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Not Racing Thoughts, what is this ?


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I was prescribed 10 mg of Saphris nightly after last ER visit. Since going off symptoms have returned strongly. 

 

When I was on it - I felt I was thinking a little more clearly, I was a bit more outgoing, I was more active in life. However ... I had that notorious flat affect. At this point, I would prefer that flat affect. At least I was somewhat engaging in life. 

 

Now that I am off of it it feels like my head is literally going to explode is the best way to put it. Like I can't think straight. I don't have multiple trains of thought going on at the same time that I know of. If I do I am unable to tell. I remember getting manic, or a worse version of this, back in December of last year where I thought my head was going to explode and it lasted about a month. This started 2 days after I stopped Saphris though so obviously the medication was helping with it. 

 

What I am getting confused about is this a psychotic symptom or hypo/manic/mixed state ? I don't feel manic. If anything I feel a slight down, anti social (as usual), and I have no desire to develop or maintain any of my personal relationships I have built up and torn down so many times over the years. My own mother I live with I talk to for 5 minutes a day - often days less. I just don't like interacting with people. My words fumble, I feel akward, my mind literally feels like it is going to blow up. 

 

I however am not suicidal - I am just .... blah ... Not flat, but blah ... 

 

If I had to describe it - I would describe it as I feel like I am literally going crazy. Period. 

 

Obviously I need AP medication. Finding a psych doctor has been a problem for me without insurance, and General Doctors don't like to dabble with them. So I'm screwed. I can't even get more Saphris right now. Only mood stabilizer stuff. Which does keep my moods level now but doesn't help with the stuff mentioned above. So I am well aware of this. Please no suggestions to see a Pdoc or go to PPARX, I have tried both and am unable to get a prescribing Dr. right now. I even went to the ER, Dr. Office, and everything last week - nothing but a discharge with a 14 day supply of medication I can't afford. That isn't enough for help from manufacter. Dr. doesn't want to touch AP meds, only choice of medical doctor I have. 

 

So all this said ... First question first. I know no diagnosis can be made. But if you have went through something similar what part of your illness were you battling ? I am still confused as to my diagnosis - more and more as time goes on. I should also mention when this stuff happens and throughout the day my memory, cognition, and all that are severely impaired. I can't figure out the simplest things that require any sort of thinking above basic levels. No memory. 

 

Second of all - would this be flat out psychosis I am experiencing ?

Edited by lanry78
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I am not a Dr, and I have only really had psychotic features, but nothing you describe sounds like psychosis to me. Maybe someone who has experienced a more florid psychosis will chime in to correct me, but that is my take. You can become psychotic during manic episodes, but some people with MDD become psychotic as well.

 

What you are describing sounds like it could be a depressive OR a mixed episode. If what you are experiencing happened to me, I would guess I was mixed, but it turns out I have dysphoric manias, and I could be conflating the two.

 

Someone on CBs once said she felt like her brain was in a blender when she was mixed. I found it a metaphor that really resonated with me. I don't know what kind of episode you are having, but maybe that description would be useful to you, so I included it.

 

What country are you in?

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Not psychosis as far as I know. The closest like it that I've had was what I call brain scramble. Mixed state but with only enough energy to screw your head in a way that is different than racing thoughts. In one phase, I was in like a stupor. Couldn't process thoughts, really. Empty head but with a constant buzz. In another, my head was a noisy place with lots of static. I couldn't think for anything. For me, both were more of a cognitive thing than a racing thing, although I've had racing thoughts and super racing thoughts. Both were precursors to psychosis. Both included depression but depression was worse with the empty head with buzz experience.

 

AAPs help clear my head in a way that stabilizers alone don't, and I've been on most of the ACs and Lithium, including combos.

 

This is what my pdoc did in a similar situation when we weren't trying AAPs (most give me akathisia, so I've gone without). Raised Lamictal, ditched the AD, added Tegretol, Trileptal, or Depakote to deal with the up energy since Lamictal mostly deals with depression for me. Tegretol worked the best. Maybe your GP would be okay with a plan like this. Talk it over. Or ask to switch to Depakote. Unlike Tegretol, it really helps some with depression as much as hypo/mania.

 

Do you have someone who can help find you a pdoc? Have you checked the county? There has to be some sort of service or wait list in your area.

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I agree with crtclms and AnneMarie.  What you are describing sounds like a mixed episode which is its own little brand of hell.  When I have a mixed episode, I can't sit still and my mind will not shut up.  I feel depressed, yet I am agitated.

 

It sounds like Saphris was working for you.  I am frustrated for you that you can't find a prescribing doctor.  Have you tried widening your search area?  I know its a PITA, but I used to drive 3.5 hours one way to see a pdoc.

 

I hope things work out for you.

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Thank you everyone for the replies. I really do appreciate it. 

 

The brain in a blender analogy REALLY made sense, wow ... Did it ever. Someone unplug that frieking thing, lol !! 

 

Everyone gave some good information. AP medications may help it as it reduces the mania leveling things out, but still leaving me with the depressed part of the mixed state. It would make sense as to why I feel "flat" 

 

As far as psychosis. I still encounter it. Ironically iy is more dominant in depressive episodes. It can also be very heavily induced by stress and work. Social situations can also induce it. Psychosis aside, Paranoia seems to be a dominant feature when stressed, in social situations, or out of the blue at times. That is why I thought I might be schizo affective. BP I with rapid cycling  makes much more sense as I look back at my past history though. I remember doctors telling me at my first impatient stay "It is impossible to have moods change that much due to Bipolar". I was like "WTF" 

 

2nd visit they were more understanding, different hospital ... First visit BP II diagnosis. 2nd one BP I with rapid cycling and psychotic features. 

 

Anyways, I think it will take a long time to get this all figured out but those that posted have helped immensely. The mood stabilizer med adjustment suggestions were helpful as well. It just seems the AP help clear my mind more whereas I don't know if Mood Stabilizers would. It does make sense if I am having mixed episodes stable moods would help clear up my mind though. 

 

I wish I could remember a 6 month period where I didn't have 3 MAJOR mood shifts. Usually more often than that. The reason I didn't think I was BP I is because I have had long periods of VERY VERY VERY serious depression (3-6 months) and I didn't think that was typical for BP I ... Anyways, I am babbling now lol 

Edited by lanry78
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BTW I am trying to see if the doctor that treated me inpatient 2 hours away will see me since I had charity assistance there.

 

I was told he is not taking new patients but they would ask him given he treated me inpatient. We will see what happens. I made the call yesterday. 

 

Yesterday I was also lucky enough to get GDoc to fill out patient assistant forms for Saphris - so within 3 weeks, if all goes well, I will have my Saphris back. 

 

Now if I could only get disability to get some sort of life back. Some financial independence. A place to live. Able to pay my bills. Not reliant on others. I want to be able to work again eventually but right now, and for the last few years, it just isn't an option ... Regardless of what the government thinks. 

 

I have been hospitalized twice since my first stage denial. I have also had more Gdoc care, and followed up with all after care suggestions. I have spent countless hours seeking assistance in the psych field with no results. My main fear is without a steady psych doc they will send me to their state doc again and regardless of my actual condition and hospitilizations they will declare me fit to do unskilled labor again. It is disheartening at best. 

 

I am considering getting my congressman involved. I already called and they mailed out the forms. But does that do anything but speed the process up ? If I write me full story do they go to bat for me or do they just speed up the disability process ?

 

P.S. In The U.S.A.

Edited by lanry78
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