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Hi all. I've been in a %*#@ storm for the past 2 months. Pretty sure I'm in a bipolar 2 mixed state.

About 3 weeks ago my pdoc added an extra 20 mg geodon to the mix, total of 40 mg. it really seemed to help right away, felt pretty good for about 10 days, but the symptoms returned with vengeance.

About a week ago I started getting irritable. Pissed at everything and everyone. Everything hit the fan on Thursday. I felt very spun and detached. Brain completely scrabbled. Doing and saying weird things. That night the irritabilty physically took over my body and mind. I was snapping at my husband and son for everything. I'm still feeling the same way :( I'm so tired of this. I thought I was getting better, and now back to square one:(

I just want this to stop. I'm generally a pretty easy going person.

I'm not sleeping well. Been having weird lucid dreams and sweating all night.

Current meds: geodon 40 mg., zoloft 75 mg., remeron 22.5 mg., lithium liquid citrate 100 mg, lorazepam 1/2 mg 3x a day (doesn't do anything but can't stop because of withdrawal)

Anyone have any thoughts on bipolar mixed state? It's a living hell! I want to crawl out of my skin!

Edited by Britton
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I feel your pain. I'm surprised I haven't finished a mixed state surrounded by the severed heads of people who've irritated me.

I communicate to my girlfriend that I needed space and not to talk to me unless necessary, and certainly not to ask me to do anything. I'd find something to do that wasn't irritating and away from people.

I'd talk to your pdoc. Whatever you're on doesn't seem to be helping. I know for me ssri's (Zoloft) are a huge, huge, huge mixed state maker. I avoid the hell out of them. I've also read that the first goal of any bipolar treatment is stability. It's ok if patients are a little depressed, as long as they are consistently depressed.

Good luck.

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Thank you! That made me laugh:)

I've heard that about SSRI's. Ugh. Not sure if I should talk to the doc about ditching the zoloft of what. He's had it with me anyway, which is lame, he's only been my doctor for 3 years and I've been pretty stable the whole time. Now that I'm going through this, he seems irritated with me. I'm actually needing him to work with me and do his job, but he doesn't seem to be willing to put the effort in.

Is 2 months a long time to be going through a mixed state? I thought the extra geodon was helping, but now I'm more irritable than ever. I feel like I'm going to snap! (Or maybe I already did! Lol) Don't know what to do and I don't have an appointment until the end of February. Could the increase in geodon be causing more irritability? I'm so confused.

Edited by Britton
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I'd call and see if he can squeeze you in before then; my pdoc is very busy, but if I call he usually squeezes me in somewhere. It's part of their job to monitor and respond to things as they come up. Because he just changed your meds two weeks ago, I think that's even more reason for him to see you sooner. 

 

Two months does seem like a long time. I don't think I've done more than a few days with a mixed state; the only time I've gone two months is when I was taking SSRI's (without any mood stabilizer -- they thought I had depression). My mixed state was bad. Really bad. I could have gotten into a car accident the way I was driving. 

 

I don't know anything about Geodon, but you're telling me it's not helping, which might be the most important thing to know.

 

You say you've been stable the whole time with your pdoc, but your med list makes me think it took you a while getting to that point; you're on a lot of meds. I'm on two mood stabilizers (Lamictal and Trileptal) with just a little bit of Adderal. I've been on other mixes of meds (lithium, seroquel, some SSRI's thrown in), but Lamictal and Trileptal are my twin pillars -- I've been taking them consistently for over eight years. But if your mix has been keeping you stable for three years, then that's something to really consider; but so is a two-month-long mixed state. Lucid dreams and sweating are also things your psychiatrist should know about; wellbutrin gave me vivid dreams (gory, vivid dreams), so maybe your dreams are influenced by your meds, too. 

 

I know some of my worst periods were due to major life disruptions. Any major changes in your life? Are you seeing a therapist, too? 

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I'm very sorry to hear you're going through this struggle. If anything, you can admit yourself to the ER if you feel you are losing it.

When I was irritated in my manic state 9 years ago, I would do aggressive things and break the fridge, slam the door etc. My family had to take me to the ER

because the irritability would make me break things in the house and start picking fights with people around me.

 

I hope it does get better soon and hope the meds start working better and you get to a stable mind as close to normal as possible.

Another thing you can do is call your pdoc and tell your symptoms. They can arrange for an appointment asap.

Then you might have a change in meds for the best. Once the meds started working at that time I was on risperidone, my irritability went away.

It was tough being in a hospital for 14 days. Good luck.

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It's weird. Over the past two months my symptoms have morphed and changed so that every time I talk to the doc, I say something kinda different, so I feel like I'm loose credibility if that makes sense.

This extreme irritability has "only" been about a week, and particularly bad the past 4-5 days. I just don't know what's going on.

I actually admitted myself to a hospital from December 28-January 6, but we didn't make any progress. Waste of time. They didn't tap into the bipolar aspect. When I checked out my paperwork said major depressive disorder, which isn't my problem right now. It's irritabilty, anxiety, spun out feeling and insomnia. Ugh. I can't take this feeling anymore.

I will call Monday and see if I can get into another doctor sooner. My doctor is only in the office once week a month these days...which was fine until now. But I'm not even sure what to say to the doctors anymore. There must be something about the way I come off that to them that makes not know what to do with me. It's very frustrating :-/

I'm going to ask about zyprexa and risperadone But as you can see, I'm already on a ton of meds. It's slowly accumulated over the years. Started out 10 years ago with zoloft for post pardum depression. That didn't work, so he added 20 mg geodon which worked like a charm for a few years. Had a bad episode similar to what I'm going through now 5 years ago and added Remeron for sleep, which worked like a charm until 2 months ago. Wondering if this mix of meds is all wrong. Frustrating thing is that when I started the 40 mg of geodon (upped from 20mg) about three weeks ago, I felt like I was slowly coming out of it for 2 weeks, but then everything went to hell this past week. Such a bummer. I don't know what to make of it.

Will this cycle ever end? I'm starting to feel like I'm going to be stuck this way :*(

Edited by Britton
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Will this cycle ever end? I'm starting to feel like I'm going to be stuck this way :*(

 

 

I would definitely call your pdoc about this.  If you work with your pdoc the less likely you will feel "stuck."

 

 

But I'm not even sure what to say to the doctors anymore.

 

I would tell them everything you've said in these posts you have written.  When you see your pdoc, maybe print this whole thread out and just hand it to him/her to read.

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The reason why your symptoms are all over the place is because you are unstable. :)

 

Geodon made me agitated immediately. It's the med I was pulled off fastest of all my meds. I think I was actually having a paradoxical reaction, because I have a tendency to do that, but I can't swear that is what was happening.

 

But it definitely did not help, it was pulled, and I started Risperdal, which stomped on things nicely. I always come off the Risperdal after a couple of months, when the sedation is no longer a good thing.

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I also almost always have perioxical effects from meds! It makes finding meds very difficult! ALL, and I've tried them all, sleep meds WIRE Me. Even benzos all work opposite on me. I'm in a bad spot with ativan, they don't calm me down, never have, and I think they make me aggitated, but I'm physically dependent on them, so when I try to go off, I have horrible withdrawal which I don't want to go through right now. I tired to go off of them in the hospital last month at my request and I was sweating profusely, shaking, headach etc etc. for 5 days, so when I got out, I started taking them again. I was able to lower my dose though which was a good thing.

I think I need something to squash this good. I will talk to my doc about some of the other meds suggested. Are risperdal and zyprexa both antipsychotics? What about the new drug Latuda? Has anyone taken that? Is it an antipsychotic?

I would like to eventually get off of zoloft as I know it can be bad for bipolar.

Edited by Britton
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Yes all three you mentioned last are antipsychotics. While I was never mixed on zyprexa, I'm sure had I taken it during one it would've pulled me out. I never had much luck on risperdal. I had the opposite effect, I got it because I was psychotic and I ended up getting WAY more psychotic. Saphris was good at mixed states. But that's about all I've tried in terms of AAP's. 

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Yes all three you mentioned last are antipsychotics. While I was never mixed on zyprexa, I'm sure had I taken it during one it would've pulled me out. I never had much luck on risperdal. I had the opposite effect, I got it because I was psychotic and I ended up getting WAY more psychotic. Saphris was good at mixed states. But that's about all I've tried in terms of AAP's.

Zyprexa has pulled me out of mild mixed states, but I don't know how it would do on severe mixed states. I always take it right away if I'm mixed because it's such an unpleasant feeling.
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I also almost always have perioxical effects from meds! It makes finding meds very difficult! ALL, and I've tried them all, sleep meds WIRE Me. Even benzos all work opposite on me. I'm in a bad spot with ativan, they don't calm me down, never have, and I think they make me aggitated, but I'm physically dependent on them, so when I try to go off, I have horrible withdrawal which I don't want to go through right now. I tired to go off of them in the hospital last month at my request and I was sweating profusely, shaking, headach etc etc. for 5 days, so when I got out, I started taking them again. I was able to lower my dose though which was a good thing.

I think I need something to squash this good. I will talk to my doc about some of the other meds suggested. Are risperdal and zyprexa both antipsychotics? What about the new drug Latuda? Has anyone taken that? Is it an antipsychotic?

I would like to eventually get off of zoloft as I know it can be bad for bipolar.

If you aren't having trouble with it, there's no need to come off the zoloft. Lots of bipolar people use it with a mood stabilizer, and I used zoloft without one, back in the day (like 1990). I didn't like it, but it didn't make me crazy.

 

I use Latuda for bipolar depression, and I lurve it. It has stabilized me, I'm functional, I sleep normally (well, the tinazadine (Zanaflex) I take daily for migraine helps with that, too) and I am not aware of any side effects. Not even drooling. It might cause constipation in some, but I drink so much water for the lithium, I haven't had that problem. Or maybe I wouldn't have anyway, we're all individuals with different responses.

 

Depending on your insurance, Latuda is expensive. I'm on medicare, and the cheapest plan I could find costs $150 dollars for my *copay.* I'm going to try to start getting it mail order to cut down on the price a little.

 

I liked how risperdal just powered through all the crazy when I was mixed, but as I said, after a while I would find it too sedating, and would come off of it. My pdoc preferred that I do that anyway. Risperdal made me drool, but it wasn't actually *that* bad.

 

 

I haven't tried Zyprexa.

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I remember one of my worst mixed episodes ever. I was walking out in front of traffic, I was so agitated, I felt like I was losing my mind. My pdoc at the time prescribed seroquel XR, and that seemed to get rid of the mixed state. Even if you feel like a bother to your pdoc call anyway, get an appt. sooner. YOU are paying him to treat you. I wish you the best of luck. And keep us updated. 

 

And FWIW, latuda and risperdal are both good AAP's in my opinion. Geodon worked for me the first time I took it but the second time a year later had me an anxious wreck, I felt like I was being tormented mentally. 

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Thanks for the responses everyone. I will definitely ask the pdoc about the meds suggested here. I know everyone is different, but what is the "gold standard" med for bipolar 2 especially in a mixed state? Is it common to take a med just until the mixed state is over?

I'm Definitely going through a mixed state. Today I feel kinda manic/hyper (in a yuck way) but my body is physically irritable and my jaw is hurting. I hate it. I feel like I'm losing my mind. I want it to stop so bad. When I'm stable, well.....I'm stable! Lol! So weird how our brains can flip on us and change is into something out of nature.

I can tell I'm going to become irritable and pissy as the day goes on. Boo :(

I wonder if the geodon is doing this to me? Is it possible? I was jacked up before before starting the additional geodon as far as anxiety/derealization/insomnia, but the irritabilty thing seems to have gotten worse.

Butterflykisses- can completely feel your story about being agitated out in traffic. I wonder if like you, geodon severd its purpose at one point, but maybe it's not my med anymore.

Crtcyls (I hope I got that right!) thanks for sharing your experience with zoloft. Makes me feel not so scared of it ;) I am interested in latuda. Is it mostly for depression, or can it help with other symptoms of bipolar?

I'm such a creature of habit and afraid of change, in my mind, if it worked once, it will always work. I need to get over that mentality. I just get afraid. I'm afraid of taking something away (geodon) that I've been on for nearly 8 years and trying something different. There's a part of me that's afraid of trying a new medication and it sending me to a very dark place, or permanently altering my brain forever. Could this happen?

Edited by Britton
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Hi all. So I have definitely noticed a pattern and wanted to see if anyone can relate or has any thoughts. Each time I have had an episode of derealization/panic/anxiety (which has been 3 times now) for the week before the episode begins, I'm extremely irritable for about a week to two weeks, Both physically and mentally irritable and my brain is scattered all over the place. Then I have the episode, which is just that, it's like an event, then irritability mostly goes away and then all the other symptoms set in. It's just weird that it always goes down this way. Any thoughts?

When I started this thread I was going through the irritabilty part, and now the anxiety, derealization, fight or flight, panic has set in.

Edited by Britton
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  • 2 weeks later...

It's weird. Over the past two months my symptoms have morphed and changed so that every time I talk to the doc, I say something kinda different, so I feel like I'm loose credibility if that makes sense.

This extreme irritability has "only" been about a week, and particularly bad the past 4-5 days. I just don't know what's going on.

I actually admitted myself to a hospital from December 28-January 6, but we didn't make any progress. Waste of time. They didn't tap into the bipolar aspect. When I checked out my paperwork said major depressive disorder, which isn't my problem right now. It's irritabilty, anxiety, spun out feeling and insomnia. Ugh. I can't take this feeling anymore.

I will call Monday and see if I can get into another doctor sooner. My doctor is only in the office once week a month these days...which was fine until now. But I'm not even sure what to say to the doctors anymore. There must be something about the way I come off that to them that makes not know what to do with me. It's very frustrating :-/

I'm going to ask about zyprexa and risperadone But as you can see, I'm already on a ton of meds. It's slowly accumulated over the years. Started out 10 years ago with zoloft for post pardum depression. That didn't work, so he added 20 mg geodon which worked like a charm for a few years. Had a bad episode similar to what I'm going through now 5 years ago and added Remeron for sleep, which worked like a charm until 2 months ago. Wondering if this mix of meds is all wrong. Frustrating thing is that when I started the 40 mg of geodon (upped from 20mg) about three weeks ago, I felt like I was slowly coming out of it for 2 weeks, but then everything went to hell this past week. Such a bummer. I don't know what to make of it.

Will this cycle ever end? I'm starting to feel like I'm going to be stuck this way :*(

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