meal?
• f - how quickly do I recover from a meal?
• g - are there foods which make me worse? (spikier - higher highs, lower crashes = worse)

  I now have protein for breakfast to prevent a mid afternoon slump.  I manage my blood sugar with fat and protein (and by limiting carbs and sugars), and by trying to time my food with my cortisol cycle (much harder to do, this is my cutting edge of effort).

 

2.  Niacin and Zinc.  It is preferable, with the zinc, to be under the management of a naturopath or orthomolecular physician.  I have access to a little liquid drink called "zinc test," which is not as accurate as blood tests, but gives me a rough reading of whether or not I have enough zinc.  I take a sip of the liquid, if I cannot taste it, then I need more zinc.  If it tastes awful, I probably have enough zinc.  Many times, a zinc / copper imbalance is misinterpreted as bipolar, as a high copper state is an emotional state.  

Niacin, is vitamin B3.  Pure niacin will give an uncomfortable "flush," but that means you are getting the real stuff.  You can take alternatives, like time-released Niacin or niacinamide, which have no flush - but - the studies for mood stabilization have not found them to be effective.  Extreme cases might take multiple grams per day (up to 10!), but I only take 1 gram per day.  As always, especially with B-vitamins - start wayyyyy low to make sure you aren't going to react to it.

 

Additionally if you are in Paxil withdrawal - having symptoms - Niacin can activate them, make them worse.  But there are many "bipolars" who can control their moods with just niacin and zinc.  With ALL supplements only make one change at a time so that you know what is happening with you.  Wait a week in between changes in dose or supplementation.

 

3.  Recreational drugs and alcohol, caffeine, common substances which alter your brain = don't.  I was addicted to caffeine, and weaned down to 1 cup of tea per day.  Alcohol will release you from the social norms, lower your inhibition and impulse control,  and can turn into binge/crash cycles (also commonly called "bipolar") - and sometimes an alcohol problem is a blood sugar problem in another form.  Cannabis has mood stabilizing properties, but THC can send you off the wall:  "high" is not something you want to be!

 

CBD oil - I haven't tried this one (still illegal here), but it is getting proper research here in Queensland as a mood stabilizer.  Be sure to get pure whole plant CBD oil, not just "made from seeds" (which is a cooking oil, really, not medicinal at all).  The amounts required are so tiny, that reactions to it are minimal.  Again, though, if you are in withdrawal, be extremely careful, and do tiny test amounts before going up to a full dose.

 

4.  Magnesium - find the magnesium which is right for you, and take it.  You may wish to take Mag Taurate, which is excellent brain food, but expensive and hard to find.  Mag Glycinate is easier to find and quite affordable - if you want to, you can (carefully, as with all supplements in withdrawal) add a Taurine to the magnesium as a co-factor (bonus:  the taurine makes the niacin flushes more bearable).  There are some who believe that Mag Threonate is better for the brain - I do take one tablet a day.  After years of taking 3 tablets a day, I am finally down to just 2.

 

Also - magnesium baths.  A good 1-2 cups of magnesium chloride in the bath is as good as a Valium for calming your nerves!  And it is non-addictive, with no hangover or side effects.  Epsom salts works, too.  You will find that you can get slightly different effects at different temperatures.  A cool bath is good for pain, a hot bath is good for shifting mood - but can be overstimulating.  For best magnesium absorption, take the bath at body temperature.

 

My recipe:

1-2 cups of mag chloride or Epsom Salts

1T borax (my water is fluoridated, this helps neutralize that)

1/4 cup baking soda - for muscle pain

a splash of Apple Cider Vinegar - to improve absorption.

a few drops of a pleasing scent - lavendar, sandlewood, eucalyptus - whatever helps you to feel better (there's a whole science of scents, I'm only an egg, and just use what I like)

 

5.  Daily walks.  Make yourself do it, in rain, snow, sleet, wind, hot, cold.  Every day, just walk 10 minutes.  Preferably in sunlight, to reset your sleep cycles.  I realize you are in Canada, but I was outside in Indiana almost daily, even when the light was poor.

 

6.  Develop a practice.  This is HUGE!!!!  I cannot emphasize this one enough.  Maybe you will start every day with the Lord's Prayer, or an affirmation.  Maybe you will do one 10 minute yoga session per day.  Maybe you will do one 10 minute session of dancing to music.  Maybe it will be 10 minutes of silent mindfulness meditation.  Breathing.  Coloring.  Something that you do every day that you can come back to when your mood is off kilter.  The more you do it, the more comfortable you will be coming back to it.  10 minutes is good (I have no excuse to not do 10 minutes) but 20 minutes is better for building a "bank" that you can draw upon in times of stress.

 

7.  Related to #6 - Breathing.  With my breath, I am powerful.  I can survive the storms my body makes when it is firing, anxious, heart pounding, thoughts flying - just by breathing.  There are so many things you can do with your breath.  Slow it down.  Make it hiss in your throat like a snake.  Exhale.  No - REALLY exhale, all the way out, and hold there before you inhale.  Breathe into your belly, then breathe into your lungs, then breathe into your upper chest - then reverse it, pour the air out of your chest cavity like a pitcher.  Count your breath.  My favourite one for dropping from my head into my body is a single inhale, double exhale.  For every 3 counts you breathe in, breathe out for 6.  My favourite rhythm is 4 in, 8 out, but even though I've been doing it for years, that sometimes changes.  Go here to learn some more breathing exercises:  Pranayama - Yogic Breathing

 

8.  Also huge:  Take responsibility for your mood.  Don't blame it on others, don't victimize yourself.  It's true, you are in a chemical state, and that is going to affect your mood - but - be responsive and responsible to your mood.  If I've had a bad day, and the car has been crashed and I'm feeling so guilty, and I get stuck in a mood - the best person to change that mood is myself.  I can't look to hubby for that, or even my friends.  They can help, by listening, offering support - but ultimately, it's up to me to balance and affect my own mood.

 

9.  External stimuli.  I avoid horror movies.  I avoid TV news.  I avoid people shouting on the TV.  I avoid issues which may trip me into an obsessional journey (like conspiracy theories or intense video games).  I avoid toxic people, and seek out gentle, caring people.  I don't go to parties, or if I have to, I try and put fences around it so that it's not so stressful.  I avoid places where people drink a lot of alcohol (sometimes that's tricky in Australia!).  I no longer listen to heavy metal "downer" music.  I listen to the mood and tone of my music, and make sure it is nourising and sustaining me.  (again, a little catharsis is fine, but if you are daily death metal, it will take a toll on your mood).  

 

10.  Educate yourself.  Learn about yourself, learn about "mania."  Learn what your triggers are, become sensitive to what makes you feel better - and do more of that.  Sometimes you will have symptoms, that's natural, especially on a withdrawal journey - be gentle with yourself, and educate yourself, so that these peaks and valleys are not so important.

 

11.  You are NOT your mood.  You aren't your thoughts, nor are you your feelings.  You are something greater than all of that.  Thoughts, moods, feelings, are like clouds in the sky - they come, they go.  YOU are the person who can observe them.  There is nothing you can do about clouds except to wait for them to pass.  Let them go.  More will come in their place, watch them, observe them, too.  Practice watching the thoughts, feelings, moods - and you will realize that the "you" which is watching - is not them.  When you disidentify with your moods, they have no power over you.

 

I hope there is something here that helps you. 

 

Most of my time healing has not been about withdrawal and tapering - but has been about managing my mood so that "the illness doesn't return."  I have worked very hard at it, and it has paid off.

 

You may have to always be aware of mood, but once you get these items in your toolkit, it will be a reflex.  I come home after a long, tough day, "I'm taking a bath!" or if I wake up in a hazy foggy grumpy mood, a little tai chi and a walk outside gets me ready for the day.  I don't think about these things anymore, and haven't listed them in one place (they are all over my thread, but reading that is too tedious!).  

 

Believe me, my whole taper I lived in fear that the mania would return.  I wanted very much to prove my p-doc wrong, and so I did everything in my power to ensure that I was in the driver's seat, I controlled the helm of me & my moods.

 

I hope you see the sun today (even if it is behind clouds!)

Next up:  soothing and tending the kidneys!

[JanCarol]

Okay - Scally reassures you with this:

you are experiencing kidney failure as a result of your long time on lithium. Your doctor(s) should have been monitoring your liver and kidney function regularly to prevent this.

 

And I sadly have to say that my experience is like yours.  My doctor was monitoring my kidney functions.  She insisted that nothing was wrong.  I showed her the weird rashes (annulare granuloma, which means bumps arranged in circles) on my upper arms, outer ribs and inner thighs.  She looked at the labs, they said "normal."

 

And - in your experience - all it takes is one episode of dehydration and then you are in trouble.  I learned this from reading Patty Duke's book - she was on lithium treatment for decades, and had to be extremely careful of dehydration.  It's a killer, when you are on lithium.  You will frequently see me asking people about dehydration here when I see that they are on lithium.

 

But dehydration has 2 components:  drinking enough water - and - getting enough electrolytes to accept the water into your tissues.

 

You can use Gatorade or Pedialyte formula.  For my electrolytes, I prefer pink himalayan salts.  You can grind a little into your drinking water, or just use it on your meal.  Stop using processed table salt, and use the pink himalayan salt (or celtic sea salt) instead.  You will get a more complete profile of electrolytes, including potassium and magnesium, and your kidneys will thank you.

 

Can kidneys heal?  Your doctor is likely to tell you no.  That once a kidney fails, it's stuffed.  But in the natural healing profession, I hear more stories of hope.

 

My own condition was less severe than yours, diabetes insipidus which meant that my kidneys were dumping more fluid than I was taking in, and I had to use the bathroom at least every hour.  When I confronted my p-doc about this, she looked at my kidney function tests "all normal."  I told her that diabetes isipidus was a side effect of lithium toxicity.  She had to look it up.  She was embarrassed that she had to look it up.  

When I started going to an orthomolecular doctor, she looked into other tests and ratios that I'm not going to pretend to understand.

 

The first thing you can do - is get copies of all of your tests and look them up on the internet to find out what they all mean!

 

When I started going to acupuncture, my TCM practitioner recommended barley water for my kidneys.

 

I have had great improvement using barley water, and over time, I've learned to feel when my kidneys are "acting up" and I make a batch to soothe them.

 

Here is my recipe (the adzuki beans were added by a "traditional Western Herbalist"):

 

1 cup pearl barley

1 cup adzuki beans

1 strip kombu seaweed

2 Tbsp himalayan salt

1 Tbsp grated turmeric

1 Tbsps grated ginger

Dash pepper

 

4 litres filtered water (roughly, quarts)

 

rind of 1 lemon

Rind of 1 lime

rind of 2 oranges

brown sugar to taste (about 2-4 tbsp)

 

juice of 2 lemons

Juice of 2 limes

Juice of 4 oranges 

(Citrus is interchangeable - I use whatever is on hand._

 

Rinse the barley, bring water to boil.  Add barley, adzuki, kombu, salt, turmeric, ginger, pepper to water, when boils, reduce and simmer 40 minutes.

 

Zest the citrus rind and set aside, juice the citrus and put in fridge.

 

When barley is boiled, strain, discard the barley & bean mixture (this goes out to the bird feeder for the critters, but could be nutritious with the right sauce - haven't figured it out yet.)

While liquid is still hot, add citrus rind and sugar, stir well.

 

Leave to cool. Then refrigerate.   When it's cool enough, stir in the citrus juice.  Strain again  to discard the rind and any messy pulp or seeds from the citrus.  Refrigerate.

 

Makes 3-4 litres.

 

Drink 1 cup a day.  Kidneys will thank you.

 

Pasted from <http://survivingantidepressants.org/index.php?/topic/3595-meimeiquest-my-introduction/page-7>

 

I would also like to note that organic barley, organic turmeric, organic citrus is much cleaner, and since cleaning the kidneys is the goal - clean is important.

I have a few more suggestions, but step one is getting off the lithium, as it will be difficult-to-impossible to soothe and heal your kidneys while you are still taking it.

 

Another thing you should never take is NSAIDs.  Non-steroidal Anti Inflammatory Drugs.  Ibuprofen, naproxen, moxicam, aspirin.  Not for you, never again.  I don't know if you received the NSAID warning when you were on the lithium, so I'm giving it to you now.  These will damage your kidneys.

Turmeric, as presented in the barley water recipe is amazing stuff. It can function as an anti-inflammatory, soothe tissues, and actually aid in healing.

 

Keep it close - put it in everything, your omelettes, your smoothies, everything.  Look for excuses to take it - or take it in a supplement.  But know that - it is absorbed best when taken with oil - like a good Indian curry!  I take turmeric with my fish oil - but I also add it to practically every meal I eat.

 

Acupuncture - has helped my kidneys immensely.  Acupuncture is touted as good for pain by Western and Eastern medicine.  But what they don't tell you is that it is amazing for the internal organs, lymph system, and endocrine, too.  It gets things flowing again.

 

Yoga and/or Tai Chi - works well with acupuncture to keep your body in tune.

 

 

Are you having symptoms with your kidneys?  Did you have to go to the hospital and have dialysis?  Do you have any pain?  Have you had your kidneys ultrasounded to see if there are any cysts or stones?

 

I hope that there are some tools in here to help you feel better - and I'm hoping even more, that you have found some directions to look to keep improving.  I've found that managing mood and body is a life's work, and I need all the help I can get.  But it does help.  I am better.  I can still have kidney "flare ups," but I'm not in crisis all the time - the same with mood.  Flare ups, but nothing worth drugs or hospital.

 

I hope you see the sun today. 

[JanCarol]

Just a thought - you don't really need a psychiatrist to get Seroquel.  GP's give it out all the time.  Additionally, a psychiatrist might want to try some newer fangled one - Seroquel is one of the easier ones to work with, where lower doses have good effect, and "therapeutic" can be anywhere from 25 mg to 800 mg.  I'm hoping you will be at the 25 mg level.

 

another random thought:  coconut oil is really soothing brain food.  I cook with it exclusively.  Use it on my skin.  Put it in my coffee (when I'm allowed to have one).  It's got a thing called Medium Chain Triglycerides which are excellent for the nervous system.  A high fat diet is also good for treating insulin resistance and blood sugar spikes.  And, paradoxically, it will help you lose weight.

[AliG]

There's a lot to take in here but I hope you have success with some of Jan's suggestions. They will help you find some stability. I hope it goes well. 

[Tchi]

You're an amazing bunch of ladies !

Thank you so much.

 

I never had a manic episode , never spent money I don't have , no multiple partners , so psychotic episode .

Some racing thoughts , definitly tend to be an overthinker . Take walks and do meditation .

Eat well , sleep 8-10 hrs per day.

 

I'll get back to you later

[Tchi]

No alcohol for nearly 20 years., no drugs for even longer.

Two very diluted coffee in the morning 

[JanCarol]

That's good!

 

So - you've never had a manic episode - statistically, there is still a chance that the withdrawal from lithium will look like a manic episode, even if it is strictly drug induced.

 

But the statistics are in your favor at this point.

 

I know, I put a lot of information out there - re-read it as much as you need to and see what attracts you.

 

I am curious to see what your doctor calls "kidney failure."  Is he talking about numbers on a lab chart?  Or did you have to go to hospital for dialysis?  What symptoms do you have that fit in the category "kidney failure"?

[Skeeter]

Tchi,

First, how is your liver doing?  At the beginning of your thread, you note that you were Hep C positive.  Did you undergo treatment for this? Ae you still positive? All of the following is based on you still being positive: If still positive, have you had your blood tested within the last 12 months?  If not, you may ask that they run everything related to your liver function that could be affected by Hep C.  I will explain why in the last paragraph below.  If they have not run your bloodwork on this in the past year, and you are still positive, you may wish to  ask that they do blood tests specifically regarding Hep C and your liver function.  How long have you tested positive for Hep C?  Any liver pain? Any positive findings on scans or other testing? Have you been told you have a fatty liver?  Is your liver function impaired as far as you know?

 

Your kidney issues are new.  Did they tell you how impaired your kidneys are currently, and if any permanent damage has been done yet (if they know)?  If you have your lab results, can you list ONLY the high and low (abnormal) tests and the numbers associated ( it will be easier for everyone reading for all irregular lab tests if you list what the test is, as in Creatinine, then your result, followed by the normal range in parentheses).  Have they given you any idea if you can retain normal kidney function if you get of lithium as quickly as they say, or what you will lose if you slow it down a bit, perhaps?  They are trying to save vital organs, but your comfort is the least of their worries, obviously.  If the damage is done, and it will not change anything if you do it in 5 months instead of 3, that could be important to know.  At some level, I believe that lithium is no longer toxic to the kidneys, but JanCarol is far more knowledgeable than I on this point.  I am just trying to ascertain if they gave you a specific diagnosis to go along with acute kidney failure, and if you have lab results, see how bad they look right now.  Sometimes I am able to dig up extra information that is helpful if given all of the facts.  I want you to be as educated as possible going into this. If is totally up to you whether you wish to share any of this information.  I happen to like doing research, so I like to assist in any way I can if needed.

 

Now the reason I asked about the liver is because all prescription drugs AND over the counter medications are metabolized via the kidneys or the liver (there are only 4 ways for the body to metabolize substances; liver, kidneys, skin and lungs). Your doctor should give you a list of what to avoid, and what to look for on packaging for any OTC meds. Since you have a known liver issue, whether you are positive or not at this point, you may still have liver damage, and guess what, Seroquel (or anything else they will prescribe) is metabolized through the liver.  This is why, if you still have Hep C, you should be tested. If there is damage, it can affect how your body metabolizes substances.  I assume that your doctors are on top of this and have already ordered exhaustive blood tests for the liver, so they know what they are working with.  If you are highly self-educated on your liver issue, you probably need no assistance from me what-so-ever.  There is a ton of information online regarding kidney injury from Lithium, but it depends on how severe things are and if you got treatment right away after you noticed a problem as to what your permanent issues may be, and what you lab results are currently.  All I have read thus far does say to get you off of the lithium as fast as possible. While I wait for a response, I am going to continue looking this up to see if there is any reason or way to slow your taper down without putting your kidneys in any more danger.

 

Hang in there!

Skeeter

[Tchi]

Hi Skeeter , and thanks for your support .

 

I did pass the Hep C treatment with flying colors , test every 6 months and still negative for the virus .

 

As for acute kidney failure , we're not at that point . Not having my notes nearby , all I can say is that creatinine is high and higher since September.

I'm going for an ultrasound in april .  Nephrologist said the situation wasn't that alarming , but he got stuck on the word lithium and went on to tell GP that I had to get off it asap , find an alternive in case of mania and be followed by a shrink. GP being somewhat young and not at ease with the situation , she put pressure on me  , I got pretty upset ( not a good attitude to have with a doctor)

 

Quote from JanCarol :

 

Just to let you know, I did not go manic during my tapering.  Not once, not even close.  Everybody is different.

 

Here's the thing - how you act in doctor's office makes a difference.  If you can breathe, and calm and be still, and quietly describe your withdrawal symptoms in quantitative remarks:  I am sleeping only 4 hours a night, I eat 2 balanced meals a day including meat and veg & fish, I take fish oil, etc.  If you can do this, you are less likely to be diagnosed, and more likely to be reported as drug symptoms.  

 

If, however you bounce up and down in your chair and kick out your feet and raise your voice and insist "It's a drug side effect!" then you are more likely to be diagnosed.

 

This latter is behaviour which I call "behaviour that will get you caught."  The goal is to not get caught.

 

 

 

I pounded that , at 61 , I was educated and well researched and wanted to be in charge of my heath , with her help. 

 

JanCarol , I'm now at 240mg lithium ( from 300 ) since friday . All ok .   Can you tell me if it's under the therapeutic level ?   Doctor told me so last year after test.

 

Pharmacologist - who suggested I skip doses - was very young . When I mentioned the weight gain and libido loss , he said '' Well , you have to choose between that and your mental health '' . It's this kind of attitude that bothers me.

 

So....I'm sticking to my guns . Slow tapering , NOT skipping .

20% in one shot . So far , so good.

[Skeeter]

Tchi,

I know you are waiting for JanCarol, but I want to tell you that I am SO RELIEVED that the doc just freaked out, and it is not this HUGE DEAL that I was afraid it was going to be with the way the docs acted.  I am glad that you stuck to your guns, just stick to regular testing so that you can make sure that you are not damaging your Kidneys, and you will do just fine.  I cannot believe that the doc freaked so badly. Can you imagine this happening t someone who is not grounded, and is always worried about their health?  This would have thrown them off the deep end, and all due to inexperience on the healthcare provider's end!.  Glad you got all of the facts and approached it calmly once you knew everything.

 

I am THRILLED that you are no longer Hep C positive!  YAY!!! Happy party for you!! WOO HOO!!! l.

 

I do like research, so if you ever need any done, I am happy to help out. Just ask!

 

Please keep us updated on how you do.  I really want you t do well!

Skeeter

[Tchi]

Hi , people 

Just to give some hope to the lithium crowd :

Went from  240mg lithium to 120mg since the end of january , and it's going well . 

More alert , but zero signs of mania , sleep a bit off ( intermittent , but I do get 8-10 hrs per night ).

If all goes well , I should be done early this summer .

Lost 16 pounds in the last years , my knees are loving it !

Still at 20mg Paxil ,

Will resume taper after the lithium is finished .

Pretty happy about  things , especially running into this forum .

[scallywag]

Glad to read that you've been doing well after that dramatic -- 50% -- decrease in lithium two months ago.

 

You were tapering very conservatively last year; please consider holding for several more months at your current lithium dose AND then returning to smaller decreases of the lithium.

[Tchi]

Hi Scally

 

I don't have much choice with the kidney failure .

But it's going well .