I drink regular coffee. I cannot give up caffeine.

I am so sorry you are having such a rough freaking time right now. Too bad you don't lve in MS, I could babysit for you and you could try to relax in a quiet dark room for a while. For some reason, when I am really manic, the only time I seem to be able to sleep is for a few hours during the day, almost because I feel like I'm not supposed to sleep then or something. When I lay down at night is when my thoughts start screaming and then its exceptionally hard to go to sleep. My son gave me a sound machine for Christmas (he's so thoughtful and only 8yrs old!). It has rainforest, rain, waterfall, waves, heartbeat and something else that I cannot remember right now. I have been going to sleep to the rain and it has helped me tremendously. When I am getting sucked away from sleep because of my thoughts, I concentrate on the rain sounds and try to find patterns in the sounds. I cannot tell you how much better I am doing with sleep these last few weeks. Even my husband's chain saw like snoring hasn't kept me awake (which is usually can).

I really hope that your pdoc doesn't look at lithium as the end all be all. There are tons and tons of meds you can try. Hell, I've been going through a med circus for the past 4 years and still haven't found any sort of miracle combination. With the meds I'm on now, I feel like my symptoms are barely contained, mostly just dulled down a little, I still get big highs, big lows and feel like a sack of **** most of the time. Hm, maybe I need to change again? I am tired of it. I bet I've been on 30 different meds in these past 4 years.

Wow, have I said anything helpful or supportive yet?