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I've been doing well on Lithium and Mirtazapine

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Posted 6/1/2022 9:09 PM (GMT 0)
For about 20 years now, I've been doing well as a bi-polar on Lithium (2, 300 mg tablets a night) and Mirtazapine (7.5 mg a night) anti-depressant.

I need both of those. The Mirtazapine gets me out of my depression and the Lithium stabilizer keeps the anti-depressant from throwing me into mania and possibly causing anxiety attacks.

I try to tell my psychiatrist how much I appreciate her prescribing those 2 for me and how wonderful it is to be balanced for an extended time. I can remember years when I was not.

I know for a fact that my grandmother had bi-polar and they had no medicines for it there in the 1930s and 1940s. I have an idea of what she went through because of the times when I was unmedicated or mis-medicated.

We are indeed lucky to live in the era that we do and can be treated at home and not in a mental institution 100 miles from home like my grandmother.

Just wondering how other's medicines are keeping them balanced and if there is anyone out there who is struggling with this.
Posted 6/5/2022 11:09 PM (GMT 0)
Hello Tim Tam.I am on 350 mg of Lamotrigine and 2 mg of Abilify..i have been feeling rotten the last 2 weeks and It is hard to get an appointment with my DR. ( a GP ) .Almost impossible to get an appointment with a psychiatrist ..My family Dr thinks that 350 mg of Lamotrigine is about the top that I can take and he does not want me to go on Lithium
( because of the side effects ) so I m stuck between a rock and a hard place. I envy you ( that you are OK with lithium ) and feeling good.. Maybe increasing the Abilify will get me back on track. Take care.
Posted 6/6/2022 1:21 AM (GMT 0)
Perfect Time:

You say, "i have been feeling rotten the last 2 weeks"

Two weeks is like a milli-second compared to what I've been through.

Of course, when you're in it, two weeks can seem like forever. When is your next appointment?

It is a shame that you can't see a psychiatrist, but we have to do the best we can. What is the deal with the psychiatrists?

I would keep a journal of what medicines you are getting, dosage and what is the result.

I would also be taking steps toward getting a psychiatrist. If it's a matter of time you can start the process now.

I would also try to be positive that this, and other problems, will work out OK.
Posted 6/6/2022 11:16 PM (GMT 0)
Here I n Canada there is a lack of psychiatrists so it can take up to 2 years to see one and after one visit they generally send you back to your GP with a prescription .I have been treated for mental illness since 2013 and have tried 15 different meds ( because at first they thought that I was suffering with depression ) .The depression meds made me worse off so I can tell you that I went through a lot of pain before i was diagnosed and treated for bipolar . I do have a journal since 2013 and keep it up to date..I will be seeing my GP this Wednesday and he will probably increase the Abilify .Will let you Know.
Posted 6/7/2022 7:38 PM (GMT 0)
That does sound tough. As a bipolar, I was also mis-diagnosed as depressive for years which is why I put in my original post that I am being treated with two meds, an antidepressant and a stabilizer, Lithium, to keep the anti-depressant from sending me into mania.

I, too, have been given only an anti-depressant which sent me into mania, and sometimes panic attacks, because there was no stabilizer to stop the anti-depressant, because I had been mis diagnosed as only depressed when I was really manic depressed.

Now many years later, doctors are still doing that. The mind boggles. You described your situation as between a rock and a hard place. It sounds like it. What year is this, 1955?

What is wrong with this picture?
Posted 6/8/2022 10:49 PM (GMT 0)
Just got back from my doc (GP ) . After a long study of my file and of the meds that I am already on for Bipolar, he ,decided to increase the Abilify from 2 mgs per day to 4 mgs per day..With, the possibility of going up to 5 mgs per day and more (,if needed)..If that does not help ,the next step will be to increase the Lamotrigine from 175 mg twice a day to a max of 250 mgs twice a day..At least there is still room to play with my meds. Take care
Posted 6/9/2022 12:04 AM (GMT 0)
That sounds like it could work, so I hope it does.

One thing you might think about is, since Canada doesn't have enough psychiatrists, and they're all in the bigger couple of cities, according to the net story that I read, who are the best general practitioners in your area? I'm saying, if this situation doesn't work, and you'll have to decide that, if you had the names of a couple of the best GP's as far as psychiatric help is concerned, you could go to that if you choose.

I found a good psychologist by going to a women's health center, which was connected to a hospital, and asking the head person there that question. And she was right, she named a good psychologist.

I found the current psychiatrist that I've had for the last 15 years, by calling a woman at a Friendship House which works with people who have emotional problems, and asking her for the name of such. She said, "`Jane Jones,' I would go to her myself." Again, that person was right about that recommendation.

On the net, you might want to look up mental health organizations or women's health centers in your area, and try to get the names of GP's who are good with psychiatric problems.

Also, you might ask about, "Hey, I need a psychiatrist. How do I find one around here?" Talk to some of the people who work in that field and see what they say.
Posted 6/9/2022 10:59 PM (GMT 0)
Thanks for the suggestions .. I will follow up and keep you posted. I belong to a group that has mental health problems (we meet once a week) and we all have the same problem, that is , to find a psychiatrist . You almost have to hurt yourself (or threaten to ) to get one .Health care is free in Canada and is generally very good except for mental health.I had open heart surgery last year (aortic valve and four bypasses ) and the care was A1 but, there are just not enough mental health specialists.I have had many sessions with psychologists ( at least 5 different ones ) and they never helped me.I have a chemical imbalance in my brain so we can talk about it all you want but,I need the proper medication to compensate for the imbalance..
Posted 6/10/2022 5:41 PM (GMT 0)
You're saying you have to get into real trouble before you can ever see a psychiatrist is like it was with harassment. Simply getting harassed, you were not the victim of a crime. But if a person got killed during the harassment, the police would get involved. It was too late, but still they were involved. They've changed that now, I'm thinking.

That's good that you're a member of a group with the idea of finding a psychiatrist. Maybe dig a tunnel between your place and Toronto. I'm just throwing out ideas here.

I mean if we can get a man on the moon, why can't we get a psychiatrist in more than 2 cities in Canada?

You say, "I have had many sessions with psychologists ( at least 5 different ones ) and they never helped me.I have a chemical imbalance in my brain so we can talk about it all you want but,I need the proper medication to compensate for the imbalance."

I think you're right about psychologists. I would get them to help me think as in trying to solve a problem. I think a psychologist could be good for that and to help us through a crisis. A good psychologist that is.

But I know what you mean by needing a psychiatrist to help with medicine to hopefully correct a chemical imbalance such as bipolar.

Can we pool our money in the group to send one of you to a psychiatrist in Canada, get the diagnoses, get the medicines, then go back home and do telephone visits after that? I had a psychiatrist who did telephone visits. I mean, it's not the most difficult thing in the world.

Look up "Telephone Psychiatry in Canada" on the search engine. Any port in a storm. Type in "Desperate Housewives." See if you get a reaction.
Posted 6/10/2022 9:16 PM (GMT 0)
Thank you and will look it up !!!
Posted 6/10/2022 11:15 PM (GMT 0)
I think I typed in telephone psychiatry, and data about some nearby psychiatrists appeared on the screen, with one saying, I do telephone therapy.

Which made me wonder if they do that in Canada. When I was not able to ride in a car and get to my psychiatrist, he agreed to telephone appointments.

So I looked in the search engine for psychiatric telephone visits in Canada. Well, yeah, it was like a roller coaster. So there's some good news and there's some bad news.

OK, so we switch to America which apparently have psychiatrists who even advertise on the net they do telephone visits.

So, why couldn't somebody from Canada call a psychiatrist in America, get at telephone appointment, have the doctor call the scripts to a Canadian drug store, and there it would be?

So, if we have extra doctors in American and a shortage of psychiatrists in Canada, why not allow the American doctors to accept telephone appointments from Canadians?

I e-mailed 3 of these groups discussing this on the net, with those questions, and about 2 or 3 hours later I got 3 responses saying they had gotten my question.

1. "If you are commenting on an email from us, we will respond to you, if applicable.

Non-CMPA members will receive a response to their inquiries within 5 to 10 business days. Thank you.
The Canadian Medical Protective Association cmpa-acpm.ca 1-800-267-6522

2. ZUR Institute
"We have received your inquiry.
"A customer support team member will review your inquiry and respond as soon as possible."

3. "Thank you for contacting us. Your message will be answered by trained staff or volunteers at the Canadian Mental Health Association's BC Division. If you sent us a request for mental health information or support, we are happy to help and we will respond within 3-5 business days."

That's where I am so far.
Posted 6/13/2022 5:55 PM (GMT 0)
I just got the 1st reply to my 3 above mentioned e-mails concerning the possibility of telephone psychiatric appointments in Canada where the net says there is a concentration of psychiatrists in the 2 largest cities and relatively few in the rest of the country.

I just got the first replay today:

"We are writing to acknowledge receipt of your email dated June 10, 2022.

"The Canadian Medical Protective Association is a mutual defence organization with a mandate to act on behalf of its members. We are unable to respond directly to questions from patients or their representatives.

"If you have concerns about medical care, we suggest that you communicate those concerns directly to your doctor or your other personal advisors.

"Sincerely, Membership Services"

Or, Drop Dead.

To refresh my memory of where we are:

1. In my initial post I wrote: "For about 20 years now, I've been doing well as a bi-polar on Lithium (2, 300 mg tablets a night) and Mirtazapine (7.5 mg a night) anti-depressant."

1A. You responded: "Hello Tim Tam.I am on 350 mg of Lamotrigine and 2 mg of Abilify..i have been feeling rotten the last 2 weeks and It is hard to get an appointment with my DR. ( a GP ) .Almost impossible to get an appointment with a psychiatrist ..My family Dr thinks that 350 mg of Lamotrigine is about the top that I can take and he does not want me to go on Lithium ( because of the side effects ) so I m stuck between a rock and a hard place. I envy you ( that you are OK with lithium ) and feeling good.. Maybe increasing the Abilify will get me back on track. Take care."

2A.Your second response: “Here I n Canada there is a lack of psychiatrists so it can take up to 2 years to see one and after one visit they generally send you back to your GP with a prescription .I have been treated for mental illness since 2013 and have tried 15 different meds ( because at first they thought that I was suffering with depression ) .The depression meds made me worse off so I can tell you that I went through a lot of pain before i was diagnosed and treated for bipolar . I do have a journal since 2013 and keep it up to date..I will be seeing my GP this Wednesday and he will probably increase the Abilify .Will let you Know.”

3A. Your third response: Just got back from my doc (GP ) . After a long study of my file and of the meds that I am already on for Bipolar, he ,decided to increase the Abilify from 2 mgs per day to 4 mgs per day..With, the possibility of going up to 5 mgs per day and more (,if needed)..If that does not help ,the next step will be to increase the Lamotrigine from 175 mg twice a day to a max of 250 mgs twice a day..At least there is still room to play with my meds. Take care

4A. Your 4th response: Thanks for the suggestions .. I will follow up and keep you posted. I belong to a group that has mental health problems (we meet once a week) and we all have the same problem, that is , to find a psychiatrist

Again, this refreshes my mind about what’s going on and the frustration level of not having a psychiatrist but having a general practitioner as your substitute psychiatrist.

The first response to my mail shows that first agency has no plans to do telephone psychiatry to the vast part of Canada has no psychiatric care.

Why not graduate more psychiatrists from medical schools and have a portion of them do telephone sessions? That way the psychiatrists could live in the two largest cities but treat patients in outlying areas of the county.

I hope you’ll let me know how the new meds are working.
Posted 6/17/2022 6:22 PM (GMT 0)
First week completed on 4 mg of Abilify and I am starting to feel a little better (very slowly ).
Posted 6/17/2022 7:23 PM (GMT 0)
Yea! You said, "First week completed on 4 mg of Abilify and I am starting to feel a little better (very slowly )."

Yeah, and compare that to 12 days ago on 6/5/2022 when you said, "I am on 350 mg of Lamotrigine and 2 mg of Abilify..i have been feeling rotten the last 2 weeks and It is hard to get an appointment with my DR. ( a GP)."

OK, from "feeling rotten" to "feeling a little better." Huge difference. One of the differences is the direction that this is going.

You also said on 6/5, "Maybe increasing the Abilify will get me back on track."

On 6/8 you said, "Just got back from my doc (GP ) . After a long study of my file and of the meds that I am already on for Bipolar, he ,decided to increase the Abilify from 2 mgs per day to 4 mgs per day..With, the possibility of going up to 5 mgs per day and more (,if needed)..If that does not help ,the next step will be to increase the Lamotrigine from 175 mg twice a day to a max of 250 mgs twice a day..At least there is still room to play with my meds."

Well, it sounds like to me this is going pretty good. He's first trying to see what works, then if it works, increase the dosage. Cancel that trip to Ontario. Forget what I said about telephone treatments. No, just forget that.

One thing I was worried about were your meds, because you were worried about it, and another thing I was worried about was general practitioners treating psychiatric cases. Right, OK, I do tend to worry.

And I was curious about how both were going to go on this. I also thought, maybe it's better for a GP to personally treat a bipolar whose office is relatively close by than telephone treatment a thousand miles away with someone who's never seen. Then I thought, a nearby GP might be better.
Posted 6/17/2022 10:46 PM (GMT 0)
Thank you Tim Tam .I will keep you informed of my progress.
Posted 6/17/2022 11:35 PM (GMT 0)
Some days are better than others.
Posted 6/26/2022 11:15 PM (GMT 0)
The last few days have been really good . Feel better, positive outlook Therefor, the extra 2 mg of Abilify are doing the job that was urgently needed. I am now on 4 mg of Abilify and can go up to 5 mg without seeing the Doc. So far ,,so good !!!!
Posted 6/27/2022 1:04 AM (GMT 0)
That is very good news.

You said, "The last few days have been really good . Feel better, positive outlook Therefor, the extra 2 mg of Abilify are doing the job that was urgently needed. I am now on 4 mg of Abilify and can go up to 5 mg without seeing the Doc. So far ,,so good !!!!"

You said, "Feel better, positive outlook...."

I just want to say that, I used to have a negative attitude, from being raised in a negative family, and it really caused me some problems, to say the least.

Then I saw this column in the newspaper that said in effect, it was possible I could improve this situation by, when going into a problem thinking that I could solve it. So, I told myself, next time you have a problem, don't think about the problem, think first about that you can solve it, which clears out the negative.

So, I put the column up on my bulletin board, and I told myself, next time you have a problem, get the column down off the bulletin board. A few days later, my son came in and said, "The car won't start. It's in the backyard." I thought, our driveway is so tight of a turn, a wrecker can't get in here. I'll wait till my wife gets home and ask her."

Then I thought, "Wait, I'm not supposed to try and solve the next problem. I'm supposed to read the column on being positive before trying to solve my problem."

So, I got the column down from the bulletin board. When I got to about the fourth paragraph, I thought, "Johnson's."

What was "Johnsons?" It was a garage up the street which had a small wrecker that had gotten into our narrow driveway, pulled out one of our cars and took it up to it's shop. How did I do that? How did I solve the problem? I had solved it by first getting the unconscious negative out of my mind and replacing it with positive that I could solve the problem.

This opened up my mind to look for the solution, rather than with my unconscious negative which was looking for defeat, as I had programed it to, and I found the solution in about one second. All my mind was doing was what I told it to do.

Well, as it turned out, I wasn't such a dummy.

After that, whenever I was away from the column, I told myself don't think about the problem, think about clearing the negative out of your unconscious, which you can't see. So, I would tell myself, "Think positive, think positive, think positive" to clear the negative from my unseen unconscious. Only then would I think about the problem.

So, it sounds like you come from a positive household. Just lucky I guess.
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