Today's Tdoc Appointment - Bipolar Disorder Message Board

dreams in neon · 05-05-2009, 02:20 PM

Hi everyone,

I just came home from seeing my tdoc and the appointment went better than expected.

My tdoc told me politely that it sounds as if I'm in a mixed state right now. He said he could tell this by my rapid speech (mania) and thought content (depression). He also said that I looked tired.

We spoke about what mixed episodes were as well as my feelings about them. Next week we are going to work on some techniques I can use to help me deal with my feelings the next time I'm having a mixed episode.

I expressed my frustration about what happened on the other message board to which he said that even if you're on meds, it doesn't prevent you from having a manic, depressed, mixed or psychotic episode. He also said the person who told me that I should take responsibility for sleeping regularly should understand that not everyone with bipolar is stable and that there are many of us who continue to struggle even if we are on meds and do everything we can to reduce mood swings.

He looked at my mood chart and said that April's chart looked very, very good. When he looked at May's chart, he said it appears that I'm having a bit of a rough time, but agrees that this is due to my health problems.

He suggested that I think about trying a different med combo given my mixed state or at least try a different mood stabilizer. I told him I'd rather not since the regimen I'm on addresses all of my symptoms and I was doing really well until I started having headaches and allergy attacks.

Besides, I don't want to take Lamictal because of the titration that is necessary to reach a therapeutic dose. I don't want to wait 6-8 weeks for the med to kick in. I also don't want to be on Lithium and have blood tests every 6 months or check my salt and water intake.

I said that I also worry about having another manic/psychotic episode and so far, Depakote has been preventing that for the past 3 years. I don't want to fix what isn't broken.

I told him that I took 2 Klonopin before our appointment so that I wouldn't end up crying. He said it would have been perfectly fine if I did. I expressed a great deal of anger today about my diagnosis and it felt good to get it all out.

My tdoc told me to remind myself that when I'm in a mixed state or am depressed to think about how far I've come since the early 90s. I'm not as severely depressed as I was back then and I'm certainly not the same way I was in 2006.

He told me that this mixed episode won't last forever and that it will pass. He also told me it was a good sign that things are already starting to improve since I was able to fall asleep this morning for 2 hours before my appointment.

I feel better, but am still feeling mixed although I'm not as depressed as I was earlier today.

katlin09 · 05-05-2009, 02:27 PM

Dreams,

Good job, it doesn't seem liek you had any problems getting your points across today, that's great.

kat

dreams in neon · 05-05-2009, 02:30 PM

Kat,

No, I was quite clear and direct today. My tdoc said I sounded a bit agitated as well which he said was understandable. I knew exactly what I wanted to talk about and we were able to cover everything except my journal and a letter I had to write to my late mother (as part of my PTSD exercises), but my tdoc said he will read that before our appointment next week. We also need to work more on my PTSD exercises as well as helping me learn how to cope with flashbacks and nightmares. As he said, "We've got a full plate of things to discuss."

CarenR · 05-05-2009, 03:58 PM

YOu are so lucky that your-doc talks with you.. when I go to my appoinment for meds. he just gives me prescription refills.. ........he doesnt anything with me I have Bipolar 1...

hugs, Caren

dreams in neon · 05-05-2009, 04:33 PM

I'm sorry to hear that Caren. I used to have a pdoc who was the same way. Every time I told him I was rapid cycling or manic he would tell me to schedule an appointment with him in 3 months.

Update: I spoke to my pdoc again because the Clonazepam that I'm taking isn't working long enough like it used to which he thinks is due to my mania. He suggested that I take 1 tablet 4x/day. He also told me I could take Melatonin. My Trazodone regular and PRN doses will remain the same since they cannot be increased much higher. He feels that the extra Clonazepam during the day and night will help me fall asleep. If it doesn't, he would like to increase my dosage of Clonazepam to 2mg until this episode passes. I was told to call him again on Monday to let him know how I'm doing. I'll be crossing my fingers that this change works.

I forgot to mention that I asked him about my Depakote and Fluoxetine. He said that given my weight (114), I'm on enough Depakote. As for Fluoxetine, he said it can cause mania and thought about taking me off of it, but after I told him about my IP hospitalization in December and the fact that I haven't been depressed since, he decided to keep it in my regimen.