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What is recovering from a manic (or mixed) episode like for you? What kind of manic symptoms hang on the longest? Do you experience any new symptoms in the recovery period? How long does it take you to feel normal again?

I find that I'm still experiencing distractibility and agitation, and that I've also started to have foggy thinking and dissociation. I'm just wondering how typical it is to have lingering symptoms and a generally low level of functioning, even though the acute mania itself is gone. It's only been a little more than a week but it already feels like forever.

Edited by aura
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Lithium and Zyprexa ended my last episode of mixed mania. The manic and depressive symptoms kept reappearing for a month and a half or so after I started the meds. The depressive symptoms were not as severe, but the manic symptoms of euphoria, increased energy, little sleep, and Hypersexuality were pretty intense. After the last twinge of mania ended (just literally overnight), I was left with a much milder depression than I had been having (I was having the crashes periodically prior to taking the meds). Then one day I noticed the depression was just gone. If memory serves, it just gradually lifted over the course of a few days. I think it was within a week or so of hitting a therapeutic dose of lithium. 

Edited by Flash
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I had a severe episode of mixed mania. It was the first full-blown episode I had so I didn't know what was going on, and I didn't seek treatment until it got to the point where I couldn't function. I got started on Lamictal and within a short time I could feel it was working, but it wasn't enough by itself so when I started seeing my pdoc he helped me find the right cocktail.

For months afterward I still felt like my brain was smoldering. I had trouble paying attention and focusing. Gradually that subsided as well. I think the symptom that held on longest was anhedonia. I had this odd feeling some people call "being at sixes and sevens," sort of like just not knowing what to do with myself. I was back to work so that helped, but at home I didn't have the feeling of, "Okay, I feel like working on my sewing," or "I'm in the mood for a little snack," things like that. I was just sort of mechanical for a while.

I would say it took a little over a year till I gradually regained my enthusiasm for life and the ability to take pleasure in the little things, like looking at a beautiful sky or reading a good book on a rainy day. But it did come back, gradually.

Of course everyone is an individual, so no one can say, "In X amount of time you will be feeling back to normal." It's a function of your meds helping your brain to recover, and that takes a different amount of time for everyone. But one day I realized I was looking forward to things again, and looking back I could see how far I had come.

If I could give you one piece of advice, you might consider talking with a therapist and/or going to a support group to help you get your bearings on your journey back. Hope this helps!

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1 hour ago, wnek2 said:

For months afterward I still felt like my brain was smoldering. I had trouble paying attention and focusing. Gradually that subsided as well. I think the symptom that held on longest was anhedonia. I had this odd feeling some people call "being at sixes and sevens," sort of like just not knowing what to do with myself. I was back to work so that helped, but at home I didn't have the feeling of, "Okay, I feel like working on my sewing," or "I'm in the mood for a little snack," things like that. I was just sort of mechanical for a while.

This is exactly how I feel right now. It's encouraging to know it'll go away eventually and my brain isn't stuck like this, thank you!

I have a therapist and I do go to support groups when I can. It's a little overwhelming, actually, but I'm trying to stay connected.

2 hours ago, Flash said:

With lithium and Zyprexa, I quashed my last episode of mixed mania. The manic and depressive symptoms kept reappearing for a while, over the course of a month and a half or so. The depressive symptoms were not as severe, but the manic symptoms of euphoria, increased energy, little sleep, and Hypersexuality were pretty intense. After the last twinge of mania ended (just literally overnight), I was left with a much milder depression than I had been having (I was having the crashes periodically). Then one day I noticed the depression was just gone. If memory serves, it just gradually lifted over the course of a few days. I think it was within a week or so of hitting a therapeutic dose of lithium.

I think I'm having some symptoms of mild depression... did this last long for you? I feel sort of... I don't know, stunned or in-shock or something like that.

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I'm actually pretty lucky - after my manic episode in January this year, I recovered fully by the time I was discharged from hospital. In my last few days in hospital, I was having some breakthrough hypomania, but they increased my dose of Zyprexa and that seemed to help. In the hypomanias I've had since, I've found that racing thoughts and distractibility persist longer than the hypomania itself. 

After my manic episode, however, I was quite depressed - I was sleeping 14 hours a day, wouldn't move off the couch, wanted to die. I think it was situational though rather than biochemical - a manic episode is a large shock to the system. 

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Aura wrote: I think I'm having some symptoms of mild depression... did this last long for you? I feel sort of... I don't know, stunned or in-shock or something like that.

I was having a week or two of milder depression following each crash, after which the cycle would start over again. Once I got Zyprexa, the mania would end and I wouldn't crash. It just left me mildly depressed. Lithium finally lifted me out of that depression, a couple weeks or so after the last bout of mania.  I had about 45 good days and then got clobbered by a soul-crushing depression. That moderated to anhedonia after about 5 months. I finally got rid of the anhedonia with doxepin another 7 months later. My mood has been good since, about 7 months.

Edited by Flash
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9 hours ago, aura said:

What is recovering from a manic (or mixed) episode like for you? What kind of manic symptoms hang on the longest? Do you experience any new symptoms in the recovery period? How long does it take you to feel normal again?

I find that I'm still experiencing distractibility and agitation, and that I've also started to have foggy thinking and dissociation. I'm just wondering how typical it is to have lingering symptoms and a generally low level of functioning, even though the acute mania itself is gone. It's only been a little more than a week but it already feels like forever.

I was full blown manic in May - July ish. I was put IP after a meeting with the county crisis unit.

I was only IP for about a week thankfully. But getting back on seroquel really made all the difference. I was on latuda and then risperdal and they did nothing to stop me in my tracks, so to speak. My pdoc was out of town, husband was going to be out of town. 

The IP pdoc put me back on seroquel and that really controls the mania for me. I can still get hypo but not full blown manic on seroquel. *knocks on wood* 

i was still hypomanic after asking to be discharged from IP early. They wanted to keep me longer.

So after IP I had to stay with my parents for a week as per my discharge agreement. Husband was out of town at that point. I found myself still very distractable and still not sleeping my usual number of hours. I had issues with impulsivity as I spent $80 or so at a thrift store on clothes. You can imagine the number of bags I ran out with.

Unfortunately it takes our brains time to regain balance. That's always been my experience. 

As my mood became less and less manic I had a mini crash for a while. I was just disgusted with myself and what I had done while manic. I ruined a lot and spent money I am still paying off to this day. Poor and completely impulsive and irrational decisions. I won't bore you with the details.

It made me feel suicidal and full of self hatred and embarrassment. But my mood improved to just mild low mood if anything. I think it's mostly even though now. Just other obsessions and problems persist. But mood is ok mostly. 

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  • 2 weeks later...

I am getting over a mixed / manic episode that occurred during October-November. The most notable lingering symptoms for me were the racing thoughts, flight of ideas, and the sleep disturbance. I would eventually be able to have more self-awareness into my condition and found myself tripping over my words. It was not a very elegant way to slow down - but it was necessary. The agitation and the sleep disturbance went on for some time. Instead of 0-3 hours of sleep I was starting to average 4-5 hours of sleep. My lithium dose was increased to 1050 mg in an attempt to get me out of the mixed episode at first. This seemed to help temporarily but then the depression aspects faded and it morphed into a pure mania. I was in a partial hospitalization program during this episode and I am thankful I had watchful eyes on me. Since I didn't tolerate 1200 mg of lithium last time I was on it very well - they decided to add Saphris. The Saphris ensured that I was getting at least 3 hours of sleep. Not ideal - but better than zero - which was key for keeping the hallucinations at bay. In retrospect I am very surprised at how long this episode dragged on. Normally I crash and burn immediately. About 1.5-2 weeks after we upped my Saphris to 10 mg at bedtime it was clear that it was bringing me back down to earth. At that point I recall having a full day of panic and reactive depression. I felt tired and scared of the feeling and was sure it meant I was going to lapse back into the suicidal depression I had just climbed out of two months back.

I'm happy to report that that didn't happen and only more recently have I been able to really see that my body's reaction made perfect sense after what I had put it though. The depression never took hold but there are still pangs of sadness. Part of me misses the creative energy. The truth is - it turned me into a disorganized mess and I cringe a little when I think back to the way I acted in front of people. It's all part of the healing process I guess. 

I'm sure if they had given me something like Seroquel or Zyprexa the mania would have been stopped earlier. However, I have to say I really like how the Saphris makes me feel. It's great for sleep induction and I don't have a sleep hangover the next morning. It doesn't make me feel slower than normal - there is no fuzziness. I am unclear what the lithium is doing for me. I had a borderline therapeutic level (0.6) so perhaps it was just not enough. I do suspect that it may be keeping me from cycling again at the tail end of this episode, and for that I am very grateful. 

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