Is this chemical or situational?

I've been bipolar for years, and I'm fairly well-read and thoughtful.  Here I am, having extreme upheaval in my personal life and changing antidepressants at the same time.  I know I'm coming off of a hypomanic as well.  I'm starting to have intrusive thoughts of suicide and self-injury, which I haven't had in months, and I am trying to figure out if they are part of my "typical" swings or situational, because one I can be more proactive about dealing with.

I'm nervous... I've been out of the dark for a while, and don't want to go back.  Ah well.  All thoughts are appreciated, and if you need more detail let me know.

[ILADVOCATE]

Sometimes anti-depressents can worsen mania in a person with bipolar and changing medications certainly brings out symptoms. What primary mood stabilizer are you taking? Is it working? If you have thoughts of suicide and self-injury speak to your psychiatrist immediately as if things are being adjusted I'd be concerned they'd get worse over time. On the links page there are some good informational websites on mood stabilizers and anti-depressents. You could look them over and speak to your psychiatrist about your options and what might be more of help.

[LeftCoastChick]

You should be more gentle on yourself, as well, you need to speak to your psychiatrist.
As you know, BP folks will have swings even on meds, it just happens, as much as I hate it, it's a part of life. As well, sometimes med changes or med adjustment is required. Our brains don't deal as well with change and non-BP folks. Stress and massive change can trigger it. Check in with your pdoc as soon as you can, you don't want to let it get worse.
Keep posting!
LCC

If you feel at any time that you are at risk of harming yourself, please go to the ER!

[misterhamtastic]

I know.  I'm intimately aware of when to go check-in.  My stabilizer is Lithium.  I'm coming off of effexor because it was messing up my circulation so badly.  Starting Wellbutrin, but since I had to move, I ran out of wellbutrin, and now I have to find a new pdoc...etcetcetc.  Just tough right now.  Klonopin is my friend right now.  I'm just trying to figure out the chem vs situ thing right now.

[LeftCoastChick]

Yeps it's hard to figure out which is which, but saying that, you can't go without meds, going off Wellbutrin will give you exactly what you are thinking. BP folks can go without them. Lith will help, but it's usually in tandem with another med, just being on the one is generally not enough. Find a doc, you can't rely on a benzo to get you through, if you use them more then a short while to balance moods, it will do the exact opposite.

[bernie40]

I don't think this is a case of chemical or situational, it is a combination of the two.  The two are instrinsically (sp) linked.  You have the chemical swings which are exacerbated by outside stressors.  No matter how stable you are any change from routine can trigger a swing.  If you didn't have BP you may or may not react to changes, it depends on how big an impact those changes are having.  If you are BP it is likely that you will react as part of maintaining stability is to stick to good routines (as you probably already know).

It may just be that you need a little additional help while you go through this particular phase of change so as the others have said, I would speak to your psychiatrist and explain that you are having to cope with additional stressors at the moment.  I hope it doesn't take to long for you to find a new psych - is it possible for you to see your current/previous psych in the meantime?

[misterhamtastic]

I wish.  It's 90 miles one way to the old pdoc.  Me without a car... not so good.  A month until my appt with a new one, but I did go down to the old one and pick up meds, so I have 30 days of antidepressant.  I took one today and it perked me right up, so that is a good sign.  

Ah well.  Just working on a new routine now.  Trying to keep the mind busy with philosophy and such.  Better than thinking about... other things.  Thanks so much all.  I hope my time to be there for everyone else will increase soon.