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suicide

Arkteia

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Maybe I am opening another bag of worms, but hopefully, not.
In a very interesting book that I have read about writers and suicide, the author arbitrary divided mankind into three groups:
- those who never thought of suicide
- those who had fleeting thoughts but never came up serious plans
- those who occasionally became so serious about it that they started planning or tried

In a statistic anonymous study done among college students, 25% commented on having thoughts of suicide at least once in their lives. Note that these are high-functioning, serious, ambitious people who potentially have promising future.

So it is close to us. While there may be statistic differences between different groups of the society (I am not talking about economic status; it probably plays no role), suicidal thoughts and attempts are ... more common than many people think.

I always thought I was emotionally very stable, and was considered such, and probably one needs to be to work in my profession, but I remember how after birth of my second child everything got wrong, I developed serious OCD and anxiety. And at the peak of it, I had this very, very strange thought. "Maybe there are worlds where it does not matter if you are alive or dead". It was so weird and unlike me... I stopped it but for several days felt... uninvolved. I was doing everything, but very mechanically, even my OCD went away. It was not classical postpartum depression because I did not have any symptom of depression. Then it all went away.

Professionally, I think, It was good experience. I understood that these feelings are creeping, that in most cases, a person does not wake up planning to kill himself, and that even minute thoughts require attention.

I do not know if our medications have reduced the rate of suicide. Likely, in those who take them. Unfortunately, only 40% are fully compliant, and medications may be either a total hit or a total miss. I can talk a lot about medications and which of them help to reduce the risk (actually, only two - Lithium and Clozaril, have statistically been proven to), but this is not a professional post.

We all see it, hear about it. I feel profoundly sad when someone ends his/her life, and this is the main feeling...

I think that other people might chime in. I am not asking to share personal experiences, although 25 %, likely, stands for all groups, just to tell us what they think of it.

Feel free to delete this post if you feel it is too serious for this forum.

P.S. this post was not about me, my own example, likely, proves that there is no first group. It was about the sadness of suicide... something else which is hard to explain.
 

marymm

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In my personal experience I know several people who have committed suicide who were taking psychopharmaceuticals (as prescribed) at the time of their deaths. I think the brain is the last frontier - we really don't know enough about it - and I find truly alarming the number of people (adults and children) who are put on anti-anxiety and anti-depressant and anti-psychotic and ADD meds. These are serious drugs and I know they are useful and sometimes critical drugs, and of course behavioural change is expected if one is on these drugs -- but oftentimes their life-threatening side-effects creep onto the person only gradually and while the patient or those around him/her might even start wondering "is this normal?" it can be too late. It is terribly sad.
 

Pandora II

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I am someone who probably wouldn't be here if it wasn't for my medications. I have bipolar disorder and it wrecked my life for many, many years. I took a number of meds that made me so miserable that I stopped taking them which made me feel much better till the next relapse. Finally after nearly 17 years I discovered Lamotrigine - I have been extremely stable (for me) and although I had very bad antenatal depression and a few blips after my daughter was born, they just tweaked my dosage and things improved.

My ex-bf of 7 years hanged himself a few months after we split up. He never suffered from depression and was not depressed at the time of his suicide. He was however an alcoholic. He had threatened on many occasions and I was not suprised when he actually went ahead.

The aftermath of that is another reason why I can keep those thoughts away - the horribleness that everyone went through afterwards was just awful. I have never felt pure hatred towards someone like I did for years about him. I also then dated a man whose mother had shot herself when he was 11. I remember him saying that he hated her for not loving or caring enough about him to live. I always thought people felt sorry for the person and just said, oh how sad. Nope people feel angry, betrayed, guilty...

Even so, when my brain chemistry has decided to take a walk on the dark side it can start to seem like an option again. Fortunately I have a fantastic team I can turn to anytime, day or night, and DH has a phone number in case he gets worried!

One of the things about medications especially with anti-depressants is that it can take a number of weeks for them to have an effect on mood, but they tend to start working on things like sleep problems much earlier than that.

If you give them to someone with bipolar disorder (as happened to me) they can send you sky high in a matter of hours. Unless there is a history of manic depression in the family or you have very defined manic episodes it is very, very hard to identify hypomanic episodes and most people present with depressive episodes. It took over 8 years and 5 different psychiatrists to get diagnosed and that only happened because I was seeing someone every week for several months and they spotted my very sudden switch from severe depression to hypomania. Then took another 6 years to find a medication that worked for me.

Often when people commit suicide it is because the medication has taken them out of the deepest stages of depression and given them sufficient energy and clarity of thought to actually carry it through.

I don't know about in the USA, but here suicides are almost never published in the newspapers as it tends to spark a load of copy-cat suicides for some reason. My ex was one of many who killed themselves within a week of Michael Hutchens (INXS) in 1997.
 

zhuzhu

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I think about it because I am curious about complexity of human life, as in what triggers suicidal thoughts and how those thoughts came about. But I never think about doing it FOR or TO myself. What category do I belong to then, according to that definition?
 

MakingTheGrade

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I'm actually planning on going into Psychiatry in the near future, in part because I think it's a fascinating field, both from a scientific perspective (the brain is still a great mystery, and we're only beginning to understand it ) and from a social perspective (many of the defined illnesses in the field are based in large part on something being "abnormal" to the point of "interfering with function". You can see how this would lead to a lot of debate. I often wonder if our psychiatric illnesses would even be recognized as illnesses in other countries with different values and norms).

Many people (regardless of education, social standing, etc) have at one point or another thought of death and what it would be like to die or be dead. Which is very different from wanting to die, which in turn is very different from actively planning a way to take your own life. I would be interested in how this study defined "thoughts of suicide". I would argue that many people (especially those in fields like medicine, law enforcement, social work etc) have at some point or another thought about suicide in at least an abstract, intellectual way.

I know I for one have thought a lot about death, how I might "want" to die were I ever to go down that road, what the aftermath of my death might be etc. I think these kind of thoughts are "normal" in that these thoughts are occasional and usually sparked by something external to me, and not something that interferes with my life or my functioning. Heck, I've had fellow classmates sit around and argue why one way to overdose is better than another (it's gallows humor for sure, but it's also a way to cope when your profession involves a lot of death). It might make me a little strange to some people, but I would say I'm a fairly mentally healthy person at low risk for suicide.

And while I do think that there is some over medicating going on, I can also attest to the amazing things I've seen while working on inpatient psychiatry. Sometimes the right medication gives somebody just enough balance to want to try to enjoy their life again, and that kind of change is amazing to see.

If you're interested in mental illness, I highly recommend the book "The Center Cannot Hold" It's a memoir written by a very successful and recognized law professor about her life with schizophrenia. She articulates very well how the fear and embarrassment of not being able to control your thoughts.
 

Circe

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I see a lot of truth in BOTH the posts by MaryMM and Pandora.

My best friend takes anti-depressants. As she puts it, they keep her alive. Without them, she's not in a good place. With them, she can function, and be happy, and just has to be very careful to watch out for foreign or unexpected thought patterns. They're not perfect ... but they're considerably better than nothing.

Me? I'm prone to depression, natural and otherwise.

Left to my own devices, I can succumb to situational depression and have "It would be easier to be gone" thought patterns (which I would never follow through on, because I think it's a hideous thing to put friends and family through - which, btw, is a sign that I'm generally on the light side of things, as what I've read about more serious depression points towards thought patterns that indicate that those around one would be better off without one).

Put me on any steroid-based medication? I will bawl like a baby over things like, say, my carry-out order taking too long, and am prone to self-harm (I have a nasty tendency to punch things when I'm upset, which is a classic sign of emotional disassociation - hard to focus on how bad you feel when you need to go and get a plaster for your knuckles).

And, apparently, the chemical sensitivity doesn't stop there: after my first miscarriage, I got put on Ambien so that I'd be able to sleep through the night. The first day, I remarked to my husband that I'd never actually been so sad without having been clinically depressed. The second day, I coped. The third day, I took my medicine, washed it down with some water, and very seriously thought about eating the glass. Took me a few days to figure out it was the Ambien, too - I was on a few other things to help with the physical symptoms, and my doctor was absolutely no help in pinning things down.

I realize I'm probably at the most extreme of extremes in my chemical sensitivity, but I'm quite horrified by how lightly doctors prescribe things without considering (or warning patients about) possible side effects. I've actually gone to doctors, told them flat out "If you give me a steroid-based inhaler, I will be at risk for clinical depression if not flat-out suicidal ideation," and had to turn down prescriptions for several steroid-based things ... because in the course of looking the things up in the PDR, they apparently lose their train of thought.

I don't want this post to come off as an anti-medication tirade: I just want to underscore that whenever an ... odd thought ... pops up, before ascribing it to a personal desire, consider outside factors. Everything from hormones to random medication can affect the ways in which we think: I firmly believe that an increased awareness of the fact that you will not always feel the way you do at the time (with a decrease in the wrong medication or a prescription for the right medication) could make all the difference in the world in many cases.
 

hawaiianorangetree

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Suddenly stopping medication without your doctors knowledge also increases the risk of suicide.

Unfortunately I didn't find out about that fact until after my bf had killed himself, 3 days after stopping his medication without telling his doctor.

Also, if you have been affected by the suicide of someone I read that you are 3 times more likely to commit suicide yourself. Lucky for me I didn't go down that road, I thought about it a lot in those months after but seeing what he put his family through, I just couldn't bring myself to doing that to my own, (thank god).

I personally have mixed feelings about suicide. I see it as the most incredibly selfish act that a person can commit but at the same time understand that when a person reaches a point where the pain it takes to kill themselves is far less than the pain it takes to keep on living, then they must be in a pretty bad place. I know it is not like that for all suicides and some people do it for revenge or out of spite, but that was not my personal experience.
 

random_thought

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I had bipolar depression as a teenager and was prescribed paxil. Throughout those years, I tried suicide a few times and thankfully it never worked. I was talking to my doctor about this because I had been having migraines during my pregnancy and the depression had also started to resurface. It was then that I discovered that they no longer prescribe paxil to teenagers as the hormones used in it actually caused the likelyhood of suicide to increase!! Who knew!! Anyways, back then my boyfriend at the time mentioned that the medication actually made me worse to be around so I quit taking the pills on my own and stuck only to counseling at school. Now that I'm pregnant I've been prescribed a different kind of anti-depressant. I feel a million times better than I did before I started taking it! I always thought negatively of anti-depressants because in my own experience...they didn't work. Now that they do work, I can't say enough positive things about them!! And also, my migraines have completely disappeared :)
 

Cehrabehra

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I could say so much but I'd like to just ask a question... What someone said about how doctors don't explain the meds they give you (or ignore your warnings) rings true in more than ways relevant to this discussion, but I do have a specific question that I would like a generalized answer for... I am on wellbutrin for the 2nd time in my life. This time I've been on it for about 2 years and I really don't want to ever go off of it. My only side effect is always being thirsty and I feel really balanced on it. In the past, my last doctor really tried to get me on all sorts of others in the zoloft/paxil ever expanding family but they were HORRIBLE for me. I have tried 4 of them and always get the same result. They give me unlivable side effects AND they don't solve my problem. But they are very popular it seems and if I recall correctly they have to do with seratonin production or uptake or something like that. (I don't google medical stuff, it makes me rather hypocondriacal.) But what exactly does Wellbutrin do? I would really like to know what particular piece of the brain chemistry puzzle *I* am getting filled by taking wellbutrin. I know people have used it to stop smoking and it is not a very common antidepressant, but it works for me and I'm good with that... would just like to understand my brain chemistry better, or at least what the meds I'm on are doing for it.

ETA - I don't think you get over bipolar or outgrow it... perhaps you were misdiagnosed?

Also - HOT, I'm sorry for your loss.
 

House Cat

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Cehrabehra|1297005299|2844769 said:
I could say so much but I'd like to just ask a question... What someone said about how doctors don't explain the meds they give you (or ignore your warnings) rings true in more than ways relevant to this discussion, but I do have a specific question that I would like a generalized answer for... I am on wellbutrin for the 2nd time in my life. This time I've been on it for about 2 years and I really don't want to ever go off of it. My only side effect is always being thirsty and I feel really balanced on it. In the past, my last doctor really tried to get me on all sorts of others in the zoloft/paxil ever expanding family but they were HORRIBLE for me. I have tried 4 of them and always get the same result. They give me unlivable side effects AND they don't solve my problem. But they are very popular it seems and if I recall correctly they have to do with seratonin production or uptake or something like that. (I don't google medical stuff, it makes me rather hypocondriacal.) But what exactly does Wellbutrin do? I would really like to know what particular piece of the brain chemistry puzzle *I* am getting filled by taking wellbutrin. I know people have used it to stop smoking and it is not a very common antidepressant, but it works for me and I'm good with that... would just like to understand my brain chemistry better, or at least what the meds I'm on are doing for it.

ETA - I don't think you get over bipolar or outgrow it... perhaps you were misdiagnosed?

Also - HOT, I'm sorry for your loss.
Wellbutrin does for dopamine what SSRI's like paxil, prozac, etc do for Seratonin.

You don't outgrow bipolar disorder.
 

MichelleCarmen

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Cehrabehra|1297005299|2844769 said:
I could say so much but I'd like to just ask a question... What someone said about how doctors don't explain the meds they give you (or ignore your warnings) rings true in more than ways relevant to this discussion, but I do have a specific question that I would like a generalized answer for... I am on wellbutrin for the 2nd time in my life. This time I've been on it for about 2 years and I really don't want to ever go off of it. My only side effect is always being thirsty and I feel really balanced on it. In the past, my last doctor really tried to get me on all sorts of others in the zoloft/paxil ever expanding family but they were HORRIBLE for me. I have tried 4 of them and always get the same result. They give me unlivable side effects AND they don't solve my problem. But they are very popular it seems and if I recall correctly they have to do with seratonin production or uptake or something like that. (I don't google medical stuff, it makes me rather hypocondriacal.) But what exactly does Wellbutrin do? I would really like to know what particular piece of the brain chemistry puzzle *I* am getting filled by taking wellbutrin. I know people have used it to stop smoking and it is not a very common antidepressant, but it works for me and I'm good with that... would just like to understand my brain chemistry better, or at least what the meds I'm on are doing for it.

ETA - I don't think you get over bipolar or outgrow it... perhaps you were misdiagnosed?

Also - HOT, I'm sorry for your loss.

Wellbutrin works well for many, but it's suppose to cause mania in many bipolar patients. Both of the people I know who take it have to take it in the morning otherwise they are up all night. Also, I've heard from the wives of both that if their husband misses a dose, they are very aggitated. I tried it for 1 week (taking in the AM) and didn't sleep AT ALL that entire week!

As Hawaiianorangetree mentioned stopping any medication abrubptly can result in the patient committing suicide. This happened with someone I knew.
 

Pandora II

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random_thought|1296970011|2844596 said:
I had bipolar depression as a teenager and was prescribed paxil. Throughout those years, I tried suicide a few times and thankfully it never worked. I was talking to my doctor about this because I had been having migraines during my pregnancy and the depression had also started to resurface. It was then that I discovered that they no longer prescribe paxil to teenagers as the hormones used in it actually caused the likelyhood of suicide to increase!! Who knew!! Anyways, back then my boyfriend at the time mentioned that the medication actually made me worse to be around so I quit taking the pills on my own and stuck only to counseling at school. Now that I'm pregnant I've been prescribed a different kind of anti-depressant. I feel a million times better than I did before I started taking it! I always thought negatively of anti-depressants because in my own experience...they didn't work. Now that they do work, I can't say enough positive things about them!! And also, my migraines have completely disappeared :)

I am very suprised you were diagnosed with bipolar disorder if you don't have a history of manic or hypomanic episodes. It would also be a very odd doctor (and frankly a very negligent doctor) who would prescribe anyone with bipolar disorder an antidepressant unless used alongside a moodstabiliser. It has the potential to send you manic/hypomanic and can initiate rapid cycling. Most people with Bipolar II have a lot more problems with depression (and long to be hypomanic on a permanent basis :naughty: ) but the first line of treatment is always a mood-stabiliser NOT and antidepressant.

Are you sure that it wasn't unipolar depression? Again, very suprised that you are currently taking an antidepressant with a prior diagnosis of BAD. The doctor would need to be very, very sure that you don't have it to do that IMHO.

Just out of interest, which antidepressants are you on? I've got a friend who is pregnant and having bad migraines and so can't take her triptans... this could be an avenue for her...

ETA: Bipolar disorder is not something you grow out of, it is a lifetime disability in the same way as Type I diabetes or epilepsy. The best you can hope for is to find a system of meds that provide you with as much stability and quality of life as possible with minimal side-effects.
 

somethingshiny

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My SIL is bipolar and has had severe issues in the past. She even got an abortion after trying for a baby because when she was off her meds she kind of lost her mind. Thankfully, she's on a set of meds that keep everything well under control. To my knowledge, she has always been prescribed a stabilizer prior to an antidepressant.

I have never contemplated suicide but am currently dealing with post-partum depression. Before my meds, it was miserable, heart-achingly unbearable. I thank God that meds are available to treat it and I look forward to the day when I'm back to normal.
 

MakingTheGrade

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Wellbutrin (Buproprion) increases your levels of dopamine and norepinephrine. I think if it works for you, then stick to it!
Also, bipolar is often over-diagnosed, but to be fair, it can be difficult to diagnose mania based on a history. I think most of us can recall times when we didn't sleep very much, spent more money shopping than was appropriate, felt like our mind was racing, or took risks that in hindsight were impulsive. So while most physicians can easily spot someone who is currently IN a manic episode, it can be a little tricky to diagnose if someone has ever had one in the past since you're really relying on what the patient is telling you and the questions can be a little vague and difficult to answer and interpret.
 

Haven

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I have never had thoughts of committing suicide myself, or even of wanting to be dead rather than alive. I feel very fortunate that I've never suffered from depression or even sadness extreme enough to want to be anything but very much alive. We don't have a history of depression or mental illness in my family, and for that I also feel very lucky.

That being said, I have thought about suicide intellectually, meaning after the suicides of a friend and of students over the years I've thought about how they could have possibly wanted to kill themselves, and all the other contemplations that come with dealing with such a loss. My friend had bipolar disorder, and survived several attempts on his own life before he was successful in killing himself. The students I knew who killed themselves all had a history of depression or bipolar disorder, as well, and as they were all teenagers, their deaths were extremely difficult to comprehend. I cared for my grandmother at the end of her life and she tried to commit suicide the night before my own wedding, a fact that was hidden from me by my uncle until after she died. She tried to kill herself on a few other occasions, and as we were extremely close these attempts were heartbreaking to me, to say the least. She was in horrible pain, and demoralized by her inability to care for her own body despite the fact that her mind remained sharp as ever.

I don't know to which category I belong, Crasru, probably the first--those who never had thoughts of suicide, because I never had thoughts of my own. Your 25% statistic really shocked me, I'll admit, and saddens me to learn.

Have you seen the documentary on Evan Scott Perry called A Boy Interrupted? It was terribly sad, but also enlightening, because prior to seeing that I would have found it impossible to believe a child could suffer from depression. As I said earlier, I have no experience with it myself, so my knowledge of it is extremely limited.

There was a recent article in the NYTimes magazine about childhood depression, as well, which you might also find interesting:
http://www.nytimes.com/2010/08/29/magazine/29preschool-t.html?scp=1&sq=childhood depression&st=cse
 

random_thought

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Pandora|1297019663|2844919 said:
random_thought|1296970011|2844596 said:
I had bipolar depression as a teenager and was prescribed paxil. Throughout those years, I tried suicide a few times and thankfully it never worked. I was talking to my doctor about this because I had been having migraines during my pregnancy and the depression had also started to resurface. It was then that I discovered that they no longer prescribe paxil to teenagers as the hormones used in it actually caused the likelyhood of suicide to increase!! Who knew!! Anyways, back then my boyfriend at the time mentioned that the medication actually made me worse to be around so I quit taking the pills on my own and stuck only to counseling at school. Now that I'm pregnant I've been prescribed a different kind of anti-depressant. I feel a million times better than I did before I started taking it! I always thought negatively of anti-depressants because in my own experience...they didn't work. Now that they do work, I can't say enough positive things about them!! And also, my migraines have completely disappeared :)

I am very suprised you were diagnosed with bipolar disorder if you don't have a history of manic or hypomanic episodes. It would also be a very odd doctor (and frankly a very negligent doctor) who would prescribe anyone with bipolar disorder an antidepressant unless used alongside a moodstabiliser. It has the potential to send you manic/hypomanic and can initiate rapid cycling. Most people with Bipolar II have a lot more problems with depression (and long to be hypomanic on a permanent basis :naughty: ) but the first line of treatment is always a mood-stabiliser NOT and antidepressant.

Are you sure that it wasn't unipolar depression? Again, very suprised that you are currently taking an antidepressant with a prior diagnosis of BAD. The doctor would need to be very, very sure that you don't have it to do that IMHO.

Just out of interest, which antidepressants are you on? I've got a friend who is pregnant and having bad migraines and so can't take her triptans... this could be an avenue for her...

ETA: Bipolar disorder is not something you grow out of, it is a lifetime disability in the same way as Type I diabetes or epilepsy. The best you can hope for is to find a system of meds that provide you with as much stability and quality of life as possible with minimal side-effects.

I actually was prescribed Amitriptyline first and foremost for the migraines and secondly for the depression. I almost wonder if I have seasonal depression compared to bi-polar but I do have severe mood swings regardless of what it is! The reason I think this is because I originally am from North Dakota. Once dh and I moved to Colorado where they have more sunlight, dh noticed a significant change in my personality (for the better). Honestly, I don't care what I have, I'm just thrilled I found something to take that leaves me feeling so much better! I know some people/doctors say not to take certain anti-depressants during pregnancy but I'm seeing a complications with pregnancy doctor so I trust what he has to say. For the most part, you should avoid them in the first trimester and once you are into the second it's safer to take them. I started in the middle of my second trimester and then they are going to try to reduce my dosage as my due date gets closer, soley because migraines are more common in the second trimester.
 

JulieN

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25%??? I would guess it to be much higher.
 

Pandora II

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MakingTheGrade|1297022727|2844964 said:
Wellbutrin (Buproprion) increases your levels of dopamine and norepinephrine. I think if it works for you, then stick to it!
Also, bipolar is often over-diagnosed, but to be fair, it can be difficult to diagnose mania based on a history. I think most of us can recall times when we didn't sleep very much, spent more money shopping than was appropriate, felt like our mind was racing, or took risks that in hindsight were impulsive. So while most physicians can easily spot someone who is currently IN a manic episode, it can be a little tricky to diagnose if someone has ever had one in the past since you're really relying on what the patient is telling you and the questions can be a little vague and difficult to answer and interpret.

Totally agree with that - it's why it's surely better to err on the safe side and go with a mood-stabiliser first if there is any suspicion of BAD or a history within the family.

It is also tricky to know the difference between very cheerful, extrovert, focused person with lots of good ideas and someone in a hypomanic phase. Most people who meet me when I am mildly hypomanic just think I'm an uber-positive person with tons of energy who talks quite a lot. I just thought it was great to not be depressed, to have loads of energy and such good ideas (and they are honestly good) - this was obviously what NORMAL really felt like, it would have taken very detail questioning from a doctor to make me mention any of the signs.

It took becoming very hypomanic to see it wasn't normal - and I was devastated to find that out especially as I had been desperately trying to find a way of being permanently that way. Being very hypomanic was a lot more scary - too many thoughts all crowding each other rather than just good ones, feeling really jittery all the time, finding it very hard to be with other people who were so slow and couldn't follow what my ideas were.... fortunately I never had major spending spree issues nor did I take a lot of risks with my health.

RT - My sister has taken prozac throughout both her last two pregnancies and while breast-feeding and couldn't really do without it, my other sister was pregnant on lithium and venlafaxine - and is breast-feeding on both, and I took all my meds while I was pregnant so I am definitely not anti taking meds when pregnant etc. I was just really shocked that you would be prescribed anti-depressants as a first line treatment if you had a past history of bipolar disorder as it is such a dangerous thing to do. Every episode you have increases the likelyhood of a subsequent episode (the 'kindling' effect) so it's not a good idea to take risks, especially as episodes of depression/mania/hypomania during pregnancy can significantly increase your risk for PPD and PPP.

If you haven't discussed the past diagnosis with your HCP then you would be well to do so as amitriptyline is notorious for sparking manic episodes and isn't licensed for treating bipolar depression. It is great for migraine though! If you have and your HCP has still prescribed it, I find it a strange choice but presume that there are reasons for that choice.

I had lots of 'fun' with amitriptyline which I was prescribed for nerve pain in my spine - during one of the numerous phases where I had decided that THEY were wrong and I didn't have manic depression and I was seeing a doctor who didn't have access to my medical history as it was in another country. I was mildly depressed at the time and living with my parents due to being very unwell (physically not mentally).

Within 5 days I was high as a kite, had put into action plans to start my own business (brand-new idea that week) including fixing appointments with banks, built a complete website from scratch and given up sleep... the following week I met my now husband... the week after that my parents clicked that things were not quite as they should be! I'm very good at being convincing that I'm not getting manic, I'm just having good ideas... and like shopping! :naughty: Heck, I nearly bought a house in a week once till my husband worked out what was going on... :rolleyes:

They took all the amitriptyline away and then I crashed badly for about 3 months... not so fun... :nono:

Sounds like you could well have something like SAD. Have you looked into light therapy? I've heard a lot of people do well with that.
 

JewelFreak

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I guess there are degrees of manic-ness but having known 4 people with the problem, I have a hard time seeing how you can confuse it with a normal-but-energetic range of moods. During manic periods my friends did waaay out-there things, quitting jobs & moving to Mexico w/no means of support, buying or totally renovating houses they couldn't come close to affording; my brother's f-i-l compulsively built fires in the fireplace all night long, adding & adding & adding wood till only his wife's interference kept the house from burning down. Lots more, but it's far more extreme than the occasional run of impulsive purchases or difficulty sleeping. Pandora's 100% right about mood stabilizers first. And -- suddenly discontinuing psychotropic meds is very dangerous physically as well as mentally. NEVER do it w/out help from a dr!

When an adult commits suicide my first emotion is enormous pity & sorrow. I know how it is to want the pain to end, any way you can manage it. Death offers rescue; you won't hurt anymore. It's impossible to describe the anguish of severe clinical depression to anyone who hasn't had it -- like telling a blind person what the color green looks like. An article I read reported a survey of depressed patients -- each one depicted symptoms or feelings differently, but all of them, in the process, used the word "pain." It's psychic pain but as agonizing & real as physical. Depression runs in my family & I had it from childhood until I was diagnosed at about 28. When I passed cemeteries, I actually envied the people there -- it was over for them, what a gift that seemed. I took tri-cyclics for a while but SSRIs really gave me my self back. Our chemistry is individual -- some work for some folks, not for others.

Suicide is often done for selfish reasons & the hurt that engenders usually influences generations. Sometimes, though, it's the only remedy someone can find. Enormously tragic.

--- Laurie
 

Arkteia

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First of all - my condolences to those of you who have lost their relatives or close people to suicide. This scar stays forever...
Since bipolar disorder has been mentioned here, I decided to comment on it. My comments are mostly about bipolar II disorder. I can subscribe to 90% of what Pandora has said, but wanted to mention that not all cases of hypomania are classic, exuberant and happy. Also, some cases of unipolar depression are undiagnosed bipolars. Likely, there are small "blips" of hypomania that are either unnoticed or seen as "normalization" of mood after a period of depression. Some people with bipolar II are "either sad or mad", anger being another version of hypomania (high-energy state). Such people will tell you that sometimes they feel very happy, but it is so rare that they barely notice or enjoy it. They probably cycle very fast and come across as "having anger issues". Many of them drink to self-medicate.
Then there is "mixed mood", a curious state when a person looks and behaves hypomanic but feels depressed. Probably the mood is cycling so fast that the person notices the "lows" (they feel worse) but appears "high" to others. Old term "agitated depression" likely described another form of mixed state.
Everyone cycles, to a degree. Try saying, "Gosh, autumn is really my bad time of the year, but the sun makes me so happy". How many of us would respond? Bipolar people just cycle more intensely, are very emotional and have more nervous energy. It is an extreme of cycling. And yes, they are smart, fast-thinking, can easily multitask, are type A, leaders, motivated and motivating. I simply do not believe that any artistic talent can exist without a certain degree of bipolarity. One has to go through periods of inspiration, sleepless, creative nights... Unfortunately, each "high" is followed by "a low". "Lows" often last longer. Pure depression is probably less risky for suicide, there are ample thoughts but no energy to get out of bed. As Pandora has mentioned, with rapid change to hypomania, comes energy and impulsivity, but the mood still lags behind. That is why monotherapy with antidepressants may be dangerous. Or it, can cause rapid cycling. More typical scenario, antidepressant works for a while, then stops working, then another is tried, same pattern... When patient finally comes to us, it is harder to treat the illness. And if in the meantime the patient also developed a habit of self-medicating with drinking and drugs... you know.
Re. antidepressants. The book "talking to Prozac" was followed by an avalanche of prescriptions. During my residency we had "depression screening days", everyone could fill in anonymous questionnaire on a computer, some would screen positive, and we'd give them our clinic number. Many would come, get on Celexa, and feel better. God knows how many of them eventually ended up hypomanic or suicidal because of our teachers' enthusiasm. But who, at that time, was aware of manic switch caused by antidepressants? They were miracle drugs! The first warning (Paxil) came out in 2003 I think...
The biggest obstacle in treatment of bipolar disorder is stigma. Pandora, maybe there is less stigma about bipolar disorder in England. In the US, it is still a stigmatizing illness, the diagnosis implying more problems with getting own insurance, a firm "no" when applying for some jobs, possible loss of a child in a custody battle, and other sad consequences. All of it discourages people to seek treatment and, sadly, may end up in higher suicide rates. Luckily, Abilify got an indication for treatment of depression, and it is a good mood stabilizer. So patients are less apt to mind taking a "mood stabilizing antidepressant". Like many of our medications, it causes weight gain, and it is another reason for noncompliance, and a huge one.
Oprah is listened to. I do not watch her, but from conversations with patients, I see that she has done more to destigmatize mental illness than anyone else. I'd give her huge credit for it.
Bipolar diagnosis has become a stigma among teenagers. "What are you, bipolar?", if anyone behaves too happily or is too giddy. And this is a group with 2nd highest suicide rate! Unfortunately, our medical community is so divided on the diagnosis of bipolar disorder; it surely does not help at all. I also hate it when PCPs start teenagers on antidepressants or Xanax before they refer them to us.
Sorry can not stop... Re. taking mood stabilizers or antidepressants during pregnancy. Our approach is, potential risk of depression and suicide during pregnancy or postpartum over-weighs the risks of any medications. One can not compare these things.
 

JewelFreak

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Interesting stuff, Crasru. I only disagree about unipolar depression being less dangerous. Believe me, "no energy to get out of bed" doesn't describe it. There's a point where you absolutely cannot stand the pain any longer & death seems the only cure. I've been there. Anti-depressants literally saved my life.

Re fast cycling -- my grandfather was never diagnosed, but a psychiatrist told me after I described him that he sounded textbook manic. I commented that if he ever was depressed, it was for 10 seconds while he was sound asleep & the dr. said, "That's possible." He probably cycled through low stages very very quickly. Brilliant difficult crackpot of a guy.

--- Laurie
 

Pandora II

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crasru|1297068039|2845437 said:
First of all - my condolences to those of you who have lost their relatives or close people to suicide. This scar stays forever...
Since bipolar disorder has been mentioned here, I decided to comment on it. My comments are mostly about bipolar II disorder. I can subscribe to 90% of what Pandora has said, but wanted to mention that not all cases of hypomania are classic, exuberant and happy. Also, some cases of unipolar depression are undiagnosed bipolars. Likely, there are small "blips" of hypomania that are either unnoticed or seen as "normalization" of mood after a period of depression. Some people with bipolar II are "either sad or mad", anger being another version of hypomania (high-energy state). Such people will tell you that sometimes they feel very happy, but it is so rare that they barely notice or enjoy it. They probably cycle very fast and come across as "having anger issues". Many of them drink to self-medicate.
Then there is "mixed mood", a curious state when a person looks and behaves hypomanic but feels depressed. Probably the mood is cycling so fast that the person notices the "lows" (they feel worse) but appears "high" to others. Old term "agitated depression" likely described another form of mixed state.
Everyone cycles, to a degree. Try saying, "Gosh, autumn is really my bad time of the year, but the sun makes me so happy". How many of us would respond? Bipolar people just cycle more intensely, are very emotional and have more nervous energy. It is an extreme of cycling. And yes, they are smart, fast-thinking, can easily multitask, are type A, leaders, motivated and motivating. I simply do not believe that any artistic talent can exist without a certain degree of bipolarity. One has to go through periods of inspiration, sleepless, creative nights... Unfortunately, each "high" is followed by "a low". "Lows" often last longer. Pure depression is probably less risky for suicide, there are ample thoughts but no energy to get out of bed. As Pandora has mentioned, with rapid change to hypomania, comes energy and impulsivity, but the mood still lags behind. That is why monotherapy with antidepressants may be dangerous. Or it, can cause rapid cycling. More typical scenario, antidepressant works for a while, then stops working, then another is tried, same pattern... When patient finally comes to us, it is harder to treat the illness. And if in the meantime the patient also developed a habit of self-medicating with drinking and drugs... you know.
Re. antidepressants. The book "talking to Prozac" was followed by an avalanche of prescriptions. During my residency we had "depression screening days", everyone could fill in anonymous questionnaire on a computer, some would screen positive, and we'd give them our clinic number. Many would come, get on Celexa, and feel better. God knows how many of them eventually ended up hypomanic or suicidal because of our teachers' enthusiasm. But who, at that time, was aware of manic switch caused by antidepressants? They were miracle drugs! The first warning (Paxil) came out in 2003 I think...
The biggest obstacle in treatment of bipolar disorder is stigma. Pandora, maybe there is less stigma about bipolar disorder in England. In the US, it is still a stigmatizing illness, the diagnosis implying more problems with getting own insurance, a firm "no" when applying for some jobs, possible loss of a child in a custody battle, and other sad consequences. All of it discourages people to seek treatment and, sadly, may end up in higher suicide rates. Luckily, Abilify got an indication for treatment of depression, and it is a good mood stabilizer. So patients are less apt to mind taking a "mood stabilizing antidepressant". Like many of our medications, it causes weight gain, and it is another reason for noncompliance, and a huge one.
Oprah is listened to. I do not watch her, but from conversations with patients, I see that she has done more to destigmatize mental illness than anyone else. I'd give her huge credit for it.
Bipolar diagnosis has become a stigma among teenagers. "What are you, bipolar?", if anyone behaves too happily or is too giddy. And this is a group with 2nd highest suicide rate! Unfortunately, our medical community is so divided on the diagnosis of bipolar disorder; it surely does not help at all. I also hate it when PCPs start teenagers on antidepressants or Xanax before they refer them to us.
Sorry can not stop... Re. taking mood stabilizers or antidepressants during pregnancy. Our approach is, potential risk of depression and suicide during pregnancy or postpartum over-weighs the risks of any medications. One can not compare these things.

Great post!

There's still a lot of stigma in the UK. I felt/feel that it is helpful if some people who are in the public arena are prepared to show that mental illness doesn't mean you look a certain way or that you can't have a meaningful successful life, so I have always been quite open with people about it. The only time I'm nervous is when applying for jobs - less so now that I feel I can potentially be stable enough to function on a long-term basis.

Re. Mixed episodes, I have been fortunate enough to only have one of these and it was the most frightening week of my life. If it hadn't been for my husband and GP I don't know what I might have done - I don't mean suicide, but I was way out of control. In the end my GP told me that I had a choice: 3 weeks of work starting there and then or being sectioned. He stood there while I called my employer to make sure I did!

Funnily enough I have a degree in design and I always paint and design so much better when I am hypomanic - I also tend to write a lot. During depressive episodes I can't bring myself to do it as it depresses me even more thinking how dreadful my work is... sadly I have cupboards full of half-finished projects where I got depressed half-way through and couldn't complete them. :blackeye:
 

MichelleCarmen

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Pandora|1297100171|2845654 said:
Re. Mixed episodes, I have been fortunate enough to only have one of these and it was the most frightening week of my life. If it hadn't been for my husband and GP I don't know what I might have done - I don't mean suicide, but I was way out of control. In the end my GP told me that I had a choice: 3 weeks of work starting there and then or being sectioned. He stood there while I called my employer to make sure I did!

Funnily enough I have a degree in design and I always paint and design so much better when I am hypomanic - I also tend to write a lot. During depressive episodes I can't bring myself to do it as it depresses me even more thinking how dreadful my work is... sadly I have cupboards full of half-finished projects where I got depressed half-way through and couldn't complete them. :blackeye:

Pandora - have you tried light-box therapy or cognitative behavioral therapy? Just curious. I'm also on Lamictal (have been for 8ish years) - now on the generic Lamotrigine - at 250 mg per day and have found over the last few years, it's pretty much quit working for the depressive episodes. The only other anti-depressant I've tried was Wellbutrin which made me bounce off the walls! Not sure what to do now...I read that w/drawals from Lamictal can be nasty and the person I knew who committed suicide had gone off that right before she took her life.
 

Pandora II

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MC|1297101854|2845670 said:
Pandora|1297100171|2845654 said:
Re. Mixed episodes, I have been fortunate enough to only have one of these and it was the most frightening week of my life. If it hadn't been for my husband and GP I don't know what I might have done - I don't mean suicide, but I was way out of control. In the end my GP told me that I had a choice: 3 weeks of work starting there and then or being sectioned. He stood there while I called my employer to make sure I did!

Funnily enough I have a degree in design and I always paint and design so much better when I am hypomanic - I also tend to write a lot. During depressive episodes I can't bring myself to do it as it depresses me even more thinking how dreadful my work is... sadly I have cupboards full of half-finished projects where I got depressed half-way through and couldn't complete them. :blackeye:

Pandora - have you tried light-box therapy or cognitative behavioral therapy? Just curious. I'm also on Lamictal (have been for 8ish years) - now on the generic Lamotrigine - at 250 mg per day and have found over the last few years, it's pretty much quit working for the depressive episodes. The only other anti-depressant I've tried was Wellbutrin which made me bounce off the walls! Not sure what to do now...I read that w/drawals from Lamictal can be nasty and the person I knew who committed suicide had gone off that right before she took her life.

MC, tried both and neither helped, CBT was useless as I know my triggers and early signs, but I can't actually prevent episodes except with meds. I have to have Lamictal as I don't get on with the generic for some reason.

I take 125mg and it keeps me 5% above baseline and pretty stable although I can still get a little hypomanic if I'm not careful to watch my triggers but it slows it down so I don't switch abruptly like I used to. The only major depressive episode I've had in 3 years was when I got pregnant and they majorly cut my dose. It also needed tweaking up and down when I was doing badly PP. I've never tried coming right off Lamictal and have no intention of ever doing so, so can't comment on withdrawal - didn't have any problems reducing.
 

MakingTheGrade

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JewelFreak|1297083294|2845477 said:
Interesting stuff, Crasru. I only disagree about unipolar depression being less dangerous. Believe me, "no energy to get out of bed" doesn't describe it. There's a point where you absolutely cannot stand the pain any longer & death seems the only cure. I've been there. Anti-depressants literally saved my life.
--- Laurie

I think Crasu isn't saying that unipolar depression isn't dangerous, but I believe there have been studies showing that episodes of mania result in more self-harm proportionally speaking than do episodes of depression. I think part of that is in manic episodes, some people
feel grandiose and like they are divine or cannot be harmed, which lead them to do things that get them hurt. And of course, mixed episodes are very dangerous and frightening to almost everyone.

Crasu, are you a psychiatrist here in the US? I'm hoping to be joining those ranks in another year or so. :wavey:
Speaking to your point of artists and bipolar disorder, have you ever read the book "Touched with Fire"?

http://www.amazon.com/Touched-Fire-Manic-Depressive-Artistic-Temperament/dp/068483183X

There was also a recent article in Scientific American Mind that talked about a study that looked at the Dopa chemistry in the brains of creative artists, and those with schizophrenia, which found some marked similarities. I believe the phrase they used was "Perhaps the reason you think so well outside the box, is that your box is a little broken to begin with." I've always found the discussions about creativity and psychiatry interesting. Being creative is about stretching or breaking norms and expectations, and much of psychiatry is defined in a similar manner, so it's easy to wonder if there is a connection there.

And speaking of stigma, I spend half my life in China, and psychiatry is practically an unrecognized field there. Mental illness isn't recognized, things like depression or anxiety disorders are just considered a character flaws and being too weak of will. :angryfire:
 

Arkteia

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Yes, I am a psychiatrist, and also a child psychiatrist, and live in the US. :wavey:
Recently I started treating addictions, although it is probably the least grateful area of psychiatry. Many of my colleagues do not want to do with addicts, and I sometimes want to pull myself out of this field, but stay, because several of my patients have already quit using.
Yes, I have read the book, and it is very interesting, although I believe that "an unquiet mind" is still the best of her books. As to talent and bipolarity, I haven't seen a single artist without a touch of mania.
 

Pandora II

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crasru|1297232296|2847413 said:
Yes, I am a psychiatrist, and also a child psychiatrist, and live in the US. :wavey:
Recently I started treating addictions, although it is probably the least grateful area of psychiatry. Many of my colleagues do not want to do with addicts, and I sometimes want to pull myself out of this field, but stay, because several of my patients have already quit using.
Yes, I have read the book, and it is very interesting, although I believe that "an unquiet mind" is still the best of her books. As to talent and bipolarity, I haven't seen a single artist without a touch of mania.

Still laugh at the penguin book 'colony' in Unquiet Mind - definitely the best, wasn't a fan of Touched by Fire.
 

MakingTheGrade

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crasru|1297232296|2847413 said:
Yes, I am a psychiatrist, and also a child psychiatrist, and live in the US. :wavey:
Recently I started treating addictions, although it is probably the least grateful area of psychiatry. Many of my colleagues do not want to do with addicts, and I sometimes want to pull myself out of this field, but stay, because several of my patients have already quit using.
Yes, I have read the book, and it is very interesting, although I believe that "an unquiet mind" is still the best of her books. As to talent and bipolarity, I haven't seen a single artist without a touch of mania.

Neato Crasu! What city if you don't mind my asking?
I'm doing an elective in Child Psychiatry in April to see what it's like and if it's a tract I might want to pursue in residency.
 

SapphireLover

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Interesting debate. I do think there is still a stigma about mental illness in the UK, however bipolar disorder is almost the more acceptable of mental illnesses. I have worked in acute mental health for 10 years, and have seen quite a handful of people who have been diagnosed with schizophrenia be unhappy with their diagnosis and paid for second opinions in order to get it changed to bipolar disorder. Every single person has been from an affluent middle class background, and have had concerns about the stigmatising diagnosis of schizophrenia and have viewed bipolar disorder as being more acceptable amongst their peers. Its almost like a Stephen Fry effect.

Pandora- its wonderful to hear that you are stable now on lamotrigine. Its such an infrequently prescribed drug these days, and there is such a dependency on valproate at the moment. My BFF swears by lithium, and I have never seen her so stable ( and I haven't had to drive round at 3am in the streets in the rain to find her when she is manic!)

As for me, yes I have thought of suicide. When I was a teenager I tried taking a slow overdose of paracetamol (spread over several days), however I didn't take enough. Thank G-d we didn't have the internet as I would actually have been able to research how much to take to get it to work. I also used to self harm, which is probably the reason why I ended up working in mental health. I
 

Pandora II

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SapphireLover|1297263530|2847561 said:
Interesting debate. I do think there is still a stigma about mental illness in the UK, however bipolar disorder is almost the more acceptable of mental illnesses. I have worked in acute mental health for 10 years, and have seen quite a handful of people who have been diagnosed with schizophrenia be unhappy with their diagnosis and paid for second opinions in order to get it changed to bipolar disorder. Every single person has been from an affluent middle class background, and have had concerns about the stigmatising diagnosis of schizophrenia and have viewed bipolar disorder as being more acceptable amongst their peers. Its almost like a Stephen Fry effect.

Pandora- its wonderful to hear that you are stable now on lamotrigine. Its such an infrequently prescribed drug these days, and there is such a dependency on valproate at the moment. My BFF swears by lithium, and I have never seen her so stable ( and I haven't had to drive round at 3am in the streets in the rain to find her when she is manic!)

As for me, yes I have thought of suicide. When I was a teenager I tried taking a slow overdose of paracetamol (spread over several days), however I didn't take enough. Thank G-d we didn't have the internet as I would actually have been able to research how much to take to get it to work. I also used to self harm, which is probably the reason why I ended up working in mental health. I

I only have Lamotrigine because I specifically told my current psychiatrist that I wanted to try it. He was a little dubious and said it wouldn't have been his first choice but agreed and has been impressed. I did a lot of research beforehand and opted to titrate up on a more American schedule rather than the UK one - I went up in 12.5mg increments with a fortnight for each increase and didn't have any issues. My sister also tried lamotrigine but they upped her dose by 25mg every week and she got a rash and so had to come off it permanently. I'm told the slower increase hugely reduces the incidence of side-effects.

I did reduce to 25mg for the first 14 weeks of my pregnancy - and ended up with a 5 month long severe antenatal depressive episode - and then titrated up to 150mg by the end. I was advised not to breastfeed, but I did loads of research especially with the Epileptic Society and found loads of women who breastfed on doses that were 2 or 3 times what I am on. I'm still breast-feeding now 20 months PP. In the end the hospital said that they couldn't officially condone my decision but off the record thought it was a good plan as I'd get more sleep - lack of sleep is a massive trigger for hypomania for me.

I know another girl who goes to my 'nutters and babies' group (a playgroup for mothers with serious mental illness - where we are all terribly middle-class, all have at least one degree and are much saner than the people running it :bigsmile: ) who is also on Lamictal. She's had a very bad mixed episode in January and spent 2 weeks in the psych unit, we were talking meds last week and she was also only on lamotrigine but only 50mg - I suggested getting them to up the dose and they've now done that so I hope she's feeling a bit better when I see her next week. One of the reasons I wanted it is because of its possible effects on nerve-pain - I was one of the 20% for who it was effective so it also really helps with the neurological pain I have in my spine and legs. I do have to majorly watch my weight with it as I find its a huge appetite suppressant.

Talking of stigma, I utterly refuse to take lithium. I know that sound stupid, but I'll never forget telling my mother about a friend who took lithium and her saying that I should be very careful as people who took lithium were very dangerous... and this from a woman who had worked extensively in psychiatric units! I just can't get past it and even though I'm so open about being manic depressive I wouldn't be able to tell people I take lamotrigine, ridiculous isn't it.

Would also agree that bipolar has a much better profile than schizophrenia. I think that is probably because most murders in the papers carried out by people being actively treated for a MHC seem to be schizophrenic rather than bipolar and so that is what the general public are exposed to. Perhaps Eastenders has also had a positive effect?

I'm very glad for your sake that the paracetamol didn't work - such a terrible way to go. I do remember my psychiatrist asking me if I felt safe with 3 months worth of lamotrigine in the house - I told him that unless it gave me Steven-Johnsons it wasn't actually a good choice for overdose as it appears to be pretty safe, and anyway I had enormous quantities of amitriptyline and codeine in the house - the former of which would be a much better choice and hadn't felt the need to eat them all over the previous year...
 
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