I have bipolar 2, more depression rather than hypomania, and am on 200mg of lamotragine. It has stabilized my mood well, and while the depression has lessened and is less sudden and crippling, it’s still there along with bad anxiety.

I also have GAD and suspected C-PTSD (getting an eval to double confirm this). I do get panic attacks at times, particularly related to my past trauma, and anxiety induced nightmares and frequent disassociation. These have lessened with my med, but are still present and tough to live with.

It is being considered adding an antidepressant with my lamotragine, but I have had very bad severe reactions to SSRIs before.  That’s how I was diagnosed. They were making me 10x worse.

I think I clearly need something in addition to my mood stabilizer, but I’m not sure what I can even take with being bipolar that won’t make it worse. I’m trying to avoid anything that kills libido or causes a ton of weight gain for personal reasons.

I’m wondering what’s worked for everyone else.