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Chronic fatigue


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Hey, everyone. This is my first time posting on here so I’ll give all the details:

In April, I had a scary psychotic break and my mania took over my body, making me delusional and paranoid for weeks in the hospital. I was put on Lithium and Geodon (Ziprasidone) and I got discharged after a month. Mid-May, my appetite started to decrease until fully disappearing. I was slammed with crippling fatigue, lack of focus, and my libido plummeted. My emotions felt flat; I had no ups and downs. It took me months but I switched to Lamictal and Latuda and I felt pretty much the same. My psychiatrist even prescribed me Nuvigil (a medication for people with sleeping disorders) to help my fatigue but it just made me restless and overly anxious with no change in mood or interest levels. I did a sleep study and no sleep apnea was found.

It’s been over three months and I still have no appetite, flat moods, low libido, fatigue, inability to concentrate (I’ve been out of work for months because of the fatigue) and little motivation to do anything. My physician ran bloodwork and only found low testosterone. I’m losing hope here and I’m scared that switching meds won’t help. I was off of meds for nine days as a mini experiment with my psychiatrist and nothing changed. I have been on Abilify for over four weeks with no change.

Has anyone else experienced bipolar related chronic fatigue? Did it fade with time? Did medications help? I am contemplating applying for disability because of it.

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hi @alen welcome to CB! I am curious to know if you have any kind of history/previous diagnosis of mental health issues? Was there a particular stress or event that precipitated this manic/delusional episode and were you diagnosed with Bipolar? What you are experiencing could be the "crash" in Bipolar disorder..the depressive phase that hits after the mania subsides.

Sudden extreme/chronic fatigue syndrome can also be due to hidden viral illnesses like Lyme disease or encephilitis causing acute symptoms. You mention a blood workup, I'm assuming they tested your thyroid, iron, or vitamin B levels?

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I had (have) extreme fatigue issues myself. I started having them as a teenager, and my whole life I have been constantly lacking energy. My mom said to me once, "You were born tired." 

Recently I got tired of it and my pdoc said it was due to my meds probably. (See my sig for meds). But I went to my gdoc and he ran bloodwork, and found high PTH (Parathyroid Stimulating Hormone) and low Vitamin D, which caused Secondary Hyperparathyroidism, which is responsible for things like bone mass and other things, one of them being fatigue. So I took 50,000 IU's of Vit D  2 x a week for 2 months, and now take 3,000 IU every day. I still don't feel like it has helped much with the fatigue but at least my parathyroid is back to normal levels so my bones are ok. lol.

I don't know what to do. I drink energy drinks (the boost lasts 4 hours then plummets), coffee is a joke, (so is tea), and I'm not about to get into anything illegal to help me with energy lol.

If you find something that works let me know!!

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Like Blahblah wrote, it reminds me of the "crash". I've been depressed for months and today's the first day in quite a while I even felt like posting. No energy, zero sex drive, no interest in much of anything, bleh appetite (although, for me, lithium makes most things taste like charred metal ash). I was told by pdoc it's depression. I think some of it's med, too. Hope you get some answers and relief.

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@Blahblah Thanks for the welcome! :)

To answer your questions, I did not have a previous history of mental illness; I was unexpectedly fired from my job and the stress triggered my first full-blown manic turned psychotic episode. The psychosis lasted for weeks and I remember believing paranoid delusions even after being medicated in the hospital. I think you're right about the crash because I have amnesia about how psychotic I was; my family recalls me acting in grandiose, arrogant ways for days that I don't even remember. The episode was huge and destructive and I'm hoping that with time this depressive phase subsides (I've never had chronic fatigue before this). As for the blood work, I'm not sure what my physician actually tested for but I remember that they told me that my thyroid was fine.

To be frank, I highly doubt that I happened to develop a physical illness at the same time I experienced a huge bipolar mental health crisis that can result in fatigue, you know? The chances seem very slim. I hope my meds actually make a dent in my symptoms because so far they haven't. 

@Alien Navel Cord If I find something that works, you'll be the first to know!

@AyYiYikes I'm glad you had the motivation to post! I hope you feel better, too. I never thought the crash would be this bad. 

Edited by alen
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Hi, what you are saying sounds like what I've been feeling since april or so. I got diagnosed bipolar in december last year. They told me I have the rapid cycling type, usually more in the depressive side. I think this is called hypersomnia or something like that. After lunch I'm energy-less, foggy and sleepy all day, I only start to "clear up" by night. They gave me wellbutrin and it's been three or more months and it doesnt work, but it seems to do wonders to some people, so maybe try that. I also got modafinil and it didnt do anything too. I recently read that welbutrin can kill the stimulant effects from other stimulant drugs, like adderal or, I guess, modafinil too.

I suppose you are eating healthy, taking vitamins supplements and doing some kind of physical exercise. I lift weights but since this started happening I have not been able to keep up a rutine. Is really fucking up my studying too, for months. Too confused and tired.

Anyways, good luck.

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Hi, Alen. Welcome to CB. Please feel free to PM me or one of the other mods if you have any questions about how the site works.

For me at least, it isn't uncommon to feel exhausted for months after a bad manic episode. I think it works like this: When you're manic, your body is burning a tremendous amount of energy, both mental and physical. After the crash, you have a lot of healing to do. It's like being any other kind of sick for a long time, in a way. Your body is mustering resources to try to repair what's been done.

Also, if your appetite is zero and you aren't eating, that's going to impact your energy level and make you fatigued. I never eat right during a manic phase, and after one my stomach has shrunk so much I'm not hungry, so I keep on not eating.

It's also very common to be depressed after you're manic, even if it doesn't get to debilitating levels. And depression makes you tired.

Lithium and Geodon can both make you tired and flat. Doesn't happen to everyone, but it happens to enough people that it's worth telling you. That could have been impacting you while you were on them.

I would give it time, and absolutely do not give up. You've been through a lot. Your body and mind are wiped out, you're adjusting to meds for the first time, and you're not eating. Getting to a cocktail that works can be quite a trial for the bipolar. You'll find one. You will.

Gearhead (admin)

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