I have Bipolar 1 and have been on many med combinations since late 2006. I have consistently felt stupid, empty, unmotivated and dulled, just not myself. I always feel better on lower doses, but there is a limit on how low I can go without mania and hospital. For the past year I have been on risperidone, Trileptal, gradually lower doses of clonazepam, and lamotrigine since Jan or Feb.

I was feeling completely mentally blank and numb, so we lowered the risperidone down a few steps, from 3 mg to 2 mg. Now I am feeling somewhat smarter and more able to engage with the world, but I still feel like I am not at 100%, more like 50% (I was at 5% at 3 mg). However I feel like this is the best it's going to get. It wouldn't be wise to lower the risperidone any further. And I don't think the Trileptal is really contributing to the blankness or numbness, I think it's the risperidone.

I feel I just have to settle for having some ability to think but nothing deep, and not being as motivated or interested as other people, or motivated enough to do much at all. Like I can at least follow a conversation, even if I don't have much to say. It's a relief to at least understand what people are saying, now. It's better than having zero verbal comprehension. I can also understand what they're saying on the news, which is a very positive change. But I do wish I had more feelings and initiative, more reactions and interest than I have now. It would be nice to wake up wanting to do something.

I don't feel I have any wiggle room on the medication. I feel like I cannot even bear to be alive when the risperidone is 2.5 mg or higher, and lower than 2 mg would just put me at higher risk for mania, another hospitalization, and probably a higher, more soul-sucking dose of something and needing to die because of being such a zombie. I have already been on lithium, valproate, carbamazepine, lamotrigine and most of the atypical antipsychotics. Never found a combo that worked to prevent mania without the severe brain fog (and even with the fog many meds have failed). Have spent many years just sitting around doing nothing, or going through the motions in what few jobs or volunteer opportunities I have been involved in. Brain at 50% is a relatively good number for me.

I feel like this is quite possibly the very best it gets for me. I know people talk about trying meds until you feel normal and good and functional and all that, but I am not sure that is possible in my case. You eventually run out of options and have to settle.

Have others had the same experience? Just kind of limping by, impaired by mania-prevention meds but not wanting to get manic? Not able to adjust meds downwards anymore? Not really being a deep or real person, but having to just live with it? Stuck that way for lack of reasonable alternatives? Or afraid to try anything else for fear of the brain fog / numbness / amotivation being even worse - or failing to prevent mania and landing you in hospital?

How do you cope with being half alive? Surely it's better than being completely dead / 100% zombified, but it's still not a great state. It still doesn't afford much inner movement. It doesn't make therapy that possible, for example. (You need emotions and thoughts for therapy.) It doesn't make you an active participant in life.

I don't know whether it's worth adding something "for depression" or not, when it seems like the meds for mania are the problem. Lamotrigine was supposed to be "for depression", but we've had to limit the dose to 100 mg because it was making me foggy (or we thought so - this was before risperidone was lowered). So it seems like I am stuck here, in this limbo state, not really living.