Irritability

[PenelopeAnn]

I have had bipolar disorder all my life, but it wasn't diagnosed properly until I was in my mid-twenties. For a long time, depression was my primary and most debilitating problem. As I moved into my thirties, mania became my primary issue. Now, at 37, it has moved into mixed episodes, three days sky high, three days way low, over and over or, manic and depressive symptoms simultaneously. When they are together, I have the hyperactivity, racing thoughts, and insomnia of mania, but the content of the racing thoughts are very negative and can fall into the realm of delusional. Luckily, this doesn't happen often, but this new symptom has become a problem - irritability. It is unlike normal or even PMS irritability. It comes on SO fast and I act before I can stop myself. I throw things, kick things, hit things. It is embarrassing and I am afraid of it happening in public. After the event, I can see how it was inappropriate and an over-reaction. I'm too old to behave like a 13 year old throwing a tantrum. I'm wondering why my bipolar disorder has evolved into this.

[PenelopeAnn]

Thanks. I do use the journal feature here, but mainly just to make notes in relation to my moods. For more serious journaling, I prefer to use paper and pen.

[Venora Moonwind]

( iam smiling here) I wish there was a magical solution.
Hang tight till you can see your new doc on the 11th Everyday is a victory with us and every day is a new day.
I am holding on till the 15th myself.I see my regular doc and I am putting him in charge of everything as I no longer trust my thyroid doc and its getting expensive to drive all the way to see my head doc.
Come here and rant and rave all you want . I find the journal quite an emotional release when the stuff at work and at home get me down. you should check out my journal entry on the I hate all men. LOL Got lots of feedback from that one.
think of it as free therapy.
Vee

[PenelopeAnn]

Maybe I should have mentioned- I do all of those things. I am the 'ideal' bipolar patient when it comes to doing what needs to be done to keep my moods as steady as possible. So, what I am describing here is in spite of doing all of that. I eat right, I exercise every day, I take my meds, I make my appointments, I journal, I am educated on my disorder, I follow a strict sleep hygiene routine, I am in therapy, etc. I have been treated for my bipolar for more than 10 years. I was doing great for 3 years on Seroquel and Lithium. I moved. I lost weight. I started getting a side effects from the Seroquel that were very uncomfortable, racing and pounding heart rate. Because I'd been stable for so long, my new pdoc decided I didn't need to be on the Seroquel anymore. When it was decreased, my moods went up and down out of control mixed episode crazy. They are more stable now that I am back on the higher Seroquel dose. (I fired this psych doc because of incompetence, I see a new one on the 11th) The irritability was becoming a problem before the decrease of Seroquel, it just intensified and hasn't gone away. I reluctantly and briefly added a very low dose of Lamictal. It did horrible things to me the first time I took it and it didn't work out this time either. I have been on EVERY mood stabilizing medication over these past ten years. Lithobid is what I am on now. My levels are where they need to be, can't go any higher on that. Before extended release I was unable to take Lithium at all. Here is what I have tried and cannot take due to debilitating side effects-
Regular lithium- severe tremors, Neurontin, Lamictal, Tegretol, Trileptal- these four caused double vision so bad I couldn't drive or read or watch tv, and my balance was so off I fell down the stairs regularly, Topomax- messed with my short term memory like I had Alzheimer's, Abilify- akathisia or as I call it 'itchy muscles', Prozac- excruciating heartburn
Medications I refuse to take because of bothersome side effects- Zyprexa and Risperidal turn me into a lifeless zombie, I might as well be dead; Remeron and Depakote made me fat, among other things, and so depressed over being fat I hated myself and wanted to be dead; lost that weight, not going there again
I wish to avoid anything like Xanax, Valium, Ativan because I don't need addiction added on to my problems, I what I can using relaxation techniques and deep breathing
I will NEVER do ECT again- fried my brain, lost memories and messed up memories permanently, I was like a stroke patient
I just hate typing all of this every time I post on a forum. And those side effects I mentioned were low dosages. I'm just that person that simply can't take a med or it is the best thing ever, most I cannot take.
I am on- Lithobid 900mg at bedtime, Seroquel 450mg at bedtime
I also take a very low dose of Neurontin for facial nerve pain 200mg at bedtime and 100mg in early am to avoid daytime sedation
VERY RARELY I will take Xanax .5mg at bedtime for insomnia
I am only 5 ft tall and only weigh 105 lbs now

At 15 years old I was diagnosed with depression, but in retrospect BP was the real problem
In my early 20s was treated a few times for recurrent depression, again, mania was present, just wasn't enough for anyone to notice a problem
Mid twenties hypomania sends me to the doctor and I'm diagnosed with BP II, basically because I could still work but if they'd known what was going on in my head and things I'd been doing it would have been classified as BP I - I hide my manic delusions well; initially I am tried on Lithium, before I get to any sort of dose that could stabilize a mood I am having tremors so bad I can't hold a cup with two hands; so, over a period of ten years everything that might possibly help me is tried. I am just one of those people that don't tolerate medications well, or they didn't help. I've already listed what I've tried. When I was last in the hospital, completely and utterly delusional, Lithium became available in extended release form. With that I finally got some mood stability. I was even ready to go back to work until this mess with the Seroquel occurred.
Anyway, I used to just complain about the irritability, but now it is to where I throw things, break things and I am afraid I am not going to be able to control myself in public. My vet asked me to volunteer to help teach dog basic obedience, and I'd really like to, but I can't if I don't know if I'm going start making an *** of myself or throw something at someone or hit someone's dog.
It just feels so unfair because I am doing everything I can on my end. I guess I was just hoping someone had some secret magic suggestion.
Sorry, so long.

[shortcircuited]

It's dysphoric mania, which means you are irritable instead of euphoric-happy for no reason.

I think it may be a natural progression of the illness, especially if left untreated.  I went through my most severe episode progressing from hypo/extra active, to feeling great despite all odds, to being pissed off all the time.  Also, if you don't get meds to slow down the cycles, it will usually become more and more rapid, like you are describing.

Ask your doctor for a mood stabilizer, like lithium or lamictal.  You could take a ton of Seroquel, but then you might have major depression and have a hard time getting out of that.  If you take too much anti-depressants without a stabilizer, you could end up schizoaffective from lack of sleep.  Hopefully your doctor can work with you so that you can take something for sleep only when you need it, but something that really works--helps you stay asleep for the time you need, but not hungover later.

[Lizz67]

I have  a long history of Bipolar I.  I've been stable on meds for three years, although I stil suffer from depression that varies in intensity. A few months ago I suddenly becme extremely irritable and mentioned it to my counselor in passing.

  She suggested it was a symptom of mania (maybe an upcoming episode), and I had one of my meds changed (increase in Seroquel) and it helped right away.  I'm not a doctor - can't give you a diagnois- as Verona Moonwind said you should tell your doctor everything. Everything because something you think is unimportant may be a big clue for your doctor. And she's right that people on this site can feel for what you're going through. Just wanted to share my experience

[Venora Moonwind]

diet, exercise,regular sleep pattern, meds and therapy are the secret to managing bi polar. Oh and no sugar and caffiene as these both aggravavte bi polar.

you didnt say if you are in therapy or what meds you take. If you are on meds it sounds like they arent doing what they are supposed to do which is to keep your mood stable.
Your meds probably need tweaking as they do every so oftten for many reasons.

I can really identify with you because before I got on the celexa/zyprexa combo I used to do the same thing. I call it going bi polar on the manic side.

I am porbably due a meds tweaking my self  due to weight loss. I have dropped 20 pounds .I dont known if  I need the thyroid med or my bi polar meds adjusted. So I am going to discuss this with my doc on the 15th.

See your doc and tell what you have told here. you dont have to have these mood swings You arent alone . we can help you through this time. We who are bi polar understand what you are going through,