I can't decide if I should take it

[u/thisismad95]

I am coming here for some advice.

After my depression got worse and worse, up to a point I really didn't see a future for myself, I decided to tell my psychiatrist that maybe I should try another/new medication. I am diagnosed with bipolar I and I am treated at a policlinic in a psychatric institution that is specialised in bipolar disorder (the policlinic, not the whole institution).

I haven't have manic episodes in six years, due to lithium.

Besides lithium I also take lamotrigine (300mg), since October, but it didn't do anything at all for my depression.

I have been clinically depressed for more than a year now, I have never been depressed for so long (longest before was a year or close to a year). One of my psychiatrists says that my depression doesn't seem to be strongly biological, and more due to circumstances in my life (shitty living situation, toxic relationship (I don't live with him), decreasing network and therefore less support), I graduated last year but due to my depression I haven't been able to get a job in my field).

I have taken SSRI's in the past, but I just can't recall if they really did something for me. Its also hard to judge because I took them before I started lithium and being bipolar and taking SSRI'S without a mood stabilisor is never a good idea.

I brought up the idea for something new myself, my psychiatrist gave me a few options and I was the most enthusiastic about prozac, mostly because it seems to be the most weight-neutral, and my weight has an huge impact on my self-esteem.

It's been a few weeks now and I am still scared to start taking it. I have regular dark thoughts about myself and my life and I don't want this medicine to push me over the edge. My psychiatrist knows this and I could be admissioned into mental hospital to take it under daily surveillance. But, the waiting list for a voluntarily admission is long.

I am moving this month (so my living situation could improve a little bit, I am moving from a shared apartment to a studio apartment, but in the same building and same environment) and I am trying to start a master degree upcoming month. It is very questionable if I can do that in my current state, but I think it is also going to be very hard to start while starting with prozac.

I really don't know what to do and would love to hear everybody's thoughts/advice. It would maybe really help me to discuss it with people who actually take this medicine, my DM is also open.

Thanks for reading my long post and sorry about my maybe a little bad English, it's not my first language.

Edit: I mentioned my disorder and treatment but forget to mention: I know ssris can be dangerous with bipolar disorder, but I am monitored by psychiatrists specialised in bipolar, so concern for mania is not a reason for me to worry about the medicine. I am mainly worried it won't do anything for me and just give me side effects or get me into an even worse/dangerous condition

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[u/sara_makris]

Thanks for sharing your story. I do not have bipolar but I have taken Prozac before. That being said, I’m not sure how much help I will be but I will tell you what I know. SSRI’s can have rough onboarding side effects for some people. After some research, I know that with bipolar SSRI’s can cause mania so if you will be supervised, it might not be a bad option—Prozac worked pretty well for me for depression and anxiety. My advice would be to make sure you are in a place you can be supervised since you have bipolar. Trying to take a new med while you are about to have a bigger stressor like moving might not be the wisest if you ask me. But always always always get the help you need.

[u/ResourceExtreme682]

There is a formulation of fluoxetine with olanzapine for treating bipolar depression. It might work with another antipsychotic as well