Bipolar Disorder

Dear Dr. Hidash I am being treated for BP for the past 4 yrs AND am on Lithium, Lamictal, Effexor AND Xanagis At first the mood stabalizer was sufficient, in time other medication was added. In addition I am seeing a psychotherapist twice a week AND in acute circumstances even 3 AND 4 times a week. My BP cycle is short , rapid AND extreme but I have improved considerabily AND commencing from last month my doctor has begun the gradual procedure of reducing the drugs. However, I suffer from severe insomnia whereby some nts. I get no more than 2-3 hrs sleep which leaves me a wreck. This is a sign that the rest wont be long in following. This time I even shocked myself I have been shopping like there is no tomorrow buying AND buying stuff with my money, the money I dont have AND stealing. When I think abt. it, it makes me sick but then I simply can't control myself. I can buy a couple of hundred OR even thousand shekels worth of stuff AND suddenly a small article of costume jewellery catches my eye, I try it on AND simply keep it. I can afford to pay for it but I wont. I even thought how stupid of them they have not caught me, OR I tell myself I must stop what I am doing is a criminal act AND can get me into serious trouble but even then I dont seem to care. I saw a blouse with pretty buttons so I cut AND took out 2 buttons AND decided to sew them onto the blouse I purchased. My husband is abroad this week (on work) AND the last few days I have been exhausted but am still out from morn to late evening at the shops. I was not shocked to see that in a matter of 2 weeks I purchased over 20 underwear. I've been obsessed with many things this time its underwear, clothes AND accessories AND its the accessories I dont pay for. Also, I bought a table mat which was open AND I took an empty nylon case which had a price tag for NIS 5 less AND then the next day I bought a few more AND this time I intentionally changed packages AND all for 5 shekels less. I dont need it, yet I cant control myself. Moreover, I cancelled my meeting with my psychotherapist because I am too ashamed to tell her about my recent whereabouts re. regression, next week I meet my psychiatrist too. Things were going so well I'd improved, I took control over my life, the self destructive signs were fading, hysteria, crying fits, panic attacks, nightmares became less, AND now this. WHY? What should I do this time? I dont want any more Respirdal. Has all the shopping made me feel any better? No. only momentarily. I would appreciate your comments. A

לאנה את סובלת מהפרעה דו-קוטבית וכעת במצב של פעילות יתר ולכן הקניות המרובות. את חייבת לפנות בדחיפות לפסיכיאטר שישנה את התרופות, או להוריד בתרופות נוגדות הדיכאון ואפשר להוסיף גם זיפרקסה או דפלפט אשר מתאימים יותר למצבים של השתנות מהירה בין דיכאון למאניה. בכל אופן את אינך מאוזנת תרופתית. כל טוב דר' גיורא הידש

Thank you doctor for your response. I realize I must call my doctor but cannot get myself to do so. However I will be seeing her in a couple of days. I guess its this relapse that upsets me from approaching her as I am in the course of reducing the medication AND under the circumstances I am sure she won't be doing so in the upcoming visit. Meanwhile my husband has returned from his business trip AND we discussed the complications of last week which to his opinion is also connected to his being away. Despite the aforementioned, I cancelled my meetings with my psychotherapist as I felt most uncomfortable to admit to her my misgivings re. theft of accessories during my intense shopping sprees. Subsequent to my husband's return I have managed to get some decent sleep, thereby reflecting on my entire constitution AND once again am in control, that is to say that the episode has past. But, somehow I can't get myself to fix a meeting with my therapist in the usual setting. I seem to associate the therapy room to a "confession-persecution" venue, AND suddenly feel sick AND tired of the same room AND setting which feels equivalent to a prison AND all I lack are hand-cuffs. I would very much like at least one single session in some open place like a park, near the ocean, etc., I have felt this way in the past but have been fine for the past 2 years AND yet the feeling of confinement has once again returned. Do you believe in changing the venue on a one term basis if the patient could benefit from this especially if we are dealing here with long term therapy? I personally feel that despite the strict guidelines of therapy some modicfication to meet the patient's needs won't hurt, do you agree? Hope you have a good week end Kind regards S