While we're continuing to look for a decent local psychologist, I thought I'd post over here to see if anyone else has experienced anything similar... Truthfully? It's been extremely unnerving to see something akin to my own manic behaviour from an outside perspective. And I really need some kind of answers so we can figure out where to go from here. So, onto my concern:

Last night, at about 4:30am, my boyfriend woke me up to ask me for an Ativan. He never asks me for anything but he was EXTREMELY out of sorts. Hyperactive, couldn't stop moving, muttering to himself, paranoid & suspicious, kept hearing disembodied running footsteps on the tile around him, giddiness, racing/chaotic thoughts, hypersexuality... I'm pretty sure a good portion of you can relate! Uhm, it took an hour for the pill to get him to sleep but it was slightly disturbing for me throughout. For some history:

He has confirmed Major Depressive Disorder, Panic/Anxiety Disorder, & Anger Management problems. The only time he's had professional help was when it was mandated due to work outbursts & the fallout of being fired from said job. He was prescribed Paxil then Zoloft, Vistaryl, Klonopin, & Seroquel -- though he only took the first three. [The Vistaryl only during a panic attack to get him properly sedated.] They thought his outbursts were the result of a nervous/psychotic breakdown but it was ultimately inconclusive because, while he can be eccentric & creative, he's extremely level-headed & in control.
He wound up having dysphoric-manic reaction to Paxil, which is why he switched. And after some months, he quit the meds cold turkey because he felt he didn't need them anymore. Once he got a new job, he didn't have the same degree of problems.

And now here we are, roughly 3 years after said mental breakdown. He's typically melancholic & stressed out... But over the past few months, he has isolated incidences of mania ONLY at night. He'll start having auditory hallucinations, paranoia, & get really anxious. I'm just at a loss, because I'm worried about this happening in greater frequency. His day was great yesterday; better than most! Which is why it was doubly weird. I could understand if it were a bad day & he snapped, but I don't know what to think. Is he Bipolar? Psychotic depression? Or even a medical cause?

I appreciate anyone who has managed to read the whole thing -- I appreciate the support. I'm not often distressed, so I'm at a complete loss trying to figure this out! I've always been at the opposite end of the caretaking situation. I'm looking up some local psychologists for advice before we jump into psychiatric treatment... Even though I just started taking meds regularly after 4 years of resistance, we'd both prefer to find out the source of this problem before making a decision like that.

sfgfdhbsgjhjtrehtr *bump*

[Trippin2.0]

Shay, I have no idea what could be triggering these episodes in your bf nightly, but just wanted to let you know I read your post and am bumping your thread in the hopes that someone knowledgable reads it.

[Victoria'smom]

I can't tell you what's going on. I will tell you my symptoms ramp up at night or they're just harder to hide. We have full-spectrum lights to help. It sounds like 'sundowner syndrome' which does it can happen with any mental /physical illness but is usually associated with Alzheimer's. Get him checked out physically first please.

[BlueInanna]

Sounds like hypo... Has a great day but still restless at night... I would worry too about his paranoia level & hearing things. May as well get checked out for some medical issue. But go to a pdoc & you're sure to get some dx, yanno? Then they say meds meds meds.... Maybe he just needs his own anti anxiety rx to get through those type nights idk... I hope he is ok.

this reminds me of the man I used to talk to online. he would stay up really late IMing with me (England/US), we talked for hours, he would get giddy happy, then, sometimes would be in the pits of despair, one night he thought my avatar growled at him and he was being serious. I was told by people who lived around him that he heard voices in the rain and saw auras. they just thought that was him. I was told he was 'scary' because of his temper. he was all over the place emotionally, I knew something was wrong but neither of us knew what it was, I thought it was just depression at first and alcohol use. he was undiagnosed at the time we were talking online.

I would very seriously get your bf to a psychiatrist as soon as you can. Only a pdoc can diagnose him but it sounds like something that needs to be seen about soon. best wishes.

Sundowning usually happens during evening hours... I would actually consult a sleep clinic, to be honest. Before a psychiatrist.

There are some uncommon but not super rare sleep syndromes that can cause individuals to behave very bizarrely at night... in various ways... the reaction the medication and the original breakdown may or may not be coincidental. If he is having problems with depression, yes he should see someone about that as well.

However, if these issues are almost entirely occurring at night, he is likely having some serious circadian issues as well which can have a drastic effect on mood. It makes sense to address that before the mood issues if at all possible. It is possible there could be some improvement in mood if there are any sleep problems present to address.

Though it makes the MOST sense to triage- if he is in a crisis situation, mood issue first.

that is what I would do anyway.
I'm not a health professional ny any means.

[A Red Panda]

I'd put looking for a "good" psychologist on hold (not sure what you're looking for specifically!) and I'd be finding well, any one who would be on your insurance or affordable if you're in the US? It sounds like he could really use some help, because whatever it is sure isn't just depression or panic disorder.

And I get how he could seem different at home than when he's out during the day - I'm extremely well-controlled in my behaviours. I very rarely display hyperactive behaviours, and it's usually only when I've gone out for the evening with friends. I'll be more energetic and chatty than normal, but it pretty much never appears to be out of hand - I just babble away to myself in my head if I have to really. I internalize it. Maybe your bf does that. But once I get home I just can't be bothered and I'll be a bit more nutty at home.

For me my psychotic symptoms and anxieties are worse at night because I have no distractions and am lying all alone in the dark with nothing else to do or think about. So it could be these symptoms are more unmanageable at night but are still around during the day, IDK?

Anyway you've got loads of advice about checking him out physically, his sleep and seeing a pdoc. Tbh I can't see a psychologist seeing him without a pdoc seeing him first or at the same time.

All the best to both of you Shay

*Willow*

[LacunaCoiler]

When I was on Paxil I had really bad night terrors and that would make it hard to sleep. Because of these night terrors they switched my to Zoloft which only gave me worse night terrors. During my time taking Zoloft I was hyperactive because it was causing mania (which I later found out because it put me in a hospital), which caused the paranoid feeling and hallucinations.

I swore that there was someone in the house and I could not only hear them downstairs, but I could see them on the landing outside of our bedroom door and see them in the vanity area. I was so creeped out by this that I stopped sleeping all together.

So maybe looking at his meds might help. I know night terrors are side effects of Paxil and Zoloft and sometimes Seroquel but so far I haven't had them yet with it. Hope this helps.

[Jackiebot]

It sounds like he should be monitoring his sugar, caffeine and alcohol intake. And limiting them. That is always my first step to helping someone level out. If he is fine for periods of time without medication, he might not need it. Regular exercise and a clean diet are definitely the places to start.

This is also an opportunity for you to see what it's like on the other side, and to practice all the love and tolerance you have been shown yourself. Be grateful for the opportunity to give back. 😺

-Jackiebot

Oh wow. Thanks to ALLLLLLL of you for providing input!! It has been incredibly helpful.

I will respond more thoroughly when I'm not heading out the door. But ohh ****, seriously, thank you all. I have a lot to think about in terms of a gameplan.