Intro and Questions, Questions, Questions...

Hey All,
I’m new here, I’ve already posted an introduction in the New Members section as well as the BPD forum, but my doc says I'm Bipolar, so I wanted to introduce myself here.

Intro:
I have had multiple diagnoses in the past, and they all fit in their own ways. Major Depressive Disorder, yes, I am most likely to be depressed; Major Anxiety Disorder, yes, I’m prone to panic attacks; and Bipolar Disorder, yes, I switch from one extreme to the other, usually, however, I don’t top out the manic scale and there is no cycle, I can be “fine” one minute and one wrong sentence later can be nearly in a rage. In the last couple of years, I have begun to over-react to EVERYTHING, something as simple as a co-worker answering the phone incorrectly sets me off to screaming and cussing, a simple typo makes me want to throw things, and something as stupid as my mother buying the wrong brand of something can send me into tears. Even as I’m over-reacting I can tell that I’m doing it, but cannot seem to make myself stop. I feel like that spoiled teenager that got the wrong colored car for her birthday and flipped out about it. I hate being this way, I HATE myself. I fear that even my family, who are all used to dealing with mental illnesses, is starting to hate me, and I can’t even blame them for it. (No, they have never told me that they are tired of or that they hate me, this fear may very well be symptomatic.)

I had my first doctor's appointment in 4 years on Thursday. He says he thinks I'm Bipolar, but told me not to worry about the name, that we would work on the symptoms. He started me on Seroquel XR 200mg and gave me a low dose of Xanax to take only as needed for panic attacks.

Questions:
My doc says that a percentage of people with Bipolar don't cycle. Do you?

How have you done on Seroquel XR? Anything I should be watching for?

After taking my first dose of Seroquel I slept for 15 hours, woke up for about half an hour and went back to sleep for another 4 hours. I might have just been exhausted, I've been averaging 3-4 hours of sleep a night/day. Does this sound familiar to anyone else? Did it go away once you got used to it?

The pharmacy pamphlet that came with the Seroquel said I should watch for over-heating. Is this something you've had to deal with? If you over-heat easily and the medicine makes you gain weight, how do you watch your weight?

I know that I have more questions, but I can't think of them right now. In fact, I have a hard time remembering much of anything these days, is this a "Bipolar thing"?

I thought of another question, though it's not strictly for Bipolar people. Do people have a hard figuring out your moods, i.e. they can't tell the difference between you being angry and you being exasperated? Does anyone else dwell on these instances? Does anyone else dwell on things they have done wrong (real or imagined)?

First, did you see a psychiatrist or just a family dr? Because with those meds you really need to be seeing a psychiatrist (also for a real diagnosis, they are the ones who are really trained in diagnosing mental illness). I'll try to answer your questions below.

Yes, memory can be affected but not sleeping much and just starting Seroquel and Xanax can do that too and for the moment I'd say that's the more likley cause. Not sleeping is really hard on your body. I'm trying recover from not sleeping much for a really long time and my body is so tired.

As you think of questions keep posting them. There's lots of help available here.

I've never heard of bipolar without cycling. If you don't ever become manic but just get depressed and have mood lability I think just BPD and depression make sense.

I sometimes can't tell when I'm having an episode. I get upset when someone tells me I am in an episode when i don't feel like I am and I stay in denial until it gets pretty bad and then I believe it. That doesn't sound like what you're going through though. It sounds like you're having trouble distinguishing what emotion you're having at any given moment. I don't feel like I have that problem.

Just a family doc, it's nearly impossible to find a psychiatrist around here that is accepting new patients unless you are under 18, are court ordered, or have actively (and recently) attempted suicide. Evidently, not a lot of people in the area are willing to go to school so long for psychiatry, at least that's what I was told.

Risu, I agree, but I'll play along with the doc. I really don't know what else to do at this point, I know I can't keep doing nothing because I just get worse and worse. I suppose there have been times I was manic, I stayed up for days at a time and was very creative, but I don't remember having any of the other signs of a manic phase. Maybe I just didn't recognize it for what it was, like you? The upside is that I think this doctor will listen to me when I tell him, well, anything, so maybe that'll help.

I generally know what I'm feeling any given moment, I just have trouble figuring out why. It's other people that can't figure out my emotions.

My thoughts exactly. Bipolar cycles -- it's the nature of the beast. BPD goes back and forth with extremes of emotion and is that way consistantly (consistantly inconsistant you might say). Also, it is driven by interaction with others. The way one feels is reactive. (Someone says/does something and it sets off how you feel.) Something happens, and boom! instant (over) reaction. It also brings on a lot of assumptions regarding motivation (this or that happened/didn't happen = they must hate me! Etc.)

Anyhow, I'm sorry to hear that it's so hard to get in to see a Pdoc there. Alas, GPs are almost invariably out of their depth in psych issues. In the meanwhile or whatever, you may want to check into something called DBT (dialetical behavior therapy). It's well-regarded for helping with the very thing you are frustrated with-- not having more control over emotional response. Those kinds of reactions/interactions are largely controlled by thought processes -- how one perceives and interprets what is happening. I've heard that it can be super useful and very much worth the effort.

*********
Mr. Robot

Makes me sick to the heart, Oh I feel so tired. And the way the rain comes down hard, that's how I feel inside.

--The Cure

I live where there aren't psychiatrists either. I think there is one in town a day or two per week and there's probably someone with community mental health. Otherwise that's it.

I drive to a city to see my psychiatrist. It's 2.5 hours each way (I maybe could see someone closer than that if I could find a Medicare provider who accepts bipolar patients--the last time I tried to find someone closer (an hour) I was turned down in 5/6 places and the 6th place put me on the waiting list. It's been 12 years so I'm thinking they are maybe not going to call me back? ). I started seeing my psychiatrist when she was much closer and then I moved and she changed jobs and so I travel the 2.5 hours monthly. And it's a pain but it's worth it to have a good dr who knows what she is doing taking care of me.

Is there any chance of going to a city and at least getting a firm diagnosis and some suggestions about treatment? Even if you only went once or a few times you may gain something from it.

I just know that I had a GP trying to manage my situation before I was diagnosed but after I was ill enough to be diagnosed pretty easily and he did his best and his best probably made things worse. In contrast my psychiatrist keeps everything set up well and I know what is going on. She had a mastectomy while I was IP and with the surprise factor I left the hospital being told they'd set up follow-up with someone and then being told I should just wait to see her. But I had just started an MAOI which is a little scary at first while you adjust to all the restrictions and it also needed the dose increased, plus it caused a lot of agitation. Things were so well organized that my family dr felt comfortable treating me for the time my psychiatrist wasn't available although he did reach the end of his comfort level and at that point he stated that clearly. (And fortunately she was bad the next day).

But just having someone to check in with if there are issues and to make sure that you are on the best meds for you and that kind of thing would make a trip to a city worthwhile if you are able to do that.

Welcome!

As for Seroquel, I was practically a zombie on it. I eventually adjusted to it and didn't sleep as much, but at first, I could've slept 20 hours if someone let me. I didn't notice overheating. My biggest side effect was increased thirst/dry mouth. I gained about ten pounds really fast on it and then didn't gain anything after that.

My memory is definitely affected, but I'd agree with others that it might be the sleep issues so many of us have.

I'm gonna call your GP out on this one. This doesn't sound anything like Bipolar Disorder to me. I'd bet every penny I have on this being Borderline, and I don't gamble (obviously, I can't actually diagnose you). Is there any way you can get a second opinion from a pdoc? Even one or two visits might help. You'd probably have to pay out of pocket, but it could be worth it. Seroquel is a heavy drug to be taking when you don't know if you even have Bipolar. I wouldn't trust a GP with that kind of medication, and I don't think they should be allowed to diagnose Bipolar (personal opinion). And yes, it will make you feel like a zombie every time you take it.

Do you happen to have access to a therapist? While Bipolar Disorder is primarily treated with drugs, Borderline is usually treated with long-term psychotherapy.

There are Bipolar I patients who only experience mania without depression. However, that's very rare, and pdocs think that if the patient lives long enough, they'll eventually experience depression. They're not certain, though. I wonder if that's what NyxAngel's GP was referencing. In any case, that doesn't seem to be very relevant to you, NyxAngel, since you don't exclusively experience mania. It's odd that your GP would mention it.

I'm generally very aware of my moods. I used to have difficulty telling the difference between my normal mood swings and my bipolar mood swings, but I've figured it out now.

I only dwell on things when I'm depressed, because it becomes a lot easier to ruminated on real or imagined wrongdoings. However, I'm usually able to let things go pretty quickly.

Questions:
My doc says that a percentage of people with Bipolar don't cycle. Do you?

I've never heard of it before. I know that with me I cycle, my manic episodes don't last super long usually 2-3 weeks and my depressive episodes last for months generally.

How have you done on Seroquel XR? Anything I should be watching for?

I've never taken Seoquel but there is plenty of great answers here.

After taking my first dose of Seroquel I slept for 15 hours, woke up for about half an hour and went back to sleep for another 4 hours. I might have just been exhausted, I've been averaging 3-4 hours of sleep a night/day. Does this sound familiar to anyone else? Did it go away once you got used to it?

I do know that Seroquel can make you extremely sleeping when you first start taking it. That is why it is recommended to take at night. Eventually this is a side effect that can wear off.

The pharmacy pamphlet that came with the Seroquel said I should watch for over-heating. Is this something you've had to deal with? If you over-heat easily and the medicine makes you gain weight, how do you watch your weight?

I also know that Seroquel is a weight gaining drug. Almost all drugs in the antipsychotic class have weight gain side effects unfortunately.

I know that I have more questions, but I can't think of them right now. In fact, I have a hard time remembering much of anything these days, is this a "Bipolar thing"?

This is most likely caused from adding Xanax and Seroquel at the same time as they are both sedating medications that can cause you to feel fuzzy until you get used to them.

I would also like to echo that I would seek out psychiatrists for treatment. I started out seeing my GP during a depressive episode and she started me on Lexapro. Which then as I started to get super agiated and couldn't sleep she added BuSpar and Trazodone. Which should of been the sign that something was off for me. However I entered this really rocky area of moods where I would cycle about every month with no real middle ground I was either manic or depressed. Luckily I was seeing a therapist who works in my now psychiatrists office. The nurse there suggested I see the psychiatrist for med management and I had also gained close to 30 pounds on Lexapro. The psychiatrist reviewed my history prior to medication and what is going on currently and decided to take me off of Lexapro and start me on Abilify. Abilify did more harm than good I went in to a really bad manic episode really quickly where all my meds were stopped and I was started on Lithium, Ativan, and a higher dose of Trazodone.

It took about 2 weeks but I started to come out of the episode and have been stable for a bit now. I am getting ready to have my Lithium dose increased tomorrow.

Moral of my story is by just sticking with my GP for something than was out of their scope I caused my self to suffer for much longer than I needed to. I am getting the right care for myself now. So I advocate for finding a psychiatrist. You might be able to find someone through a community mental health clinic.

Lots of great advice given. Of course none of us can diagnose , we just go by what we have learned ourselves. It's very common to be BP and BPD its a very common combo, Brings up the suckiness level for sure. Bp typically is a mood swing that last at least 1-2 weeks minimun. BPD is a in the moment swing, highly emotional happy to flipping your shyt in 60 seconds is the trademark of BPD.

Seoquel? yeah it will slam you into a sleep coma, especially if you have been getting little to no sleep. Sleep coma is a good thing, Did the same to me years ago. As for all the nasty lil side effects that is possible well, you need to probably weight the pros and cons once your more rested and thinking a bit clearer.. so unless hitting side effects you just can not handle.. Just sit with the medication for a while..... few weeks at least. It is a heavy hitter.

A bipolar that doesn't cycle ? Bwhahahahh yeah , Nope not a thing at all.

I know in Canada it is very difficult to find a Pdoc , But seriously get on every waiting list possible,, GP's are great for general health problems but they are just so lacking in the realm of mental illness and the plethra of psych meds and how the work and interact its just not a wise idea to let then manage that part of your health.

CBT and DTB is so helpful and the latter is really the only treatment for BPD. So while waiting to see a Pdoc get in to a therapy setting or just a support group. Anything can help . Get educated, YOU need to be your own best advocate.

There is alot to learn here on PC, I hope its helpful to you.

Most of what you described is Borderline related. Have you tried DBT yet?
They'll tend to diagnose as Bipolar even though it is not the actual cause because its easier to get meds/insurance etc. Switching between moods that quickly is not BP.

As for the questions -

I cycle but very long and not predictable cycles. So its not like winter depression and summer mania. I was 4 years stable, 2 yrs depressed, up to 9 months hypomanic, 8 months mixed etc all at different periods. I mostly depressed but that is becoming more and more agitated each time it happens.

Seroquel will sedate, 200 isnt that large a dose for XR you can easily function on it if you need it, if you dont need it, it'll make you sleep a lot. Gave up watching my weight on seroquel or zyprexa, doesnt matter what you do unless you are really lucky you are going to gain weight. Seroquel munchies are like nothing on earth but XR isnt so bad, especially at such a low dose.

Thank You! I’ve always thought this was a major part of a Bipolar diagnosis and since I’ve lived with a manic-depressive for the better part of 30 years, I’m not exactly new to this.
This describes me perfectly.
I hadn’t heard of DBT before coming to Psych Central, but I will certainly educate myself further about it, thanks for the tip!


I was put on a waiting list around 5 or 6 years ago, too. Maybe there’s still a chance… lol As for finding one in another city there is no open psychiatrist in 100 mile radius according to the Find Help tool this site has and that’s pretty much what any doc finder will show and I can’t drive which makes getting there potentially problematic.


All I’ve done, so far, is work and sleep, but I haven’t really tried to much else since I’ve been working 12 hour shifts since I started taking it. I can already tell that this effect is lessening, I even managed to watch a movie last night before I went to sleep, but I’ll admit to not really remembering the ending. (It was a 2 ½ hour movie.) I’m interested to see how my first day off work will go. My memory is already so bad I’m not sure I would even notice if it got any worse, lol.


Thank you. I seriously cannot tell you all how relieved I am that you agree about me not sounding Bipolar. My mother is convinced that I just don’t want to have the same thing as her. I couldn’t care less what it’s called, as long as it stops, or at least comes under control. I’m still thinking about finding a GP closer to home, anyway, so I may still do that. My first/last appointment with the GP was last Thursday and he already has me scheduled for this coming Thursday, so he does at least understand that I need to be closely monitored with this stuff. My old GP wouldn’t have seen me again for another 3 months.
I think he plans on setting me up with one. I used to see a wonderful therapist in the same office as my GP, but he unfortunately retired, so there’s paperwork/referrals/stuff to be done I suppose to see if this one will accept me as a patient.


I’m just glad what you’ve all learned matches what I’ve learned. I honestly wouldn’t be surprised to find that I have a combination.

I do think there were a combination of factors helping that sleep coma along. The research I’ve done so far says that Seroquel is also a treatment for BPD and so far sleep is the only side effect I’ve noticed, except for a slight strange buzzy(?) feeling when I first get up, I’ve had much worse side effects with other medications, so I’m gonna keep trying it. The decision to go with Seroquel was made after considering the long list of other medications that didn’t help me or made me worse. The doc wants to try a mood stabilizer before playing with anti-depressants and from what I’ve read this seems like the appropriate response no matter which diagnosis is correct.
I am determined not to get pushed around by my GP this time. I would get so anxious just going to my old GP that once I got there I’d go along with whatever he decided just so I could get out of his office as fast as possible. I’m no longer allowed to go to the doctor alone.



Not yet, I intend to look into it immediately.
I already weigh 250lbs, so gaining more isn’t really a huge deal for me, but I already overheat easily, so that’s why I was wondering about that particular side effect.

Yet another question, when there area lot of posts to respond to should I do it all in one post like this one, or do one post for each person?

Nice to see someone who will take on board some advice Many are just full of excuses.

The way you replied was fine and I think easiest to read like that.

I wonder though, being heavier what is your diet and exercise lifestyle like? Much of what you described can also be put down to not enough exercise, the wrong types of foods and food sensitivities. It is something worth exploring too.

Do you have Medicaid? In my state Medicaid will provide transportation to appointments. I heard a commercial about it today when I was at the hospital to see my psychiatrist.

I have plenty of excuses myself, but I came here looking for advice, so it seems silly to me not to give the advice consideration.

The lightest I've been as an adult was 160lbs and even then I had problems with depression, mood swings, anxiety, etc... When I went to college I lost weight instead of gaining, 160 was my plateau. After dropping out of college I stayed around 180 until a few years ago when I had what I would consider a breakdown of sorts. I stayed in bed 24/7, I only left my bed to use the restroom and maybe grab a Mt. Dew and wouldn't so much more than stare at the walls in between sleeping day and night. Even without eating I guess the Mt. Dew and total lack of movement 'caused me to balloon up to 300lbs, I've been losing it very slowly as I've (just as slowly) pulled myself out of that... whatever you call it. Nowadays, though, I walk my dog, walk down the street (and back up the hill) to visit a neighbor and swim when the weather's warm enough. So I'm by no means an active person, but I am slowly but surely getting my activity levels a little higher.

Please forgive me if I come across a bit sensitive on the topic, my old GP used to tell me that I only had problems because I needed to lose weight and quit smoking. I'll admit that those two things are probably complications that I could do without, but I seriously doubt they are they only reason I'm nuts.

Nope, craptacular company insurance here. It's great that they do that for Medicaid patients, though. We have a RIDES bus for low income people, but I don't think they'll take a passenger that far.

So, if my doc says I'm Bipolar, but we all agree that doesn't sound right, do I hang out here or in the BPD forum?

Also, my mother thinks I do cycle, but am unaware of it. Any thoughts on that one?

Thanks for the answer - it can be a sensitive topic. Sounds like you are doing super well in working on it in your own time.

Have you tried any mood tracking to have a visual representation of your mood cycles?

Also there are plenty of BPD people on this forum too