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Apologies in advance for a long post. I've been struggling with Trileptal, Lamictal & Seroquel before; but now I'm more messed up than usual & don't know what's causing what anymore. The worst thing.

B/F of 2+ years ended a live-in relationship with me recently. My current physiological handling of the issues are somewhat related to (as discussed in greeeat length in therapy) dissociative impacts of the dissolution (very bad and veeeeery long).

In any case I've been on both Adderall (now 25XR and/or 20mg IR once or twice a day) & Lamictal for about 2.5 years. They've definitely helped overall in that I could get on a crowded subway platform without feeling that I wanted to curse out the train conductor if he was late, or throw a two-foot stack of files on my desk when I got impatient with my staff. B/F issues were okay--even better when the L. went up to 300 and the Trileptal entered the scene at the very end (25mg?).

Until now. I've felt that very pissed-off--/fuck you--you are so inane--you're bothering me--can't you see you're in my way--it's your fault--I feel like screaming for little reason--you are so boring/I have to get out of here now/I'm really going to explode again now--

Worse than that, believe it or not, I cannot complete any single task worth a damn. I've been on Adderall for a while, and to be honest from the beginning was only able to either hyperfocus on something or start about 10 tasks (on average), very excitedly, thinking that I'd finish them all within the hour. And then the closet would need organizing. And on and on.

Last 2 months I've been out of the XR (too lazy/out of scripts/missed p-doc appointments/thinking I'll be fine without them/late to work so can't drop by the pharmacy/etc/etc). Also stopped Trileptal--totally incogniscient of it--I think I ran out of it one day & decided I could wait until the next appointment to get more. And then forgot.

So I've just been taking 20mg Adderall in the a.m. (and 350 Lamictal) at about 10am or so. I stopped crashing later in the day--which I'd always done in the past--and which suggests my tolerance has increased--so that I'm not really getting the effects in the first placea/

Despite less of the amphetamine in my body, I've lost weight. Dropped 2 sizes (down to size 1). 4am comes & I'm not tired. Bored, so I'll have a martini, scotch, and then a bowl of popcorn. Every other night. Not taking the Trileptal or Seroquel because it makes me too lethargic the next morning (I've always been sensitive to that & can't afford to be tired by 1pm).

T-doc suggests Concerta. I don't want to gain weight or get the sugar cravings. I like my weight now but perhaps am deranged (I'm not emaciated looking; eat good food throughout the day--just not much of it).

I don't want to sleep. I don't feel like I need it. I don't need food. Popcorn tastes just fine--it's fresh, organic, with good sea salt & butter. I'll walk to the store & get some almond thin cookies. Fall asleep on the couch. Wake up at 5:30 & turn off the VCR. Wake up at 9:30 am & look like shit.

I know all of this is a function of the emotional stuff I've been through. But I need meds to come in somewhere. My p-doc just isn't that savvy. Both she & my therapist are just going to get angry that I'm not in bed right now. Maybe prescribe a sleeping pill finally. I want something to manage it in a real way. I know I'm not doing all the things I should be doing--but I don't want sleeping pills, either.

Concerta? My main concern is that I want to stop feeling compelled to start 10 projects at once, without finishing any of them. Sometimes at 10pm, sometimes at 10am. OCD or mania or overfocsing....that's what I need to find a way to address.

Thanks for reading! I always learn more about what I'm going through from writing abou it.

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Apologies in advance for a long post. I've been struggling with Trileptal, Lamictal & Seroquel before; but now I'm more messed up than usual & don't know what's causing what anymore. The worst thing.

B/F of 2+ years ended a live-in relationship with me recently. My current physiological handling of the issues are somewhat related to (as discussed in greeeat length in therapy) dissociative impacts of the dissolution (very bad and veeeeery long).

In any case I've been on both Adderall (now 25XR and/or 20mg IR once or twice a day) & Lamictal for about 2.5 years. They've definitely helped overall in that I could get on a crowded subway platform without feeling that I wanted to curse out the train conductor if he was late, or throw a two-foot stack of files on my desk when I got impatient with my staff. B/F issues were okay--even better when the L. went up to 300 and the Trileptal entered the scene at the very end (25mg?).

Until now. I've felt that very pissed-off--/fuck you--you are so inane--you're bothering me--can't you see you're in my way--it's your fault--I feel like screaming for little reason--you are so boring/I have to get out of here now/I'm really going to explode again now--

Worse than that, believe it or not, I cannot complete any single task worth a damn. I've been on Adderall for a while, and to be honest from the beginning was only able to either hyperfocus on something or start about 10 tasks (on average), very excitedly, thinking that I'd finish them all within the hour. And then the closet would need organizing. And on and on.

Last 2 months I've been out of the XR (too lazy/out of scripts/missed p-doc appointments/thinking I'll be fine without them/late to work so can't drop by the pharmacy/etc/etc). Also stopped Trileptal--totally incogniscient of it--I think I ran out of it one day & decided I could wait until the next appointment to get more. And then forgot.

So I've just been taking 20mg Adderall in the a.m. (and 350 Lamictal) at about 10am or so. I stopped crashing later in the day--which I'd always done in the past--and which suggests my tolerance has increased--so that I'm not really getting the effects in the first placea/

Despite less of the amphetamine in my body, I've lost weight. Dropped 2 sizes (down to size 1). 4am comes & I'm not tired. Bored, so I'll have a martini, scotch, and then a bowl of popcorn. Every other night. Not taking the Trileptal or Seroquel because it makes me too lethargic the next morning (I've always been sensitive to that & can't afford to be tired by 1pm).

T-doc suggests Concerta. I don't want to gain weight or get the sugar cravings. I like my weight now but perhaps am deranged (I'm not emaciated looking; eat good food throughout the day--just not much of it).

I don't want to sleep. I don't feel like I need it. I don't need food. Popcorn tastes just fine--it's fresh, organic, with good sea salt & butter. I'll walk to the store & get some almond thin cookies. Fall asleep on the couch. Wake up at 5:30 & turn off the VCR. Wake up at 9:30 am & look like shit.

I know all of this is a function of the emotional stuff I've been through. But I need meds to come in somewhere. My p-doc just isn't that savvy. Both she & my therapist are just going to get angry that I'm not in bed right now. Maybe prescribe a sleeping pill finally. I want something to manage it in a real way. I know I'm not doing all the things I should be doing--but I don't want sleeping pills, either.

Concerta? My main concern is that I want to stop feeling compelled to start 10 projects at once, without finishing any of them. Sometimes at 10pm, sometimes at 10am. OCD or mania or overfocsing....that's what I need to find a way to address.

Thanks for reading! I always learn more about what I'm going through from writing abou it.

I get a lot of "aggressive"feelings from the Lamictal, especially in the evenings. Your post made me think...maybe I should take the Lamictal around noon each day so I don't get all crashy in the evenings. I was taking 200mg but go too manic from it, so now on 150 and it's not quiet enough (maybe) or maybe it's just the tapering that's getting to me. The 150mg will probably gain momentum with me. Stuff like this always does. Sooner or later I always speed up to the point where I'm better-fine-happier-busier-creative-producing-producing too much-too creative-philosophic- psychotic. No wonder this sneaks up on me. I adore the last precursor stages. I hope against hope that this time I will stay creative and productive indefinitely like when I was younger before my first episode. Everything is different now though. I've lost myself for good. By the way...what does Adderal do? I can't take another upper eventhough I could use one....augh! Lost forever. Will I ever be me again without the danger?

AND P.S. My doc gives me 25mgs of Seraquel for sleep since I can't go up on benzos.(need them to quell the Lamictal crazys) It works great when I need it. It's such a small dose that you don't get the craving thing...much.

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Hey sita, I only skim-read your post as I've got all sorts of shit going on at the moment, but the way you're describing yourself at the moment sounds a lot like me when hypomanic..... if you carry on with the not not eating/sleeping etc for more than a week or so (don't konw how long it's been so far) I'd suggest seeing your psychiatrist. Or at least, I would if it were me!

xx

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My feeling is for that something to change here, you're going to have to do something about it. From what I gather, you've been through something very stressful, then suddenly stopped your meds for no good reason, you're not eating properly and you're self medicating with alcohol, so you now have all the classic symptoms of hypomania (if not full blown mania) yet you're questioning your pdoc's recommendations and thinking that just a sleeping pill will be the solution? I don't think a sleeping pill will do a thing if you're not taking the meds that you are supposed to if you need to manage your condition.

I'm not sure what BMI you are if you're a size 1 (to be honest it sounds emaciated, and you have said that you don't want to eat at all, and what you do eat is unhealthy and bound to leave you pretty malnourished), but I know that if I have to choose between a few extra pounds and being able to function in daily life/get some sleep at night/eat properly, I'd much rather go for the latter.

I don't know a lot about Concerta other than that it appears to be a drug for ADHD and I am not sure how it reacts with Bipolar people (or if you have that.) I curious as to what your pdoc thinks about you stopping the others/lowering the doses, and whether they want you to remedy this. I think your pdoc really is the best person to consult here as they know your dx and your history. I can say from my own experience that if you have bipolar you need to take responsibility for your condition by taking the right meds, eating properly, exercising, staying away from intoxicating substances, trying to maintain a good sleep routine and doing all the boring but necessary things to keep from going batshit crazy. I don't see much of that in your post, sorry.

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Karuna,

While I know the dangers of going off meds, and see it's being precipitated here by not eating, sleeping, etc., the fact is that I shared what I'm going through for support & insight into how to get out of this state. I do want advice & help--and know that the person I'm paying for it is the one that was trained & certified to do so.

That being said, I try & research on my own as well to deepen my own understanding of things. And to be honest, I haven't always trusted the medical advice the doctor has given in the past. But I've always heeded her direction on what to do medically (I got akasthesia from Rispedral, for example, and she had never heard of the possibility before), but feel like it's my responsibility to agree to what she suggests.

I also post here because I feel welcome. No matter what state I'm in, or how damaged I feel by this thing. Or things. I am ADHD as well, and dealing with the 2 is overwhelming.

I re-read my post today after I read your reply, looking for signs that I have totally thrown in the towel. Yes, I stopped my meds. But that wasn't 100% a 'decision'; I was honest about just looking for an alternative to the ones I was on. I am not looking for a sleeping pill--just know her well enough that he'd suggest one. And he did.

All of that being said, and in the risk of sounding like I take stuff personally, I was a little hurt by your response & felt it was a little judgmental--I think a 'reality check' or 'tough love' for a better term is in order, but sometimes, for me anyway, that can be balanced by a little practical advice emphasizing the small steps people can take in that moment of hypomania. That's what I see people do so much for each other here, and why I think this board is so cool.

I feel a bit inadequate now, although it's good to get the 'tough love' part & really appreciate the attention you give to my situation. I don't post much; I want to more often than I do, but get distracted or lethargic or just plain too depressed to participate much in anything. Blah, blah; yes, I'm using that as an excuse, but I'm doing that a lot right now & I feel really vulnerable & weak.

I am not emaciated-looking & have never had issues with food or fear of gaining weight. I love food, a lot. I just don't feel like eating & I think I don't need food for energy, which I feel I naturally have right now. Yes, that false sense of euphoria. Like I'm on top of the world.

I know this post, again, is so long because I'm on that wavelength, and you know sometimes how the words just come to you so naturally & it feels so good you keep going on & on.

But once again, all that is coupled with this distraction thing, and the co-existing BP and ADD just sucks. So I was just looking for advice because I need to get out of this thing, now. I don't mean to say that I don't appreciate what you say, really; but just that I feel like I need some 'soft love' right now, too! ;-)

Anyhow, my doctor agreed to nix the Seroquel, but insisted I stay on the Trileptal. Brought it down a little bit to ease the tiredness for me. Left the L at 350, and cut out the Adderall XR, leaving me with IR tabs when I need some focus. I don't abuse the amphetamine--I take breaks & ease off when I feel the anxiety come on--and in general want to be on less meds rather than more. Strict consistent bedtimes & lots of small meals.

I just feel a little desperate right now & want out.

Thanks again.

[quote name='karuna' date='Apr 23 2007, 01:57 PM'

My feeling is for that something to change here, you're going to have to do something about it. From what I gather, you've been through something very stressful, then suddenly stopped your meds for no good reason, you're not eating properly and you're self medicating with alcohol, so you now have all the classic symptoms of hypomania (if not full blown mania) yet you're questioning your pdoc's recommendations and thinking that just a sleeping pill will be the solution? I don't think a sleeping pill will do a thing if you're not taking the meds that you are supposed to if you need to manage your condition.

I'm not sure what BMI you are if you're a size 1 (to be honest it sounds emaciated, and you have said that you don't want to eat at all, and what you do eat is unhealthy and bound to leave you pretty malnourished), but I know that if I have to choose between a few extra pounds and being able to function in daily life/get some sleep at night/eat properly, I'd much rather go for the latter.

I don't know a lot about Concerta other than that it appears to be a drug for ADHD and I am not sure how it reacts with Bipolar people (or if you have that.) I curious as to what your pdoc thinks about you stopping the others/lowering the doses, and whether they want you to remedy this. I think your pdoc really is the best person to consult here as they know your dx and your history. I can say from my own experience that if you have bipolar you need to take responsibility for your condition by taking the right meds, eating properly, exercising, staying away from intoxicating substances, trying to maintain a good sleep routine and doing all the boring but necessary things to keep from going batshit crazy. I don't see much of that in your post, sorry.

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Sita,

Sorry if your feelings were hurt. I considered trying to comfort you but to be honest, I've found in my own life and from what others with BP have said, when we're in that manic phase where we are starting to deceive ourselves about how we are coping and how our life is being affected, sometimes some tough love is actually what we need in order to come down and take notice of what is going on. Comfort can just enable us to carry on getting further and further into mania, and the worse it gets, the more difficult it is to treat. So be reassured that I do care and want you to find a solution that you feel happy with, I was just offering what worked for me. This board is really all people trying to give their own opinions and experiences, and replies will not always be welcome or relevant. Feel free to discard whatever part of my advice doesn't fit.

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Thanks & I appreciate your response.

My therapist is going the 'tough love' route. I feel like she's mad at me, and am only tempted to skip sessions because I fear I'm going to be berated. I'm kind of pissed at her for not being more understanding. But if I haven't listened or learned after what's going on 3-4 weeks of staying up until 3, 4, 5, 6 in the morning--with 1 to 2 times a week not sleeping at all--then perhaps you're both right. And what am I paying her for--to remain cycling like this?

A friend of mine goes the comfort route a bit. When I talk to her do I find myself justifying what I'm doing to myself--I think what I reinforce in conversations with her is this thought that I can't control not going to bed, and all the destructive aspects of what's happening. Instead of believing that I can survive this & control it to the best of my ability, even if that means taking half a sleeping pill at first to force myself to go to sleep--at least it's taking the meds whatever my doctor thought to give me. I want to imagine a way out, but am looking for some practical solution or set of things to do or a script to follow to get out of this. Is that wrong to desire something like that? At times I do feel helpless. When I'm manic & spending time with someone I feel guilty, like I'm hiding something. I feel ashamed. Maybe not so much over the past day.

I know the answer lies within myself but I think I need some guidance right now. Not that I'm asking anyone here for it, but writing about this & getting it out is a way to find the stuff within myself & develop that voice or tools that I have to survive & not let this get the best of me.

Thanks again--

Sita,

Sorry if your feelings were hurt. I considered trying to comfort you but to be honest, I've found in my own life and from what others with BP have said, when we're in that manic phase where we are starting to deceive ourselves about how we are coping and how our life is being affected, sometimes some tough love is actually what we need in order to come down and take notice of what is going on. Comfort can just enable us to carry on getting further and further into mania, and the worse it gets, the more difficult it is to treat. So be reassured that I do care and want you to find a solution that you feel happy with, I was just offering what worked for me. This board is really all people trying to give their own opinions and experiences, and replies will not always be welcome or relevant. Feel free to discard whatever part of my advice doesn't fit.

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  • 1 month later...

Sita,

I don't know how you are doing, ok i don't even know you ;) , but your post really grabbed me. Not eating and not sleeping and the energy to do it is such a cause and symptom in BP. I'm not here to recommend anything medically, talk to your pDoc. but for me Zyprexa did wonders more with its side-effects than its intended function. Tiredness and food cravings are what brought me out of some serious mania. Sleeping pills just altered patterns so much and the psychology of dreams keeps me sane. anyways that's my two cents. Like taking a corner at high speed: Diminuate the elation, don't crash. It's hard to come down for sure.

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Over the yrs I've been there many, many, times. Like now, ;) I've been bouncing around since the May. Shedding pounds, and getting bruised ,flipping between pissed and super happy go-getter! Happens every yr like clockwork for me-up to six times a yr. (FUN HUH?) Meds have never helped,some have sent me to lock down. Meds have made me crash but then the clean-up is months in the making. Now I ride it out, hanging on tight, and remind myself that YES, I am manic now, (must say to yourself repeatedly) and I'll gain everything back in the depressed state! (JOY)

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Guest Watrfall
Over the yrs I've been there many, many, times. Like now, ;) I've been bouncing around since the May. Shedding pounds, and getting bruised ,flipping between pissed and super happy go-getter! Happens every yr like clockwork for me-up to six times a yr. (FUN HUH?) Meds have never helped,some have sent me to lock down. Meds have made me crash but then the clean-up is months in the making. Now I ride it out, hanging on tight, and remind myself that YES, I am manic now, (must say to yourself repeatedly) and I'll gain everything back in the depressed state! (JOY)
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Sorry, the last response wasn't intended.

It really sounds to me like hypomania. No food, no sleep, alcohol.....been there, done that, doing it now as we speak. Tonight, take some Seroquel or some benzos or whatever you need to knock yourself out. Eat. Stay away from alcohol. Not forever, just for now. Just until you are stable.

I too research the shit out of everything. I think you have to. Why rely on some doctor that doesn't know how your individual body reacts to psychotropic medication? Hell, they tried to tell me that Abilify was a sedative. Maybe for some people but certainly not for me. It was activating but when it comes down to brass tacks, it was the Lamical and the Wellbitrin (and some Klonopin thrown in there for sleep) that kept me from the edge. And I got really close to the edge.

It sounds like you are going through a lot of situational stuff right now. Try and be in the moment. Sounds ridiculous, I know.

And EAT. SLEEP. Because you and I both know what comes after mania/hypomania. It's severe depression. Sometimes even suicidal depression. Nip it in the bud now while you still have a chance. I know how seductice those highs are. Yes, they are wonderful. We become superhuman. Little food, little sleep, drinking......absofuckinglutely!

I am in a similar place right now for similar reasons though they are maybe more complex than I have ever sharedon these boards. But right now you need to focus on you! Taking care of yourself physically, mentally, emotionally.....just do it. Yes, the high will subside. But so will the upcoming fall.

Trust me, I am in your shoes right now for many reasons, and I am not taking care of myself physically. Drinking, not sleeping, not eating.....I know.

Let's both go have a big bowl of pasta.....I know I can't I eat low carb.....but something filling and healthy. And take something to knock you the4 fuck out. Sleep!

I am sorry if this sounds preachy. I don't mean it that way. I just know what it is like to be bipolar. I am here for you.

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i'm sorry, my adderall is wearing off and i can't read all of this, so i skimmed through it. sorry if i'm rambling on an already covered topic. i also don't mean to offend at all whatsoever, only be a helpful reflection.

i also have ADD and BP. i take Adderall and Lamictal, though not your other meds.

lamictal mainly treats the lower end of the BP, though is also very helpful, in my experience, in curtailing the upper end as well. i'm very happy with it.

however, it can excite people and actually throw someone into mania. it doesn't do this to me, but is known to for some people. this could be a part of your problem perhaps.

adderall is for sure known to excite the bipolar and cause aggression in some people. this could be an issue too, as you know.

i understand the feeling that you want to maintain current weight and maybe aren't hungry.

i've never tried concerta. adderall is the only med i've ever used for ADD, and i like it for really focusing me. i've heard that concerta is really good though. it is popular with the other ADDers in my pdoc's office.

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