Managing irritability

[ed108]

Hello. My name is Ed. I have Bipolar II. I was diagnosed in 2005 and stabilized with Lamictal and Abilify. However, I've never really gotten a handle on irritability. Although I've dealt with anxiety and depression, those have more or less been managed. But I still find myself having uncontrolled irritability, and I get crazy over things that wouldn't make a normal person crazy (chirping of car alarms, people whistling, other stupid stuff). About four months ago I got off Abilify and upped my Lamictal to 150 mg/day. Although I feel like a fog has lifted, my sleep patterns have been interrupted. This, of course, pushes mania and increases irritability. My PsyD put me on Depakote today (250 mg) to help with the mania and hopefully help me sleep better. Will this help me with my irritability? Any other suggestions? Thank you.

[psychdegree]

Like I said in my above post irritability is so hard for not only us but others to understand..obviously bc were are acting cranky towards them, when were really not trying to be, its like just a trigger sets you off. I also tried Lithium, but eventually it began making my liver count way too low so had to stop it. But honestly I think irritability out of all my symptoms of BP is the hardest to treat. Bc there are meds to control all the other symptoms, which only help with irritability, there is no specific drug for it. But for myself I wish there was, bc some days I just cant even stand myself. But I try my best to scream a song or a word in my head when I hear what irritates me and have to think b4 I speak if its something to do w a person, bc its not there fault. But its hard and many ppl don't understand. My mom ask why I get an attitude when im really close to her and hear her lips smack..and I just cant take it. But again she thinks im being rude and it hurts her feelings. So I get where you guys are coming from bc its hard when no one understands that you just cant help it & its nothing personal. So id like some advice on this one too!! lol

[justj567]

my husband recently has been prescribed Lithium for his 'irritability' which sounds like things you are talking about that makes your blood boil he says it has worked wonders and I agree so far...granted we are two weeks in...he is also on Lamictal for BP but that didn't touch his irritability  

[amatchmaker]

I totally empathize with you ed.  No matter how stable I feel I still always feel like irritability is my nemesis.  I complain about it to my doctor and since I've been stable for over a year, we don't change anything. He has actually implied that if I have to be irritable, then that's not so bad.

I do take 1 mg Risperdal at night, and it seems to help sometimes with the anxiety that can be associated with my irritability.  Don't let it get to you that it is considered an anti-psychotic.  I know it bothered me when I first learned that but it is used for many different things, including BPD.  

I'm on Zoloft, Wellbutrin, Lamictal, Depakote, Risperdal, and Ativan for anxiety as needed.  I try not to take the Ativan unless I really, really need it, every now and then to relax to get to sleep.  

I've also always had a hard time understanding my irritability and trying very hard to identify the "cause" of it, i.e., is it from mania or depression?As most of us know, it can be either or both in cases of mixed.   The handling of it is not as easy as everyone thinks.  And, of course, unless you've experienced it, it is very hard to explain.  

I wish I was able to add some pertinent and valuable information to help except, liket I said, I am very empathetic. As soon as I read your post (I just joined today to ask for help for my arthritic knees - - speaking of which dealing with pain and bipolar is another story!), I was like, that sounds exactly like me.  I know it helps me to know that I'm not the only one.  Sometimes I can get on the pity pot and think that I  am indeed the only one dealing with this.  Maybe it will help to read the other comments here.  Thanks for your post, ed.  

Best wishes in finding that effective combo!

[Crystal413]

My dr and I have lowered my dose when I felt that way. Who can function feeling like a zombie. My rule of thumb is to try the least dosage possible to see if it will work for me. If it doesn't than my dr and I just increase slowly until the best dosage is reached. I would recommend you work with your dr for this method.

[ed108]

I've taken over 2000 mg of Depakote a day early on to help stabilize. It worked, but I was exhausted all the time. It's not worth it to me to be a zombie. But is 250 mg/day enough?

[Robbi50n63]

License Clinical Social Worker, did you really mean that? I was going to try and list some other words that went with the initials,lol

[psychdegree]

What does LCSW mean..lol

[Robbi50n63]

Yeah and the "LCSW" I saw after all of the above symptoms I had plus some told me I'm just depressed, you think? ha, just had to add that one in. Anyway, hang in there for the right meds will come and you'll even out and find that balance you need. For me it was def the Lamictal along with depakote at night 2 500 mg, though Ive been up all night as it has no effect on me to help me rest. I started with 1 Lamictal 1x a day for 7 days then up it to 2a day.

[psychdegree]

Hi! I have bipolar too & I know exactly what your saying! Its like u wonna smack the person who's doing that irritating thing. One of my things is to hear some1 smack their lips or gulp their drink. I kno most ppl would think we were seriously disturbed! Honesty it never completely goes away, but you can manage (I still have bad days or moments with it) I have a degree in psych so I try & remember what exactly is happening in my.mind. plus my meds are pretty good I take both meds ur on also neurontin & seroquel at night (and valium at night & a pinch when I'm really on edge) I recently started cymbalta too. But a calming med is always a great way to start. I'm on 750 mg of the ER of depakote & its awesome. The seroquel is great for sleep too. You may just be experiencing mania irritability, which I know is so bad..some times very constant. The best thing to do is when it something irritates u, count backwards immediately! If your alone do it loud! Trust me..gets ur anger out & gives a shock to ur mind to forget about the irritant..don't scream it in public tho!!! Haha..they then may think ur a nut. Try little things like that c what helps, were all different..so something diff may work for. Just find something to take ur mind off it in that moment. Let me kno if this helps!!