Agitated Depression (trigger warning)

There is a war going on inside me.
I love my precious wife and daughters and never want to hurt them, so suicide isn't what I want to do.
But I am overwhelmed with self destructive thoughts - not cutting to ease the pain - but violent self annihilation. I fight them away and count my blessings, focus on doing positive things. But all sorts of thoughts and ideas, images and emotions buzz around my head at lightning speed, like bullets ricocheting off steel walls - too fast for me to make sense of or reach any conclusions.

I'm depressed, yet was so restless that I worked out for an hour last night before bed, then couldn't sleep until about 4am, then was up at 05h30 to take the kids to school. For the previous week I have been sleep 12 hours a day. Now my body seems calm, but my mind is buzzing with restlessness, and I can't concentrate on the simplest cognitive tasks (except write what I feel).

I fear that this war I have with racing thoughts is driving me insane. The reality outside my head is fading away, and is being replaced by the more real terror inside my head. When people speak, it seems like they are far away or that I am hearing an echo of what they said long after they said it.

How do I deal with this?

I only see my pdoc on Monday next week.

That happens to me all the time. The only thing that helps is playing a computer game to get my head to calm down enough to go to sleep. Try reading or relaxing. Talking about your feelings also helps. I talk to my fiancee' to help ease some of the feelings. He has a good ear and listens to everything. Try talking to your wife about how you feel and see what happens. She may be more understanding than you think.

Someone switched on a light by suggesting that Citalopram could be the culprit - for the agitation and suicidal ideation, at least. If I go off that, I will have to find something else to fight the depression. Still using Epilim (Valproate) as a stabiliser.

Sounds like you might be nearing a psychosis, don't freak out by the term! It just means dissociating, that sort of business. Take care not to do anything you don't have to do and don't take action of any sort unless you have thought it through. If the thoughs get too overwhelming, or you think you will act on them, have your family take you to the emergency room.

Thanks for that, ladyjrnlist. I'll discuss it with my pdoc next Monday. And as you suggest, if my wife thinks I am losing it too badly, I can take a Seroquel or she can get me to the hospital asap. (I just hope not, cos hospitals and controlling environments really freak me out).

I have been right there with you. I am still working on meds, but I think we are getting somewhere. The most important thing right now is to make sure you are safe. Second, call your p-doc and see if you can get a sooner appointment. Hopefully your p-doc works with you. I have found that my p-doc working with me helps me get through a hard time because I know she is on my side. Also, I rely on my therapist who is a constant calm voice and reality check when I need it.

Psychosis isn't about disassociation, it about having delusions (strong false beliefs) and/or hallucinations. You don't sound like you have psychosis.

I know that feeling all too well, Tsunamisurfer. The aggitation, endless stream of restless thoughts, nervous/anxious energy, reckless thoughts and impulses... Not fun stuff. The lovely mixed state. Not much advice that I can give you except to keep trying to function until next Monday. Definitely go to the hospital if need be. Hope you feel better soon!

Try a mini meditation: set a timer for 5 min and think about 1 phrase or verse that is positive and significant for you, if 5 min is too hard, start shorter....

Thanks everyone for your support and ideas. Hugely appreciated.
Pete

Hope things get better Pete! Please keep us posted♥

{quote}
I fear that this war I have with racing thoughts is driving me insane.

The reality outside my head is fading away, and is being replaced by the more real terror inside my head. When people speak, it seems like they are far away or that I am hearing an echo of what they said long after they said it.{quote}

What I believe IMO and obviously I am not a doctor is going on here is called Depersonalization disorder (DPD) is a dissociative disorder in which the sufferer is affected by persistent or recurrent feelings of depersonalization and/or derealization. Please go here to look up info about this disorder. See what you think and maybe you can talk to your Pdoc about it when you see them if you think it fits.

http://en.wikipedia.org/wiki/Depersonalization_disorder

I hope that you start to feel better soon - and know that you are definitely not alone in this bipolar battle my friend .

Wow! Thanks so much for those references, LaraLynn. They explain all of what I have been experiencing. It seems my strange perceptual distortions of the world around me are not chronic, but short and disorientating, none the less, and are quite common in a range of disorders, including bipolar.

In the last 2 days I have been shifting gears rapidly towards mania, and having sleep trouble (who needs to sleep, right?).

Thanks again for your valuable help.
Pete

This is a great idea When I get that way I find setting the stupid timer at 1 min is hard enough, but keep working on it....even if you do the "mini-meditation" 10 times through out the day, I know it really works at keeping me sane.

There are some really good ideas posted here, I'm going to use them next time I'm in this mood.
I am also on valporate and am not sure how effectively it is working, but I know it is different for everyone so maybe you can discuss your medication and any changes that need to be made with your pdoc.
Go well
Snowy

Hey there, Snowy. I have found that valproate has reduced my sensitivity to stimuli that once excited me (e.g. music), and has also had a strong positive influence on my ability to keep a lid on my anger. I no longer impulsively blow a gasket before I have had time to think about a rational response.
I can't testify to how well it has influenced my cycling though. I went through a couple of weeks of stability in mild depression recently, but I started cycling again and swinging to extremes of suicidal lows and severely agitated and sleepless highs. The only thing that changed that could have brought this on is that I cut out junk foods, refined wheat products, sugar, fried foods, etc; and began exercising more seriously. Not quite the response I was expecting.

Update: I saw my pdoc yesterday.
He wasn't sure what to make of the depersonalisation experiences, and didn't seem too concerned (suicide ranks higher in his worry list). He said it could be a form of epileptic seizure or possibly anxiety.

I have been taken off all antidepressants (again) and put on a combination of Lithium Carbonate and Valproate. He said in my case the Lithium is useful for its effectiveness in reducing suicidal impulses, particularly when the is a high risk of impulsively acting on them (and I'm fairly impulsive at the best of times).
I'm hoping that it will work to improve my stability, as I am still rapid cycling a lot with about 2 troughs & 2 peaks per month.

The down side of Lithium for me is that it is likely to push up my weight and there is a risk of tremors which can interfere with my profession - photography. So this is a trial period for lithium.

The really good news at the moment is that since I dropped my Cipramil dose down to 10mg daily (tailing off before quitting it) I have had 4 consecutive days of being free of depression and wild agitation or hypomania, and have been feeling more alive too.

Hope things jis keep getting better and better Pete XOXO