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Recent BPII Dx, have a couple Qs...


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Just wondering...when do you get your drive back? Or was whatever drive I felt before just whatever hypomania I'd had? Or does this seem like low-level depression? I don't know there's any way to tell, but I don't feel what I usually associate with depression -- not being able to get out of bed, etc.

I know that it took getting up to 400mg a day of Lamictal for me to get out of that low-level  depression.  I got to 200mg, had a relapse, titrated up to 300mg, and then just hung out there, in low level blah-land for about 2 months.  I finally printed out my moodtracker chart and carried it into my pdoc and said "hey, can we do something about this, please!?".  Maybe you just need to hit the right dose?

In the past what I would do is to go to my doc's and get a couple shots (usually some kind of cortisone shot and another non-steroidal anti-inflamatory). And it would help, at least temporarily. But now that I know I'm BPII, I'm wondering about doing this. I never was aware of it causing any BP problems, but then I wasn't aware I was BPII either. I don't think it caused a problem, but I'm wondering whether I should do this or not.

I'd run screaming in the other direction from ANY kind of steroid--I know you are an avid reader of Jim Phelps' site, so you've probably seen his notes on steroids triggering mania.  Baddddd juju.  I know that they can't be avoided at times, but damn, they can mess up a perfectly stable life in a snap.  I'm miserable when the pine pollen is coming down, and pretty much just have to tough it out.  I'm sensitive to everything.  Bleh.

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Similar story. I got stable, but found myself drifting along aimlessly without much motivation. I guess I was kind of waiting for the world to pick me up and put me back on track. I started to get more and more frustrated at the situation, until I finally realised that I had to do it myself. There was thread I started on the boards here, and the answer was "Fake it till you make it..."

So I forced myself to just get out there and pretend everything was normal, pick it up and carry on with life from the point where the wheels had fallen off.

I'm not there yet, but it's making a big difference.

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lack of motivation could stem from a number of things. as anelize suggests, low-level depression, or it could be the meds damping you down, or it could be residual bp brain damage.

recently, i blamed my own less than stellar motivation on my lithium and tried cutting it out on my own. the result was just more anxiety, mixed states, agitation, restlessness and emotional pain--but i was still as scatter-brained and escapist as ever. so, i went back on my prescribed dose. i shall be making a sheepish entry to my pdoc's once i get the lab tests she requested in the first place.

good luck in figuring out the source(s) of your lack of drive,

7

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Thank you everyone for your feedback.

Well, what I thought for sure was allergies turned into a full-blown cold. Just trying to keep it all flowing enough to prevent it from turning into a sinus infection, which is my tendency.

This was the weirdest start to a cold I've ever had. My housemate had a bad cold last week, and I thought for sure I was coming down with one late Saturday night and all day Sunday. Then Monday I felt better; since I had a regular appt. with my doc that day, I had him check me out and he said he didn't see signs of a cold. Tuesday, so-so. Then yesterday, I had all the signs of bad allergies, so I thought that's what it must have been all along. Then late last night -- boom -- a cold. Strange. I've never had one hit me quite like this.

I know what you're saying, Unregistered. I don't think that's really what's happening with me now. I know I'm the only person who can pick me up, and I've done this a zillion times in the past. I've been a real artist at creating something out of nothing when needed. This time there seems to be some spark missing. I'm wondering if in the past I'd had some level of hypomania that made it more possible for me to do this, and now it's not there. Maybe it is still a low level of depression, and in the past the hypomania (even slight?) helped to compensate for it. I guess I need to learn a new aspect of picking myself up?

On a different topic, last night as I was snuffling and trying to breathe enough to get to sleep, I remembered yet another incident years ago that screamed "Bipolar!" It was the end of my first semester in grad school (as it turned out, my only semester) and this other student let slip that everyone in my department thought I was a coke head! Ha, I said...I barely take aspirin (which was true at the time). Just my being "tired but wired" I thought, and people misinterpret that -- though I was shocked that this was what they'd thought.

God, if only I had gotten this dx'd years ago. I wouldn't now be 51, out of work, and still trying to figure out what normal moods are. ;)

Thanks again to all.

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Hi revlow, on the motivation vs. the hypomania, I have asked myself the same question more times than I care to remember.  Or possibly even could try! I suffer from a lack of motivation, direction...all of that stuff too but I am "functional."  And I don't feel particularly depressed.  And yet my sleep is entirely fucked up without meds that my doc feels is "low-grade depression."  And yet...like you say, "I don't *feel* depressed."  But we've all read it on the boards before that you don't have to feel depressed to be depressed.

I know, I know...how do you know?

I don't know.

But one thing I do "know" (is this getting confusing yet...I'm a bit tired) is that I think the answer is different for all of us.  For me, I think I do yearn for my hypomanias a bit and I might be under the misconception that I was somehow better off functionally because of them.  But what I and anyone else who may also think this is that those hypomanias came (and come) with an awful price.  I was also a lot younger then and really, I am who I am now.  I have to be who I am now...fully in the present.  Not who I was in the past.

It's painful.  At least sometimes for me it is.  But again, I think I may have come convincing of myself to do...that it doesn't have to be painful. We don't have to try to tackle Mt. Everest or K2 every day we get out of bed; just do what we can do.

It's funny, I was talking to a friend about this very thing last night.

As for the allergies, I've only ever used cortico-steroid nasal sprays and always without incident.  But you have a cold so that point isn't really that relevant anymore.

Not sure if any of the above helped,

Karen

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Hi Revlow,

Thanks for referring me to the BP website in another thread. I've done some research and at present am not convinced. I plan to think about my past hypomanic episodes some more...collect some more data points.

I found two online articles that you and others may find interesting:

Bipolar Spectrum Disorders: Diagnosis and Pharmacologic Treatment

http://www.continuingedcourses.net/active/...s/course001.php

and

Are You Bipolar?

http://www.newyorkmetro.com/nymetro/health/features/n_9986/

I haven't taken any mood stabilizers yet so I can't comment on your questions.

Good luck,

--Weasel

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Kind of funny, but I just addressed this issue with my tdoc this evening.  I'm, for the first damn time in my life stable, but I'm having what I perceive to be trouble having motivation to get things done around the house.  Since I've always been on overdrive and stressing myself to always be doing something (does this reek of hypomania) and my mind was constantly torturing me onto the next thing that just had to get done...I've never known what it is to be normal.  So now if I don't feel like doing it, I don't; which is totally abnormal for me, but I don't particularly feel like I care.  It is just so hard to get used to.  My tdoc says I've always had to be doing something and now my mind has relaxed to a more "normal" state for the first time.  She said to enjoy it. 

Man, this is really rambly.  I hope I was able to convey my point...

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Rev, I understand what you mean about picking yourself up a million times already. Did I read somewhere you were only recently dx'd? I was, and it was a bit of an anticlimax. Suddenly I didn't need to fight it, I had meds. And once it wasn't just me doing it, I had an excuse, a bunch of meds and a pdoc to fix things for me. Except they don't, they just give you a stable platform to start from.

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well put Unregistered. and when you do think normal means feeling dynamite, it'll turn out you're just hypomanic, running around like a jet plane in inappropriate places. it's not easy dealing without that spark we're used to.

7

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7, that's just it!  It is not easy dealing without that spark we're so used to having.  I'm glad the consequences of that spark are gone, but man, I used to get SO much done (nevermind that I was screaming at everyone while I was doing it).  Now, who cares if it gets done or not!  I'll do it eventually. It is just weird...

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As for me, I've definitely got my spark back.  Even through the mild depression of the past 2-3 weeks I've been motivated to work hard.  I haven't had that since starting Depakote 6 years ago.  Lamictal is my friend.

Revlow, sure, it's possible that without mania you might not feel motivated.  But maybe not.  Maybe you're still adjusting to stability.  Maybe you're not stable yet.  I forget, what level of lamictal are you on?  You might not be where you need to be yet. 

If getting out and doing the "fake it until you make it" is impossible, it seems likely you're mildly depressed.  More lamictal may help.  An adjunct MS might help, if more lamictal doesn't.  I hope you'll give lamictal a good trial, which means getting to your own personal therapeutic level and seeing what happens.  Until then, hang in there.  Work with your pdoc.  You may never be "normal" (whatever that is) but you can be more than barely functional. 

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Hi. Sorry I hadn't responded the past couple days. Thanks for all your responses.

Trust me, I won't me going off Lamictal any time soon. I may not be *there* yet, but this is better than I've felt in a long time. In many ways, better than I ever had. (Hello, good night's sleep! Didn't know what the hell you were before.)

The possibility of BPII was raised years ago (1991) but wasn't pursued by the docs (long story). Prior to my recent dx as BP (most likely BPII), I'd been dealing with dx of refractory depression and meds for 33 years, so I don't think the idea of a dx and meds sends me into submissiveness. Certainly not anticlimatic for me, either -- I'm thrilled to find a dx that makes sense and a med that finally helps!

Will write more later. It's late, going to bed. (Hope this post is semi-coherent.)

Thanks again!

PS - NARS, just re-read your post. I'm at 225 mg, which I'm sure is too low; I'm also on OCP. Have a very cautious doc, who does very slow titration. Which is good from a scientific standpoint, but difficult from a real-life standpoint. ;)

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I don't know where to put this. My guess this is as good a place as any. I guess for now this is a temp BP, AC/MS, Not Otherwise Specified, quasi-Springer Show for me.

It's past 5AM and I'm not sleeping. Haven't been sleeping very well the past week or so. Think there's a bunch of stuff going on. At the moment I'm having one of my few nights of the month of cramps and mild hot flashes. (See http://www.crazyboards.org/index.php?showtopic=7714&st=30 if you want details :) ) My sister will be going back East from her extended stay with my mother, so I will be heading to So Calif by the end of next week to take care of my mother (see http://www.crazyboards.org/index.php?showtopic=7827 for details). This has me pretty anxious. I love my mother and want to do this, but: 1) I'm broke, 2) I don't know how long I'm going to have to stay, and 3) I tend to get inertia once I get somewhere. Oh, and 4) I hate So. Cal.

My housemate has been talking of moving out. I'm already borrowing $ to keep this place going. I need to focus on getting work. I'm so discouraged about work to begin with. I've lost 4 jobs in the last 3 years. I'm gun shy at this point. I worked for some truly bat-shit crazy and drug-addicted bosses during this time, but I also now believe my BP had something (if not a lot) to do with it all.

I could probably hussle up some consulting work in web development/design or marketing, but I'm so sick of both I could scream -- feel like doing this robs my soul. There's barely any work of any kind in the town where I live, but the last time I was staying with my mom in So. Cal a few years back (in a much more populated area), I couldn't find work there either.

I have bills up the ying-yang. I still owe thousands of dollars for the 2 surgeries I've had in the last 1.5 years, and it all has gone to collection. Oh, and my COBRA'd insurance will go up $60 month in Feb. (Been paying $356, going up to $416. Enjoy low premiums while you can, if you're young.)

And I still don't think I'm getting enough Lamictal. My wonderful doc here is very conservative. Been taking Lamictal since late Aug. or early Sept. (never can remember which, but close enough). And I'm still only at 225 mg. Can feel depression and anxiety creeping in. Okay, with all the shit I've got going on, who knows what's at the heart of it? But regardless I still don't think I've hit my target for Lamictal. On hormones, so no doubt need more Lamictal, yada, yada, yada. Will mention all this when I see my doc on Monday, but again very conservative guy. Don't quite know yet how I'm going to deal with this med business while I'm out of town (going to ask doc about doing phone consults).

As far as sleep, Klonopin helps but I'll find myself sort of logy the next day. Worse yet, I find myself more depressed. Ambien works okay, but I always wake up after a few hours (doesn't matter if it's CR or not). Maybe I'll ask about trazodone; haven't been on that since the '80s.

Well, here I am venting. I'm just mad and depressed at my lot in life. At various points I had a lot going for myself: was an art student with potential; later a potential art therapist. Didn't finish my grad degrees in either. Later started a successful non-profit organization. Later still, had a successful consulting biz. But I could never hold any of these together. Now I feel like I am barely capable of holding anything together.

At this point I feel like Maynard G. Krebs on the Dobie Gillis show, for those of you who can remember. My inner mind just screeches "Work!" in quintessential Maynard fashion whenever I think of it.

To be honest, I was probably better off years ago when I was on SSI, even though I still had to borrow money then in order to just get by. But I was always pushing myself to be able to make a living.

For example, in the early '90s, I taught myself HTML and other aspects of web design/development at night while trying to hold it together with my then-asshole SO, who'd returned to drinking almost immediately after we gained custody of his two kids from his meth-addict/prostitute/convicted thief ex-wife, after we fought 2.5 years to get the courts to take the situation seriously. I essentially raised them single-handed during that time, and as I said, taught myself HTML, et al. at night so I could figure out a way to eventually make a living. Just got on the Internet, found what I could and taught myself. (When people ask me how I learned HTML, I say "A bad relationship.") At first it was kind of thrilling; now I just HATE it.

I think the kindling effect, and all those decades of not being dx'd as BP, has taken its toll.

Okay, woe is me! I know part of this right now is that I'm feeling overwhelmed. Not to mention pissed at my sister for creating the situation with my mother. (Yes, the control-freak idiot insisted on putting my 77-year old mother up on a ladder and making her paint the ceiling of a porch, even though my mom kept saying "I don't know if I should be doing this." She fell backwards onto concrete, and has been dealing with a head injury since. Doing pretty well now, but *still*. Idiot sister ;) )

On the other hand, I am really disheartened about me, and what I am capable of doing. What I'll ever be capable of doing. I just don't seem to be able to make it in the normal world. And I guess I miss my periods of hypomania, 'cause at least I felt hopeful during those times, no matter how hairbrained I was.

That's it for tonight. Hopefully this venting will help me get to sleep. Though I kinda doubt it.

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I think I'd just tell your pdoc to up your lamictal, and quick.  As in 100mg.  Good lord, I went from 300mg a day right up to 400mg a day without a problem.  Geez.  The way I understand it the rash issues occur when you are first titrating up, as in when you first go on it.  I'd insist to him/her you feel like shit, and he needs to do something about it.

Hope you feel better soon ;)

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