[franz kafka]

I sometimes wonder if I have the wrong diagnosis. Whenever I read official descriptions of mania, it's always some person staying awake for days and days on end. This has not been my experience. I sleep less when "manic," but I do sleep. At the very least I get 4 hours, but usually more like 5 or sometimes even 6. My sleep quality is typically poor though, with a lot of waking up in the middle of the night. Even so I fall asleep again rather than getting up and running around.

Could the many doctors (5?) who have diagnosed me with bipolar be wrong? Or is it possible to get some sleep and still be manic?

(Just some context... it has been about a year since my last manic episode, so my memory of it is starting to fade. When that happens I tend to question my diagnosis.)

[still_crazy]

Diagnosis isn't all that important. The label helps guide treatment and is useful for insurance. Doctors diagnosis Bipolar I much differently than they did back in the day, when manic depression was thought to be a rare condition with a fairly good prognosis. Back then, a lot of people who have "Bipolar" these days would have been diagnosed with some kind of Schizophrenia, maybe a sub-type of depression, etc.

Do the drugs work? Are you concerned about adverse effects, long term effects, etc.?

When there's psychosis, some old school doctors go for Schizophrenia/Schizoaffective (especially when the person is a minority and/or poor), while some more modern doctors go for "Bipolar I w/psychotic features," especially when the patient is white and comes from a more affluent background.

I wouldn't worry too much about the label(s).

FWIW, you're on Saphris and Seroquel. Both are pretty sedating. But I thought I'd mention that decreased need for sleep is only one of the possible symptoms of mania, and that symptom does not need to be present. You also don't necessarily have to stay up for several days in a row.

And btw, I get pretty restless too when I'm hypo/manic, so my sleep quality is poor even when I get 2-4 hrs of sleep.

You should also consider how much sleep you normally get because "decreased need for sleep" is all relative. For example, if you normally get 10 hrs a night, but you're getting 4 hrs, that's a decreased need for sleep. But if you normally get 6 hrs and you get 5.5 hrs of sleep, it's debatable if that's a "decreased need for sleep".

Hope that helps!

[Aurelius710]

What always happens to me when I am hypomanic or manic is an inverse correlation between the amount of sleep I get and how energetic/rested I feel. I could get 3-4 hours of sleep and feel like a million bucks and be dead in the water with 7-8.

My sleep schedule has never been that consistent to begin with, so for me, that helps me gauge my upward ticks.

[BipolaRNurse]

I have bipolar 1 and strangely enough, I'm always able to sleep, even during manic episodes. I normally sleep at least 9 hours a night, so getting only 4-5 with frequent awakenings (and no fatigue) is a big change for me and never leads to anything good. Fortunately I'm on a number of different meds that make me sleep, so I don't have those ridiculous highs anymore.