[Martina]

So, on Feb. 28th I had an appointment with my new therapist. She noticed that I was talking REALLY fast, and asked a few questions.....and well, I hadn't been sleeping, I had a lot of energy...long story short, she called my pdoc and said something is up.

My pdoc is out of town, but over the phone decided to increase my dose of Invega to 9mg. She just assumed I was going manic.

Now, I know it's important not to let me go up, because then I must come down.

But I explained CLEARLY to BOTH of them that I had four 12-oz cups of regular coffee AND a 16-oz latte with 3 shots of espresso in it. Hello! That's why I couldn't sleep! It's got nothing to do with mania.

And why am I not allowed to just feel a little bit energetic and happy? That weekend - the 25-27 - I cleaned the whole house top to bottom, it actually looked presentable for a change, and I exercised, cooked, played with my daughter - it was GREAT!

Now that she has me doped up, I could barely clean off the kitchen table this weekend, the bathrooms are disgusting, I didn't wash the dishes (hubby did), I didn't cook (we had microwaved crap)...it's a totally different picture.

Why is it so WRONG to have energy?

I'm considering just dropping to a smaller dose, but I don't want to get in trouble for it.

How do I explain to my pdoc and therapist that it really wasn't mania?

[Miss Laura]

Could it be maybe a bit of both?

I don't drink tea or coffee so I really can't comment well.

What does your Hubby think?

[codeWeasel]

In my mind the first question you should be asking is why you had that much caffeine? If you normalize the values, you had approx 900mg of caffeine or about 8 cups of coffee. For a regular person, that is a lot of coffee. For people like us with mood disorders, its potentially ruinous. One of the first things I did after my dx was eliminate as much mood altering foods from my diet as I could.

Don't get me wrong, I still need coffee in the morning, but I drink 2 cups of half-caf only, so about the same caffeine content as 1 cup of regular coffee. To me its all about stability, and caffeine, alcohol, sugar, etc all destabilize, so I avoid them when possible.

As far as dosage goes, simply call your pdoc and say the new dosage has unacceptable side effects (low energy), that you don't feel manic anymore, and that you want to go back to the old dosage. I can't see your pdoc saying no to that.

It does seem kind of weird that they didn't seem to take into account the considerable amount of caffeine you'd had. Combine that and talking with a new T? I'd've probably been going a mile a minute too(!)
Though... like you said, she asked some questions and you hadn't been sleeping and had a lot of energy before the caffeine thing, so...
Maybe it was some mania starting? There's nothing wrong with having some energy. Maybe they're just erring on the side of caution?

Go ahead and check in with them, maybe your Pdoc will be agreeable to lower the dose back and keep an eye on it. Certainly worth asking. (Besides, then you don't have to worry about self-adjusting. )

[ladyjrnlist]

caffeine makes mania worse.

[Tsunamisurfer]

I used to drink a lot of coffee - 10 shots of espresso a day - but it didn't excite me or interfere much with my sleep. (alcohol did mess with sleep). Talking rapidly, getting Tongue tied, frenetically cleaning the house, ironing, filing have usually been good indicators for me that I am heading into mania. I can understand your T's response.
But zombie meds are not optimal either. Lithium doesn't do that to me.
Hope you get it sorted out soon.

[Yoda]

People respond differently to coffee. I used to drink three pots of coffee every day. That was before I was diagnosed bipolar and looking back I did have some symptoms of bipolar then, hypomania most. But for some reason when my body hit menopause everything changed and I had wider mood swings to severe mania/depression and then I became more sensitive to coffee. Before menopause I could drink coffee right before I laid down and I went right to sleep no problem. But now caffeine interferes with sleep.

So basically I am saying that caffeine and bipolar symptoms are very individualized and you can't judge what works for someone else, you need to know yourself. The increased dosage of meds seems to be troublesome for your functioning so explain your change in symptoms to your pdoc. He doesn't know if you don't tell him. Good luck and feel better soon.

[Ryask]

I know for myself i can't even drink one cup of coffee, i get so jittery and the anxiety comes back...just one cup is enough to destroy me.

[Martina]

Caffeine normally doesn't have much of an effect on me. I'm just addicted to the act of getting coffee. In my office, the coffee machine is clear across the building. Often I get up just to walk around....and get a cup of coffee while I'm at it.

I have a slight mom-crush on the guys at the local coffee shop. The day I'm speaking of, I went there on my lunch break - more to talk to the guys than to actually get coffee.

I can often go to the coffee shop at 7:00 or 8:00 PM and still sleep like a baby after a quadruple-shot espresso drink.

So I don't know. Maybe I really was manic. But I was enjoying it! I'm a little upset. I finally got a "happy" mania (mine normally aren't so happy) and they don't let me stay that way.

And it wasn't my standard mania like in the past. In the past, my symptoms were the impulsive stuff - reckless spending, binging on food, sexual indiscretions (over 3 years ago, but still), ignoring duties at work/jeapordizing my job, and lack of sleep.

The only thing that really was the same this time was the lack of sleep. This time I actually felt happy, I had tons of energy, I was getting up at 5:00 AM and exercising for an hour, I was cleaning the whole house, I was always on time to work....I fail to see how this is all such a bad thing. I guess the fact that I had a night of ZERO sleep is a problem. But maybe it's just insomnia from the Wellbutrin - and a little (ok a LOT!) too much caffeine.

I talked to her about it and she's going to try switching me to a different antipsychotic (Saphris) which she says doesn't have the morning hangover effect like the one I'm on. We'll see.

[mgran]

When there's proper coffee in the house I can easily go manic on it... and the worst is that I'll start with the first coffee of the day, and then, because each cup makes me feel a bit better, drink more and more of the stuff till I'm through the roof. Even before I knew my diagnoses I knew coffee made me mad... and that I only drank it because I liked the manic feeling it gave me.

So... honestly, why did you drink that much of the stuff? I'm not accusing you, I'm just saying if I drank that much of the stuff it would probably be to lift me out of a depression, or to prolong a mania.

[Tsunamisurfer]

Originally Posted by mgran

When there's proper coffee in the house I can easily go manic on it...

Sometimes when I smell a really good freshly roasted espresso or cappuccino, I can be so swept off my feet I want to make loooooooove to my coffee. I wanna waltz around the room with it, do somersaults on the trampoline with it, treasure it, tell everyone how dizzyingly amazing it is, then savour it sip by sip, allowing the rich crema around the rim to swamp my palate ... ok, you're right, I am already completely manic by then and I only experience coffee in this way when I am so high I am well on my way to buying the majority share holding of the roastery.

I'm absolutely convinced that God created good coffee specifically to appeal to people on a bipolar high!
Any other coffee consumption is purely coincidental

[Martina]

I don't drink that much coffee every day. I'm not sure what was going on that day. I know I often get up from my desk at work and just want to walk around, and to make it look like I had some purpose to be walking around, I get a cup of coffee. And drink it. And the cups are 12 oz cups.

And I like our local coffee shop because the coffee is GOOD and the owner and all the coffee guys are very nice to me. I guess I just like to be treated nice by someone. But I could have ordered a decaf, or tea, or a smoothie....and still accomplished that.

I don't know.

I do believe I'm addicted to coffee, but on the other hand I can go an entire weekend without it and not have a headache. I don't have a coffeemaker at home.