[PiperLeigh]

I was hypo for just over a week. It was WONDERFUL. You may have been there before. Creative, fast, happy, no need for sleep, social, fearless, etc. But then it turned on me. And I was a mess. A really big mess

I was able to get in to see my p-doc immediately. (She is WONDERFUL) My thoughts were racing. My anxiety was high. I was completely agitated and couldn't calm down. I wasn't sleeping more than a couple hours a night and I had started crying every few minutes over everything. (yeah, it was lovely) I'm not sure if I was crashing or going into a mixed state or what.

I love my p-doc. She is patient and never rushes me. She takes the time to listen to me and explain everything. The very first thing she said she had to do was get me sleeping. She had a whole plan of action for me laid out but then I dropped the news that I have to be able to function and drive over 100 miles a day to drive my kids to and from (private) school that is a few cities away. Drugs that would make me drowsy wouldn't be good. Well that put a kink in things. But she regrouped and came back with a plan B. She said I have extremely severe anxiety and she needs me to get that calmed down. So she wants me taking Ativan several times a day. That made me cry a lot. I have always told her I do not want to take any Benzos. She gently pointed out that if I'm trying to stay out the hospital I need to take these meds because if I end up in the hospital I'm going to be taking them anyway, plus probably even more medication. Sigh. (She really is a sweet doctor and is sensitive to what I want. I do appreciate that.) So then she tells me that I also have to start taking ambien at night. Oh fine. So now I'm going to be on benzos during the day (strategically taken right when I get home from taking my kids to school so it wears off before I have to go drive to pick them up) and then take it again after I have brought them home. And then I'll need to be zonked out on the ambien at night. Evidently the goal is to just zonk me out as often as possible. She also doubled my lamotrigine, and I think she added something else in, but I'm having a hard time remembering what. Anyway. Right now I feel tired. But I still feel like I'm probably a bit on the manic side of things inside. My thoughts are fast. I do not WANT to sleep even though I am tired. I want to be impulsive and fight whatever the heck these stupid drugs are trying to do to me. (Really mature of me, right?) I'll be going in to see my p-doc really soon and then again after that for several follow ups. She knows how badly I want to stay out of the hospital and I am trying very hard to be compliant (even though in my head I have a desire to fight the effect of these drugs). I know she would have liked to prescribe Klonopin and a few other drugs to me, but because she felt the need to work around the situation where I have to drive my girls so far each day, she settled for others she doesn't usually go to first.

Does this sound like the type of strategy for treating a hypomanic or manic (non-psychotic) type state? I feel like my meds are designed to zonk the manic out of me out.

This whole latest episode was triggered when I didn't sleep for four days when my husband was away on business. He's about to leave again in a few days for a week on business and will then be home for two weeks before leaving out of the country to an extremely dangerous location out of the country for another week. (relief work in a dangerous third-world country) I don't normally sleep while he is away. My P-doc is concerned I need to be treated constantly over the next month and a half so I don't end up escalating things into a mixed state from not sleeping. Ugh. I just hate the thought of taking the benzos and the sleep sedative. She told me that I am not to sit around feeling bad about taking either one or worrying about physical dependence or addiction because it is more important that we get me through this; she'll get me through the other side of it after this is over. I do trust her. I know I have to comply and I want to be responsible but the rebel in me REALLY wants to fight this. I really hate that part of myself. I don't want to take either the benzo or the sleep sedative, but I also don't want to spiral down into a bad state where I can't be a functioning mother to my kids. I hate it when I know WHAT I have to do, but I just DON'T want to do it.

[hamster-bamster]

I understand your desire not to take benzos - I do not like them and am not taking them anymore, thank you. But what is so bad about Ambien? Are you resentful that you cannot sleep on your own, without drugs? Is that the reason?

[PiperLeigh]

Ambien isn't technically a benzo by it's chemical structure. But it works on the GABA BZD1 receptor complex just like the benzo's do, so it basically gets to the same place. I guess I lump them together. But nah, I don't really have a problem with Ambien. I don't think Ambien is bad. I don't even think benzos are "bad" necessarily. I know they are a really helpful to many people. Evidently I just joined their ranks. I can't sleep when my husband is away, and it's become clear that not sleeping is my trigger that makes me cycle towards manic. I just wish I didn't have to rely on any of these things. I'm not very articulate, but it's almost like in zonking me out it's like I have to stop being me for a while. Like I need to be turned off "for my own good." (which technically I do, but I don't like it when I think of it like that.) I doubt I'm making sense.

[hamster-bamster]

Now I remember, one on-call p-doc whom I saw a few years ago was explaining to me that these guys - Ambien, Lunesta, Sonata - work just like benzos. So what can I say - try what I do, which is a low dose of an old tricyclic AD, Elavil (NOT a benzo, would not require an increase in dosage, is not habit-forming, would not stop working with the passage of time, does not require breaks in use). At the low dose that I am taking, NO side effects. In the beginning there was morning grogginess, but that went away. I am so glad that my sleep is regulated by something that is not habit-forming!!

[~Christina]

Not sleeping is the gateway to hell for me. If I go more than 5 days without sleep I am a complete mess. I understand your Pdocs thought process. Makes sense to go ahead and stay on the meds for a month or so. I understand your not wanting to.

I hope you can figure out what will work best for YOU

Oh, Piper, you really are having a difficult time of it. When your psychiatrist gets you through this episode, please take some time to do some research on your diet, because I'm convinced that the diet plays a very large part in the mood shifts and
particularly the severity of the mood shifts in some bipolar folks.

Maybe we could talk a little about it when you recover from this episode. In the
meantime, please stop using caffeine, tea, and chocolate until you learn whether or not you have a sensitivity to them. They will wreak havoc with your sleep schedule
if you use them and have a sensitivity to caffeine.

I would suggest that you stop using grains, as well. Evidence is piling up that they
cause real problems for many people and that they are long-term slow poisoning for
us because of changes in agriculatural chemistry to increase gluten--but that's just
part of the problem.

I know you haven't time now to think about it, but when you're better, please give
some time to research on this. Making changes has helpled some people to reduce
strongly the meds they are taking; from your message, I gather that's what you're
hoping to do in time.

Follow your good psychiatrist's advice and get through this episode; then think about the ideas I've suggested as helpful.

Saying a prayer for your recovery.