Procrastinating and tired all the time but can't sleep

[leadinglady]

I want to do nothing but sleep. I put off everything from showering (too much energy expelled) to making phone calls, to filling out important papers that need to be mailed in. It's like I just dont have the energy. I work a full time job out of my home from 3p to 11:30p so I try to save up all my energy to do that and I can barely do that. I'm supposed to be working right now and yet here I sit, talking about how I procrastinate. LOL

I have tons and tons of things to do but just feel overwhelmed and have no energy to do any of it. I can go grocery shopping and come home and be ready to go to bed for the night. But I lay down to go to sleep, and can't fall asleep. I toss and turn until daylight and then nod off.

Any advice on how to get out of this procrastination crap?

[null0trooper]

I have tons and tons of things to do but just feel overwhelmed and have no energy to do any of it.

Stop trying to do "tons and tons of things to do!" To quote an ancient philosopher "That trick NEVER works!"

Make your list of things to do, but stop at 3. It does not have to be the most important 3 or the most urgent 3, just 3. If you can get all three done that day, have a cookie. If not, cross out what you did get done and go back to bed. Try again the next day.

[OreoKitty]

I know this is a big leap...but you sound depressed.

I have felt the exact same way. Wait a minute...I still feel the same way most of the time. I conserve all my enery to get to work and do my work. Then I come home and do nothing. I do talk to some people on the phone if I'm in the mood. I hate to take showers still. It seems such an overwhelming task at times. I'm not a neat-nick anyways, but my house is a little scary right now because God forbid I clean.

Actually, I have been going to work much more regularly. I don't know if it's eating better, a regular sleep schedule, more routine, or the overwhelming stress at work due to budget cuts which makes me a little hypomanic while at work.

I have worked from home here and there, but find I usually don't get as much done.

I know that exercise would help me with my energy, but I haven't done it yet.

So anyways, I feel what you are going through. I read the book Take Charge of Bipolar Disorder which had some of the suggestions I used and listed above. A regular sleep schedule has definitely helped me show up at work.

Good Luck,

Oreo

[liveoak]

Your meds don't seem to be working. When do you see your pdoc next?

[lysergia]

I have tons and tons of things to do but just feel overwhelmed and have no energy to do any of it.

Stop trying to do "tons and tons of things to do!" To quote an ancient philosopher "That trick NEVER works!"

Make your list of things to do, but stop at 3. It does not have to be the most important 3 or the most urgent 3, just 3. If you can get all three done that day, have a cookie. If not, cross out what you did get done and go back to bed. Try again the next day.

very very good advice there.

i also agree you do sound depressed - this is the exact same stuff i do when i'm depressed past the part where any kind of behaviour is going to change my mood. get thee to your doc! get this monster under control while you can still beat it with a small stick (rather than a lead bat).

hang in there!

- rita

[leadinglady]

Thanks all. I went off my Paxil for a few days and felt really really bad and so I figured well, it can't be depression because I feel better on the Paxil than I do off of it. But I guess it's just suboptimal. I agree they all do sound like depression symptoms. So far we haven't found the combo that works for me to get rid of it and the anxiety. I hate playing Russian Roulette with meds.

I don't go back to the pdoc until June because right now i have no insurance.

[liveoak]

leadinglady, you might want to ask your pdoc about Seroquel.

I have treatment-resistant depression, and Seroquel finally solved the puzzle for me, particularly with the anxiety. I'm also on Cymbalta. I still get depressed and suicidal, but it's far less often. I"m able to do without klonopin now also.

[SunshineOutside]

I know how you feel. I promise. I'm so sorry you're feeling this way.

I support you in calling your Pdoc tomorrow morning and make sure that you leave every single symptom. Explain the situation about the insurance. I'm almost positive they will work with you.

The depression sounds bad. I support you in getting help immediately instead of waiting, if at all possible.

Depression can worsen much in a short period of time and the worse it gets, the harder it may be to treat and control.

Better safe than sorry. I imagine that when your Pdoc. hears of your symptoms he/she will want to do something as soon as possible. It may just be adjusting your meds and that might not require a visit.

I know, we all hate taking meds. You can resist if you want, but it is highly discouraged here. Because we know what can happen when we don't take responsibility for ourselves and get and maintain treatment for any illness. It still sucks.

I really would like it if you feel better soon.

sincerely,

Sunshine Outside

[nightshade]

I understand your predicament. I experience some of the same problems myself. My doctor just increased my Paxil Cr to 75 mg, hoping it will help, but I won't know for a few weeks.

Thinking of you in this time of need.

[ldo]

Well, first off you deserve congratulations with keeping up with that job. I'm sure it's not easy. Not sure I could work out of my home with so many distractions around. (unfinished projects, good books, undone laundry, etc.)

Are you having some kind of treatment for the sleep apnea? Seems like that could be aggravating a lot of other things. I had this nasty sinus thing recently which would wake me in the middle of the night kind of strangling, and I can tell you that I didn't feel too sharp. Getting better now but haven't dispelled all the fog yet. Could this be part of your picture?

Also, I'm sure everyone's mentioned the bit about regular hours, healthy diet etc. But I want to emphasize that the right kind of physical activity at the right time may help. For me, a walk late in the day can help, and vigorous exercise earlier in the day can help me wake up for a while after and sleep better in the evening. (Lately I seem to have evolved the ability to work out late and still sleep, but that's another story and I understand it doesn't work for most people.) I'm also aware that exercise doesn't work like this for some people, you'll have to see for yourself.

For me, it also helps to get out of the house for a while every day. Not sure if it will work for you.

[leadinglady]

Hi all thank you for your concerns. I go to the pdoc on the 25th. I hadn't checked back here or I would have definitely taken your advice SunshineOutside and called sooner. I have tried Seroquel in the past and it made me even more depressed. Lithium gave me headaches. It seems like I get every side effect known to man with medications. Cymbalta made me feel like the devil's spawn, almost homicidal for the first time in my life.

I am still battling it. Granted I've noticed I do stay up very late but that's because I can't fall asleep! I think it's a combination of things. I'm the worst possible combo: An obese, depressed, hypothyroid, sleep apneic.

So I'm going to schedule a physical too to see if any of that is the cause. I had a meltdown yesterday (In looking back at what everyone said about it getting worse I totally concur!) and it DID get worse and I freaked. I ended up popping a Paxil/Zyprexa/Lithium/Xanax combo that knocked me unconscious for a good 14 hours but hey at least I wasnt screaming at anybody.

Oy, I hope this gets better soon.

[GroovyGwen]

I'm the worst possible combo: An obese, depressed, hypothyroid, sleep apneic

So I'm going to schedule a physical too to see if any of that is the cause.

You're kidding me right? Do you know anything about the symptoms of ANY of those things???? How about a tired or sleepless, ridiculously depressed, hurts to be alive kinda gal? I'm serious. You need medical attention in a big way. Definitely some anti-depressants up in this hizzouse, but I am pretty sure once you get the thyroid thing a little better, you will feel MUCH better. You went OFF your paxil? Really??? Why would you think that was a good idea?

YOU DO NOT NEED TO BE RANDOMLY POPPING PILLS. That is a very good way to DIE. From Aidsmeds.com:

Major Drug-Drug Interaction: lithium (lithium) and Paxil (paroxetine)

--------------------------------------------------------------------------------

MONITOR CLOSELY: Lithium may enhance the pharmacologic effects of selective serotonin reuptake inhibitors (SSRIs) and potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5HT1A receptors. The exact mechanism by which this interaction occurs is unknown. Conversely, SSRIs may elevate the plasma concentrations of lithium and increase the risk of lithium toxicity. The interaction has been associated with fluoxetine, while citalopram and paroxetine reportedly do not cause the interaction. Excessive somnolence has been reported with lithium and fluvoxamine. MANAGEMENT: Caution is advised if concomitant use of SSRIs and lithium is necessary. Lithium levels should be assessed regularly and the dosage adjusted accordingly. Close monitoring is recommended for signs and symptoms of lithium toxicity as well as excessive serotonergic activity such as CNS irritability, altered consciousness, confusion, myoclonus, ataxia, abdominal cramping, hyperpyrexia, shivering, pupillary dilation, diaphoresis, hypertension, and tachycardia.

Moderate Drug-Drug Interaction: Xanax (alprazolam) and Zyprexa (olanzapine)

--------------------------------------------------------------------------------

GENERALLY AVOID: The safety and efficacy of intramuscular olanzapine administered in combination with benzodiazepines have not been established. Deaths have been reported in patients who received IM olanzapine during postmarketing use. The cause has not been determined but in many of the deaths, patients were treated with multiple concomitant drugs including IM benzodiazepines and other IM antipsychotics that are known to have the potential to induce hypotension, bradycardia, and respiratory or CNS depression. In addition, IM olanzapine may have been administered to some patients in a manner that was inconsistent with product labeling and also to patients with significant medical comorbidities or other medical conditions associated with potentially fatal outcomes. As of September 30, 2005, there have been 29 cases of spontaneously reported fatalities temporally associated with the use of IM olanzapine. Nineteen of these fatal cases had been or were concurrently being treated with benzodiazepines (seven with more than one benzodiazepine; six with IM or IV benzodiazepines; five treated within 2 hours of death). Based on estimated exposure, the incidence of fatal reports was less than 0.01%, which is similar to that reported for other parenteral agents used to treat patients with acute agitation associated with mental illness. A causal relationship is difficult to establish because there tends to be a higher risk of mortality associated with this particular patient population regardless of treatment. MONITOR: CNS- and/or cardiorespiratory-depressant effects may be increased during concomitant use of olanzapine and benzodiazepines, especially in elderly or debilitated patients. In clinical trials of elderly patients with dementia-related psychosis, the incidence of death in olanzapine-treated patients was significantly greater than in placebo-treated patients (3.5% vs. 1.5%). Risk factors for the increased mortality with olanzapine include age greater than 80 years, dysphagia, sedation, malnutrition and dehydration, concomitant use of benzodiazepines, and presence of pulmonary conditions such as pneumonia. Limited data in 15 healthy subjects receiving IM olanzapine followed by an IM benzodiazepine (lorazepam) found that the combination prolonged somnolence by 3.3 hours compared to IM olanzapine alone and 5.8 hours compared to IM lorazepam alone. MANAGEMENT: Caution is necessary when olanzapine is used in combination with benzodiazepines. Ambulatory patients should be made aware of the possibility of additive CNS effects and counseled to avoid activities requiring mental alertness until they know how these agents affect them. They should also be advised to avoid rising abruptly from a sitting or recumbent position and to contact their physician if they experience symptoms of hypotension such as dizziness, lightheadedness, or fainting. Concomitant administration of IM olanzapine and parenteral benzodiazepine has not been studied and is therefore not recommended. Patients given this combination when necessary should be closely monitored for excessive sedation and cardiorespiratory depression.

Moderate Drug-Food Interaction: Xanax (alprazolam)

--------------------------------------------------------------------------------

GENERALLY AVOID: The pharmacologic activity of oral midazolam, triazolam, and alprazolam may be increased if taken after drinking grapefruit juice. The proposed mechanism is CYP450 3A4 enzyme inhibition. MANAGEMENT: The manufacturer recommends that grapefruit juice should not be taken with oral midazolam. Patients taking triazolam or alprazolam should be monitored for excessive sedation. Alternatively, the patient could consume orange juice which does not interact with these drugs.

Moderate Drug-Drug Interaction: lithium (lithium) and Zyprexa (olanzapine)

--------------------------------------------------------------------------------

MONITOR: The concomitant administration of lithium with neuroleptic agents may increase the risk of extrapyramidal reactions and neurotoxicity. In addition, central nervous system-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients. MANAGEMENT: Patients should be monitored for altered efficacy and safety during coadministration. Dosage adjustment or discontinuation of one or both drugs may be necessary if an interaction is suspected.

Moderate Drug-Drug Interaction: Xanax (alprazolam) and Paxil (paroxetine)

--------------------------------------------------------------------------------

MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients. MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

Moderate Drug-Drug Interaction: Paxil (paroxetine) and Zyprexa (olanzapine)

--------------------------------------------------------------------------------

MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients. MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

Good god.

[jett]

i do the procrastinating thing too! then i end up even more overwhelmed cause so much gets added to the pile.

when my energy gets really low and i am totally overwhelmed i will sometimes set a timer for 15 minutes. that way i know i don't have to do everything, but i will get something either started or done. often i find that i can keep going for longer cause i have some momentum. i did this last week when i had to sort through 3 months of paperwork and figure out what bills needed to be paid!

hope this helps.

jett

(there are safe ways to get off meds, but withdrawl can be dangerous and can cause your symptoms to be much more acute. it can take a really long time and lots of support. please take care of yourself)

[Gussie]

I want to do nothing but sleep. I put off everything from showering (too much energy expelled) to making phone calls, to filling out important papers that need to be mailed in. It's like I just dont have the energy. I work a full time job out of my home from 3p to 11:30p so I try to save up all my energy to do that and I can barely do that. I'm supposed to be working right now and yet here I sit, talking about how I procrastinate. LOL

I have tons and tons of things to do but just feel overwhelmed and have no energy to do any of it. I can go grocery shopping and come home and be ready to go to bed for the night. But I lay down to go to sleep, and can't fall asleep. I toss and turn until daylight and then nod off.

Any advice on how to get out of this procrastination crap?

[leadinglady]

I'm the worst possible combo: An obese, depressed, hypothyroid, sleep apneic

So I'm going to schedule a physical too to see if any of that is the cause.

You're kidding me right? Do you know anything about the symptoms of ANY of those things???? How about a tired or sleepless, ridiculously depressed, hurts to be alive kinda gal? I'm serious. You need medical attention in a big way. Definitely some anti-depressants up in this hizzouse, but I am pretty sure once you get the thyroid thing a little better, you will feel MUCH better. You went OFF your paxil? Really??? Why would you think that was a good idea?

YOU DO NOT NEED TO BE RANDOMLY POPPING PILLS. That is a very good way to DIE. From Aidsmeds.com:

Major Drug-Drug Interaction: lithium (lithium) and Paxil (paroxetine)

--------------------------------------------------------------------------------

MONITOR CLOSELY: Lithium may enhance the pharmacologic effects of selective serotonin reuptake inhibitors (SSRIs) and potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5HT1A receptors. The exact mechanism by which this interaction occurs is unknown. Conversely, SSRIs may elevate the plasma concentrations of lithium and increase the risk of lithium toxicity. The interaction has been associated with fluoxetine, while citalopram and paroxetine reportedly do not cause the interaction. Excessive somnolence has been reported with lithium and fluvoxamine. MANAGEMENT: Caution is advised if concomitant use of SSRIs and lithium is necessary. Lithium levels should be assessed regularly and the dosage adjusted accordingly. Close monitoring is recommended for signs and symptoms of lithium toxicity as well as excessive serotonergic activity such as CNS irritability, altered consciousness, confusion, myoclonus, ataxia, abdominal cramping, hyperpyrexia, shivering, pupillary dilation, diaphoresis, hypertension, and tachycardia.

Moderate Drug-Drug Interaction: Xanax (alprazolam) and Zyprexa (olanzapine)

--------------------------------------------------------------------------------

GENERALLY AVOID: The safety and efficacy of intramuscular olanzapine administered in combination with benzodiazepines have not been established. Deaths have been reported in patients who received IM olanzapine during postmarketing use. The cause has not been determined but in many of the deaths, patients were treated with multiple concomitant drugs including IM benzodiazepines and other IM antipsychotics that are known to have the potential to induce hypotension, bradycardia, and respiratory or CNS depression. In addition, IM olanzapine may have been administered to some patients in a manner that was inconsistent with product labeling and also to patients with significant medical comorbidities or other medical conditions associated with potentially fatal outcomes. As of September 30, 2005, there have been 29 cases of spontaneously reported fatalities temporally associated with the use of IM olanzapine. Nineteen of these fatal cases had been or were concurrently being treated with benzodiazepines (seven with more than one benzodiazepine; six with IM or IV benzodiazepines; five treated within 2 hours of death). Based on estimated exposure, the incidence of fatal reports was less than 0.01%, which is similar to that reported for other parenteral agents used to treat patients with acute agitation associated with mental illness. A causal relationship is difficult to establish because there tends to be a higher risk of mortality associated with this particular patient population regardless of treatment. MONITOR: CNS- and/or cardiorespiratory-depressant effects may be increased during concomitant use of olanzapine and benzodiazepines, especially in elderly or debilitated patients. In clinical trials of elderly patients with dementia-related psychosis, the incidence of death in olanzapine-treated patients was significantly greater than in placebo-treated patients (3.5% vs. 1.5%). Risk factors for the increased mortality with olanzapine include age greater than 80 years, dysphagia, sedation, malnutrition and dehydration, concomitant use of benzodiazepines, and presence of pulmonary conditions such as pneumonia. Limited data in 15 healthy subjects receiving IM olanzapine followed by an IM benzodiazepine (lorazepam) found that the combination prolonged somnolence by 3.3 hours compared to IM olanzapine alone and 5.8 hours compared to IM lorazepam alone. MANAGEMENT: Caution is necessary when olanzapine is used in combination with benzodiazepines. Ambulatory patients should be made aware of the possibility of additive CNS effects and counseled to avoid activities requiring mental alertness until they know how these agents affect them. They should also be advised to avoid rising abruptly from a sitting or recumbent position and to contact their physician if they experience symptoms of hypotension such as dizziness, lightheadedness, or fainting. Concomitant administration of IM olanzapine and parenteral benzodiazepine has not been studied and is therefore not recommended. Patients given this combination when necessary should be closely monitored for excessive sedation and cardiorespiratory depression.

Moderate Drug-Food Interaction: Xanax (alprazolam)

--------------------------------------------------------------------------------

GENERALLY AVOID: The pharmacologic activity of oral midazolam, triazolam, and alprazolam may be increased if taken after drinking grapefruit juice. The proposed mechanism is CYP450 3A4 enzyme inhibition. MANAGEMENT: The manufacturer recommends that grapefruit juice should not be taken with oral midazolam. Patients taking triazolam or alprazolam should be monitored for excessive sedation. Alternatively, the patient could consume orange juice which does not interact with these drugs.

Moderate Drug-Drug Interaction: lithium (lithium) and Zyprexa (olanzapine)

--------------------------------------------------------------------------------

MONITOR: The concomitant administration of lithium with neuroleptic agents may increase the risk of extrapyramidal reactions and neurotoxicity. In addition, central nervous system-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients. MANAGEMENT: Patients should be monitored for altered efficacy and safety during coadministration. Dosage adjustment or discontinuation of one or both drugs may be necessary if an interaction is suspected.

Moderate Drug-Drug Interaction: Xanax (alprazolam) and Paxil (paroxetine)

--------------------------------------------------------------------------------

MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients. MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

Moderate Drug-Drug Interaction: Paxil (paroxetine) and Zyprexa (olanzapine)

--------------------------------------------------------------------------------

MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients. MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

Good god.

Sorry but I was in kind of a "I-don't-give-a-fuck" mood when I took them.

Edited June 18, 2008 by leadinglady