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Crazy Bear

How Hypomania Produced My Novel and Made Me Crazy

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Dx bipolar, usually more subject to depression than hypomania. 59 y/o male 100% VA disability, retired criminal defense lawyer. Hypomania has been my friend for the last few months as I finished a novel due Oct 1. Writing is all I did. Do. Literally. In bed, never left my bedroom, typing, well, crazy hours nonstop. That and keeping up a fairly popular daily blog. And social media. I sleep only every other day, but am still pounding the keys. (Yes, it's decent, or at least the publisher thought so- out for Xmas!) I lost 40 lbs, which is a good thing.

Somewhere along the line, I decided I had to have an autographed picture of Ginger Rogers for $585. Yeah, I know. I used my personal money I make off my blog, so the money was not an issue. Even so. (But it's Ginger!) I also have racing thoughts, flight of ideas, etc.

Okay, we can all probably agree all that is non-normal for ordinary people. I have had to switch pdocs twice in the last few months due to personnel problems at VA, and lost my therapist, who was great. New one is awful, but the VA  "team" said I can't dump her.  I am meds compliant: lithium, bupropion, quetiapine, modafinil (yeah, I know), and to down-regulate, 5-10 mg diazepam + 100 mg. hydroxyzine. I am also on a significant dose of hydrocodone for pain. Maybe it's because I'm a Bear, but none of this stuff helps me wind down. (I wish they prescribed tranquilizer darts!) I am just more chilled / alert. I remain awake and driven. I am no doubt benzo tolerant.

New pdoc knows all this (I even went to the ER once, and got zero care) but since he's new, he doesn't want to change anything. Obviously, bupropion and modafinil are activating. But bupropion is my magic bullet vs. depression & pdoc says modafinil helps with that, too. One more thing. I have a significant kinetic tremor that is "benign" and neuro & pdoc attribute to lithium. But the VA loves lithium, and it does seem to be a demon repellant for me. (Hx suicide attempt / problematic thoughts sometimes.) I have requested zolpidem but they act like it's simply not an option in responsible tx. (I have had it before, and it works for awhile.) 

Am I fooling myself to consider this adaptive under the circumstances? Once I get final feedback from beta readers and submit the novel on the 1st, there will still be responsibilities for the foreseeable future. Am I  somehow "choosing" hypomania because I enjoy the productivity? This is unusual for me. I have never had an episode last anywhere near this long. I have a suspicion that after the creative rush, I am going to be susceptible to a big let-down once the novel is submitted, so I want to be careful not to aggravate that. What's with the every-other-night sleep schedule? Am I harming myself?  Of course, I'm thinking, "Damn, these meds aren't doing much for me..." Yeah.

Reality check, please + any advice would be welcome. It's weird, because subjectively, I feel pretty good, but my insight is good, and I know I'm not right. TIA

Edited by Crazy Bear

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2 hours ago, Crazy Bear said:

to a big let-down once the novel is submitted,

I think all of this should be brought up with your DR or therapist (tdoc).  I also think it could be a possibility that you might have a crash when all the novel stuff is over with.  Idk for sure, but it could happen, IMO.  It happens to me sometimes when I am hypo ... eventually I'll crash.  NOT saying you will, but it is possible.

But I would talk to your DR about this all.

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I had a bit of a let down after a year+ fight with the insurance goon squad but now that is back on so I'm not sure what to say other then that many people find they function in the middle of a project quite well but its the down time that is the problem.   Whats the next project?  Maybe thats the solution?

Insomnia wise?  I just stopped taking ambien for the first time in years and I'm amazed I can sleep without it.  I've tried leaving the bedroom shades open so that I wake up with the sun which might be regulating my sleep (Which has always been a problem until now)   One night up until dawn the next one totally different.

Anyhow keep plugging away.   "Rite" everyday or else!  Or so my editor told me when I did that sort of stuff.

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I have a two-book deal, so I will segue right into the next. I envision myself just staying hypomanic since there will always be something to do. As for doctor, well... he still has me taking modafinil in a hypomanic episode, which pretty much says it all. I'm not knocking the VA. I had a good pdoc for years. Just frustrated at total lack of concern. Tonight is third night awake. I'm thinking of starting another blog, chatting on FB, editing... I'm just afraid it won't be addressed until I'm going to have to be tripped out. I do NOT want to be inpatient at Jefferson Barracks, where the first thing they'll do is refuse to give outside Dr. prescribed opiates. Then I'm trapped looking at cold turkey withdrawal. 

Thanks for the comments. I'm just glad I'm 59, not 29, or I would be getting into a lot more trouble.

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Yes, you are fooling yourself, and yes, you are harming yourself. 

The next time you see your doc he won't be so new anymore, and you can explain all this to him again and tell him again what a shit idea it is to have a bipolar patient in a hypo/manic episode on modafinil. 

If youre 59 years old, I assume you've been dealing with bipolar a long time. There's going to be a crash. You know there is. Try to ease back now, before it gets worse than it has to be.

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Yeah, not so much hypomania, and only short before now, so kind of a mystery. I'll see if I can get in tomorrow. I am an educated and experienced consumer of mental health professionals. I stay compliant, but sometimes wonder if I don't know more than some of them do.

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13 hours ago, Crazy Bear said:

Am I  somehow "choosing" hypomania because I enjoy the productivity?

It seems like it to me.  Even with you knowing how important sleep is (or at least knowing it in the back of your mind), to me it seems like you are "choosing" to avoid it.  Personally I would make sleep a priority.  That might get you back on track and might help avoid any crash that could happen (or lessen it).  I think you already know that sleep is important, and IMO you need to focus on getting that back on track.

I know you get a lot done when you are awake, but I don't think being awake every other night is helping the hypo get any better.  You seem to like being hypo (to me at least) because you get a lot done.  Trust me on this ... if/when you crash, you will regret being so hypo for so long.  After a crash, I feel dead to the world, and nothing gets accomplished.  Sometimes I sit and stare because that is all I can do.  And this can last for a long time.  If this happens to you, you won't be getting much done with writing (if anything at all).

I think maybe with the modafinil and bupropion, you can ask pdoc to at least lower the doses of both. 

 

13 hours ago, Crazy Bear said:

New pdoc knows all this

I hope you do get an appt with your pdoc soon, because I think it is important he knows about all of this.  Again.

Maybe if you are willing to try to sleep more, he'll give you a med (even if temporarily) to help you start doing that.  If sleeping is your choice.

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I can get into some pretty weird wake/sleep things, including "stay up for two days, sleep one night, stay up for two days, sleep one night" kinda routine.  That's been present since I was a kid though, I've always had problems self regulating certain things and sleep has always been one of them.

This can make it difficult to tell if I've got hypo/mania coming up, of course.  I've had to rely on my psychiatrist telling me if I should be worried or not, in the past.  These days I'm much better at telling what's going on with me.

I'm also a lot better at sleeping though.  I totally agree that personally, I'd make sleep a priority.  So much about my life has changed since I did that, since I've been able to do that.

I don't really get the productive thing with hypo/mania, though.  Like sometimes I get creative because I have all this jittery energy and I am so incredibly frustrated and angry and RRRRAAAAUUUGGGHHH if I don't have some kind of outlet for it, and sometimes I can channel it toward something creative, like making myself a blanket fort instead of running away to the mountains, or scribbling with pastels, or pouring my heart and soul into nonsense babbling shitposts on a private blog somewhere.  But I do those things while I'm getting the episode treated (/treating it myself, mostly, these days.)  So like.  There's that.

Prioritizing sleep is so important though.  And yeah the crash is coming, most like.  I don't get those either?  My crash happens with the episode (yay mixed features!) it almost feels like, and then a lot of cognitive hell afterwards that I figure is as much post anti manic medication strategy shit as it is post mania shit.

However I am much more capable of actually being productive.  I haven't had to sacrifice my creativity or energy.  It is good that you are an educated and experienced consumer of mental health professionals and have a well established history of compliance, that should help you when it comes to advocating for your specific health needs.  I can't imagine how extra complex the VA stuff makes your situation; I hope your new (but not so new) doc is better able to help you with this stuff.  My pdoc goes to bat for me in some really important ways and I'm certain my treatment path would've gone in a vastly different (and incorrect) direction without her by my side to help advocate for my needs.

On 9/21/2016 at 11:38 AM, Crazy Bear said:

It's weird, because subjectively, I feel pretty good, but my insight is good, and I know I'm not right.

My most recent episode was largely euphoric; I think this is connected to a new medication I started, perhaps.  But basically, I know exactly what you mean.  Subjectively I felt pretty damn great, but my insight was also still great and I knew I wasn't right.

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Thanks. No modafinil. Appt. 27th. I know I can "go with" depression. Probably with hypomania, too, since I was extremely motivated and under a deadline. Now I'm thinking back on being an ass during this episode. Oh well, fuck 'em if they can't take a joke.

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2 minutes ago, Crazy Bear said:

Thanks. No modafinil. Appt. 27th. I know I can "go with" depression. Probably with hypomania, too, since I was extremely motivated and under a deadline. Now I'm thinking back on being an ass during this episode. Oh well, fuck 'em if they can't take a joke.

I'm glad you got an appt that will be here soon.

Was it really a joke?

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