I learned a lot more about my diagnosis today

I actually did a lot of communicating with my pdoc today - achieved a lot.
When pressed about my actual diagnosis again ( I know I obsess a lot) my pdoc told me that she thinks that I have bipolar disorder mixed in with significant OCD symptoms.

She told me that OCD can complicate the bipolar picture significantly and this is why I have a difficult time functioning in some areas. She told me that there are some similarities between schizophrenia and OCD and this was probably why I was diagnosed with schizoaffective in the past.

My pdoc also said that I was hit hard with 3 different types of Anxiety on top of my bipolar disorder - GAD, Panic Disorder, and OCD - she told me that Antipsychotics become necessary for me to control mood/psychosis and quell down my severe anxiety symptoms.

She also called me Neurotic in presentation and I am not currently psychotic - with lots of different anxiety symptoms.

She said that I was High Functioning in most areas and I can reason and have good judgement - I am on top of things when it comes to taking care of myself and managing my meds etc…

My pdoc told me to get off of the Lamictal, she agreed that the Lamictal could be making me more anxious/paranoid, she also said that paranoia is very much part of bipolar disorder, even when moods are stable.

I had a pretty long talk with her today and learned a lot about myself.

She wants me to stay on the current dose of Risperdal and if I have to switch APs, she wants me to try Saphris next.

A lot to absorb today!


Congratulations for getting assertive and getting those answers.

It seems to have opened up some options for you.

I’m glad you had a chance to get some answers.

I know I shouldn’t obsess about the label on the page… but I do (sadly) put some of my identity in that label… If you happen to do the same… it would be quite a rotation in thinking to find out… what you thought you had isn’t what you had.

I feel for you on that one… it’s a lot to absorb. But I am glad it’s giving you some options on your health.

Good luck and I hope all gets easier from here on out.



Really interesting rundown, as well as good dot-connecting for you. Accurate dot-connecting is very empowering for me. Helps me with “tool development.”

Interesting comment about the Lamictal lamotrigine, though. I just rechecked the sfx list for it and do see that while there’s no “direct” correlation to anxiety, per se, there is to “dizziness, tremors, sleepiness, loss of coordination, headache, double vision, blurred vision, nausea, vomiting, stomach pain, dry mouth, changes in menstrual periods, back pain, sore throat, runny nose, or sleep problems,” all of which could appear to be or even induce anxiety I expect.

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Lamictal can be a very activating drug for some bipolars - it triggers mania and agitation in me at doses above 50 mg.
my pdoc said that it could aggravate anxiety as it can be activating for some.

She told me that if my depression returns with a vengeance to at least try to stay on a lower dose of 25 mg or go back up to 50 mg, my current dose

I think you could use something like klonopin for anxiety and mania and an antidepressant to control the lows of bipolar. But are you chronically psychotic or does that happen only during mania or mixed states? Klonopin has been used well to control mania as well as anxiety.

The big problem with Klonopin clonazepam (and all the other “minor tranquilizers”) is that they are tolerance-inducing, habit-forming and potentially addictive… requiring one to take more and more to get the same effect. I know. I used K in the '90s to try knock my relentless GAD down.

Better (most times, not always) to go with a med less likely to induce tolerance etc., like the “major tranquilizers” we call anti-Ps, even if the sfx are crappy. And better yet to use the anti-Ps to achieve sufficient stability to be able to tackle the CBTs that can realign the bogus beliefs that cause most of the emotional and behavioral problems.

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Well yeah benzodiazepines are addictive as ■■■■ but mine still help to an extent, at least with catastrophization and tremors. I’m still an anxious person. It sucks monkey balls. I even have some OCD symptoms. I have trouble sleeping, agitation, and I pathologize my thoughts and behaviors even when they’re not that bad (I like black hair and red hair and I really like it, was imprinted and have a template, oh no, then the shrink is like dude that shit is harmless)

Mortimer - I take Klonopin daily, but @notmoses is correct, tolerance is a big issue with benzos - it basically is no longer working like it should, thanks to tolerance.

Like with most bipolars, antidepressants can induce awful manic and mixed states - so antidperessants are a big no for me

Ah. I suggested it because I know a guy with bipolar who is on that regiment and doing well. Everyone is different- your case sounds pretty high caliber.

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Do you think the Klonopin might be the cause of the tremors, anxiety, trouble sleeping, agitation, etc.? Because all benzos are known to cause these symptoms when used to excess but below tolerance levels, especially when used PRN.

I had to ask. (Well, duh.)

Is 1mg Xanax three times a day too much?

It could possibly become a problem. I don’t think that Xanax is meant to be taken on a long term basis, is it?

S##T, man. That’s six times as much as I took to pound myself to sleep.

Next to Serax, Xanax is the most potent of the benzos. Way more potent than Klonopin, and with a much shorter half life, translated as “potentially far more tolerance-inducing.”

No. Xanax is appropriately used for extreme agitation or anxiety in the very short term. But… it is widely mis-used… and (I think) rather cynically prescribed by docs who like to keep their pts around.

But it’s also for akathisia

Xanax for akathisia? Please. (I really do know about these things.) Xanax alprazolam is waaaaaaaaaaaaaaaaaaaaaaay too strong for akathisia. Ativan lorazepam would have been fine. And if you have Klonopin clonazepam on hand (which would also work for akathisia), why would someone need another (much stronger) benzo?

(Should we be getting honest here?)

It’s for agitation, anxiety and also akathisia. Same with propranolol

I took Inderal prop for akathisia years ago, as well. Briefly. On top of the Risperdal, Klonopin, Clonidine, Luvox and Buspar the Argentine spitfire had me on. I was waaaay over-medicated and crawling on the floor much of the time. A friend finally took me to another doc, and he pulled me off.

How long have you been on this combo?

Almost two years

I had been fully alcohol and drug abstinent for 14 years when I was put on that combo. It may be that I was more sensitive to those meds as a result. Do you drink or otherwise “boost” or “dull” your consciousness?