Help, Hypomanic and can't sleep

[Crystal413]

I slept 2 hrs last night. Even took a 0.5and a .25 Klonipin.Eyes and body are tired but mind isn't. Per my dr I took half a safaris pill and slept the day before. The day before that I slept 4 hrs. My norm during mixed and hypo is 5-6 hrs. I am very drugged right now on meds. The hypo was very bad. I have so many sx going on with me right now. Too much med too. I took Saphris (my emergency pill) for hypo and sucidal feelings last Friday and Sun. They make me sleep many hrs. So currently in my body in the past 7 days, which I am not use to at all are as follows: 21/2 Saphris at sep times, klonipin 3-4 times per day 0.5 and .25 at pm. Lithium 600mg and 600mg pm. I am currently weaning off of Lamictal and I am at 50mg right now and will start 25mg tomorrow  for 2 weeks. I also take iron and doxycycline which is nothing new.

I am a wreck and this wole week has been bad but many sx started before this past week. So it's been bad for a time.

There is my med hx this week. The hypo stuff I'll just have to deal with. I can't deal with no sleep and not being able to sleep. My mind just won't shut off. I tried walking, no help. I tried the Klonipin, no help. I cant't read because I can't focus or concentrate. The TV just continues to keep me awake. I don't know what to do. Dr is aware, no answers. I can't function very well and this drugged feeling is awful in addition to the sx I am having with the hypo.

Do you have any ideas of how to help me? Any suggestions for things that have worked for you so you could sleep?
Two things, one,  my mind needs to shut down and two I desperately need to sleep.

Thanks for any help you can give me.

I

[Hellodolly12]

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[Crystal413]

I have no idea how that last sentence got to the bottom. There is a typo though. It should read sleep depravation not slapped. I guess it's time to stop typing and try try to sleep.

[Crystal413]

Great info, thanks. Believe it or not I hung in there despite my rotten side effects until I reached and continue 175mg. Then at that point we started the taper down process. Our target goal was 200mg which I did not make. I really wanted it to work since people speak so highly of it and it is one of the few weight neutral drugs. All I can say is wish me luck on this new med. I can't tell anything right now because Iam still feeling drugged.

I had some visual hallunications today out of the corner of my eye at diff times. The computer basically said it can be caused by med, something to do with neurotransmitters etc. For me it certainly could be both since this is new to me.

Thanks again for all of your help!
A Florid Hallunication is caused by slapped depravation

[persephonedemeter]

Hi Crystal. You may want to try having someone read to you with music going on, and try a different time of day to catch some sleep. A book that was read to us in a therapy session where we lied down on a mat with a pillow under our heads while pleasant music was going on was "The Happy Prince."  Pretty much, all of  us was snoring. It was also 2 hours after lunch. Also, try a nice massage. My massage therapist calls it "naps with benefits."

I agree that it would be nice to make things a lot slimpler by being able to point directly to a med and see it's affects clearly. That question, "Well will it end?" I did ask the doctor. He said,"i don't know. It differs with everyone. For some, it only takes one medication. For others, it's more." I was hoping I was somewhere inbetween. I ended up struggling with getting stable after 12 years.

If you like and feel comfortable with your psychiatrist, don't give her up. There aren't that many psychiatrists out there for one, let alone someone you feel comfortable with. It took me 4 years to find the one I have, and at the time I first asked him to take me on, he had no room for me. You can ask your doctor if a consult  with another psychiatrist who specializes just in bipolar disorder to recommend possible treatments and medications or advice. My psychiatrist asked me to see a bipolar expert twice. These experts are MD's who not only practice psychiatry but mostly do research and keep up with research by others. The one I went to was based in Stanford University.  When it's a doctor generated request, most insurances will cover the consultation which is only 2 hours. It is very likely you have one in your part of the country and your psychiatrist probably attended one of his/her continuing education course lectures. Those consultations really helped me and my doctor alot. i am only on 3 medications, and presently, I am being weaned down to discontinue lithium. It also helped for me to learn cognitive Behavior Therapy, to get rid or distance myself from stresses and to  hold on and bring to lthe foreground the good things in my life. I have to constantly remind myself to look at the bigger picture.

[Anonymouse88]

I hope the bath works.  Regulating schedules is good for bipolar, so you could look into taking melatonin at the same time each night to help your internal clock reset itself, and then get in bed even if you aren't sleeping.  Early morning sunshine and exercise during the day also help regulate the circadian clock.  They usually suggest no naps, in order to encourage your body to sleep when it's supposed to, but I think in this case you need all the sleep you can get.

A family friend of my grandparents was really psychotic (took stelazine for 30 years or something), and also had migraines.  When she had a migraine, she was supposed to sit in a dark, quiet room, but when she was sitting in the dark like that, she had intrusive psychotic thoughts.  The solution they came up with was doing those wooden puzzles where you try to put a bunch of wood pieces together just right to make a 3D shape.  Doing them by feel was a good way to stay unwound for her, and something like that, laying in the dark and doing something tactile, might help cool the brain off a bit.

How high up on the Lamictal did you get?  I've read a lot of reports of Lamictal making people hypo at first, with the effect going away once you hit 100 mg or so.  

[Crystal413]

The bath sounds good actually. I actually have some soothing Aromatherapy salts to put in the tub that I totally forgot about.

I tried laying down relaxing  in hopes of sleeping, several times,  in my bed (my son is home from college so he gets the couch. I gave up each time.

We'll see if the CD works, it has in the past I just forgot about that as an option. When I'm well, I can think of a ton of things but unwell it seems to just vanish. Thanks again.

[Crystal413]

The thing is, I don't have any bad thoughts. I either think about everything else in life going on or I'm not thinking anything but either way my brain is full speed ahead. It just won't shut off. I am still so tired I could cry. My friend said my body is drugged but my brain isn't drugged enough to put me out until all of this is over. I'm still of course dealing with the hypo. I don't recall being such a total mess. It's an awful feeling being drugged. Tried 1mg Klonipin, did nothing. I forgot about meditation CD's to help you sleep. I will go to the library today. I tried an old one I had, actually a few,  that said meditation but the music was so loud even on low and the beat was too upbeat for me to relax.  My husband read all of your responses to me because I can't focus my eyes and concentrate what I'm reading. I will still keep watch though. I can still type.

This is bad. Do you suppose it's more common than we think for this to happen to BP people? I know there's a million things that can happen but I was thinking about this one in particular.

Last year I tried Lamictal for 2months and it made me Hypo so dr disc it. We decided to try it again, a full year later) and it made me hypo again. Hypo for 2 weeks and then straight into mixed states. Then as she called it BP mix. Then next which is now, VERY Hypo. This past week was the worst ever. Complete irrirational mess with the full speed ahead in your body. Brain can't stop thinking, very aggitated, anger easily,  frustrated easily, no patience very anxious,  crying at the drop oh a hat, literally shaking at at times if something is really upsetting me etc. My list is so long I can't even type it all.

Even though I suspected stopping continuing my Lamictal taper at the same time as starting Fanapt was and iffy thing to do, Dr says it,'s okay, no drug interactions and I asked if we could speed it up by one week. I know all of these drugs are too much. I'm the type of person that doesn't even like to take drugs unless I have to. Maybe the Fanapt is causeing this mess. Or then again could be the Saphris or Lamictal or all of them or any two combo. I know, ideally you do one at a time so you do know but that's not my case this time. Maybe I need a new dr(have had her for 5 years). I'm comfortable with her and I like her but a lot of the time I seem too much in charge. And maybe that's okay because I am my own advocate but their are time when, like this week I needed her to be in charge. She piece medaled me together the past  couple weeks. I will think about this.

I'm not well right now as you know. It would be nice if someone could tell me when this will be over. Just when you think things are bad it really makes you realize when things aren't as bad. I'm crying now, I feel so so alone and wonder if all this stuff, not sleeping and feeling hypo and such a mess  includung the one episodes after the other that keeps  happening to me, will ever be over. If I had a time frame of how long this particular episode will last, it would be a light at the end of the tunnel. I have been up all night, nap for 7hrs yesterday afternoon (with Saphris) since I only slept 2 hrs pm. Before. I can't live on Saphris even though I realize it's only been a week. I don't like combining so many meds. Thanks for reading my long winded story.

[Crystal413]

Thanks for everyone's help.

[persephonedemeter]

I forgot to say in my long reply that the 3rd part of my sleeplessness strategy developed between me and my psychiatrist was that I call and give him feedback the next day if it did or didn't work or how much sleep I got. If it meant calling every day until I got sleep or when I saw him, that's the way it goes. What he usually tells me to do, is if I don't get sleep in an hour to go up the dose by 50 mg. If that doesn't work, by another, and so on. Rarely, we will combine it with Thorazine. I presently, do not take any medication designated just for sleeping, because I'm on the last resort antipsychotic which makes me sleep too well and has very bad side effects. Sorry about the typos in the previous reply. I'm not great typing on a touchscreen.

[persephonedemeter]

Hi. I have bipolar 2 disorder like you, and just like you, I had difficulty being able to be medicated to fall asleep. I was a rapid cycler, in and out of hospital for 7 years running, and I've been on every med in the book and kept relapsing. I really feel for you. I had to get off Lamictal because I developed a rash, and it really didn't affect my sleep cycle. What affected my sleep cycle was the antidepressants. It was determined by a leading bipolar expert that my psychiatrist requested I consult, because I ran out of  meds to try and he was running out of ideas. My antidepressants were determined to be the culprit of my rapid cycling. The longest I went without any sleep was 2 weeks, until we broke it with me being hospitalized again and being placed on a rapid climb by 100 mg of Seroquel. I slept for 3 days and could barely open my eyes. So, it was a good thing I was already admitted to a psych ward when tht happened. Anyway, my psychoatrist and I developed a strategy to deal with sleeplessness. He told me I didn't call fast enough or called enough to let him know when I'm in trouble. So, as soon as I can't sleep, I'm calling him. Basically, symptoms are easier to treat and get a better result when you attack it early. second, he prescribes an antipsychotic, not a sleeping med (I can be on elephant dosages of sleeping meds and nothing touches me.) I take klonopin too, but it's primarily because I can't handle stress just yet, although I'm improving now. If your psychiatrist feels he/she cannot manage your sleep, then get a 2nd opinion. It didn't hurt my psychiatrist's ego, and I've been working with this guy for 12 years...and now, I'm finally recovering without hospitalization for 3 years. Maybe, this reply put you to sleep, but I thought I'd share what worked and didn't work for me. Hopefully, you will finally catch some zzzz's.

[Anonymouse88]

Well, when my mind has been racing in a bad way (bad thoughts) and I wasn't able to sleep anyway, I actually have ended up playing Plants vs. Zombies, because it takes just enough mental concentration to get rid of the bad thoughts, but it's not exactly hard.  You can probably insert many simple but engrossing games.  Won't help you sleep, but can displace bad thoughts.  You've already tried the med route, which is my usual go-to now that I have them (I take ambien, although when I first started and was really bad, I woke up after 4 hours).  Maybe a hot bath or shower to unwind?  If you can make yourself lie in the dark and quiet for a while, it will help your body get some rest even if you don't sleep.  You might want to try the couch for that, since sometimes a change of location can help and because you don't want to associate your bed with insomnia.

I'm wondering if you and your doctor should reconsider the Lamictal taper, since it seems to coincide with your symptoms.  I could be completely wrong, since I don't know your whole story, but it might be good to keep it up for now until you're more back to normal.

I hope you feel better soon!

[Crystal413]

I forgot to say I started Fanapt two days ago, slow taper to replace the Lamictal.