I think I’m in a mixed state triggered by a big decision and going off lithium but I’m not entirely sure. 

I had not been diagnosed with bipolar officially but I had always been on lithium for about 8 years because of treatment resistant anxiety and depression that had led to a suicide attempt. I’m in my thirties. Lithium has always been a miracle for me; it stabilizes me. I have been stable for 8 years and now have a very high pressure high powered job. 

About 9 months ago I went off lithium at the advice of a doctor because I was trying to get pregnant. While I immediately became much more serious and reactive, I was “okay” for many months. 

Until the past couple months. They have been complete and utter hell. First I was triggered into what felt like a mixed state by a work assignment, then a vacation that was stressful. Now I’m in the worst one yet triggered by a huge decision along with fertility issues. My psychiatrist put me back on lithium about a month ago but I’m still having these breakthrough symptoms. 

My symptoms are insomnia - Ive gone about 4 days without sleeping now. I just stay up and pace with racing thoughts. Last night I called the suicide hotline multiple times. Extreme agitation, body shakes, crying, sensitivity and emotional reactivity. I feel like I am in the middle of a giant never ending panic attack. Constant fight of flight and I cannot self soothe or get to a place where I feel safe. From the time I wake up, everything has an undercurrent of darkness and dread. I feel like I’m living in a nightmare and things don’t feel real (derealization). 

My thoughts are like knives hurting me with how painful and racing they are. I’m ruminating uncontrollably about this big decision and how either way I will lose everything. Paranoia - I’m convinced my friends, family, and husband are done with my shit and are leaving me. I know how tired and scared they are.  I’m blaming myself for this. 

I’ve almost driven myself to the hospital a few times. I’m not suicidal per se but I’ve had thoughts of taking a full bottle of pills to make this stop. I’m also clean and sober for nine years and thinking of using to feel better. 

I am working with a wonderful psychiatrist and talking to her tonight. I’m also working with a therapist. I’m on so many pills right now that I’m worried that we’re just numbing the pain out.

The good news is that I haven’t felt like this for two months straight. I’ve been cycling in and out of these states when I’m triggered. But when I’m in I feel like it will never end. It is pure torture right now. 

My question is does this sound like a mixed state or am I just bad at handling anxiety? My biggest fear is that this is just me and not a mental health issue. 

What helps you when you feel like this? How can I possibly get through this?

How long does it take for lithium to fully absorb and kick in? Right now I’m on lithium gabapentin seroquel and Effexor.

How long do your mixed states last?

How do I keep from my over burdening my loved ones?

Any help or even prayers would be much appreciated. I’m desperate and scared.