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Reaching my Breaking Point - Bipolar 2 and TRT.
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Reaching my Breaking Point - Bipolar 2 and TRT.

Thanks in advance for any help....

I am 26 years old.  For the past 7 years I have struggled with anxiety, depression, insomnia, irratibility, manicness, mood swings, inconsistency, etc. etc. etc.  Life has been one hell of a roller coaster, but in this time I have managed to graduate college and an MBA, secure and maintain a well-paying and fulfilling business career and marry the love of my life (and hang on to her thus far).

I have seen 3 different family doctors, 2 different psychiatrists and 1 endocrinologist...  I have been diagnosed with it all, and been prescribed just about every drug imaginable for these symptoms:  Anxiety & depression: Effexor, Effexor XR, Cymbalta, Prozac, Zoloft, Lexapro.  Sleep/Insomnia: Sonata, Ambien, Ambien CR, Lunesta, Restoril, Melatonin, Elavil, Seroquel, Provigil, Trezadone, Xanax.  Bipolar 2: Lamictal.  Low Testosterone: Testim.  None of these drugs have solved my problems permanently - some have mitigated some symptoms in the short term.

My current diagnoses and treatments are: Bipolar 2 disorder, insomnia and low testosterone (tested at 104 ng/dl).  I am currently taking the following medications: Lamictal 200mg once a day.  Testim 5g (50mg testosterone) once a day (on this for 2 months now, testosterone levels at 380 ng/dl now).  Xanax 2mg and Melatonin 9mg at night for sleep.

I am suffering.  I am constantly in a daze.  I rarely sleep more than four and a half hours a night.  My mood is up and down in a moments' time.  Anxiety is free floating and depression occurs at least once every day for an hour or so.  I am quick to snap at my wife and our dogs.  I have the shortest fuse.  The smallest annoyances set me off.  I can hardly focus on my work, but manage through it.  I have little motivation to exercise (although few people do), but manage to do 3 days a week of cardio (45 minutes) and 5 days a week of weightlifting.  Exercise helps significantly, but I don't have time for any more than I already do.  Lately, all I have wanted to do is lie in bed and watch TV.  I have lost a few close friends due to my lack of need for social interaction.  I make poor and whimsical financial purchases because they feel good.  My dreams at night are vivid, and I feel like they are creeping into my days now.  I could go one, but I think I have made the point.

Recently I have had a few notably bizarre episodes: About 2 months ago I made a very poor attempt at suicide - I couldn't break the surface with the knife on my wrist (and didn't really want to do it anyways I think).  I've had a number of overwhelming panic attacks recently where I become hot and tingly all over and feel an overwhelming sense of hopelessness.  I have had several episodes where I have "blanked (not blacked) out", curled up into the fetal position, cried and basically become frozen for a period of fifteen minutes.

And lastly, yet most importantly - I feel that my marriage may be suffering.  I am amazed that my wife can still tolerate me at this point.  I don't treat her very well anymore.  My sex drive is non-existant.  I feel so guilty that she has to bare the brunt of these symptoms.  I know she has to tip-toe around me and I hate it.

In summation: I am in a daze.  Life feels fuzzy.  My memory is poor.  I can barely concentrate enough to write this.  I want to be normal, but I am not quite sure what "normal" means anymore.  I feel like I have been over-medicated, poorly diagnosed and victimized as a patient.  I feel like I have reached my breaking point with the symptoms and issues discussed and the constant adjustment to new medications.  I don't have the guts to commit suicide and know that I have a good life, despite my mental issues - so don't worry, I am not going to go that route.  My wife and parents are amazingly supportive of me and want to help.  But I just can't take it anymore.  I'm fed up.  There has to be a solution.

I appreciate those of you who have taken the time to read this rant, and any help or advice you might have to offer.

Thank you,

Andrew



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Hi Again,

I left out a few things that I think may be important as well (in no particular order)...

I am 6'0", 185 lbs, 10% bodyfat.

When I was 23, I used marijuana and cocaine 7 or 8 times each.  None since.

I drink alcohol on average once a week - typically up to 4 drinks.  It doesn't really make me feel good anymore, and I get hungover very easily.

I was only recently diagnosed BP2 -- before that it was always anxiety or depression.

I have also been diagnosed obsessive compulsive - which I failed to mention is also a significant "symptom" for me.  I don't do rituals or anything like that, but everything must be in a straight line, no clutter, etc.

I eat a clean diet of about 2700 calories a day including lean proteins and whole grains, complex carbs, etc.

I am very doubtful that BP2 is the correct diagnosis for me.

That's all...  Thanks again for your time and help

-Andrew

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Lamictal can cause you to be in a daze.  It did with me and it's working fine.  But it can take weeks for your body to adjust to.  
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Thanks for the info Shawn...  I have been on Lamictal for almost 9 months though.  Is it hard to get off of?
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Have you taken any meds in the past from the list that you gave that have decreased your manic episodes and depression?  Lamictal is the only drug that you are currently taking that is supposed to do anything for your mood, if it hasn't in 9 mo, maybe you should switch.  Do you have any problems with Xanax? How often and what for are you taking it?
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I have been through EXACTLY the same thing. I have 3 children and struggle to keep a job longer than 6 months because of this ****...and the depression is the cause.. I sometimes just want to sleep and sleep and sleep, and I can't seem to get up, I have NO ambition! I am now on Lamictal 200mg, geodon 80mg, xanex ER 2mg, and a couple others. My sister has more of the depression side of the bipolar, and she is on almost the same things. Yeah, I'm tired alot too. Sometimes that gets me depressed..I have lost my labito, I think because of the meds, and I am a femaile.... But, from dealing with this for 13 yrs now I have come to realize none of the meds will work for more than a few months and a few that I have been on, (Zyprexa, Lythium, etc, just knock me out!). this disorder is an ongoing struggle, and I too am at a loss. This is something that does not go away entirely, we are always going to struggle with it. I don't want to discourage you, because I understand. Sometimes, I just snap at my kids for no reason at all, sometimes I just wait until someone does something, just so I can go off, and get all this agression out. But my sister and I still have not found the right meds 100%. I think maybe something to try is some kind of meditation, at least thats what my psychiatrist suggests. I don't know. Lets keep talking, and maybe we can figure something out together????  with much care and concern, Tanya
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By the way I am 28, close to your age ;)
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p.p.s. I just had to re-read your story, and I'm telling you, you just wrote mine, verbatim!  I so feel for you.
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Could it be at all possible that you're not bipolar?  uh, both of you?
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Avatar_n_tn
WELL, yeah, it is possible. But when your mood goes from one EXTREME to the other in a matter of seconds, and you make rash decisions on a constant basis and can't stop crying because it is out of control, you go to a PSCYATRIST and they put you on meds (which I really don't believe in) and suddenly your moods are not so drastic... you have to wonder. Sometimes, we just want an explination of why we are like this. My friensds think it's a joke.. they have no idea that I was diagnosed with this, or that I have been taking meds, and before I started medication they used to call me  "crazy tanya" . My children have no idea that I am on medication, and 3 weeks later, my 9 year old asked me.. "why are you being so nice and not so upset all the time?" But , maybe your right, but we don't know what else to do....
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P.S. are you like this too? Do you go through mood swings like this? Also, my boyfriend of 10 years says he has seen a major difference in my moods, and kind of misses my extreme moods at times, but he, like you does not believe in these types of diagnosis either..... or any other mood disorder... so, again, maybe your right, but sdo you have advise? what DO you think?
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Shawn -

I have a sneaky suspicion that I may not in fact be Bipolar...  The testosterone issue points in that direction -- my doctor had NEVER seen anyone test below 150 ng/dl (I was at 104) before me, and I am only 26.  Basically, I had the test levels of an 8 year old girl.  Pretty nuts.  So I am wondering if maybe I have an endocrine issue that is causing BP-like symptoms, but who knows.  

Tsnowe -

Thanks for the support.  I feel you -- sounds like we are in the same boat.  I know you are a female, but have you ever had your endocrine system checked out?  Not trying to play doctor here, but I had to uncover this myself, and my low test levels point to A LOT of BP-like symptoms...  Not sure how this works for females though.

I wish the best for you all.

-Andrew
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Actually I have had extencive testing, thiroid, testosterone, glucose, and the list goes on. All have come out fine. It wasn't until after I was hospitalized and had several psychiatric evaluations, before we found the "problem?"
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Out of all the issues you mentioned, low testosterone will cause depression and low sex drive. It would not cause cyclic symptoms of mania and depression
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Avatar_f_tn
What is Bipolar 2?  Have you tried GOD as well as medicine.
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Sorry you feel bad right now - key words being right now.  It is temporary, you will feel better at some point so just hold out.  My mom is BP.  Thank God I escaped that, but, I do have severe anxiety, panic and insomnia.  Sometimes depression follows that.  Nothing manic though.  So, anxiety and insomnia - they do feel like hell on earth at the time, but they can be helped - just give it time.  Number one - get a very, very good psychiatrist.  I happened upon mine by accident and he's been a godsend.  I get intense counseling as well.  Very important the counseling thing!!!!  I am now pretty successful - not symptom free, but not in hell either.  I have tried zoloft, paxil, lamictal - yes haze, cymbalta, elavil, you name it.  Zoloft worked for me, for 1.5 yrs, then changed to pamelor and cymbalta b/c I developed peripheral neuropathy (burning feet) and they are supposed to help with pain.  I take Valium when anxious, and tranxene 15mg to sleep every night.  Remeron used to put me to sleep, but I gained 30lbs.  Ambien - creepy but I slept ok.  You just have to give it all a chance, unfortunately.  I had to learn to be patient for the meds to work and in the meantime, I had to have a "lifeline" or someone I could call if I got a panic attack - day or night.  I also thought my marriage would fail, but it didn't!  Through sickness and in health.  And by the way, GIVE YOURSELF A BREAK!  Your testosterone is in the basement!!!  That can make you feel like **** - my co-worker is going through the same thing.  Also, vivid dreams can be from meds or just being plain tired as hell and anxious as hell.  When you wake up, get out of bed and read - no tv, very low light.  Read something totally boring and try not to fret about not getting 8.0hrs of sleep - you can still function on just 2-3 and you will sleep the next night or the next night - may not be 8.0hrs, but just let it ride.  The more you worry about the amt. of sleep you are getting, the less you will sleep.  Know that you are NOT alone - we are all out here, having issues too.  Very common actually - everyone has issues.
Take care
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Hope,

Ya know -- I never really considered the idea of just getting the hell out of bed when I wake up after 3 or 4 hours and starting my day.  I always try to fight it and lay there in and out of conciousness for the next 3 or 4 hours.  Perhaps I will give this a shot and see how it plays out.  

-Andrew
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Hi, i'm younger than you and was diagnosed with panic attacks two years ago. i know what it feels like to feel helpless and like the medication wasn't doing anything. i was on effexor xr for approx. 9 months and i decided it wasn't doing anything for me and i decided to go off.. It was very difficult. However, i did end up going to a naturopathic doctor who has really, really helped me. A lot of your symptoms can be related the side effects of the medication your taking... A lot of people can actually get suicidal on medication... or depressed etc. You need to make sure you have the right diagnosis first and second of all try alternative to prescription medication or a mix of both. Trust me, the effexor xr alone was enough to make me go crazy...  so it's just my advice but i really think you should speak to a naturopath doctor .. you never know either what the long term effects of all these prescription drugs are either... OH! and it's a heck of a lot cheaper the herbs you get rather than prescription.. it was costing me before close to $300 a month and now like $15!

good luck!
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Oh, Andrew!  your story sounds so much like mine has through my life.  And i know it is so miserable.  i feel for you-i really really do.  Mine started out that bad and finally they got me on some medicine that actually worked and stayed working-at least with the depression and the mood swings.  I don't know if you ever feel normal once you have developed this illness or that is the problem i am having.
I, too, have a graduates degree and a family (how i don't know), because i am so scattered brained and frustered with keeping inner thoughts straight.  On top of my illness, i developed concurrent severe migraines that were occuring daily.  Finally i am seeing a specialist for that and they put me on Topamax which is also used to treat bi polar, so i am no understanding why the side effects are counteracting my other meds and now i am back to up and down and really depressed.  
you can't win for losing.  i find something that helps my head, but brings back the biplor to the surface.
It really sounds like this is your problem. i may be wrong because i am not a doctor, but your story is soooooooo much like mine!   my thoughts are with you.  i know how miserable it is. it is hard for your family because only people like you and i know what it feels like and what we go through.  they don't understand.
good luck
catrina
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Okay, Andrew, thank you for telling your story. I did not want to face that I had bp for 10 years after I got off of lithium because it was so damaging, that and depakote. So I totally understand your fear/desperation with medicine. You brought up a good point, or someone did about going to an endocrinologist. I'm going to try that too. The real reason I'm writing is because my mood swings, crying, rage, etc. destroyed my marriage. I don't say that to guilt you at all. Please don't take it that way. I'm trying to help in some way to make suggestions so you never have to go through the pain that I was in. Have you ever gone to marriage counseling? You didn't say, or maybe I missed it, if you are in therapy also? I highly recommend that. Another thing I rec. is Dialectical Behavior Therapy because you have so much anger and it gives you non-medicinal coping skills. They also have classes.A good therapist would also validate your feelings which I think you probably need very badly not to feel so alone, and to empower you so that you see that you do have more control than you think. I wanted to ask you also to ask your psychiatrist about a personality disorder? I was looked at for Borderline Personality Disorder which includes all the symptoms you mentioned. DBT is great for that, and you'd be on less medication. DBT is really the most effective thing for that. Of course I'm not a psychiatrist, but if you read about bpd, you would know best of everyone. Have you had your thyroid checked? Also, what do you think about taking a brief separation from your marriage to give your wife a break and give yourself time to heal/relax, etc. I wish I'd done that. Besides, I bet the stress of your marriage/guilt is making your symptoms and stress sooo much worse. Since you have free floating anxiety, and a need for control, I bet you are also giving every little worry it's own screenplay and feel tremendous guilt and shame/self esteem loss for things you just cannot help. I am feeling that way right now also. I do hope it's a simple endocrine problem, and I'll be sending positive thoughts your way.
God bless you,
Tashi
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One more thing, are you sure you have OCD? I mean, I'd love to have you come over and do your thing to my pigsty. But seriously, maybe your need to have everything in order is simply a way of being good to yourself in some way. It gives you some kind of control over something, and gosh that's a wonderful thing! Please don't beat yourself up anymore! My sister goes to an endocrinologist and she says that a lot of BP diagnosed people, according to her doctor, are actually suffering from hormone problems that are fixed and fine. Wait and see what your results are, give that a chance and then try other things. It's good to have hope, so don't spoil that for yourself.
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I'm saying this as a mother of 2 bipolar sons and a wife of a husband with cancer.  Your wife loves you, she will endure whatever it takes for you to get things figured out.  I feel that reaching out and seeking help is the first step.  I know that I am still searching for one of my sons, and I feel so helpless and lost at times, but there is something out there that will work.  It does sound like you have most of the symptoms of bipolar.  What I have read and understand, many times bipolar is accompanied by another disorder.  You may be dealing with more than one and need to address all of them.  Don't rule out bipolar or any others until you know for sure.  None of us like to face the fact that there is something wrong, but if we try to ignore it, it only gets worse.  I don't know if you believe in God, but He is amazing and may be the answer to many of the issues you are facing.  If you don't believe, I just hope that you never give up on finding the right help.  My grandma was bipolar and didn't get medication for many, many years.  It caused more problems than any of the meds and their side effects.  She attempted suicide and ended up damaging many of her organs and suffered a long 2 years before it finally took her life.  The suffering she went through in those 2 years were far worse than what the meds put you through.  I have been in a similar situation that you are in after having a hysterectomy and not being placed on any hormones or meds.  I always felt that I was allowed to experience this so that I could further understand what my sons go through.  

Good Luck and keep fighting for yourself and the right treatment.
    
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Having these problems alone may be lonley, but throw in a wife and two kids, plus 7 years of misery, and you've got a heap of guilt.  Like another writer in one of these fora, it's not a question of if, but of when.  Basically, I'm done.  I want to tell my wife of 19 years to leave me while she's still young.  There's no question she could get a much better man than I - one that didn't mope, and who lived up to his potential because he didn't freak at the slightest stress.  I don't want to string her along for another 5 or 10 years just for her to be an angry widow dumping garbage on my grave.   She'd be appalled and angry if I told her this, and I'm also sure she is unaware of the the depth of my wish to disappear.  It would be so much easier if she hated me.

BTW - I am on a bunch of stuff for BP2, and they work ok, but I'm not interested in nursing some chronic, potentially fatal ilness for the rest of my life, and I wouldn't wish that on my wife and kids.  I can see theM standing around the dialysis machine after my lithium and welbutrin ate holes in my kidneys.
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I came to this site to find some info about testosterone replacement therapy and its effect on bipolar disorder... and ran across this forum.  I was surprised at how similar all these stories and testimonials are to my own.  

I have been diagnosed BP2 for approximately 10 years.  Was originally treated with Lithium/Prozac combo, but it didn't do the job well enough for me.  I had trouble sticking to a regular 4x a day pill regimen, and the side effects of the drugs were unnerving to say the least, including having doubts about whether things I was seeing were actually true, or imagined from past memories and confusing them with the current state of things (whether doors were in locked position or merely that I REMEMBERED what the lock should look like and it was really unlocked).  Was changed to Depakote extended release, which solved some of the dosing issues, and tidied up my mood swings some, but to this day i still suffer from bouts of occasional violent anger and deep near suicidal depression.  THe comments made about wives walking on tiptoe is exactly how my wife feels, and i can't blame her, and I have often felt like one person who said they would rather leave their spouse and spare her and anyone else the torment of living with the symptoms of the disease.

I have recently been diagnosed with low testosterone levels and thought that some of the problems may come merely from that, but I know better than to attribute everything to one cause.  I am also overweight, diabetic and generally could be diagnosed as having metabolic syndrome, which in turn can cause reduced testosterone production.  So then it becomes a chicken and egg sort of mental game, and those sorts often have no clear winners.  

However, in all of my reading about BPD, i have come away with one clear conclusion, at least for myself:  it is nothing to be ashamed of, or treat in any way as something other than a chronic and common disease, albiet one that is not curable although treatble to one level or another.  I learned that i am not alone in feeling the way I do, and can no more take blame or shame for it than i could if I had asthma or arthritis.  It just is, and the question then becomes what do i do about it.  I would hope that those who read this would find that if someone else has a "problem" with them being BPD (and in this I mean attaching some sort of social stigma to it or treating it like a joke, rather than talking about dealing with the symptoms and mood swings it causes) then remember that it is their problem, one of a lack of understanding, knowledge or compassion, and not something you the sufferer can take on.  

Does this help me cope with the mood swings and fallout thereof itself?  Not so much, but it does help some with building a more aware and understanding support system for those days i can't cope on my own.  I do agree though that what you may have is some combination, and that it will take a a lot of work to find the solution.  I'm ten years in and still no definite 100% "cure"  but I know I am much better off than i was ten years ago, and give full credit to my wife for hanging in and supporting me through it all.

I have seen the way the changes in medications work, how it takes time to build to a therapeutic level and the horrible feelings and side effects that can occur in the in between times.  Add to that a couple of more diagnoses and meds, which might counteract, and you end up with a very frustrating juggling act.  I urge you however to hang in there and look for whatever means you can find to solve it, and discount nothing until you have enough solid evidence to write off a particular med, therapy, diagnosis, or treatment.  It is still an emerging and developing medical field, and we are certainly better off nowadays than 50 years ago (electroshock therapy anyone?   EEEEK).  

I will keep a good thought for you and for all those who are also struggling as I am.  
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I know how you feel and it *****. It can get better, it sounds like one of the meds isn't working for you. I'm going to try changing mine around.
Good Luck!!
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Read all your posts and have suffered near identical issues for decades....have tried every drug you mentioned and I think a few more.  I went from doc to doc to psych to psych for nearly 25 yrs.  I am 56  6'4" 210 lbs retired Wall Street broker....had good career raised family and got out early.  Only in the past year have I truly enjoyed life or even understood what "normal" was.  I am diagnosed BP2 with uni-sprectrum depression which I think means I am either always low or lower.  Never had a manic episode.  No OCD......do have very addictive trait and must avoid all mood altering drugs.  Alcohol does nothing for me except give headache.    What happened in past year was discovery of low testosterone levels for a man of my age which hormone doc thinks was a lifetime problem.....you also seem to have discovered very low testo levels at age 26....I wish I had found out when I was 26 (30yrs ago).

I am prescribed HGH (3mg day) together with dhea, and testosterone cream, melatonon at night, 300 mg lamictal.  Within 8 weeks I began to feel like a real person.  I never slept for more than 2-4 hours at a time...now I sleep 7-8.  My mood is terrific but not hyper or high.  I am not nervous, anxious or overly worried about miniscule things.  I can for the first time say I know what normal is.......it is awesome.

HGH gets a generally bad rap from the press/sports reports etc and is really not understood by most doctors.  It is not a anabolic steroid...it is a naturally occuring hormone in our bodies. Many people simply do not produce enough for "normal" brain/body chemistry.  I was sceptical big time at first but after seeing several hormone doctors who understood I decided to give it a try.   A complete mental health miracle for me.  I tried everything and sufferd for 30 odd yrs.   Regards  Joe C
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Hello,
Sorry to ask my own question on your post Andrew, but I found it while researching the combination of Solal testosterone cream and Lamotrigine/Lamicten & Epilim.  I'm waiting to hear from my psychiatrist about it, but perhaps someone reading this can tell me whether this combination is one that could possibly cause any harmful side effects.  Once I'd been using the testosterone for about a month, while taking 200 mg Lamictin and 200 mg Epilim a day (which I've been on for 9 years for BPD), I started to get very hazy - feeling like I was 'in another place' so to speak. My doctor said to go off it, and I have. It's been a week now, and I still feel strange. Could this have anything to do with the combination of those meds? I've asked my doc, but I was wondering if anyone on this site might know.  I trust her as I've know her for years, but I just want to double check. Thanks, P
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Avatar_m_tn
Andrew,

I'm a 25-year-old male and my testosterone came back as 105 last year.  I was also diagnosed bipolar type II and have run through the same meds as you for all of my various psych diagnoses.  My story sounds so similar to yours.  

Testosterone medications may be aggravating your depressive, sleepless, or hypomanic symptoms (including any OCD).  I just found a leading endocrinologist with the University of Utah who is interesting in understanding why the testosterone levels are so low, rather than throwing a bandaid on the condition.  I'm waiting for the 3-month period of zero medications to pass before my pituitary gland and hypothalamus can reset... then I can have the correct blood work done to find out what's going on.  It is possible and easy (with the right doc) to find a cause for low testosterone and treat whatever is inhibiting its production.  Your case does not sound like traditional developmental hypogonadism and neither does mine.  

You may have two separate issues with a hormone issue and a bipolar issue, but if you can accurately identify the hormone problem, that may make it easier to treat the bipolar side.  My body had atypical responses to anti-depressants and mood stabilizers, even though I found a few that I could coast on.  

In summary, find an endocrinologist who will look deeper than your 104 test result.  Treat that problem and then revisit your bipolar II.  I'm still awaiting results, but I'm getting closer to a proper diagnoses with the hopes of lessoning the hell.  

Bipolar II presents an issue of regulating energy, and an issue of regulating mood, but slap low T side effects on top and both are certainly amplified.

Good luck and props for completing your MBA,

Brock    
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*lessening, not lessoning - sorry guys
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