RACY MIND but NO euphoria

[opus88]

I am confused abt BP I've done alot of reading and they all say there has to be at least one episode of a manic or euphoric experience.....well what if there isn't????
My son has many symtoms of BP but NO manic or euphoria....his mind races constantly and keeps him awake or unable to concentrate during the day. He has problems with drug/alcohol abuse, that he says is the ONLY time he can shut his mind OFF for awhile....I'm confused what is everyones opinion that he has a correct dx???

[LeftCoastChick]

I get the racey thoughts and anxiety, but not the mania or euphoria, what you are describing is hypomania, a milder form of mania. I have ADD like symptoms, many folks will self medicate and if they have an addiction BP is so much harder to treat. He needs to get clean before he can be properly treated.

[opus88]

thx 4 reply.....he is clean and has been for 18 months, except 4 moderate alcohol use...and ur right that doesn't help the symptoms nor is it giving the seroquel an honest chance. he has anxiety attacks and relationship issues and of course the insomnia.....but the racey mind is by far the hardest for him to deal with.
He is also a bodybuilder and using steriods, will this also interact with the medication and cause a worsening of the disorder?

[ILADVOCATE]

Absolutely yes he should stop taking steroids. They are generally dangerous and can often set off personality changes including psychosis including in people without a pre-existing psychiatric disability. He needs to attend a dual recovery group for a person with a psychiatric disability and a substance abuse issue. As he stabilizes in that regard his psychiatrist can determine what medication is right for him and at what dose but Seroquel does have a good mood stabilization effect.

[opus88]

I really appreciate your input...his drug abuse was a 10 yr ordeal and he hit bottom many many times as a mother I saw them all! and I paid for many rehab stays for him myself(I am alone and on a small income)....I got him into see a good psych. abt 5 yrs ago who did admitt him to a dual recovery place, he only stayed abt 3 wks....tried going back to work and failed a few attempts, continued using, hit bottom AGAIN and again(he's really lucky to be still alive)....finally at one point he checked himself into another rehab and stayed 3 months...than went back to retrain for a new career...(he is a professional business man)...so after the retraining he got a new job, moved to a new city and relapsed only occasionally when he hit a real low(self medicating)..he has been on and off seroquel for a few yrs, goes off when feeling good and back on when he's feeling bad...typical BP...............so now as I said he has been completely clean from cocaine for 18 months,( I can't tell u how proud I am of him for accomplishing this)  alcohol he uses as a replacement for the down days.......had a really BAD episode this passed weekend that he now recognises as an alcohol problem and has vowed to stop it also even recreationally.......the steroids only started when the cocaine ended, he needed to get a better self image thus the return to bodybuilding which he has dabbled at since high school..his psych knows nothing abt this usage....and at this point he is so far refusing to stop, says thats the one thing in his life that does give him stability and a positve image, he is 38 but still what the young call a hunk..............I agree with u this use has to also stop, I think he is still in denial of his BP, he has agreed to me to stay off alcohol and give this seroquel an honest chance to see IF IT WILL STOP THOSE RACEY THOUGHTS ...they are literally driving him crazy..if NOT he will have to FACE the fact that it maybe the steroids that are interfering.
he has used all these to self medicate himself over the years....it was a long time getting his dx'd with BP...now he has to give the meds a good try till the right combinations allow him to feel normal and not need to use substances to get through a day!
thx so much again. everyone on this forum is helping me understand my son much better, I hope to one day convince him to join himself...right now his concentration level is so low he says he can't even read.
good luck to us all eh!

[mejeba]

I really feel for you- the mum- watching your son going thru this.  My son is a constant worry for me too with his extreme form of BP and psychosis.

The steroid use scares me.  My husband knew a young man (only 18) who was doing body-building and using steroids and he became psychotic and killed his girlfriend and himself.  I know his mother and her pain was just heart-wrenching.  I don't know of any psychiatric problem with this boy- the steroids can do that to anyone, as ILADVOCATE said.

I don't mean to worry you even more with this, and we can't tell our grown up kids what to do, but ......I'd try to let him know, again, of my concern for him and how dangerous steroid use can be.  I have no idea  of how it might interact with Seroquel.  I think a pharmacist would know that.

I truly hope he can get some help.

[mejeba]

oh, and I get the racing thoughts with no euphoria, too.  It's all agitation, irritability, anxiety, confusion and often a depressed mood too.  It's often referred to as "dysphoric hypomania".  My pdoc prescribes the mood stabilizer Valproic Acid (Depakote, Epival) for that.

[corlenbelspar]

If I'm not mistaken mania can present itself with irritability instead of euphoria, which is the only way it's ever presented itself for me.

[opus88]

thankyou both for the feedback, I sure can't find much material that doesn't refer to BP symptoms without manic episodes, so thats good to know there r others with similar circumstances. I'm not familiar with 'dysphoric hypomania' I will try to read up on that.
I'm not usually such an interfering mom, however since he has no will to do any reading up on meds or symptoms I feel the need to try....with the suicide rate so high in his dads family I NEED to know and understand, I hope one day he will also feel well enough to take more of an interest..
U r all right abt steroid use, I do feel the same, its not easy to tell a 38 yr old child what to do but I will continue to not endorse...the only thing I will add (I guess in his defense)...is he IS on a very low dose of these(can't remember the name)...far below what serious bodybuilders or athletes take....so in reality not much difrerent than female birthcontrol pills!
thanks so much