I Don't Understand

Nine days ago I was put on Lithium extended release, for the first seven days I took 300mgs at bedtime with guanfacine; on day eight I went up to 600mgs. I was also prescribed quetiapine as needed for insomnia/panic attacks, I've taken it twice because I've been more agitated lately and that is not something I'm used to. For the first two days I was also coming off of Wellbutrin.

I know that's a lot.

I was on the psych waiting list for four and a half months, eventually I went to a PCP to see about the ADHD and Depression symptoms because I decided I wanted to try and be happy again. The last time I saw a psychiatrist I was 16 and was diagnosed with PTSD, Severe Depression with Mixed Symptoms, and Generalized Anxiety Disorder. Bipolar was mentioned but my dad (who us Bipolar) argued with the psychiatrist so the psychiatrist dropped the discussion.

They put me on Trazodone, Zoloft, and Lamotrigine (I'm not sure on this one because my memories aren't great), and possibly something else. None of it worked and the Trazodone in particular (maybe combined with the Zoloft) caused what I now recognize as mania that was mostly rage but other aspects as well.

The recent PCP put me on Wellbutrin off label, she said "Well if it's Bipolar or ADHD we'll know pretty quickly." It's only took eleven days for full blown mania to set in. I was swerving at people on the highway, bursting into random rage like I have never experienced before while singing songs, recording videos talking to myself, not sleeping for days, I downloaded a dating app- sent nudes to a random man after texting him for 20 minutes- got in the car of another after two hours of talking and let him drive me 50 minutes away while he knew my phone was dead, I kept thinking everything was fine because either it was a game or it wasn't real and that I was untouchable anyway and could fight anyone off, there's so much more, I almost cussed out my higher up, etc.

Then the dip came. I did a really bad thing that I hadn't done in many years. I was talking to myself, trying to talk myself into something worse, I was paranoid.

Now I'm on Lithium. The first couple of days it felt like it worked immediately, I felt more present, I had an hour of energy a day to try and clean my apartment. But after that it's stagnant.

I can say that I think I feel a little more present and am dissociating less, I feel a little less depressed I'm just voicing my desire to [do the bad thing] more for some reason, self harm thoughts are less, bad eating habits are more, agitation is more, I feel like my energy is the same because I didn't have much before either, wanting to isolate is more, feeling physically disgusting is a lot more.

Here are notes I've taken recently:

• I'm 7 days in, a decent amount of suicide noise has been dampened. Still get those thoughts maybe once every two days, still have the thoughts about hurting myself everyday though. Don't feel happy or good but feel more grounded and down to earth. Feel like things also look and feel more real/substantial. For the past couple of days though I have been experiencing anger. This is anger that has been building over the past couple of weeks. I've screamed at a YouTube video at the top of my lungs because someone kept eating/drinking during the video, I've thought about kicking one of my cats (intrusive but easily ignored), I have put that same cat in the pantry because he was being annoying while trying yo feed him> knocked my ear quite painfully when he went to rush out> closed the door then kicked the shit out of it and scared the cat inside, got extremely angry at someone trying to offer me support, more outbursts in general.

• I took quetiapine twice. Half on day six, the day I was experiencing severe, unusual anger.

• A quarter pill on day 7 because I was experiencing a dip in mood and more anger that I worried would get worse.

• Day 7 feeling really depressed and anxious, want to die. Pretty similar to normal.

• Day 8, really constipated- falling back into disordered eating habits. Still feeling really irritated, tossed a box at my cat that did not hit him, really annoyed and disgusted with guy I'm sort of dating, annoyed with coworker over explaining something.

• Day 8 been feeling tired when trying to work again, which is a big thing with the ADHD. Have many things I want/need to do but no energy. Energy I had for the past couple of days is gone.

• Day 8 feeling depressed still, though a bit more consolidated towards the afternoons and evenings.

• Exhausted at 8pm. Don't even have energy for yoga.

• Still don't have a desire to do anything. I used to like to read but have been doom scrolling and keeping things in my ears 24/7 again which helps with thoughts and ADHD focus and staying awake through boring tasks but not enjoying anything I'm recommended.

• Same pit of despair in my chest but with no thoughts to rationalize it

I don't understand if it's working or not? Is it meant to be like this? Is this a normal experience on this drug? The only reason I haven't emailed my psychiatrist is because my friend who was on it when they were a teenager but didn't need it said it's just my brain getting accustomed to it but they were on like 100mgs at most so I'm starting to question things...