Lamictal and elevated biliruben

In trying to wrap my head around the results of the blood and urine test of my 12+ year old cat. The vet has said she's CKD stage two and should now go on a strict renal diet. I don't know how well she's going to go with that and also she's tiny (2.5kg) so I'm quiet worried about the protein restriction that's going to bring.
I'm trying to learn about it as fast as I can and in reading I saw that sometimes it's not enough that creatine levels are high and that the first urine test can be non conclusive for a full diagnosis. My vets been so helpful talking me through the results but I've already bombarded her with questions so was hoping people here could help me.
Her urinalysis results: Laboratory: Type: Test: Results: Leuk- 3+ Nitrate- 5 Protein- 1+ Glucose- norm Ketones- neg Urobilinogen- norm Biliruben- neg Blood- 4+ SG- 1.018 Gross appearance - pale yellow, floating debris - appears to be fabric/lint Sediment: Wet prep - no crystals, no cells, lots of debris Stained slide - no bacteria, no blood cells.
Her bloods: Glucose a 1.9 3.2 - 7.5 mmol/L L IDEXX SDMA b 18 0 - 14 µg/dL H Creatinine 220 80 - 200 µmol/L H Urea 16.8 5.0 - 15.0 mmol/L H Phosphorus 1.8 1.0 - 2.3 mmol/L Calcium 2.7 2.1 - 2.8 mmol/L Sodium 156 144 - 158 mmol/L Potassium 5.2 3.7 - 5.4 mmol/L Calcium: Phosphorus Ratio 1.5 1.1 - 2.3 Na: K Ratio 30.0 29.0 - 40.0 Chloride 119 106 - 123 mmol/L Bicarbonate 14 12 - 24 mmol/L Anion Gap 28.2 15.0 - 31.0 mmol/L Total Protein 76 60 - 84 g/L Albumin 35 25 - 38 g/L Globulin 41 31 - 52 g/L Albumin: Globulin Ratio 0.9 0.5 - 1.1 ALT 88 19 - 100 U/L AST 60 2 - 62 U/L ALP 28 5 - 50 U/L GGT 0 0 - 5 U/L Bilirubin - Total 1 0 - 7 µmol/L Cholesterol 7.1 2.2 - 5.5 mmol/L H Creatine Kinase 468 64 - 400 U/L H Haemolysis Moderate haemolysis Index c Lipaemia Index Nil lipaemia
RBC 9.9 4.9 - 10.0 x10^12/L Haematocrit 0.46 0.25 - 0.48 L/L Haemoglobin 130 77 - 156 g/L MCV 46 43 - 55 fL MCH 13 13 - 17 pg MCHC 283 282 - 333 g/L % Reticulocytes 0.1 0.0 - 0.4 % Reticulocytes 10 3 - 50 K/µL Reticulocyte Haemoglobin 13.7 13.2 - 20.8 pg WBC 8.2 5.5 - 19.0 x10^9/L % Neutrophils 59.7 % % Lymphocytes 31.1 % % Monocytes 4.1 % % Eosinophils 5.0 % % Basophils 0.1 % Neutrophils 4.9 2.0 - 13.0 x10^9/L Lymphocytes 2.6 0.9 - 7.0 x10^9/L Monocytes 0.3 0.0 - 0.6 x10^9/L Eosinophils 0.4 0.0 - 1.0 x10^9/L Basophils 0.0 0.0 - 0.1 x10^9/L Platelets 302 300 - 800 x10^9/L
(The vet said her glucose results can be dismissed as it was due to too little blood being in the vial during the test.)
Can someone tell me also how to simplify the values when I'm describing it in future for Reddit questions. What would I say her uspg number is, her creatine, SDMA and BUN is described in the way people here are using please?
I've got other questions I'd like to ask about her treatment plan, such as if there are things to try before going fully in to the science diets because I know how much that is going to change her life upside down and I'm a bit worried about some of the things I've read about using them when in the early stages due to the possible reduction in protein doing damage to the kidneys. If it seems safe I'd would like more time if possible to try her on other things first to see if her levels can at all be brought down. (Without wasting any time if there seems no time to spare. Whatever is best for her to help her as much as possible).
I'm also a bit confused about the food plan as from what I'm reading it's to reduce her protein and phosphorous which don't seem to be at elevated levels right now?

Hey there. I'm just posting this to vent and share experiences I guess. I've been treated for a variety of mental illnesses since I was young, and was diagnosed Schizoaffective at 16. I have been on antipsychotics since about 10 years old to 21. Once I moved away from my home town and started working at college, my symptoms lifted almost completely in a year. I was off medication until I was 25.
This summer I had a psychotic break and was put on Lamictal and Olanzapine. I almost never have break downs, never cry, never have extremely elevated emotions due to delusions or hallucinations. A lot of the time, I feel nothing. I feel totally detached from the parts of me that can be extremely happy, that can be excited, or that can shed a few tears when I see an emotional movie or show. Even though my emotions were big and at times hard to handle, having no connection to them makes me resent being medicated.
I try to access this side of myself with substance use, which I know is bad. But it feels like the only thing that for sure quiets the noise and self violent images/phrases I see and hear. I don't want to increase/change my medication in fear that I'll be the same tremor ridden, emotionless alien I was from my childhood to my adulthood. I am fortunate that my medication has stopped my self destructive delusions, but I mourn the version of me that can feel human.
Idk. I just needed to say this somewhere, and nobody around me shares my diagnosis or my experience. The idea of being this person forever is so bleak.

I'm heading to the EMU in a couple days and I'm freaked the fuck out about it. This on top of other incredible, unbelievable stress. On the one hand, I'm gonna get some real data on this. On the other hand, I'm terrified of nothing showing up and getting slapped with a PNES diagnosis, basically being told I have hysteria, and getting all my *other* neurological problems disregarded.
I can't work, I can't drive, I can't function. I have very little memory of my life. I have chronic dissociation and brain fog. I lose time, I get memory gaps. I got tons of deja vu since I was a little kid. I thought I could see the future in my dreams as a child. On a daily basis now I have deja vu, and nausea attacks that make me dry heave, vertigo, waves in my head, feeling like I'm in an elevator or a roller coaster, this feeling like wet cement in my head, this odd tingling in my sinuses that feels like I've been popped in the nose. I zone out, I have odd flashbacks, I get suddenly exhausted, sometimes I feel like I'm about to pass out, like I'm a zombie. I have gustatory and olfactory hallucinations, my stomach gets upset. I lose awareness in varying degrees. I constantly get myoclonic jerks and fasciculations, like literally constantly, at any given moment something is twitching. Sometimes I start rocking uncontrollably, or my arm and leg on one side begin kicking, or my eyes jolt around, or I tense up and feel like I'm about to start shaking. I see lights in my eyes at all times, and the patterns get worse when I have my episodes. I get bizarrely agitated, or I blow up. I've had experiences at the edge of sleep that I can only describe as "religious." I talk a lot in my sleep. I've developed sexsomnia. I sleepwalk and act out dreams when I'm stressed. That's only like half of what I experience constantly! Everything I read about TLE just sounds like me. While I understand it's mostly defunct, Geschwind syndrome seems to describe me to a T. Half of my favorite artists have TLE. There's a chapter in The Idiot where Dostoevsky just describes his subjective experience of a seizure, and it's precisely what I've experienced. His fucking notebooks, literal textbook examples of hypergraphia, look like mine from when I was a kid. Everyone I talk to with TLE, *my partner* with TLE, tells me they know exactly what I'm talking about. This shit has ruined my life since I was a little kid and it's just been treated as psychiatric the whole time. 20 years hasn't helped at all. I didn't even get to go to highschool, I just fell out of life by the time I was 14, playing catch-up since the second fucking grade. Everybody just *gave up* cuz nothing worked. I've tried CBT, DBT, EMDR, AIR, ketamine, neurofeedback (therapist said my brain looks weird on EEG btw!), two courses of TMS (which seem to have made things worse!), SGB, countless psychiatric meds of every class. Only things that helped significantly were things that are also used to treat seizures like klonopin, tranxene and lamictal. That and fucking mushrooms. Four mental health professionals told me my problem seems not to be psychological. I'm on my fourth and fifth neurologists. The one I saw last year told me I'm *too young* to experience this stuff and refused to listen to me, even after I (in a separate problem) lost motor function and got sent to the ER for stroke presentation. Just said it's all in my head, despite documenting months of episodes with consistent patterns. Hell, my partner got a TLE diagnosis because I was reading about it and urged them to see a neurologist since they experience most of the same things I do. They had to see multiple docs, they cleared an EEG, and only got diagnosed after blacking out and totaling their car on the freeway. I've been writing notes for over a year now and doctors seem generally uninterested, with the exception of this epileptologist who ordered the EMU.
I just barely trust doctors now. I'm freaked out to hell. I'm worried they're not gonna detect anything, which seems to happen very frequently, and seems to be a limitation of the current state of EEG technology. I'm worried I'm gonna get slapped with PNES, of which the existence seems dubious at best, and I'm going to have all my shit disregarded even after I've spent TWENTY YEARS treating it psychiatrically with no meaningful improvement. I feel like I'm fucking crazy. I've been *told* I'm crazy. I *believed* I'm crazy. I'd like to talk to more people with TLE. Compare experiences. Feel less insane. Commiserate about the harrowing ordeal of seeking neurological care. Hear what anyone has to say about lifelong misdiagnosis. Something. Because I feel like an island, like there's no other like me in the world. Plus I'm also just sort of pissed off I have to lay around in the hospital for a week, too.

Hi I’m 24F, 135lbs, 5’6”, currently taking Lamictal & Prozac
Back in 2021, I was referred for psychological testing by my psychiatrist. I ended up being diagnosed with Bipolar I, ADHD, and anxiety (GAD). In the document I was sent explaining my results, they included a section on personality saying I had elevated personality patterns. When I brought this up to my psychiatrist at the time she told me this was a “road I didn’t want to go down.”
Recently I’ve noticed that I relate a lot to what I hear about people with BPD and I can’t stop obsessing about whether or not I have it. I don’t want to get diagnosed with anything right now because I have a little over a year before I get kicked off my parents health insurance and I don’t want even more on my health record.
I’m attaching the screenshot of the paragraph about personality and the list of tests they used. Could any of these be used to screen for BPD? Or could the wording mean they’ve already ruled out the diagnosis for me?
(It’s my first time using Imgur, I’m sorry if it doesn’t show right)
https://imgur.com/a/YC2BUIn

My cat (3M, almost 4) is a pretty healthy cat except for a urinary blockage a couple years ago. Up until a few months ago, he was peeing twice or sometimes 3 times a day when he was on an all wet food diet. There was an incident a couple months ago where I took him to the vet and the vet found that he had slightly elevated biliruben levels but everything else tested normal. He had him on some liver medicine which had drinking more water and so he started peeing a bit more about 4 times a day. A month later, the vet didn’t retest him because he looked and acted normal.
About a month ago, we switched him to the Royal Canine S/O food and are now giving him both wet and dry food. He’s been drinking more water with the dry food (not excessively) but I’ve noticed he’s now peeing about 4 times a day about every six hours. He’s a peeing a normal amount, maybe a little bit more than he used to on the wet only diet.
Should I be concerned or should I take him back to the vet? It’s been about 2 months since the vet last saw him. He gets super stressed so I try only taking him when he absolutely needs to. I’m getting a mixed amount of articles online that say 4 times is normal and some that say its abnormal.

What might be causing this sudden elevation?
For context, I had the following done simultaneously:
full metabolic panel CBC with differential thyroid A1C ….all came back NORMAL.
Trace ketones in urine urine gravity slightly elevated at >=1.030 Urine Ph 5.5
Cholesterol: Total 230 Triglycerides 54 HDL 100 LDL LDL 190 Ratio 2.3
Diagnosed with hypermobile EDS.
Get blood draws at least yearly - never had this before.
Take supplements and Tylenol on occasion, on multiple medications:
Lamictal Corlanor Vyvanese Xyzal Chromolyn oral
Thank you so much in advance!!

Hi, I need some advice on what to do next - all the Drs I have met with are stumped and really have no ideas of what to do! I am desperate for help figuring this out.
Primary complaint: Left foot considerably swollen for about 3 months from an unknown cause.
Demographics: 42F, 5'8", 220 lbs, White, recently started smoking again (Ugh! Plans to quit again soon tho) after being quit for a long time - this issue started prior to smoking, do not drink or use recreational drugs ever. Meds - I am on a lot, but there have not been any recent changes for at least a year. Checked with PCP & Psychiatrist, they think only possible ones connected would be lamotrigine (Lamictal) and Gabapentin. But I have been on both of those for 5+ years, so it seems strange that a side effect would happen suddenly now, and that the swelling would happen only on one side of my body.
Existing Medical Issues: Diabetes 2, Chronic pain in low back, hips & ribs, sciatica, unknown nerve problem in legs - waiting to see neurosurgeon for more testing, benign tumors all over my body including one inside ear canal and softball sized one in my liver, anemia which required iron infusions every few months. Had gastric sleeve surgery 2018 (lost 130 lbs), abdominoplasty Aug 2023 - complications of splitting at horizontal & vertical intersections and creating a hole with tunneling requiring being on a wound vac for 5 months. Blood work doesn't show much of concern besides iron, and a chronically moderately elevated WBC.
More details on issue:
I have already talked with my pcp, a vascular surgeon / General surgeon, a specialized vascular surgeon, a wound care nurse / General practitioner, several other nurses, & podiatrist. I also went to the ER twice. All of them are stumped and have no ideas of what to do next.
My left foot has been very swollen for a few months. I have very minor varicose veins on the outside of my left calf that hurt, throb, and "fizz". The top of that foot has also been numb to sensation (not pressure) for many years for an unknown cause. I do have sciatica which has been the main guess for now as to the numbness. I am diabetic but it's well controlled and was ruled out as the cause for that. No idea if that has any connection to this issue or not.
My right leg and foot are fine.
Nothing seems to help the foot swelling and leg pain. I wear compression socks every day, use an electric leg compression device daily, elevate any time I am sitting, eat inflammatory foods and take some supplements. Also tried: diuretics, low sodium diet, ice, heat, anti-inflammatory creams, anti-inflammatory meds (like aleve etc), massage, varying levels of activity, and a couple other things that I'm blanking on at the moment. Nothing seems to make much difference. Some days it's much less swollen than other days, but it's always swollen to some degree. I'm not sure really what makes it worse or better, there doesn't seem to be consistent patterns.
Generally I exercise every day, tho I am not a super active person. I also have chronic pain in my back which worsens if I get more than about 8k steps a day for a few days in a row, and also worsens if I get less than 6k for a few days In a row. So I usually stay in that range tho I do cardio exercise for around 20 to 30 mins every day plus 30 mins of yoga, plus normal daily household stuff moving around.
I have tried being on the higher end of that activity for a week (not sure if it has a direct correlation or not, but the swelling did seem worse with more activity). I also tried being much more sedentary. Didn't seem to make a difference, maybe a bit better than being more active.
I have been scanned for DVT twice, have had a pelvic CT scan, and an ultrasound vein mapping (tho they said this would take 2 hours and it took 1 and I'm a bit suspicious it may not have been super thorough, but the Dr said it was ..). All of those tests came back negative for any problems.
I had an abdominoplasty in August from which I had complications (it split at the horizontal and vertical intersections). Was on a wound vac for a while and only recently has it basically fully healed. However there are lumpy and hard spots around my abdomen which could be scar tissue or maybe pockets of lymphomas which I'm told should clear on their own eventually. Not sure if any of that could affect my leg.
what kind of Dr am I looking for? I live in a rural area with limited services, so local Dr's have less resources and less broad knowledge with few specialists. I have traveled to two larger city areas, and those Drs also were stumped.
Thank you so much for any insight as to what MIGHT be going on any any possible directions to go in next.

41m. Have felt like I’ve been “off” my whole life. Was started on Effexor XR (venlafaxine) in early 20’s for GAD/depression and was on it for quite a long time. I was newly married, stressed about finding a job and chalked it up to that. I was on it up until about 6 years ago when I took a Genesite test and was determined that Pristiq (desvenlafaxine) was a better fit for my DNA makeup, so I switched to that. At one point I was on Lamictal but not because of a BP2 diagnosis. I cannot recall what that really did and eventually discontinued. Last year I was also on Wellbutrin (150mg) along with my Pristiq (50mg) and felt much better late summer 2023 so decided to come off my Pristiq. I also used weed regularly and don’t have the best relationship with alcohol, but as I’ve read, for many, it really helps quiet down the noise and anxiety and makes me feel good so I kept using it. I just don’t have an off switch. In retrospect, I highly regret those decisions, but I can’t change the past, I can only do better moving forward.
Fast forward to October 2023 and I essentially stopped being able to sleep. Probably averaged 2 hours each night for an entire month. I was married to my second wife (we had been married for almost 2 years but together for 6), we each have two kids, she had just beat breast cancer and the stress of everything was at a peak in combo with the medicine switch and substance usage. Very early in November I voluntarily checked into the mental health hospital (psych ward, though I hate using that phrase) and was there for 4 days. They gave me some sleep meds and started me on some Mirtazipine. I was officially diagnosed with MDD without psychotic features. When I got out is when things started to get really bad. On top of everything else, I felt extreme shame and guilt for even letting it get to the point of admitting myself. I felt like I was letting my wife, kids, parents, siblings and work down. I do believe I went into full blown psychosis and a week later, readmitted myself to the hospital and I spent about 2 weeks in. When in I was given Trazodone to sleep, Mirtazipine, Gabapentin, and Olanzapine. I really struggled to communicate and advocate for myself with the doctors and was essentially “locked” in my brain. After meeting with the head psych doctor, he recommended me for ECT treatment. Unfortunately, I wasn’t of sound mind and just agreed to it without much discussion. I ended up with 4 treatments before I discontinued the treatments because I felt like it was frying my brain. Perhaps it did help some and snapped my psychosis, but I essentially lost the entire month of November memory-wise. On top of that, my wife told me she was getting an apartment right after one of my ECT sessions. 10 days after I got out of the hospital, she told me she wanted a divorce. In retrospect, I’m sure she was scared, confused, nervous and ultimately, she did what she felt she had to do. I still love her madly but do believe there will be no reconciliation. I’m still trying to figure out how to seek closure and apologize for everything to her, but I have not gotten there yet.
Follow all this with a recent formal diagnosis of ADHD (February 2024) and started Vyvanse 30mg and that seems to have really helped with focus, motivation and executive disfunction. I think I’ve lived with it my whole life after reading and learning more about it, and I’m glad to be able to get treatment for it.
I recently started back with a new therapist weekly to help me unravel all that has transpired and to REALLY get to the root of all my struggles. I very much relate to the concept of cycling and going from what I now believe to be Hypomanic stages and then also spending a lot of time in the depressive phases. Sometimes it seems daily, other times it’s week to week. If I look back on my life, I can see many other times where I was driven, focused, had a very elevated mood and felt like I could do anything, followed by unexplainable crashes, irritability, isolation and generally just living in my head, withdrawn and confused as to how I was one way for a while, and switched to another “version” of me. I wasn’t effective at communicating it often as I didn’t know how and felt shame and guilt that I couldn’t just be normal. My second wife was always even keeled, motivated, organized and loving and in my head, I always thought I would be dragging her down with my moods, so I masked the best way I knew how. She was supportive to an extent, but I think she kind of just wanted me to get fixed, not realizing that there is no easy fix for this, and you don’t fight mental illness like you fight breast cancer.
I’m not entirely sure why I’m writing this, and not sure if I’m in a mild form of Hypomanic phase now as I blurt all this out for this community to read. I just felt the need to get it all out there and maybe someone can relate or identify with things I mention. I feel strongly I need to get back with my psychiatrist and perhaps explore a formal diagnosis of BP2, but also, I’m scared of that and not sure how easy it would be at this point in my life while also having ADHD.
I’ve always been a high performer in my two careers and been with my second place for 11 years and even given a portion of ownership because of all my contributions. I feel like at times the possible Hypomania has been a blessing, but also realize it can be a curse and during the depressive phases, I struggle quite a bit. I’m a huge overthinker and ruminate about a lot of my past, wishing I could change things. When I’m the real me, I feel like I’m intelligent, loving, caring, kind and gentle. Other times, I don’t feel those things and it can be disconcerting to put it mildly, but I know that isn’t the real me. Maybe you can relate.
Anyways, thank you for reading and feel free to comment with perspectives, suggestions, etc. This is a throwaway account, as I’m still in the early stages of unraveling everything and because I do believe the stigma is real, unfortunately.
Take care.
EDIT: My new therapist is the one who suggested BP2 after him hearing all this. Prior to that, nobody has ever mentioned it being a possibility.

I am currently on effexor 75 mg… it has been such a long road, my goodness. Still not sure where I totally fit in the mental illness world but I was started on SSRIs at 16 and am 34 now. I cried to my psychiatrist today that I still feel like a little girl. She said my mood swings and emotional rollercoasters are likely trauma responses and I start my lamictal journey now. I am an artist, I see life very poetically in almost a torturous beautiful way? When I am feeling super elevated it’s like I am this super confident majestic woman that has everyone under her spell. I effortlessly get what I want (I don’t mean to sound gross) I am at my wittiest and most artistic, followed by a week or two of a deep depression and nonstop analyzing why I felt like just a different person not long ago. I don’t want to lose my ability to be excited and confident but the shifts in my mood are so exhausting and grueling. I’m curious if anyone has a similar story and how it is working for you? Thank you so much for reading.. 💜

I take Nardil 60mg / 3 years. Bipolar / rapid cycling. Also Lithium & Lamictal. Hate First: early side effects… 4 months of sides to acclimate to. Ongoing side effect is insomnia (up now at 4am writing this essay long post) & sometimes major irritability. Love 2nd: Best Ever med for depression. Totally changed my life. Therefore I’m glad I stuck it out through the early side effects. Used to be depressed for 2 weeks every month. Now only a few times a year.
Sides early on I experienced: First two weeks: incredible euphoria, & for a month or 2 & heightened ability to concentrate. Was able to complete a ton of work that had piled up due to previous depressions, clean organize my house for first time in years.
First few months: nightmares, intense insomnia (melatonin / active elaxation breathing exercises / music : my album -Shujaat Khan, Unforgettable Sufis-Timeless Poetry Of Kabir & Amir Khusrau.
Months 1-4: Increased appetite - gained 25 pounds, (now lost the weight / walking ever day / cut sugar esp. drinks / & cut carbs). Peripheral edema of hands & feet - (p-5-p B vitamin helped me / walking / compression socks / & elevated feet). Irritability, anxiety, agitation- / (maybe related to bipolar) increased volume of voice, interrupting others, aggressive easy to anger, racing thoughts, sense of pain decreased, sense of physical strength increased (had to recognize when being overly reactive to situations and do breathing exercises AKA stop drop & breathe. Also increased one of my meds).
Ongoing: Food restrictions- Had 1 food reaction. I stupidly had soy sauce & ended up in ER for few hours & $3,500 later. Severe SVT with extreme low pulse. I stopped alcohol, tofu, soy, , other fermented stuff, super aged cheese. Tested problem foods w/ small amounts but Doc said you can be have no reaction to a forbidden food for years and suddenly have surprise reactions. Agitation - see above. Insomnia- see above. Slight dizziness- when standing or bending over. Depression- major decrease /almost kicked out of my head.
All these were totally worth it & would go through it all over again.

I'm on a decent dose of zyprexa, a high dose of lamictal, a decently high dose of lithium, and minipress. I'm definitely in the elevated episode and have been for the last 12 days.
Has anyone else experienced this? It's super frustrating because I have this weird conflicting energy and fatigue. I mean I still feel amazing just it's really bothering me. I know I also have fibromyalgia on top so I have to lay down or else pain and It's driving me mad.
How do you combat med fatigue or sleepiness while in hypo/mania from meds without making the episode worse? Already I have pressured speech, Impulsivity, euphoria with ease of irritation, doing way too many activities, being unable to focus, and it's a struggle to not try to make my place look nice and have a casual encounter. It's already a struggle I don't want things worse.
The meds aren't even dampening things much just making me tired

It's quite long and I need to vent. I don't know if I belong here, if you see some of yourself in this but I just needed to get this out.
I (f/28, Quebec, Canada) was evaluated in October 2020 and was diagnosed with Bipolar Disorder II Rapid Cycling, ADHD and GAD.
I've been seeing PCPs at a group of PCPs because I don't have one and am on a waitlist. They've been titriating my meds since then. They've put in a request to see a pdoc. I saw one in January and had another one who saw me today.
I mostly copy/pasted some things from my other post and added additional things because I didn't want to repeat myself.
I was put on observation in a hospital because I didn't feel well and then later a psychiatrist with his intern saw me and diagnosed me with BPD. The pdoc who diagnosed me BP2 didn't see this and my therapist doesn't either. I also don't really identify with this disorder. She says I'm mostly regulated regarding abandonment and my emotions.
The one in January I saws said I have BPD traits, wasn't sure about BP, but didn't dismiss the idea of having Bipolar.
The one I saw today said the same thing and even doubted my ADHD that responds to stimulants the way an ADHDer responds to them...
They said BPD because my emotions switch due to irritability and anger and also because of a deep sense of insecurity regarding my identity.
I have irritability and anger issues because of trauma, yes, and have worked on this, but I don't really experience abandonment issues in the sense that I don't fixate on someone and my reactions are in response to other people's and not necessarily out of nowhere unless mood is elevated. I mostly get anxious but will survive.
I've been on Lamictal 200mg, Effexor 300mg, Vyvanse 50mg, Dexedrine 5mg and Seroquel 25mg. The Lamictal helps hypomania and somewhat keeps my depression from going too deep. I'd say the Lamictal have kept my over the top energetic self in check. Now, my depression feels a little bit out of whack and still invasive.
The sort of hypomania that I experience is mostly me being more talkative, hyperactive, ideas running a million miles an hour faster than my already ADHD brain, hypersexual, binge eating, insomnia, restlessness, anxiety, irritability, over spending on useless stuff like food, cosmetics, stuff I don't really need in general and maxing out my cards, I also burned through 20k in a couple of months on useless shit that I wanted but didn't need, no reckless behaviours like unprotected sex or whatever you'd judge risky. I can do a million things at once and generally have much more energy. My ADHD is out of whack, especially my hyperactive, impulsive and distractible side.
However, it is rare that I experience more energy these days. I usually feel the other symptoms and irritability, more like dysphoria. I want to do something but don't know what, and I feel restless and irritable. I just feel more energy than usual. I'm aware when I am in an episode and that I need to be careful with my behavior.
I've always been a rational person no matter what happens despite all of this.
The man told me hypomania is mostly high on coke. I don't sign $200 checks to people. He was assuming that he doesn't think I have hypomania because I don't experience the euphoric type.
The lady I saw today didn't even let me elaborate on my moods and pushed her idea of BPD. Jesus, can you just listen for once?
The man I saw also dismissed the depressive episodes because they're atypical. Right now it's mostly atypical in the sense that I manage to feel enjoyment out of life sometimes, but still feel a deep emotional distress and SI. It's invasive and leaves me exhausted.
I definitely spend most of my time in depression, but experience elevated moods.
I feel dismissed because of the idea that I can't experience mood changes and the idea that severity changes. It leaves me exhausted switching like this over the course of a week, not knowing when an episode comes. I feel like whenever psychiatrists see trauma, they're quick to diagnose BPD. The man read off their colleague's notes from my hospital stay and went along with them without necessarily taking into account my experience.
If you're still with me, then thanks for reading, it means a lot to me. I just needed to vent.
The lady just saw TRAUMA written all over my face and didn't dig deeper and decided I have BPD.
I have issues with relationships and an insecure attachment as well as perfectionist tendencies due to ADHD, anxiety and abuse.
I know three psychiatrists diagnosed BPD, but both the one who did my initial eval didn't see it and my therapist who has known me since 2019/2020 knows me better. She doesn't see it.
I just feel so dismissed and frustrated and angry. Why can't they just listen to my experience? I understand that they're professionals, but whenever I went on support groups or read the symptoms of BPD, I never connected with it except for the emotional irritability and anger, but mostly in reaction to someone else's actions.
Here's a comparison list of the three disorders :
ADHD :
I have absolutely all the classic symptoms of ADHD-PI with internal hyperactivity. EVERY SINGLE ONE OF THEM.

• Interrupting others
• Sensitivity to rejection
• Forgetfulness
• Difficulty with time management
• frequent mood swings
• inability to prioritize
• Poor planning
• jumps from one task to another
• fidgety
• Easily distracted
• Disorganization
• Excessive talkativeness
• Feeling overwhelmed
• Impulsive
• Losing items
• Agitated
• I can sit still, but I'm always fidgety and distracted

This has been consistent throughout my life and receptive to medication. So fuck this psychiatrist.
BPD

• Fear of abandonment. People with BPD are often terrified of being abandoned or left alone. Even something as innocuous as a loved one arriving home late from work or going away for the weekend may trigger intense fear. This can prompt frantic efforts to keep the other person close. You may beg, cling, start fights, track your loved one’s movements, or even physically block the person from leaving. Unfortunately, this behavior tends to have the opposite effect—driving others away. (ABSOLUTELY FUCKING NO. Yes, I get anxious due to self-esteem issues, but no.)
• Unstable relationships. People with BPD tend to have relationships that are intense and short-lived. You may fall in love quickly, believing that each new person is the one who will make you feel whole, only to be quickly disappointed. Your relationships either seem perfect or horrible, without any middle ground. Your lovers, friends, or family members may feel like they have emotional whiplash as a result of your rapid swings from idealization to devaluation, anger, and hate. (Nope. My relationships were short lived due to again self-esteem issues, but not from black and white thinking)
• Unclear or shifting self-image. When you have BPD, your sense of self is typically unstable. Sometimes you may feel good about yourself, but other times you hate yourself, or even view yourself as evil. You probably don’t have a clear idea of who you are or what you want in life. As a result, you may frequently change jobs, friends, lovers, religion, values, goals, or even sexual identity. (Yes, but also along with ADHD)
• Impulsive, self-destructive behaviors. You may impulsively spend money you can’t afford, binge eat, hyper sexual. (Yes, but mostly associated with my ADHD and possible BP, you will see below)
• Suicidal: Thinking about suicide (Yes), making suicidal gestures or threats (No), or actually carrying out a suicide attempt (Yes). Every time I tried to kill myself, it was because I definitely wanted to die).
• Extreme emotional swings. Unstable emotions and moods are common with BPD. One moment, you may feel happy, and the next, despondent. Little things that other people brush off can send you into an emotional tailspin. These mood swings are intense, but they tend to pass fairly quickly (unlike the emotional swings of depression or bipolar disorder), usually lasting just a few minutes or hours. (Usually reactions towards other people. My mood usually stays the same or I sometimes am not too bad one moment, but generally if one day I wake up depressed, I will stay depressed)
• **Chronic feelings of emptiness (**Yep, but there are things in life that help me feel better long term and fulfill me)
• Explosive anger. Yes, usually at myself and my goddamn mom who's textbook BPD and/or Bipolar and ADHD-HI.
• Feeling suspicious or out of touch with reality. People with BPD often struggle with paranoia or suspicious thoughts about others’ motives. (No) When under stress, you may even lose touch with reality—an experience known as dissociation. You may feel foggy, spaced out, or as if you’re outside your own body. (Yes, sometimes, but not always)

Bipolar Disorder
Hypomania

• Decreased need for sleep (Yes)
• Excessive spending (Yes)
• Flying quickly from one idea to the next (Yes)
• Hypersexuality (Yes)
• Increased energy and hyperactivity (Yes)
• Inflated self-image (Not really, but sometimes I feel like I can do everything I want)
• Making and pursuing grandiose, unrealistic plans (Sometimes, usually useless shit or burning through 20k in a couple of months)
• Rapid, uninterruptable and/or loud speech (Yes)
• Substance abuse (Not really)
• No psychosis
• No delusions or illusions
• My hypomanias are not really destructive, but they still make me crash after.

Depression

• Depressed mood (persistent sadness) (Yep)
• Feelings of guilt or worthlessness (Yep)
• Loss of interest or pleasure in activities (Yep)
• Low energy and activity (Yep)
• Suicidal thoughts (Yep)
• Loss of appetite or binge eating (Yep)
• Hypersomnia (Yes) or insomnia when stressed
• Agitated
• Anxious
• Stuck in irrational thoughts

So that's why I feel like I don't fit with BPD despite having some traits according to them. My therapist thinks the same.

I (f/28, Quebec, Canada) was evaluated in October 2020 and was diagnosed with Bipolar Disorder II Rapid Cycling, ADHD and GAD.
I've been seeing PCPs at a group of PCPs because I don't have one and am on a waitlist. They've been titriating my meds since then. They've put in a request to see a pdoc. I saw one in January and had another one who saw me today.
I most copy/pasted some things from my other post and added additional things because I didn't want to repeat myself.
I was put on observation in a hospital because I didn't feel well and then later a psychiatrist with his intern saw me and diagnosed me with BPD. The pdoc who diagnosed me BP2 didn't see this and my therapist doesn't either. I also don't really identify with this disorder. She says I'm mostly regulated regarding abandonment and my emotions.
The one in January I saws said I have BPD traits, wasn't sure about BP, but didn't dismiss the idea of having Bipolar.
The one I saw today said the same thing and even doubted my ADHD that responds to stimulants the way an ADHDer responds to them...
They said BPD because my emotions switch due to irritability and anger and also because of a deep sense of insecurity regarding my identity.
I have irritability and anger issues because of trauma, yes, and have worked on this, but I don't really experience abandonment issues in the sense that I don't fixate on someone and my reactions are in response to other people's and not necessarily out of nowhere unless mood is elevated. I mostly get anxious but will survive.
I've been on Lamictal 200mg, Effexor 300mg, Vyvanse 50mg, Dexedrine 5mg and Seroquel 25mg. The Lamictal helps hypomania and somewhat keeps my depression from going too deep. I'd say the Lamictal have kept my over the top energetic self in check. Now, my depression feels a little bit out of whack and still invasive.
The sort of hypomania that I experience is mostly me being more talkative, hyperactive, ideas running a million miles an hour faster than my already ADHD brain, hypersexual, binge eating, insomnia, restlessness, anxiety, irritability, over spending on useless stuff like food, cosmetics, stuff I don't really need in general and maxing out my cards, I also burned through 20k in a couple of months on useless shit that I wanted but didn't need, no reckless behaviours like unprotected sex or whatever you'd judge risky. I can do a million things at once and generally have much more energy. My ADHD is out of whack, especially my hyperactive, impulsive and distractible side.
However, it is rare that I experience more energy these days. I usually feel the other symptoms and irritability, more like dysphoria. I want to do something but don't know what, and I feel restless and irritable. I just feel more energy than usual. I'm aware when I am in an episode and that I need to be careful with my behavior.
I've always been a rational person no matter what happens despite all of this.
The man told me hypomania is mostly high on coke. I don't sign $200 checks to people. He was assuming that he doesn't think I have hypomania because I don't experience the euphoric type.
The lady I saw today didn't even let me elaborate on my moods and pushed her idea of BPD. Jesus, can you just listen for once?
The man I saw also dismissed the depressive episodes because they're atypical. Right now it's mostly atypical in the sense that I manage to feel enjoyment out of life sometimes, but still feel a deep emotional distress and SI. It's invasive and leaves me exhausted.
I definitely spend most of my time in depression, but experience elevated moods.
I feel dismissed because of the idea that I can't experience mood changes and the idea that severity changes. It leaves me exhausted switching like this over the course of a week, not knowing when an episode comes. I feel like whenever psychiatrists see trauma, they're quick to diagnose BPD. The man read off their colleague's notes from my hospital stay and went along with them without necessarily taking into account my experience.
If you're still with me, then thanks for reading, it means a lot to me. I just needed to vent.
The lady just saw TRAUMA written all over my face and didn't dig deeper and decided I have BPD.
I have issues with relationships and an insecure attachment as well as perfectionist tendencies due to ADHD, anxiety and abuse.
I know three psychiatrists diagnosed BPD, but both the one who did my initial eval didn't see it and my therapist who has known me since 2019/2020 knows me better. She doesn't see it.
I just feel so dismissed and frustrated and angry. Why can't they just listen to my experience? I understand that they're professionals, but whenever I went on support groups or read the symptoms of BPD, I never connected with it except for the emotional irritability and anger, but mostly in reaction to someone else's actions.
Here's a comparison list of the three disorders :
ADHD :
I have absolutely all the classic symptoms of ADHD-PI with internal hyperactivity. EVERY SINGLE ONE OF THEM.
Interrupting others, Forgetfulness, Difficulty with time management, frequent mood swings, inability to prioritize, Poor planning, jumps from one task to another, fidgety, Easily distracted, Disorganization, Excessive talkativeness, Feeling overwhelmed, Impulsive, Losing items, Agitated. I can sit still, but I'm always fidgety and distracted.
This has been consistent throughout my life and receptive to medication. So fuck this psychiatrist.
​
BPD

1. Fear of abandonment. People with BPD are often terrified of being abandoned or left alone. Even something as innocuous as a loved one arriving home late from work or going away for the weekend may trigger intense fear. This can prompt frantic efforts to keep the other person close. You may beg, cling, start fights, track your loved one’s movements, or even physically block the person from leaving. Unfortunately, this behavior tends to have the opposite effect—driving others away. (ABSOLUTELY FUCKING NO. Yes, I get anxious due to self-esteem issues, but no.)
2. Unstable relationships. People with BPD tend to have relationships that are intense and short-lived. You may fall in love quickly, believing that each new person is the one who will make you feel whole, only to be quickly disappointed. Your relationships either seem perfect or horrible, without any middle ground. Your lovers, friends, or family members may feel like they have emotional whiplash as a result of your rapid swings from idealization to devaluation, anger, and hate. (Nope. My relationships were short lived due to again self-esteem issues, but not from black and white thinking)
3. Unclear or shifting self-image. When you have BPD, your sense of self is typically unstable. Sometimes you may feel good about yourself, but other times you hate yourself, or even view yourself as evil. You probably don’t have a clear idea of who you are or what you want in life. As a result, you may frequently change jobs, friends, lovers, religion, values, goals, or even sexual identity. (Yes, but also along with ADHD)
4. Impulsive, self-destructive behaviors. You may impulsively spend money you can’t afford, binge eat, hyper sexual. (Yes, but mostly associated with my ADHD and possible BP, you will see below)
5. Suicidal: Thinking about suicide (Yes), making suicidal gestures or threats (No), or actually carrying out a suicide attempt (Yes). Every time I tried to kill myself, it was because I definitely wanted to die).
6. Extreme emotional swings. Unstable emotions and moods are common with BPD. One moment, you may feel happy, and the next, despondent. Little things that other people brush off can send you into an emotional tailspin. These mood swings are intense, but they tend to pass fairly quickly (unlike the emotional swings of depression or bipolar disorder), usually lasting just a few minutes or hours. (Usually reactions towards other people. My mood usually stays the same or I sometimes am not too bad one moment, but generally if one day I wake up depressed, I will stay depressed)
7. **Chronic feelings of emptiness (**Yep, but there are things in life that help me feel better long term and fulfill me)
8. Explosive anger. Yes, usually at myself and my goddamn mom who's textbook BPD and/or Bipolar and ADHD-HI.
9. Feeling suspicious or out of touch with reality. Paranoia or suspicious thoughts about others’ motives. (No, but anxious, yes) When under stress, you may even lose touch with reality—an experience known as dissociation. You may feel foggy, spaced out, or as if you’re outside your own body. (Yes, sometimes, but not always)
10. Splitting? I don't really change personalities. So no.

Bipolar Disorder
Hypomania

• Decreased need for sleep (Yes)
• Excessive spending (Yes)
• Flying quickly from one idea to the next (Yes)
• Hypersexuality (Yes)
• Increased energy and hyperactivity (Yes)
• Inflated self-image (Not really, but sometimes I feel like I can do everything I want)
• Making and pursuing grandiose, unrealistic plans (Sometimes, usually useless shit or burning through 20k in a couple of months)
• Rapid, uninterruptable and/or loud speech (Yes)
• Substance abuse (Not really)
• No psychosis
• No delusions or illusions
• My hypomanias are not really destructive, but they still make me crash after.

Depression

• Depressed mood (persistent sadness) (Yep)
• Feelings of guilt or worthlessness (Yep)
• Loss of interest or pleasure in activities (Yep)
• Low energy and activity (Yep)
• Suicidal thoughts (Yep)
• Loss of appetite or binge eating (Yep)
• Hypersomnia (Yes) or insomnia when stressed
• Agitated
• Anxious
• Stuck in irrational thoughts

​
So that's why I feel like I don't fit with BPD despite having some traits according to them. My therapist thinks the same.

Hello!
I have been taking Lamotrigine since December 2022. I have upped my dosage from 150 mg to 175 mg to 200 mg since December 2023. And been on 200 since mid January or so. So we have been increasing the dosage very slowly before that.
The last few days I have noticing small (1mm in diameter) red dots on body. They are spaced a few centimeters (inch or so) away from each other but seems to be spreading. I would say that I currently have about 30-40 of these dots on my body. They do not itch at all and are not inflamed just slightly elevated.
Could this be lamictal rashes or is it likely something else? I'm not asking for medical advice just thoughts. I will call my doctor on Monday.
EDIT:
Picture of it (Didn't understand how to add it directly) Kind of NSFW but only my extremely white stomach https://gyazo.com/c3a803467c758d2003d2f1dd6d908d93

24M, 190 lbs, 5"9, exercise often (especially strength training).
meds: lamictal, bupriopion, wixells
supplements: fish oil, milk thistle, multi-vitamin, vitamin B6 and B12.
Drink on weekends, occasional recreasional stimulant use, history of nicotene vape.
diagnoses: asthma, BPD and Major Depression
Hello! For stomach related issues, I recently went in to get labs and an abdominal ultrasound done. My blood test came back mostly good. I showed no evidence of organ problems, all liver stuff was good and on the low end of the ranges. My bad cholesterol was elevated and my triglycerides were high (230). I have a history of high triglycerides in my family and cholesterol. While I exercise and do get my vegetables and proten in, I do have an indulgent lifestyle.
I'm working with a doc to get my lipids down, and from the blood I thought I was in tip top shape. But then I got my ultrasound back and it appears there's evidence of fatty liver disease. I'm confused because my liver enzymes are on the low end of the healthy range. Is this common to have fatty liver with good enzymes?
Does the fact that I have good enzymes mean that the fatty liver is mild and that with some lifestyle changes I can reverse it? Thanks! A little concerned about this as I'm trying to get healthier. Years prior I was definitely a lot more wild.

Hello. I recently (1 week ago) was put on 25mg Lamictal for what is assumed to be a major depressive episode and generalized anxiety following multiple losses/compounded grief in my life. As far as I know no one has suspected I have bipolar. Well due to a combination of things (sleep, therapy, etc. as well) I was feeling better shortly after starting the Lamictal. Everything was fine and I was feeling good and hopeful, however due to a family emergency I missed one dose - therefore went 48 hours without it (I’ve been taking it at 9am every day). The day after my missed dose (today) I felt an anxiety I’ve never felt before, a kind of anxiety very new and foreign to me and unlike past anxieties I’ve had. I also have found myself experiencing dry mouth, elevated heart rate, diarrhea, chills. Is this “normal”? I don’t know if the medication itself is causing these weird feelings, but I imagine it has to be from the missed dose. It also doesn’t help I didn’t sleep at ALL last night due to being up all night with my sick grandma. Any insight helps as this medication is very new to me! I don’t know if I maybe was extra sensitive to a missed dose due to my body/brain still getting used to the new medication.

Hello. I recently (1 week ago) was put on 25mg Lamictal for what is assumed to be a major depressive episode and generalized anxiety following multiple losses/compounded grief in my life. As far as I know no one has suspected I have bipolar. Well due to a combination of things (sleep, therapy, etc. as well) I was feeling better shortly after starting the Lamictal. Everything was fine and I was feeling good and hopeful, however due to a family emergency I missed one dose - therefore went 48 hours without it (I’ve been taking it at 9am every day). The day after my missed dose (today) I felt an anxiety I’ve never felt before, a kind of anxiety very new and foreign to me and unlike past anxieties I’ve had. I also have found myself experiencing dry mouth, elevated heart rate, diarrhea, chills. Is this “normal”? I don’t know if the medication itself is causing these weird feelings, but I imagine it has to be from the missed dose. It also doesn’t help I didn’t sleep at ALL last night due to being up all night with my sick grandma. Any insight helps as this medication is very new to me! I don’t know if I maybe was extra sensitive to a missed dose due to my body/brain still getting used to the new medication.

My psychiatrist has given me Lamictal to take and starting me at 12.5 mg. I have health anxiety and very nervous to start new meds. I'm terrified I will have a severe allergic reaction. I also take blood pressure meds so I'm worried the Lamictal will cause my BP to go to low. I did the genesight test and Lamictal was in the green. I just need my anxiety and moods to elevate so I desperately need to start meds. Just looking for positive feedback.

I've been feeling low lately and medication are not helping me even my psy is not the only thing she does is elevate my dosage every time and I'm tired of the idea of taking medication for life. We don't even know the long term side effects so I've gold turkey on Lamictal 50mg and olanzapine 5mg .

hi everyone! i (22F) am newly back on ritalin and am wanting to drink tomorrow and am getting some conflicting answers when googling. i had a few sips of wine tonight and i think i just had a panic attack about mixing the two substances but my heart rate was definitely elevated (but now back to normal) does anyone have any advice/experience? i dont want to get very drunk but want to have a good time with my friends (i take 5mg ritalin in morning, 5mg ~2/3pm as well as 50mg lamictal in morning)

hi everyone! i am newly back on ritalin and am wanting to drink tomorrow and am getting some conflicting answers when googling. i had a few sips of wine tonight and i think i had a panic attack about mixing the two substances but my heart rate was definitely elevated. does anyone have any advice/experience? i dont want to get very drunk but want to have a good time with my friends (i take 5mg in morning, 5mg ~2/3pm as well as 50mg lamictal in morning)

I'm a 37F with a history of high blood pressure, acid reflux, and syringomyelia (as well as bipolar 1 anxiety, and adhd)
Bloodwork here: https://imgur.com/a/g6zBJHK
Current medication:
Losartan Vyvanse Seroquel Lamictal Klonopin (as needed, which is pretty rare) Prilosec
My WBC count has been elevated the last few times I've had my blood taken. I went to the hematologist at the beginning of the month after my primary recommended I see one
I was not having symptoms at the time of seeing my primary. Since I've seen the hematologist, I've been very fatigued and have been having headaches a few times a week. I've also had cold hands and feet.
WBC is elevated as well as are platelets. MPV is low. There is low iron saturation as well.
He did do an ANA test and that was negative. RF was also negative.
He ordered leukemia/lymphoma phenotypic, a blood smear, and JAK2 mutation assay, which I'm still waiting on the results for.
With my bloodowork being what it is, could the abnormal ones be causes solely by the iron deficiency?
Is there a likelihood that it could be leukemia?
Could things be off because of syringomyelia?