Insomnia, hypomania, who knows?

[AmZ]

I'm not laughing any more. The 2 1/2 year sleep issue has finally driven me insane.

I've had periods where I've slept good in the last couple of years but those days have been far lived. Hardly any good nights of sleep.

Tonight I can't even shut my eyes I'm so awake. I exercised today and had a shower, no caffeine, no iPhone after 9.30pm. Now it's just before midnight and I'm going crazy I can't even lay here and relax at least.

I spoke with the nurses. They want to give me 14mg Imovane which has helped me in the past but then my body got used to it. Now I haven't been on it for a while so I hope it helps. The on-call psychiatrist is due to arrive in 15 minutes or so.

The last two nights I've managed to fall asleep with no meds at 10pm no troubles and sleep at least for a few hours before waking up a few times. Before these two days, I slept for one night 19 hours (!) which I have never managed to do in my life. And before that, I had slept for 3 nights a maximum of 3 hours of sleep a night (what they have now said was hypomania) but was wide awake all day and not tired whatsoever.

All over the place.

Asides from getting my anti-depressant, mood stabiliser and perhaps sleep med at the right level, I see no way out of this. I've tried everything in the book.

 

[Been there Done that]

Are you bipolar? Have you tried melatonin? That's what I take to get to sleep. I am also taking Fanapt and Risperadal which cause sleepiness. I would be frustrated too if I were going through that! Grrr!

 

[AmZ]

Hi, long story.

I posted in the private section about recent events. I basically had hypomania a few days ago which was either caused from the SSRI (Prozac) that I take or I have Bipolar. It's too soon to tell.

I never tried melatonin. My psychiatrist tried to prescribe it to me and I went to my GP for the prescription and she said only over people aged 50 can get it.

However, my body has been very resistant to all medications I have tried. And I've tried a lot of sleep meds, if not, all of them.

We have to see what happens but it could have been caused by the meds that iceberg taking. Perhaps the SSRIs that I've been trying and taking for 2 1/2 years have been the wrong meds for me. As I have had times where I slept a bit better. Who knows. It's all a bit of a mess!!

 

[W00BY]

It could also be the time of year.

I don't know what the climate is like where you are but at this time of year I am always all over the place and I need to work hard on both my bi-polar and my sleeping pattern.

We get a very mark seasonal change in Scotland and I suffer SAD which exacerbates everything I already struggle with and it certainly makes my bi-polar less manageable I find waking up and going to sleep are like mammoth tasks in them self at times and some years are way worse than others.

I certainly couldn't tolerate Prozac as it made me very agitated and that is why I ended up on Efexlor which was helpful to begin with but unlike Prozac which builds up in the system over time Efexlor has withdrawal symptoms within 24 hours of your last dose. Put it this way you know when you have missed a dose.

At the point I was taking antidepressants I hadn't had a Bi-polar diagnosis.

All you can do is keep speaking about how you feel and trying new things until you hit on that magic combination.

My psychiatrist when I first had my Bi-polar diagnosis went through a massive list of medical options with different things to consider like regular testing due to effects on the liver, libido issues, etc etc

For me the libido issues where a big one because I suffer so much sexual dysfunction already and Efexlor didn't help with it either.

My point it is she explained that it is a tinkering process that in highly sensitive people or people with a mixture of issues and health implications it can take a while to find the right balance of medication and doses.

What I do think over reading your posts since I joined is you are getting a better idea of your physical effects and being able to explain them which will help.

I can imagine it is a very frustrating process with some very unsavory physical effects at times, hopefully your getting closer to a solution, you certainly seem to have more clarity and be coping with the hurdles.

 

[AmZ]

Thanks for the reply and for sharing with us your story.

For me, it's been something that has been going on permanently for the last 2 1/2 years since I had the breakdown. I was diagnosed with Major Depression and then Borderline Personality Disorder and then Avoidant Personality Disorder.

But now has been the first time that I've had hypomania and we don't know what caused it. Whether it was the Prozac - so a medication induced hypomania or whether I am now looking at Bipolar as another new diagnosis.

So the Prozac has been reduced by two thirds and I'm on just 20mg and am carrying on with Valproic Acid, a mood stabiliser.

Throughout these 2 1/2 years I've constantly been switching meds and am still trying to find the right combination. I tried Effexor for several months at the highest dosage for example.

Anyway, I don't know what I have or what is wrong with me! I've spent close to 2 years in two seperate hospitalisations and 8 months outside before I was hospitalised with a psychologist twice a week and a psychiatrist every fortnight.

Now I've had this hypomania, we are now really possibly having to change my meds big time - very frustrating. They've tried a lot of meds like 3 SSRIs, an SNRI, Lithium, Lamictal, Mirtzapine, Zyprexa, Abilify, Seroquel, Valproic Acid, to just name a few.

Is it possible that I have been dealing with Bipolar all this this time and the meds haven't been right for it because they thought they were treating Major Depression?

Thx.

 

[David Baxter PhD]

But now has been the first time that I've had hypomania and we don't know what caused it.

Not exactly true according to your statements elsewhere.

 

[AmZ]

Why?

They said they know it was hypomania but don't know whether/and/or it was due to JUST the Prozac (like an 'overdose' of it) or due to being Bipolar.

---------- Post Merged at 07:30 PM ---------- Previous Post was at 07:26 PM ----------

Ah, that this wasn't the first time?

Yes, I've had something similar before but it only lasted a day or two, maximum two times. But it wasn't as strong as this. It was like a euphoric feeling but not over energy.

 

[David Baxter PhD]

I don't think that's quite what they said, but in any case my point was that you've had probable hypomanic episodes in the past.

Yes -> your added comment above.

 

[AmZ]

I'd like to clear this up. Why is that not probable what they said? Thanks. And what do you think?

 

[David Baxter PhD]

From what you've told us, they are still investigating. As I have told you elsewhere, a hypomanic reaction to SSRIs would be very unusual for most people but not unusual at all for individuals with bipolar disorder. What your doctors have said is that the hypomanic episode(s) may very well have been triggered by Prozac. What they have NOT said is that the hypomania is just a side-effect of Prozac or that this means you do not have bipolar disorder. As I understand it, they are still investigating.

 

[AmZ]

OK, thanks for the post. To me, they seemed to point towards that it's more to do with the medications. I didn't know it was that uncommon to happen to someone that doesn't have Bipolar.

They said we need to see what happens over the next coming days and weeks to see how I react to the Prozac being reduced and stuff.

Can you perhaps elaborate on something for me? What a mixed state it. Because I certainly feel like I'm somewhere in between feeling OK and feeling 'too good', like I have the lot of energy feel and euphoria and could not sleep last night for the life of me, but unlike a few days ago, it's not like it was with the irritation and suchlike.

 

[David Baxter PhD]

A mixed state is where you experience manic or hypomanic symptoms at the same time as depressive symptoms. Note that euphoria isn't always a component of mania or hypomania - sometimes it's just the increased energy and increased irritability.

See:

Mixed Episode | BehaveNet
Mixed state (psychiatry) - Wikipedia, the free encyclopedia

 

[AmZ]

OK, thanks. I'm just trying to work all of this out. My eyes were wired open last night so I'm trying to see if that has a correlation with my moods or not. Adding on how I am feeling now, trying to type faster than I actually can (!) and somewhat feeling like superwoman. But to a lesser degree than a few days ago.

I've obviously got a lot to learn both about myself and about mental health.

My family are having a bad reaction to all of this and are saying no way I am Bipolar. It's really causing tension.

Are there sedating drugs that people take in order to help them sleep whilst they are 'up'?? What type of medications are available?

Thanks.

 

[David Baxter PhD]

There are many medications used to treat bipolar disorder but I'd recommend you take it one step at a time. Let your doctors do their investigations and consider the best diagnosis and the best treatment for you. What your family thinks is irrelevant. That has nothing to do with you; that is their issue. You have enough to deal with without worrying about how they're reacting.

 

[AmZ]

Thanks Dr Baxter. I really appreciate it. I'm finally on my laptop so I can 'thank' the posts.

Yeah, no wonder I'm not sleeping at night. I'm trying to not get caught up in the way my family are reacting - My dad said the other day that he's had enough of the hospital, doctors and medications - I was thinking (but didn't say)... If HE has had enough of those three things, then how much HAVE I HAD ENOUGH OF THEM!?

My sister just disregards the possibility of me having Bipolar at all. Just huffed when I spoke with her and went quiet on the phone with me like my dad did.

My mum just sent me an email and said that no way do I have Bipolar. Etc.

They're 'annoyed' that I'm only saying now about those other two times I was feeling a bit 'off' or 'on' (too much) -- To me, I thought that they were just much better days that I was having and finally I was feeling better. But maybe things are coming together now after all?

What a journey.

---------- Post Merged at 08:06 PM ---------- Previous Post was at 08:00 PM ----------

It's not good for me to be overwhelmed and that's how I am feeling. I don't know what to do with myself. Ideas?

 

[Retired]

I don't know what to do with myself. Ideas?

To me it sounds like you need to get the family to turn off the pressure!

As David mentioned earlier, your relationship with and treatment recommendations of your doctors is none of their business. They can be supportive, encouraging and helpful, but not challenging your doctors' judgement.

You are an adult and independent woman who is incharge of your own healthcare; family is not objective nor knowledgeable of the circunmstances to be making judgements.

If I were you, I would say something like, " Family, I love you dearly, but I don't want to hear you questioning or second guessing my doctors. Your comments are placing too much pressure on me and are making me feel stressed. I appreciate your support and your help, but I need you to let my doctors do their work and let me focus on my treatment."

 

[AmZ]

Thank you Steve. I appreciate your reply and help.

It's tough going, all of this. In a way, with my family, I feel like just keeping things to myself and keeping them out of it until I am sure of what's going on. But my psychologists have all said that I should be more honest and open with them. But then I am, and this happens and it's very frustrating. I used to say "yeah, I'm fine thanks", even after having a night before with alcohol and self-harming especially when I was living alone. And in some ways, that's so much easier to say because I'm not getting messed up with everyone's points of view.

Anyway, really, my family should be the least of my worries. After everything else, I can worry about them.

Grr.

I still can't believe all this time and this is all unravelling. I still feel so far away from finding the right path in all of this. It's like BANG BANG one thing after another. What's going to hit me next??

---------- Post Merged at 11:58 PM ---------- Previous Post was at 09:20 PM ----------

3 hours have passed since I took 14mg Imovane (2 tablets). The nurse said TWO?! IF I TOOK HALF A TABLET IT WOULD KNOCK ME OUT. this is what they've said to me. There's no point in trying other sleep meds because the 80mg Clozapine and 2 Imovane don't work. Now it's midnight.

Feeling wide awake, not yawning, nothing.

I've been laying here doing deep breathing, trying to do something, but it does no more than relax me a little. And I already feel relaxed as it is.

From a peed off AmZ.

 

[AmZ]

Well, that was strange. I just spoke with my psychiatrist and asked to sit down with her regarding what happened to me. She asked what?? She didn't know what happened to me and I had to explain everything. She said that maybe I need to accept feeling good and I said, no, it was more than that. So only the head psychiatrist knows what happened and there was some miscommunication there big time!

She said that the Prozac had been lowered but she didn't know why. She just thought that the head psychiatrist had listened to her regarding me being 'over-medicated' which she thought I was.

Rather frustrating that I needed to explain all of this to her without knowing or understanding a lot myself as to what is happening with me. She just kept asking if I'd self-harmed and I said we're talking about two separate things here!

I think I'll go to the head psychiatrist and ask that he speaks with her about it.

I'm off to my sisters - until Tuesday. I hope I'll be feeling ok. It's a religious festival and I really want to be spending it with my family and not in hospital.