Jump to content
CrazyBoards.org

Pdoc thinks I'm hypomanic


Recommended Posts

Hi all -- Haven't been here in a while because I was doing well, but now not so much, so I'm back....

Background: diagnosed bipolar II about a year and a half ago.  Took lamotrigine for about a year and finally went off it because it was making me constantly anxious and agitated and I couldn't stand it anymore.  After I went off it (so I was/am unmedicated except for a prn benzo for anxiety), I was doing really well for a while, feeling normal, doubting my diagnosis once again but still seeing my pdoc and tdoc regularly.

About 6-8 weeks ago, though, the twitchy, agitated, easily distracted and irritated, pull-your-skin-off feeling came back.  There was one day when it was really bad, when I was just really pissed off at the world and when I got home from work I went for a run to try to get my energy down.  While waiting for a stop light to change, I got into a verbal confrontation with a stranger that is really out of character for me, but I felt awesome about it.  After my run, I still had too much energy except I felt great instead of angry, but there was a kind of discomfort under the good feeling, and that little voice saying, "This isn't good, this is wrong."  My girlfriend was worried about me, and I saw her concern and I wanted to relate to it but I couldn't, it was like I was blocked from understanding it.  I knew something was wrong, intellectually, but I couldn't feel it, if that makes sense.  I took an ativan but it didn't seem to help.

That was the worst day.  The twitchy horribleness lasted for about three weeks, and then faded away.  After that I felt sort of all over the place for a few weeks, hating my life, crying a lot, sex drive went to nothing, really emotionally reactive.  I started obsessively researching early retirement and investing because I hate working full time and I think it's affecting my mental health.  I desperately wanted to drop several hundred dollars on a new gaming system (which I also obsessively researched), but my girlfriend convinced me to wait and the desire faded after about a week (I'm really glad now that I didn't buy it!).

Told all of this to my tdoc but she thought that everything I had been feeling was "within normal human experience."  Hearing that was so upsetting -- like, if this is what everybody deals with in life, then why is it so hard for me?  What's wrong with me that I can't deal with "normal human experience" like everyone else can?  She mentioned a lack of "distress tolerance" -- I told her that I think I have decent distress tolerance, I just experience more distress than other people!  She didn't seem to believe me.  I cried for an hour at home after that session and then refused to see her again (I have an appointment with a new tdoc this week).

I haven't been sleeping well, but I have been sleeping.  I haven't been tired at night and I feel like I don't need to sleep but I know sleep is important so I get into bed around the same time every night and eventually I sleep, even if I wake up a lot and toss and turn all night.  I'm good at getting myself to sleep.

I figured I was hypomanic (mixed? dunno) during the twitchy phase, but then I thought it was over and now I'm just miserable because I hate my job and where I live but I'm trapped because my girlfriend is in school and we have to stay at least until she finishes.

Saw my pdoc last week for the first time since all this has happened, and he thinks I'm still hypomanic.  He said that this isn't a big emergency but we need to be careful.  He said that the fact that I'm managing to sleep is what's protecting me, along with the fact that I have a stable job, good place to live, long-term supportive partner, and other healthy habits.  He wants me to consider taking a low dose of seroquel (25-50 mgs) at night when I'm feeling amped up, just so I can sleep more soundly.  He also said that we can wait this out and see if it goes away -- I'm seeing him again in a month, instead of in 3 months like we were doing before.

I don't feel like I'm hypomanic, but I'm also not very good at recognizing it when it's happening.  I feel like I'm constantly questioning myself and I don't know what normal is so I don't know if what I'm feeling is normal or not.

I don't know what I'm asking here.  I guess I should try the seroquel?  It couldn't hurt, right?  I just hate taking meds.

Edited by treacleweasel
  • Like 1
Link to comment
Share on other sites

Seroquel worked like magic for me for sleeping. I took 25 mg at the time. I had been unable to sleep very much and I think I was in a mixed episode. I was able to handle my life so much better when I was able to sleep. I don't think it would hurt to try it.

Link to comment
Share on other sites

I can relate to your episode because I'm living something similar right now, even the drugs are almost the same.

Our life scenarios are a lot different but we are both having trouble sleeping, angry/irritated and stressed.

I don't really think my case is hypomania because I'm active but I feel tired most of the time and besides insomnia and irritability apparently I don't have any other hypomania/mania symptoms besides something here and there.

My thing hans't a name yet and since is stress and insomnia related i'm thinking it's a mania preview because it's how in the past it started for me.

My pdoc is managing my sleep, adjusting things and presenting solutions.

I think because I can't rest I'm angry and life happened to make things worst, so the last two weeks things just went to the roof on the irritability and insomnia but are cooling now, he wants me back on another mood stabilizer, I think it's reasonable since lamotrigine didn't hold my things together for too long and probably worsened some parts of it. I'm having insomnia since I started lamotrigine.

I would definitely give seroquel a try it can work as monotherapy for some bipolars.

 

Link to comment
Share on other sites

I think that keeping in closer contact with your pdoc right now is a good idea. Whatever's going on, it sounds precarious. 

25-50 mgs of Seroquel should work for sleep, but it isn't a large enough dose to act as an anti-depressant or anti-psychotic.

Link to comment
Share on other sites

What you're describing sounds like either a mixed or hypomanic episode.  The dosage of seroquel he's prescribed is only going to help with sleep, it's very unlikely to help with mood symptoms.  One of the dangers of a wait and see approach is that it gives your symptoms a whole other month to get worse, which is likely what they'll do if left unchecked. Another is that a mixed or hypo episode left unchecked is likely to end with you crashing into a depressive episode, which can be much, much, more difficult to pull yourself out of. 

If your pdoc really, trult, cannot possibly get you in sooner than a month from now, you need to at least get him or her on the phone, to come up with a plan - med change or increase, making himself available for an emergency appointment - if you're getting markedly worse over the next week or two.  Seroquel's great for helping with sleep.  Sleep is awesome for maintaining stability, but once you're experiencing symptoms, regulating sleep and only sleep is unlikely to significantly improve them, or to prevent their getting worse.  

I get that you had some, not at all uncommon, issues with lamictal. I'd probably agree that it's not the best mood stabilizer for you. But you have a Lot of different options for a solid stabilizing med. If I were you, I's be asking my dr to start me on a therapeutic dosage of an AAP in the short term, to get you back to a more stabe place as quickly as possible. Once you're there, ir might make sense to talk about other possibilities for long term maintenance med or meds.  

Hypomania doesn't always feel to you or look to others like a big huge deal. A mixed episode is probably even worse for many people. Either has a lot of potential to blow your life all the fuck up.  Friendships, romantic or sexual relationships, your professional standing and reputation, can all be destroyed with shocking speed if you allow them to be. 

 

 

 

 

 

 

 

 

  • Like 1
Link to comment
Share on other sites

Thank you all for the support.  It's so good to have a place to talk about this stuff where people believe me and don't accuse me of making a big deal out of nothing.

My pdoc was very clear the last time that I saw him that I should be in touch and that he could call in the seroquel prescription if I felt I needed it and that I could see him before my next scheduled appointment if necessary.  He's not *super* available (he's only in my city one day a week) but he was a bit concerned so he wanted to be sure that I knew I could ask for help if I needed it.  I think I'll send him an email.

Link to comment
Share on other sites

Well IMO my Pdoc is usually right.  Hypo or full blown mania is very hard to see in ourselves.   I ask myself " Why am I always the last to know." a lot. 

I am on Seroquel and seem  to break through the dose but with each increase I am more and more stable.  It has been a great med for me. I am not taking it for sleep I  am taking is at a mood stablizer and anti psychotic. But it sure does zone me out for the night even when I am manic to a point. 

 

Link to comment
Share on other sites

That sensation of wanting to rip your skin off happens to me during mixed episodes. Of course I can't tell you that is what is going on with you, but that feeling is frequently mentioned by people on CBs during mixed episodes.

 

Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

 Share

×
×
  • Create New...