Apointment

I didn't really sleep again last night. I was up at 0600 feeling very wired. Feeling unusually positive. I have work booked in today but I cancelled the job. I have the sexual urges again and I feel like drinking alcohol. I've pulled myself down enough to realise that this would be a bad way to spend my day. I've booked an appointment with my GP for this afternoon. I think that it's best I go back and let everything out. I need to put all of my cards on the table.

My problem is this; I have so much going on in my head, I don't know where to start. Should I write a few things down or just go in and ramble incoherently, as I know I will do? I'm pretty sure I will be referred for another assessment. i don't know where to start with this. I want to get everything down but my minds is hurtling along. I know I'll miss some important information.

Yep, I'm hyper.

Got some stuff down to show my GP at my appointment later. It makes bad reading but I'm so wired I don't really care.

Here's what I'm going to show him/her:

My life since November of 2013

Folded business due to depression? Wasn't certain at time?

Euphoric in Dec 13/Jan 14

Solicitor contact in Jan 14 Re Abuse

Depression in Jan 14

Euphoric in March/April 14

Depression in April 14 Began taking Mirtazapine and seeking counselling for abuse

Euphoric in September 14. Stopped taking medication without consultation. High sexual urges

Depression in November 14

Euphoric in Dec 14. High sexual urges.

When I am depressed, it is pretty horrific. I become homicidal towards my abuser. I see that as a mechanism to stop me hurting myself. I'm detached. I don't eat. I don't sleep. I shut myself away. I find life very, very difficult. I think about death and suicide a lot. My physical health suffers greatly and I basically give up on everything.

When I am euphoric. I feel very confident. Over confident. I am aggressive. I don't sleep. I eat sporadically. I crave sex very, very strongly. I can't describe the drive. I spend money pursuing and entertaining women. I recently spent over £1000 booking hotels, entertaining, travelling etc. I don't always use protection. I don't feel bad immediately afterwards but when I do, I self loath for my actions which then makes me feel low. I spend money on things I don't need and feel bad afterwards. I take on many projects. I recently gave up smoking. Joined a gym. Started running and took my dog for excessively long walks. My work flourishes when I am up. I'm sociable. Very outgoing. Unusual need to socialise, drink, flirt, be the centre of attention. My thoughts race. People always seem to be moving too slow. I get very agitated. I had the police after me 4 weeks ago because of an incident where I became violent and paranoid for no apparent reason in a supermarket. I snap with people daily. I know this is wrong but I can't help it. I say very nasty, insensitive things to people I know and don't know. My friends have been deeply embarrassed by my behaviour.

For the past 2/3 months, I have been very up and down on a daily basis. One minute I can be really low, tearful, bad thoughts, self loathing, low self esteem. Then within minutes, I will be happy, positive, hopeful and full of energy. Sometimes I feel really hyper but also depressed. This is the worst time. I want to pull my brain out it hurts that bad. Mainly I just feel flat. In limbo. The sexual urges are so powerful I cannot describe it.

I took mirtazapine for 6 months last year but it did nothing to stop my symptoms of depression. I have also been receiving counselling for 9/10 months. This has done nothing for my symptoms either. I have got worse in the past year not better. I want to be helped but I'm scared of medication and I'm scared of the psychiatric assessment. Please can we talk about what happened at both of my assessments? I am exhausted with living like this. My life is torture on a daily basis. I have no stable moods. I don't ever sleep. I have waking nightmares that always involve violence. I don't eat. I have lost 14kg of body weight in just over a year. I am physically and mentally ill and I need help, but I'm scared. Has the medication I took last year damaged me? I woke up this morning after less than 4 hours of broken sleep. I felt very wired. I had a job booked in but I cancelled it. I had the sexual urges very strongly and I wanted to drink alcohol. I know this is wrong. Ive managed to pull myself down long enough to book an appointment with yourself and write down a little bit of what's been happening in my life and head.

I have a history of very self destructive behaviour. I am difficult to manage in professional and personal relationships. I was sexually abused as a child. I have attempted suicide once aged 19.

I have been diagnosed with PTSD, severe depression and most recently, Bipolar disorder.

Are you taking any medication? And if you are, it doesn't sound like they're working, time for some major tweaking or starting another type.

Writing things down is what I do because like you, my head is a mess. Good luck today and hopefully they get you started on a path to recovery.

Have you tried a mood stabilized instead of or with and AD? You might also consider finding a T who specializes in trauma therapy.

I've been refusing medication since September of last year. It's only recently that there's been mentions of BP. It was Type 2 initially but I was told at today's appointment that I was clearly manic. I was told Type 1 today. I've felt high all day. I think I was on one when I saw her earlier., loud and obnoxious. At least I've now presented myself in a non depressed state. She got very defensive when I challenged their use of antidepressants last year. She started saying that it clearly wasn't what was needed now. I have to go back to my CMHT again in 3 days. She mentioned mood stabilisers and antidepressants. I'm still not certain I want this treatment. It's manageable now but a full blown manic episode wouldn't be much fun I suspect. She said what I wrote this morning was helpful and to continue to log major mood shifts, actions etc. This is a worst case scenario for me now. I need to wait for the results of my assessment before I can let it sink in, but it's pretty obvious what I have. She seemed to think I've been mostly manic all my life and that it's becoming worse because of the depressions which have hit me in the last year or so. It's highlighting the mania even more. That kind of makes sense. This is such a confusing illness though.

What will likely happen with treatment from now in? Any help and advice would be great. Thanks.

T.

See above, and thank you.

That's sounds promising! First and for most, you will need a stabilizer, probably like lithium because you gave a lot of highs. I have a lot of lows so I take Lamictal. You can actually have both, really, L and L. I have to take a little AD because I stabilize depressed.

When I was on AD only, I was manic for a few years. It caused my highs to go manic but it did also make my depression way worst and harder. I was bouncing like a ball at times.

Also, we are hard to DX because we seldom report the highs but just the lows, which happened to me which made things so much worse. Good luck!

Thank you.

Lithium was a fear of mine. I've heard it takes a while to get the correct dosageand the side effects are pretty cruel. I'm worried that they're going to kill my sex drive to stop my promiscuity, will they prescribe something also for this. I have been prescribed medication before to quell my urges but I didn't take them as I was having too much fun. Oh dear.

I think the antidepressants on their own have just caused me problems. They just seem to love to dish them out like they're a one size fits all solution. It makes me very angry. I think it's just made things worse for me and I probably didn't do myself any favours by coming off a high dose cold turkey.

It's all surreal at the moment. Feels like a weight has been lifted. I still feel very up though, I'm surprised this hasn't started the dark thoughts.

It's good to talk!

T.

I'm taking lithium, although I'm told that I have bipolar 2.

For me, the side effects sucked and in the case of the tremors, still suck. When I'm hypomanic I'm very self destructive and the lithium has literally knocked that side out, providing that I take my meds.

I've tried a lot of medication though and incredibly, lithium has been the easiest to tolerate with the side effects.

Hypersexuality is one of the classic symptoms of mania. Treating mania can give you a sense of control over your sex life. Meds aren't a chastity belt, you don't have to stop having an active sex life if you want. They make it possible for you, not your bipolar, to make decisions.

I'm gonna be painfully honest. You're going to have to give up the highs to also get rid of the lows. Some people can't handle that at first. They miss the high and will ignore doctors, refuse to take meds or take them only on their whim to passive-aggressively shoot themselves in the foot and get that high back.

They end up going through divorces, SUI attempts, lose everything, bankruptcy, huge criminal records, debt, burned bridges with family and friends, have nothing at all stable in their lives because they don't know how to deal with stability because it's so unfamiliar. Eventually they crash and burn, hard. It's usually after a crash and burn that ends with hospitalization that people come out of that mindset and realize what they're doing isn't healthy, and get serious about getting better, even though it means sacrificing the high. But they lose precious time out of their lives and suffer a lot in the process.

You can make a decision right now not to put yourself through that. You have spent enough of your life suffering. This is a chance to get better. Meds can get you stable if you will take them and take them on schedule and not go chasing the high by going on and off them on a whim. The therapy comes in to help you learn how to deal with being stable, as it's a frame of life you probably haven't experienced in a long time, and it will require adjustments.

There are many, many kinds of meds and while it can take time and adjustments, you should be able to find a "cocktail" that will work for you. If one doesn't work, there's another you can try. If you have any problems with them at all, then tell your doctor and they can get you on something different.

I know this is very difficult and this is another part where a therapist can help you work through things. Getting the right diagnosis is the first step to having the kind of life you deserve. It can get better. Good luck!

I'm on latuda and lamictal but I too tend to be on the depressive side. From everything I've heard once you get the lithium dose right it tends to be very effective but people generally either hate it or love it.
I'd recome talking to the doc about what are all the possible treatment options. Therapy is good also becouse you learn ways to cope with the symptoms and decrease the crisis extremes.

How life/mood changing will this be?

Will I gain a LOT of weight? I will miss my cheekbones!

Will I be fit to continue to work? I'm self employed.

How will I finction on the medication?

Will I become a zombie, like I was on Mirtazapine?

I'm shell shocked but still feeling very positive. I'm dreading going to the dark side with this.

I've alienated most people with my manic behaviour over the years, to the point where I have zero support network. I have my parents and my brother, but who can truly be honest with their close family?! I can't talk about my sexual urges and practices with them, they'd be horrified. They know a lot of my problems, but I hide a lot. I'm so ashamed.

I hate it that I've pushed so many good people away in the past, I really do feel pretty alone right now with this. I'm not down, just a little sad at what I've become and where I am.

I guess I'm struggling to come to terms with this.

T.

Well hun, it's like this, are you tired of living the way you were living? I'm self employed and my meds don't zombie me. I'm actually quite clear headed and function well. Trust the process, don't be scared of getting well. Sure weight gain happens, some drugs more than others, but the ones I'm taking are weight neutral. Nothing a little exercise wouldn't fix. That's part of recovery, a proper diet, regular exercise, meds, therapy, and good sleeping patterns. Sounds like a lot but really isn't.

I'm very tired of living like this. My life is a total mess. I could "get away" with this behaviour when I was younger, but not now.

I get little fleeting sensations of excitement when I think what it would be like to just be "normal". I miss having things to look forward to in a non compulsive/manic way. Then I think of how drastically I will have to change my lifestyle and behaviours and it all seems very daunting.

I like the sound of sleep and a healthy diet, I've missed both of those thing desperately over the past 15 months or so. This has aged me in the past year.

Thank you for you comments and virtual support :-)

T.

Some meds cause weight gain, others do not. Lithium, Seroquel, and zyprexa are some of the big weight gainers. Lamictal and geodon are supposed to be weight neutral.mtopomax may actually cause weight loss. So you see, different Meds act differently. If you do start gaining weight and that upsets you, you can discuss being put on something different.

If you can function at work now unmedicated, you should be able to continue working on meds. Meds might even make your work easier.

The medication may sombify you but that doesn't mean you have to put up with it. If one of them does, you can ask to be switched to something different. Zombification is one of the reasons (out of many) why I won't take lithium. Even if it worked for me (which it doesn't) I would not take it because of this.

Your meds are really up to you. It might take some trial and error to find the right combination so just be patient and hang in there. Even if you against meds, therapy will be useful in learning how to mange your illness without them.

You WILL be ok. Bipolar is a tough thing to come to terms with. It took me two years - longer if you take into account I was originally dx at 18 and denied it for eight years.