[kikki]

That's understandable Superm - we all feel like that.

RCR likens their recovery to being like a spiral.  Towards - away - towards - away.  Each time making ever so slight improvements.  Like watching paint dry unfortunately - best to look away. 

[WorkingHard]

Hi. I think I'm about to reply with this same post twice. Sorry! I'm still figuring out how the threads work and where to find things. Here's my response to your query about "mixed states." For my MLCer, the mixed states existed long before the MLC behavior, but it's the recovering from the mixed states that seemed to launch the MLC. How ironic that health should spill into MLC....

My original message to you:

Hi all,

Yes, I don't underestimate the effects of mental health issues, hormonal changes, stress, and other biological/physiological processes in MLC. I feel confident that all these have been at play in my partner for some time, and that they play a role in her current MLC path even though she now feels healthy and good for the first time in years.

"Mixed states" are known by psychiatrists, but not necessarily by the general public. The (U.S.) National Institute for Mental Health (http://www.nimh.nih.gov/health/publications/bipolar-disorder/index.shtml), which has many resources on BPD, including mixed states, offers this brief description of a mixed state:

“During a mixed state, symptoms often include agitation, trouble sleeping, major changes in appetite, and suicidal thinking. People in a mixed state may feel very sad or hopeless while feeling extremely energized.”

Mixed states are also described in the DSM-5. Having witnessed them in my partner for many years, I can attest to the fact that they are truly horrible, and people experiencing them are truly suffering. It’s also a dangerous mental state because you’re horribly depressed and can become suicidal, but you have the energy to carry out the suicide (unlike some people who are horribly depressed and do not have the energy to plan and execute the act). Mixed state sufferers do not respond to Lithium or Risperdal or the other drugs commonly given to treat BPD. My partner has received amazing relief from an anti-epilepsy medicine that brings the mood back in balance without blunting cognition, clarity, or emotions. Doctors do not know why it works for mixed states, but it does, and it has worked well for her.

Except that she is now awake and energetic and ready to change her whole life without regard to family, work, or anything else!

I’d be interested in hearing from others who have insights into their MLCer’s mental health before, during, after BD and other events.

All the best to each of you out there.

[kikki]

Hi WorkingHard
Thanks so much for sharing that information and welcome to the forum.

That was posted twice, so I removed the first one. 

[Phoenix67]

Like all psychiatric conditions, mixed states looks different in everyone.  For my dad and I we primarily deal with severe depression with low energy, but high anxiety.  When something triggers an increase in anxiety it's like a switch gets flipped and we instantly fly into a manic high energy rage.  These generally only last a few minutes, but can last an hour.  Then the switch flips back down to an even deeper depression because we're horrified at what just happened.  As awful as it is to be the target of the rage or a witness thereto, being on the inside is pure hell.

[Anjae]

As awful as it is to be the target of the rage or a witness thereto, being on the inside is pure hell.

Could you please be so kind and elaborate a little about this? We often talk a lot about how horrible it is inside the MLCer mind/self, of how much worse it is for them than to us. And it is pretty horrible for us.

Do you, and your dad, take any meds? Or even with meds those manic picks you mention happen?

[RainbowGal]

I’d be interested in hearing from others who have insights into their MLCer’s mental health before, during, after BD and other events.

 Thanks for this valuable info  Working Hard.

 I will answer the above question as I have been meaning to comment on this on my own thread anyway.It's something that I have been curious about.I realize some folks here have come to the realization that their spouse had been struggling with mental health issues prior to this thing we call MLC.

 I have analyzed as best I can,our relationship over the decades and cannot see any signs of anything prior in our situation.

[Phoenix67]

I'm not sure what my Dad takes, but know he didn't start on mood stabilizers until he was I'm his mid fifties.  I'm sure he was on anti-depressants before that, which are totally wrong for bipolar, as they just throw you into near constant mania 

I take Lamictal as a mood stabilizer and a low dose of Celexa for the anxiety.  Unfortunately Celexa is an anti-depressant and my Psychiatrist thinks its contributing to the mixed states.  He increased the Lamictal a month ago and it's made a HUGE difference.  So much more stable but still able to feel emotions.  Eventually he wants to get rid of the Celexa, but life is too much of a rollercoaster right now to watch for the subtle changes that happen with med adjustment.  Plus he wants to add low dose lithium and I don't want to take it.  This is good for now.

Regarding the "hell inside"   it's difficult to put into words.  For me there's a piece of my brain that is aware of what's happening but is completely unable to stop it.  Hmmmm...  think of being trapped in a sphere of smokey glass, but floating untethered like a bubble.  You're in the bubble because a beast has taken over your brain, body and mouth.  You can't control the beast and are horrified that its hurting anyone, particularly the people you love.  For me the part of me that isn't inside the bubble feels like finger nails are shredding my skull from the inside trying to get out.

One of the reasons I chose to never be pregnant is fear of passing this on.  I wouldn't wish it on anyone.  I began showing signs during adolescence, but didn't get on meds until my early 30's.  fortunately my dad's diagnosis meant I started with mood stabilizers and didn't go through the antidepressant nightmare that so many people with bipolar suffer.  NEVER go to a general practitioner for mood meds!!!

[WorkingHard]

Hi Phoenix and others,

Just wanted to comment on the drugs used for mixed states. I'm not a doctor and don't endorse any one approach over another. I'll just share that my partner suffered greatly on anti-depressants and "traditional" mood stabilizers like lithium. However, Lamictal alone has been extremely helpful to her (she previously took lithium with the Lamictal, but the lithium shredded her thyroid, which in itself can lead to depression and anxiety, so her psychiatrist took her off the lithium and she's done well since then. Thyroid back to normal and no lithium-induced brain fog.

As to whether or how the Lamictal--or her mental health issues--contribute to her MLC behavior is unclear to me. I've been appreciating your insights and sharing on this.

[Anjae]

Thank you Phoenix67 and Working Hard.

Regarding the meds, when my cousin had MLC he spend some 18 months going from psychiatrist to psychiatrist who gave him all sorts of meds. Until he hit rock bottom and I took him to a friend of mine who is a psychiatrists. My friend gave him Lamotrigine (Lactimal) and it worked. My counsin was on anti-depressants so my friend start by removing one and introducing Lamotrigine, leaving the other anti-depressant. My cousin was also given Alprazolam (Xanax) and Lorazepam (Ativan) for emergencies. Slowly the remaining anti-depressant was removed and he stayed with Lamotrigine and the two anti-anxiety, with the first, Alprazolam also being slowly reduced. It worked.

Lamotrigine is a medicine that come from neurology and has started to be more used by psychiatrists. It seems to have better effects than anti-depressants and lithium for mood.

Your image of being inside hell (manic phase) gives us great insight, Phoenix67.

[ALL I WANNA BE IS DONE]

I was glad to read that SOMEONE realizes we ALL are somewhat "bi-polar" 

I really hate the labeling that goes on with the word ONLY because it gets overused and viewed as some kind of sin.

I was diagnosed with major depressive disorder and released with NO MEDS after teams and I do mean teams of psychiatrists talked to me on a visit I had to the wellness center.

And I shouldn't be depressed?? After the bomb that got dropped on me twice pretty much. It's a wonder I didn't kill myself. The whole thing is laughable...seriously.

This labeling doesn't make anyone feel any better about themselves.

 It's kinds like the time I got pulled over for DWAI.

 I'm was at a stop sign and was told I didn't stop long enough but if I'd sat there any longer that would have been to long. Either way I was going to get a ticket based on some one else's judgement.

Now when it comes to these MLCer's the one I'm associated with has diabetes and his father died young from it. He lacked self control. If his father took him out for ice cream he'd encourage him to BE A MAN and eat two.. So he lacks self control at his base and he's also a hedonist. And stress is only going to make his diabetes worse.

ANYTHING to excess and he's ALWAYS been this way. MLC compounded all of this I believe it is in part to FOO and the other things that was said in a previous post. It's nice to see it put into words.

None of his issues are for me to figure out. I tried .....it DID NOT WORK I've finally decided I'm dealing with a narcissistic emotionally abusive person and he always has been. MLC just compounded it and I know he's afraid of his own mortality.

For us to diagnosis H's ...exh's.... ex w ....or w is a waste of valuable time we can use to get a better perspective on OURSELVES. AND HEAL