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This is Reagan's mom. Reagan is manic right now and can't post. We're in the process of going to our 3rd facility tomorrow so are trying to be better advocates for her success. Reagan is a sophomore in college and a server at a restaurant. She has always been high functioning (was the drum major at her HS and on the dean's list in college) with no history of anxiety, depression or drug use. In 2020, she said she would take 1/4th of an edible with her roommates about 1x a month when they were partying, then when she and her boyfriend broke up in December, that changed to 1x a week. She would sometimes drink with her roommates but was very busy and did not have a lot of time to party. Only 1x did she consume "most" of a bottle of wine in one setting. We did a drug test and are a close family and I'm pretty sure this is all accurate. In January, she went to her OBGYN who prescribed her Lexipro (5mg) for anxiety. Reagan said it made her feel depressed so her school psychiatrist prescribed her 50 mg of Zoloft in Feb. and told her to discontinue the lexipro. When Reagan started the Zoloft, she immediately could not sleep and did not sleep for 7 days. We admitted her to an ER Feb. 15th (due to a snowstorm everything else was closed.) She was demonstrating racing thoughts and not making sense. The first hospital held her for 16 days (Green Oaks - Medical City - Dallas) . She was only released because we were not seeing improvement and wanted to take her for a gene test and to a neurologist. Her diagnosis was bipolar 1. The first hospital prescribed her: 150 MG Trazadone (bedtime as needed) 20 MG Propranolol 2x a day, as needed for heart 80 MG Latuda 1x day/dinner 300 MG Lithium 3x/day Once home, we quickly realized she was not near ready to come home so we admitted her into a facility closer to home. We went to Mesa Springs in Fort Worth, TX. Lorazepam - 1 MG 3x day Quetiapine - 50 MG 2x day Quetiapine - 300 mg - bedtime Divalproex 250 mg - 1 - morning and 500 mg/night Mirtazapine 15 MG/bedtime She was released after 10 days to start outpatient care. The first couple days she did ok but has been deteriorating and having racing thoughts again. She doesn't make sense. The LIFT driver that took her home from outpatient today dropped her off away from the house because Reagan didn't want them to know our address. She's obsessed with brushing her teeth (20x a day) and drinking filtered water (she talks about her water consistently.) She is making a lot of lists and post it notes and worrying about everyone in the world all the time. Outpatient called today and recommended other places because she requires more care than they can provide. We also saw a neurologist today who was concerned and ordered an MRI and something where she doesn't sleep for 14 hours and they monitor her brain activity. I'm at a point where I'm not convinced this is bipolar at all and am tempted to stop the meds cold turkey. We see another psychiatrist on Thursday and are going to order the genetic test to see if that helps. Her brain is not making sense of things. She will have a thought and then try to connect it to sentences. Sometimes she thinks she is a doctor or a nurse. Then sometimes she is completely fine. Any advice you have is appreciated.

I believe I’m experiencing rapid cycling. Manic episodes alternated by depressive episodes. I’m thinking it is caused by the fairly high (for me) dose of Effexor. I'm on 112.5mg. One moment I will be very restless and terribly anxious and within a few hours, I am deeply depressed. (It can take longer; it can take up to a day for the depression to come back.)I’ve had an antidepressant (Paxil) induced episode 21 years ago. The psychiatrist put me on mood stabilizers, and I stayed on them for the next twenty years. I went off Lithium about a year ago, with the help of a psychiatrist and naturopath. I tried to go off Effexor, started mid 2018, but didn’t know about this group yet and I went off too fast and ended up in Psychiatry in April/May 2019. I reinstated after that, but I haven’t stabilized yet. It’s been a tough road. Now what do I do? My dose of Effexor is too high, it is maybe the cause of me going manic. But it’s not advisable to withdraw when one isn’t stable yet. I’m not sure what is best. Do I stay on my current dose or withdraw? I sure hope I won’t go into a full blown manic state! I prefer not to go back on Lithium though.

Okay, this is weird... I have been having a lessening of symptoms over the past week, going from bad days with maybe some good moments to good days with some bad moments - but every day having at least some sort of background/low-level anxiety. Now today I woke up with pretty much zero anxiety and it never really even came up to the background level. But suddenly, in the past half-hour, I have begun to feel manic/hyper. Not off the hook, but in the background. Is it possible that my brain somehow overshot the mark today? Or is this just a different kind of anxiety I am feeling. To answer some obvious questions: no, I did not have any caffeine, yes my routine was the same today as it has been for the past week, except for 2 things: 1) I did go up from 250mg of Vitamin C in the morning to 250mg in the morning and 250mg in the afternoon a few days ago (so I have not had my second dose today. All other supplements have remained the same. 2) I went for a bit of a longer walk today (which was about 10 minutes before I noticed the manic/hyper). Could that have over-energized me? Does anybody have any experience with this sort of thing, this seeming overshooting the mark? SJ