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Sleep after hypomania?


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Well I should say hi since this is my first post, so hi!

Im still to be dx but my pdoc thought it was quite likely i was BP I, yet wanted to wait a while to check, well thats gone to pot since he moved away and now I have a new pdoc, who just says im depressed so gave me AD.... so might be the fun of last time i was on AD

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Heya .id,

Nice to meet you!

Welcome to CB.

We're all nutcases.

We're all going to ask, so  I'll ask it now:  What meds are/were you on, and what are your symptoms? What was your previous Dx, and why does your current psychiatrist think something else?

At any rate, I was dx'd MDD for years before I came clean to my family doc about what I *knew* was BP.

The only thing that ever worked for my sleep - and I wasn't looking for help with sleep, that I knew of -- was Lamictal.

Atypical depression, plus/minus mania, can point to a better effect from mood stabilizers than from antidepressants.  Like, lithium and Lamictal work better sometimes than other antidepressants, or else lithium plus an antidepressant helps.

I hope you post some more, and see what we have to offer.

;)

--ncc--

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I am currently on an AD called Reboxetine 4mg (Edronax) I don't think its been FDA approved though since i live in the UK.

I used to be on: Amitriptyline (which made me manic), Lamictal, Olanzapine and lastly lithium. (only one at a time)

Well lately Ive been quite stable (the old bout of depression but nothing bad) the last med I was on being lithium.

My pdoc was working on BP with me due to episodes of Mania/depression then to Mania((psychotic - suicide attempts) we believed these were due to the Amitriptyline) and hypomania and deperession there after

Well it was the first time ive seen this new pdoc, basically all he asked me was "how have I been feeling lately?" which was depressed (x-mas family issues) and as far as i know thats all he based his dx on  ;)

My sleep has been fine as of late, just the hypomania threw me off, but it wont be til march that i see him again.

Thanks for the welcome  :)

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Hi .id...

Glad you're here!

From what you've written, you do seem to be describing BP. Doesn't sound like you brought this possibility up with your new pdoc, right -- just that you were depressed? Obviously, you need to talk with him about this.

How long were you on Lamictal? How long with Lithium? What were the results?

People who know me around here know I'm always posting this link: Mood swings without "manic" episodes: Bipolar II - more than plain depression, but never delusional or psychotic. You may want to check it out; very informative about all types of bipolar, not just BPII. You might want to even print some of it out to bring with you to your next pdoc appt; could be a good starting point for discussion.

Again, glad you made it here!

Take care,

revlow

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hey id- just thought i'd chip in and bitch about the uk health system! if you're not getting anywhere with this pdoc, it is possible to be re-referred (i've just managed it due to my lovely assigned nhs community psychiatrist turning out to be an absolutely asswipe).

Anyway, as for the BP issue. I generally cycle every few days- I seem to manage about 4 days mania/hypomania to a couple of days depression, but I've also had periods where I've slipped out of hypomania into depression for a few hours and then back. the pdoc i was seeing then, who was lovely and competent, classed these as seperate episodes and said it was all a variant of rapid cycling. I don't know if your old pdoc ever mentioned anything about rapid cycling BP, but it doesn't seem to matter how fast you cycle- they still counted an hour of depression as a depressive episode. Similarly I've had full manic episodes lasting only a few hours.

Does your new pdoc not have the notes the old pdoc made? My asswipe pdoc had all my notes, my history was all laid out in front of her so she couldn't help but officially give me the BP dx.

Do you have any other people that have been part of your care team? for example I have been promised a psychologist and a CPN. I guess the idea is that if I'm flipping my shit I call the CPN as my limited experience of nhs community pdocs is that they are elusive beasts. Anyway, if there's someone like this you're seeing (mine haven't arrived yet, I'll probably get the referrals through in like 5 years or something- damn waiting lists)- could they back you up? Hell, if you've had psychotic mania, your pdoc should damn well be listening to you- it's the most terrifying thing I've been through.

As for sleep, I'd suggest asking for a sleep med you can take for a few nights so you get proper amounts of rest.

Actually- I've just read you're not being reviewed until March. So you've seen this pdoc for the first time, he's bunged you on an AD, and he's not reviewing you until March?! That's bloody shameful!! Sorry, but that should not happen. (My mother ended up going to the psych unit to complain about my pdoc, and the woman she spoke to was appalled that she wanted to leave me 3 weeks between reviews when she'd just upped me medication- so several months really shouldn't be right!).

Please bear in mind I've just been very depressed and seem to be perhaps a little hypomanic (ok, I'll admit it, I am hypomanic) so it is entirely plausible I've talked entire shite in this post. Hope some of it helps, and welcome to the land of crazy.

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I was on my other meds for about a couple of months at a time, all helped had a few side effects but my old pdoc wanted to see what I was like on a range of them before adding things, because he didnt want to give me too many meds at one time incase I flipped and went overdosing again, which is fair enough. The last lot of lithium well I ran out of them before I could get anymore and trying to get a repeat prescription round is here is hell!!!

As for this new pdoc... hmm no I didnt talk to him about it, I wasnt really in mr social mood at the time so my bad really... But he has all my notes or I would hope so since he took over from my old pdoc and its in the same place, same room, job lot. Still he doesnt seem to be that great since the first prescription he gave me the pharmacy had never even heard of them  ;) so yea not great first impressions! I shall have to see how it goes the next time if he is no better then well ill look into changing.

As for bitching about the NHS (Not Helpful Service).... well I could go on and on and on etc etc it might be cheap but then you get what you pay for!

As for the sleeping well hopefully its sorted got nine hours sleep last night (best not say how since i shouldnt promote self medicating) hopefully it will be good tonight.

Thanks for the help though peeps  :)

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Hi .id, welcome!

Well, as youve probably guessed, being hypomanic is not normal, it isn't depressed and it isn't good for you. And just because the worst symptoms have eased, doesn't mean the illness is any better.  It is just cycling, and WILL return.

The answer?  A visit to your Pdoc and probably a mood stabilizing med. 

This hypomania is a situation that rightly demands a call to your Pdoc, who should arrange to see you immediately. Don't undersell or minimize your symptoms when you see him.

- Hypomania, purpose driven behaviour (the theory work), minimal sleep, and self medicating to get sleep are all symptoms that should slap your doctor in the face like a cold fish! Any decent doc should be able to dx this (though I'm not going to).

Don't keep suffering in silence.  Take action.  You are unlikely to fix this yourself.  There are meds that will help get control. You will feel better.

Check out Dr. Phelps excellent website:

http://www.psycheducation.org

Best, 

A.M.

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Hey .id, welcome.

I can't echo everyone else's sentiments enough.  This current doc needs to take your prior history very much into account (and this prior episode.)  Treating you "simply" for depression when you are really bipolar is not going to help you at all.  In fact, it could really make things a whole lot worse.  This is what happened to me and yeah...made a real mess of my bean.

Karen

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NHS- Not Helpful Service- love it!! And so true, with the exception of the pdoc I first saw who was a star.

And just to echo Karen's sentiments- being treated for depression when you're really bipolar is not good- this happened to me, I was just fortunate enough to be under the care of a good pdoc at the time who recognised my erratic behaviour as hypomania. Otherwise I'd have been Really Super Screwed.

Anyway, best of luck with the situation- give your pdoc another chance by all means but if he won't listen you need to take action. Hope it works out.

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Hey thanks everybody

Yea I am going to try and call him tomorrow... if I can get passed the cow he calls his receptionist. Got a feeling though I'm not going to get anywhere but having a bit of anxiety atm, since it was this time last year I was on Amitriptyline and started the drug induced manias.

Thanks for the links and thoughts people  ;)

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As a fellow semi-rapid cycler (and I'm not talking about what I do with my 59cm Fuji Finest racing bike), I know exactly what you mean... When I was hypomanic over last summer and fall, I'd have these 'depressive' breaks where my hypomania would take a break... and I'd sleep and sleep and sleep...and cry a little... this stuff would last 2-4 days after which point it came back to normal.

Of course, that was until I became ADAF in mid-October, a state that lasted until around the end of November, at which point I was ironically fired (by a documented psychotic BPI no less).  I have interesting nicknames for that woman now, and I don't think any of them would be polite to use on this board.  Let's just say that she's not going to sit for long at the world's highest-ranked biomedical research institution.  (I have a multipage tirade regarding the situation that I'm not going to give anybody unless asked for it.)

Word up on trying to come up with too many theories, by the way.  Somehow I'd written an email to my father (who's in a field similar to mine) about how we could screen for cancer-causing genes 100 times faster than we could before.  Normally, as a hypomanic, my ideas get laughed at, but he actually seemed to find them quite novel and useful. :-X

One more thing, I don't think there is a perfect, or even acceptable, solution to the healthcare economy as it stands now.  You Brits have the NHS (which consistently provides mediocre and slow service to all), and us Americans have private insurance (which provides varying degrees of service, depending on your health, employer, and monetary standing... and if you're poor and MI, you might as well resign yourself to a homeless shelter right now).  The Medicare option is limited to a very narrow spectrum of users (the elderly receive first priority, then do single mothers and their families) and it provides services comparable to or below the levels of NHS. 

I might have a college degree and graduated at the top of my class, but if I can't find a benefits-providing job soon, my continuation coverage I use off my father's plan ends in 8 months, when I turn 23.  (I would have applied for benefits under US COBRA law, which allows recently terminated employees to continue their current health plan.  Unfortunately, plan conditions are subject to modification by the insurance carrier, and most carriers, including my previous one, elect to discontinue prescription benefits).  Welcome back to the world of paying well over $1,000 a month (~400GBP) for meds.

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OT, but quick note...

herrfous: Similar thing happened to me when, two days after she told me she was taking ADs, my boss fired me. I think it threatened her that I knew her "secret".

Also, I'm sure you're smart enough to have already done so, but if you haven't yet do check with your state's insurance commission. Another employer tried to screw me out of COBRA (and kept quoting me their version of our state's requirements, which was way off) till I turned around and cited the actual sections of the state code, etc. I got my COBRA'd insurance.

If you're not able to get COBRA and/or prescription benefits out of it, I hope you find something else soon.

Best,

revlow

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Hi revlow -

Thanks for your advice.  It turns out, as I just found out, that I can COBRA off of my dad's benefits regardless of my age (since I'd prior been on them for nearly 11 years as a child under the exact same insurance co.).  The cost is roughly the same as my COBRA option from J**** H****** University in Baltimore (*cough cough*), and my father's plan (he works for... a certain major pharma, the manufacturer of Zyprexa and inventor of Prozac, in Indiana), and his option, adminstered through Aetna, covers all Rx, not to mention vision and dental.  Honestly, it's quite fun conversing with your parents about insurance options when you're completely trashed.  It's even more fun when 'trashed you' sounds no different than 'sober you', and they feel they're having a completely cognizant discussion. 

Anyways, I tend to be completely, 100% irrelevant.  ESPECIALLY when sober.

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revlow-

You might not believe me, but I otherwise love that place.  I loved this job in Baltimore and the climate of the place it was at.  I've even made a deal with the head of the department I used to work for, that if they establish some sort of accountability for junior and senior faculty performance, that I wouldn't hestitate to work there again.  (It appears that they make the institution ridiculously competitive for the technicians and graduate students, but it seems more of a relaxed social club with permanent membership for any sort of faculty).  The competitive research climate there is a great place for a freakishly-competitive BPII as myself to do his work and find his own niche.  However, that's nullified completely when the supervisor has enough sand in a certain feminine indentation of hers to fill the entire Gobi Desert.  (Rest assured I'm not being sexist; I would have even more quickly applied the exact same insult verbatim to a male, in which case it would have been more insulting, as well as emasculating!).

J**** H****** University in Baltimore (*cough cough*)

<{POST_SNAPBACK}>

LOL! Glad to hear you've worked it out.

<{POST_SNAPBACK}>

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You Brits have the NHS (which consistently provides mediocre and slow service to all), and us Americans have private insurance (which provides varying degrees of service, depending on your health, employer, and monetary standing... and if you're poor and MI, you might as well resign yourself to a homeless shelter right now).  The Medicare option is limited to a very narrow spectrum of users (the elderly receive first priority, then do single mothers and their families) and it provides services comparable to or below the levels of NHS. 

<{POST_SNAPBACK}>

Yes I dont envy the health system in the US, I dont know much about it but from what ive heard I would be buggered if I were there, I suppose I should be thankful for the NHS it might be shit sometimes but its cheap, $1,000 a month (~400GBP) ;) jesus I didnt know it was that much and we pay $11.50 (6. 40 GBP) per item and thats normally a months worth if not more.... HOW THE HELL CAN THEY CHARGE THAT MUCH?!?!?!... hmm some how the nhs seems much better now

I should nick a prescription pad and send you lot cheap meds  :) I have the handwriting of a doc /a 3 year old, they will never tell the difference  :P

RANT: GDF receptionist gah *bangs head*. yea i phoned my docs but couldnt get passed the bitch!!!! RANT over, well got my appointment moved to the 6th of feb its something i suppose

well hope all is well in crazyland peeps

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