Q:  My Mania is Not Going Away

I have been diagnosed w/bp (oct. 2005). Still in therapy and trying to get my medication to "stabilize" me. Currently taking Lamictal 150mgs/day, Seroquel 150mgs/day@night, Lorazepam .5/3x/day.

Question: I still feel horrible. Mania is not going away! Feel extreme fear when waking up in the morning - afraid of myself, what will happen during the day, don't want to be around people. Memories of a horrible past. Will these feelings ever go away?  Or will I have to suffer with this all of my life?  If so, it's not worth it (life that is).

My doc. says that the lamictal will take care of this -however, it doesn't, & I told him same.  I've been on lamictal for four mo's. now.  

Pls. advise - help.thank you.

Rachel


Dear Rachel -- 
The "horrible past" part could be a trauma that suggests an additional component of your illness, beyond "bipolar" (maybe even explaining most of your symptoms better than the bipolar diagnosis; or you could have both), namely "post traumatic stress disorder", or PTSD. That sometimes does not respond to our medication approaches to bipolar disorder (although often it does; indeed I often wonder which is which at that point, i.e. does this patient "really" have bipolar or "really" have PTSD, or both?).  You could talk with your doc' about approaches that might be considered for PTSD and how that differs, if at all, from the current game plan. One obvious move would be to try turning up Seroquel but of course you MUST check with your doctor before doing that. Good luck with that. 

Dr. Phelps

Published October, 2006