Lithium, Lamictal new psychiatric np

 I went on lithium a little over a month ago do to having suicidal thoughts. There was one night in particular that was pretty scary so that's why I went on the lithium. Things have been much better since then. I'm not sure if it's me or if it's the lithium. I only had those thoughts for the one night and I hadn't had them a couple nights before starting the lithium. However instead of going off of it I decided to stay on it another week or so so I could start the ketamine before I get off of it and hopefully not notice a difference.  

I increased my Lamictal from 250 to 300. This is supposed to help with depression. I'm not sure it's really doing anything. I'm doing better, but I think that's because of vacation. When I got back I started going a little downhill again. Not as bad as before I left, but it's still there. I have to take 150 twice a day and I keep forgetting if I already took it or not or how many times. Therefore I'm thinking I need to ask if I can just go back to taking it once a day, this twice a day thing is not working out too well for me I don't think. 

Last week I saw a new psychiatric nurse practitioner to hopefully get referrals for ketamine infusion therapy and TMS therapy. She said she couldn't diagnose me after just talking to me for an hour. What a relief.  Everyone else diagnoses me in that amount of time. She said she thinks I could have bipolar disorder but she also thinks it's possible I don't have bipolar disorder. She said what makes her wonder is that I was on SSRI's for multiple years before I ever had a manic episode. Often this is how they discover someone has bipolar disorder because it pushes them into Mania. She said having a manic episode can definitely make you not sleep for 2 weeks and feel like you don't need to eat. But it wasn't the manic episode that caused me to not sleep it was the sleep and the trauma that caused the manic episode. She also said my medications don't even tell her that I have bipolar disorder. She's prescribed Latuda and Lamictal to people with treatment resistant depression without bipolar. My insurance currently only covers TMS therapy for major depressive disorder. However this new psychiatric nurse practitioner thinks she can put up a good enough argument that I'll receive TMS therapy. She's just not going to put a diagnosis. She's going to put treatment resistant depression. I'm hoping this gets approved. 

I start ketamine therapy today. I'm pretty nervous. I think I'm most nervous that it won't work. And I really don't want to throw up. I'm nauseous pretty much every day anyway. I don't want this to make it worse. In addition the nurse told me to prepare to be there for at least two hours. That seems like a long time to just sit in a room. I'm hoping I don't realize the time while doing it. Ketamine is supposed to help rebuild connections that get lost due to prolonged depression and Trauma. So it helps with treatment resistant depression and PTSD. I will do two treatments a week for 3 weeks making a total of six treatments. After that maintenance is usually once a month. They can't say for how long everyone's different. I'll probably be at least halfway done with ketamine before I find out if TMS will be covered or not.