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Insomnia or hypomania?


Guest insomniac

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Guest insomniac

I have had on and off problems with insomnia for a long time. However, when I described these to a professional when seeking treatment for depression, they suggested that it was hypomania. I oversleep like hell when I'm depressed, and I have no issues knowing that I do suffer for depression (have on and off for 10 years) but possibly BP II? I just can't wrap my head around that, to me its always just been insomnia, and a normal part of that...

I know before even writing this, that it is probably going to sound like the symptoms for hypomania...but maybe it can just be a part of insomnia, or maybe i need a kick in the ass to pursue this further...I'll either stay up for days at at a time (2-5 days) or sleep only a couple hours (2-4 hours) for weeks at a time.

I get hyper, my htoughts race and get jumbled (i've actually started thinking this is what doesn't let me sleep, but truth be told, im just not tired and don't feel like sleeping.)

I get impulsive, and very driven to do things for no reason (but, lack of sleep could certainly lower inhibitions and screw up judgement)...noticably, things like driving, I just need to go drive, and I would just drive out to the ferry, turn around, drive until the highway ended, double back go again, and speed...now I normally speed, but not too too much...but when I owned a car, It'd start shaking and refuse to accellerate anymore at 140 km/hr, so that's what I'd drive, I remember once taking a corner around 120, being on two wheels and nearly flipping it which didn't even slow me down...i've taken my moms vehicle, and done 180 down the highway (speed limit is 80)...which is a little overboard, I think, but the problem is when I'm not sleeping I don't consider what I'm doing.

I can either become super focused on a project, or super distractable, where i cant sit for more than aminute without getting up and starting something new...

...i'm more social, i mean, normally im a very quiet, easy going, semi-recluse (ok, the recluse part may be more linked to my depression, after so long its hard to say),

.....only problem is that my friends think im weird, cause i'll talk and talk and talk about anything and everything, or i'll phone them at some ridiculous time cause im up, and im working on something, and i really really really want to tell them, but don't think about the time.

Sometimes, but not always, i get irritable and agitated (which should be expected for not sleeping), I'll shout, I'll argue for the sake of arguing, I'll disagree with anything and everything even if i know it's right. I'll be laying next to my bf trying to sleep and just shakingly irritated just by his breathing to the point where I can't even lay there and listen to it anymore and have to get up...

so yes, I can see where little things in there fit in, but then i look at behaviors that are so often associated with bipolar...I don't go on spending sprees, I make the odd irresponsible purchase here andt here, but that has nothing to do with my sleep. My parents hold my money for me anyways (yes, i know it's pathetic, im 22) but i mean, i've never f'ed up financially, but its just what I've done since I moved out on my own at 17, just in case.

I know delusions, and hallucinations, and all that stuff is BP I, so i can't say "ah, i dont have that, its not a possability" if its possibly BP II... but I still just see alll of this as "normal" behavior for me when I'm in a bout of insomnia. It's just sort of what I expect from it, cause its the way its always been. I know writing this out, i can see how it all fits, but in my head, it just doesn't...

[Paragraph breaks generously provided by a.m. so his his confused brain could attempt to follow the thought]

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I'm pretty sure that insomnia can't cover dangerous driving (apart from the exhaustion type), severe irritability of the type you describe, phoning people at inappropriate times just because you're awake, etc.

I've never done overspending; it's something that is often seen in bipolar, but that not all people with bipolar disorder do.

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Well, there is something going on beyond insomnia. Insomnia generally has a negative effect- the person still feels tired and misses the sleep they aren't getting. The excessive talking, the risky behavior, the irritability and the reduced sleep together all point toward something else going on.

The symptoms/behaviors you describe are like those found in someone experiencing hypomania. Bipolar isn't always going to fit into the typical descriptions that you hear about. Just because you aren't spending thousands of dollars spontaneously or having hallucinations it doesn't mean that bipolar should be ruled out. On the other hand, lack of sleep, talkativeness, and irritability doesn't automatically mean bipolar.

mayoclinic.com

Hypomania

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Sounds like hypomania to me. But I can relate to how you talk about it: that this is just 'normal' for you at certain times. I've had episodes of depression since I was 12/13, and was diagnosed bipolar aged 23. Looking back now (having learnt more about these things), I realise that I was having episodes of hypomania through my teens as well but, like you, they just seemed 'normal'(ish) to me. Even if I did occasionally think 'I know this behaviour's a bit weird', I felt fucking fantastic, so I wasn't about to complain about it! I was only diagnosed after prozac pushed me into proper mania.

Also, what resonance said - not all bipolars display all the same symptoms. You only have to check a certain number on the list in the DSM-IV to fulfill the criteria.

I guess what you decide to do about it is your choice. But I've got to say, it sounds like you're engaging in pretty risky behaviour when you stop sleeping - personally, that would induce me (when stable) to talk to a professional and try to get to the bottom of it for the sake of your physical safety if nothing else. Like I said though, up to you. Keep posting, and we'll keep trying to help if we can!

xx

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...that this is just 'normal' for you at certain times. I've had episodes of depression since I was 12/13, and was diagnosed bipolar aged 23. Looking back now (having learnt more about these things), I realise that I was having episodes of hypomania through my teens as well but, like you, they just seemed 'normal'(ish) to me. Even if I did occasionally think 'I know this behaviour's a bit weird', I felt fucking fantastic, so I wasn't about to complain about it!

Me too... I was dx'd with depression when I was pretty young and in highschool every once in a while I knew my behaviour was a bit ''different'', but I wasn't dx'd with bipolar until after I was out of highschool. I would sometimes stay up 'til all hours and not get any sleep and have racy thoughts but still do well in school and get a lot accomplished but be doing some risky behaviours... some other things. It wasn't until after I started college and pretty much had a break down that I was dx'd.

It's hard to see things that are normal to you, that you have been experiencing for a long time and think that they might actually be a problem and contributing to other things. [Like depressions, or relationship problems, etc.]

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Let's consider your own comments in contrast to a symptom summary written for the clinical practioner (i.e. these are not the exact DSM-IV criteria). Granted, this is written more for BPI, but is still applicable to BPII, since the difference is primarily a matter of degree.

In general, for a diagnosis of mania, patient must have experienced either euphoria with three DIGFAST symptoms or irritability with four of these symptoms:

D. Distractibility. This is the most common symptom and is usually characterized by the inability to pay attention to any activity for very long.

Sometimes, but not always, i get irritable and agitated (which should be expected for not sleeping)[Rationalization]. I'll shout, I'll argue for the sake of arguing, I'll disagree with anything and everything even if i know it's right. I'll be laying next to my bf trying to sleep and just shakingly irritated just by his breathing to the point where I can't even lay there and listen to it anymore and have to get up...

....or super distractable, where i cant sit for more than aminute without getting up and starting something new...

I. Insomnia in mania typically means having high energy and requiring less sleep. (This differs from insomnia in depression, in which the patient has low energy plus an inability to sleep.)

...I'll either stay up for days at at a time (2-5 days) or sleep only a couple hours (2-4 hours) for weeks at a time.

...I get hyper....,

G. Grandiosity. Patients with this symptom have an inflated sense of themselves, which, in severe cases, can be delusional. Close to 60% of all manic patients experience feelings of omnipotence. Sometimes they feel that they are godlike or have celebrity status.

Comment: Ok, you get a bye here! ;) However, I think that too much emphasis is often placed on "godlike or celebrity status" as well as the idea of euphoria. Mania doesnt' have to feel good, or even if it does, that feeling often doesn't last long.

F. Flight of ideas. Thoughts literally race.

... my thoughts race and get jumbled

A. Activity. An increase in intensity in goal-directed activities occurs, which is related to social behavior, sexual activity, work, school, or combinations.

I can either become super focused on a project,

......i'm more social, i mean, normally im a very quiet, easy going, semi-recluse.

S. Speech. Excessive talking is present (i.e. Pressured speech)

....only problem is that my friends think im weird, cause i'll talk and talk and talk about anything and everything, or i'll phone them at some ridiculous time cause im up, and im working on something, and i really really really want to tell them, but don't think about the time.

T. Thoughtlessness. Excessive involvement in high-risk activities is present (e.g., unrestrained shopping, promiscuity). Mood disturbance may be severe enough to damage one's job or social functioning or relationships with others, or which require hospitalization to prevent harm to others or to the self.

I get impulsive, and very driven to do things for no reason (but, lack of sleep could certainly lower inhibitions and screw up judgement)[Rationalization]. ...noticably, things like driving, I just need to go drive, and I would just drive out to the ferry, turn around, drive until the highway ended, double back go again, and speed...now I normally speed, but not too too much...but when I owned a car, It'd start shaking and refuse to accellerate anymore at 140 km/hr, so that's what I'd drive, I remember once taking a corner around 120, being on two wheels and nearly flipping it which didn't even slow me down...i've taken my moms vehicle, and done 180 down the highway (speed limit is 80)...which is a little overboard, I think, but the problem is when I'm not sleeping I don't consider what I'm doing.

...I don't go on spending sprees, I make the odd irresponsible purchase here andt here, but that has nothing to do with my sleep My parents hold my money for me anyways (yes, i know it's pathetic, im 22) but i mean, i've never f'ed up financially, but its just what I've done since I moved out on my own at 17, just in case.[Rationalization].

Comment: Normal 22 year olds don't have their parents holding the purse strings. Also, in evaluating for bipolar disorder, you mostly have to ignore all the rationalizations. One item not listed as a diagonistic symptom, but which is important to note is called "Lack of insight to illness". It is a hallmark of bipolars, but very few other disorders (most notably Schizo, and Narcissistic disorders). That is the more ill we are the less likely we are to recognize our level of disfunction. This can be partly overcome with patient education and some time in learning ones own prodromes (symptoms). This is why a trusting pdoc/pt. relationship is very important. As part of this the majority of bipolars are not med compliant at some time or another. There is just a strong feeling that says "I'm not bipolar. These meds make me feel worse than not being medicated. If I can just get back to that great feeling of energy I will be able to pull things together on my own". It's so seductive till you have had your life fall apart enough times to make you realize that being stable is a much better way of life.

I managed to make it to age 43 before my life fell apart. I'm a very frugal (read cheap) guy, but over the years begining in college I knew that I had periodic times every 3 or 4 months where I would suddenly have strong urges to buy something out of the ordinary that I would normally not allow myself. Never beyond my means, but I recognized the the sort of obsessions weren't normal. The days or a week or so, when I was suddenly breezy, outgoing, outrageously funny. Then suddenly not.

Ok, so right now you don't think anything is really wrong. You are surving with being sleepless, calling your friends at 2 a.m., and alternately being ragey or somewhat depressed. The only really bad thing is your period Dale Earhhart driving imitations, no big deal. If that is something under your control, then just stop it girl! The danger is that you are going to get a ticket for reckless driving. Go fast enough or often enough and you'll lose your license, have a traffic accident, got to jail, or not be able to get a job that requires driving.

The thing about bipolar disorder is what's called "Kindling Effect". Similar to the models of epilepsy, the longer BP goes untreated, the worse it gets. The highs and lows get exagerated and the episodes come increasingly more often. That's where I am. Four years ago I had a job, was miserable but functional, now I gotta have those meds to make it thru the day.

Alright. Not meaning to bludgeon you, but open your eyes. Stick around the boards, do some reading, listen to your healthcare pro. Go talk to a pdoc and get a real professionals opinion. Read Miklowitz's Bipolar Disorder Survival Guide. Check out the resources pinned on our Bipolar Forum.

Good luck. Life can be much better. I promise. a.m.

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