Just wondering...

Apparently I can sleep 7-9 hours a night while hypomanic. Until my therapist pointed it out... I didn't realize how bad my shopping sprees were, I didn't realize I was talking rapidly, I didn't realize that I smiled a lot (because normally, I have flat affect), I didn't realize how distractible I was, and I didn't realize I was saying bizarre things. I guess I'm lucky I didn't lose my job.

This situation really frustrates me. I normally try to look at my sleep to identify potential mood changes, but evidently, sleep doesn't matter in this scenario. Now I don't know what to do to identify potential hypomanic -- or even manic -- episodes. I have no insight... and that's why I'm depressed right now... because I crashed hard. Now I'm sleeping upwards of 10-12 hours a night and feeling like total s***.

[fern46]

Sleep was not an indicator for me. I was sleeping fairly regularly. I remember waking from time to time, but I maintained a 10 or so hour rest period the whole time I was symptomatic. There were many other indicators though. I know now what to look for. If any one of them appears, I take a step back and reflect. I ask others I trust to weigh in because I need the added assesment.

You seemed to have awareness of your behavior during your last episode. You were pretty honest about it here, but there seemed to be a disconnect between the recognition of the behaviors and belief and understanding that they were truly symptoms that were adversely affecting your life. A few people let you know you were in a recognizable pattern, but you seemed to have an explanation for the beahvior to convince yourself it wasn't of concern until it went on for quite a while. I remember doing that exact thing when I was manic.

Maybe you can turn that recognition into insight next time around. If one of the warning sign behaviors begin, try not to judge it as whether or not it means you are truly bipolar or manic. Recognize it as behavior that absolutely has the potential to create harm in your life and seek to put a stop to it until you can have more time to reflect and determine if it is truly harmless or a sign that you're headed into an episode. Try not to rely on your own explanation of why it is happening or justifiable like 'I'm just bored' or 'I have ADHD' or whatever. Use the assesment of others like your parents to supplement your thoughts. If they conflict, that is an indicator to stop for a while to give yourself time to gather more info for greater insight.

So... If you begin buying gifts for others and a lot for yourself don't try to reason with it. Just know it is possible it could be a symptom and talk to your T and take a step back from the behavior for some time. If it is determined after a while you don't have other symptoms, then maybe go ahead and make a few purchases because maybe you were just genuinely in a giving mood. If it turned out you were heading up, you got off the train before it really got going. It is a win win strategy.

I know the feeling of not knowing you can trust yourself. You are amazingly intelligent and resourceful and you're still seeking out ways to get there. That is really brave and I hope you find something that works better for you in the future.

[bpcyclist]

This^^^^^^.

I must say, I do not normally consider hypo to be the level at which loss of insight occurs. For me, that is at a much higher level of florid mania. So, am also just sort of wondering if this hypo was perhaps a bit more than hypo.

I have replaced my thinking with the thinking of others for many parts of the managemend of my illness. It has worked for me.

[fern46]

Originally Posted by bpcyclist

This^^^^^^.

I must say, I do not normally consider hypo to be the level at which loss of insight occurs. For me, that is at a much higher level of florid mania. So, am also just sort of wondering if this hypo was perhaps a bit more than hypo.

I have replaced my thinking with the thinking of others for many parts of the managemend of my illness. It has worked for me.

For me hypo was where the warning signs were there and I excused them. I justified them. They fit rationally if I looked at them through a certain lens. Complete lack of insight came later like you say.

I've mentioned on the forum that I can have "blips" where I sleep relatively normally, and then during the daytime my mood becomes elevated. Then, after I take my evening meds (or even as night approaches) my mood deescalates. I do believe my Seroquel XR plays a huge role in helping with my sleep, despite slightly elevated mood states. When the evening Seroquel XR seems to "wear off a bit" for lack of better words, the mice come out and play. My husband did signal to me that my mood is a bit elevated today. It's very possible that this is a result of me stopping the morning Seroquel XR dose, with my psychiatrist's approval, that I had been taking for some months. I don't believe I should immediately restart the morning Seroquel XR dose. I'll likely give it a couple days to see if things even out. If not, or things escalate more, I'll take the morning Seroquel XR again. In these "mice play" circumstances, my mood usually starts to escalate around 12 noon to 3 pm. I guess that's when my evening Seroquel XR is heading downwards in effectiveness.

If I'm getting quite manic, I do have trouble sleeping. Sometimes my sleep is reduced to 4 or 5 hours in these cases, if well medicated. If I'm ready for l'hôpital, it can go down to 0, unless I'm given an extra horse-sized dose of a sedative. I haven't been full-blown manic for a couple years now. I think that if I become that unwell, an additional antipsychotic will likely need to be added. I've needed two antipsychotics for periods of years, in the past. Plus, my Tegretol has the potential of reducing the effectiveness of antipsychotics (and vice versa), so I need careful doctor supervision for this.

Note: Despite the relationship of Trileptal to Tegretol, I have read/learned that Trileptal does not have such significant drug interactions as Tegretol. I write this so you don't conclude that it does. In any case, bluebicycle, I think you should contact your psychiatrist asap to clue him/her in that your hypomania persists.

Do you take an antipsychotic?

[*Beth*]

From what I've heard from others with BD, and from my own experience, I believe that the sleep/mania connection is definitely not written in concrete.

[sarahsweets]

I have had episodes of mania where I havent slept and episodes where Im manic, sleep and wake up still manic. I cant use sleep as an indicator because I always have sleep issues. I am kind of.. wild? Wound up? Boisterous? All the time. I am sure I have confused people by the way I am. Its not even irritating or unlikeable I am extremely friendly and chatty and when I go off on a tear it truly is funny. Sometimes my family worries that I am manic when I am just happy but off the wall mania would be speaking faster than I do normally which would be turbo speed.

[Fuzzybear]

Good post

Originally Posted by fern46

Sleep was not an indicator for me. I was sleeping fairly regularly. I remember waking from time to time, but I maintained a 10 or so hour rest period the whole time I was symptomatic. There were many other indicators though. I know now what to look for. If any one of them appears, I take a step back and reflect. I ask others I trust to weigh in because I need the added assesment.

You seemed to have awareness of your behavior during your last episode. You were pretty honest about it here, but there seemed to be a disconnect between the recognition of the behaviors and belief and understanding that they were truly symptoms that were adversely affecting your life. A few people let you know you were in a recognizable pattern, but you seemed to have an explanation for the beahvior to convince yourself it wasn't of concern until it went on for quite a while. I remember doing that exact thing when I was manic.

Maybe you can turn that recognition into insight next time around. If one of the warning sign behaviors begin, try not to judge it as whether or not it means you are truly bipolar or manic. Recognize it as behavior that absolutely has the potential to create harm in your life and seek to put a stop to it until you can have more time to reflect and determine if it is truly harmless or a sign that you're headed into an episode. Try not to rely on your own explanation of why it is happening or justifiable like 'I'm just bored' or 'I have ADHD' or whatever. Use the assesment of others like your parents to supplement your thoughts. If they conflict, that is an indicator to stop for a while to give yourself time to gather more info for greater insight.

So... If you begin buying gifts for others and a lot for yourself don't try to reason with it. Just know it is possible it could be a symptom and talk to your T and take a step back from the behavior for some time. If it is determined after a while you don't have other symptoms, then maybe go ahead and make a few purchases because maybe you were just genuinely in a giving mood. If it turned out you were heading up, you got off the train before it really got going. It is a win win strategy.

I know the feeling of not knowing you can trust yourself. You are amazingly intelligent and resourceful and you're still seeking out ways to get there. That is really brave and I hope you find something that works better for you in the future.

Originally Posted by fern46

Sleep was not an indicator for me. I was sleeping fairly regularly. I remember waking from time to time, but I maintained a 10 or so hour rest period the whole time I was symptomatic. There were many other indicators though. I know now what to look for. If any one of them appears, I take a step back and reflect. I ask others I trust to weigh in because I need the added assesment.

You seemed to have awareness of your behavior during your last episode. You were pretty honest about it here, but there seemed to be a disconnect between the recognition of the behaviors and belief and understanding that they were truly symptoms that were adversely affecting your life. A few people let you know you were in a recognizable pattern, but you seemed to have an explanation for the beahvior to convince yourself it wasn't of concern until it went on for quite a while. I remember doing that exact thing when I was manic.

Maybe you can turn that recognition into insight next time around. If one of the warning sign behaviors begin, try not to judge it as whether or not it means you are truly bipolar or manic. Recognize it as behavior that absolutely has the potential to create harm in your life and seek to put a stop to it until you can have more time to reflect and determine if it is truly harmless or a sign that you're headed into an episode. Try not to rely on your own explanation of why it is happening or justifiable like 'I'm just bored' or 'I have ADHD' or whatever. Use the assesment of others like your parents to supplement your thoughts. If they conflict, that is an indicator to stop for a while to give yourself time to gather more info for greater insight.

So... If you begin buying gifts for others and a lot for yourself don't try to reason with it. Just know it is possible it could be a symptom and talk to your T and take a step back from the behavior for some time. If it is determined after a while you don't have other symptoms, then maybe go ahead and make a few purchases because maybe you were just genuinely in a giving mood. If it turned out you were heading up, you got off the train before it really got going. It is a win win strategy.

I know the feeling of not knowing you can trust yourself. You are amazingly intelligent and resourceful and you're still seeking out ways to get there. That is really brave and I hope you find something that works better for you in the future.

Thanks, fern.

Yes, you're right -- I need to stop making up excuses or trying to convince myself otherwise.

I will try out your helpful suggestions so that, when manic or hypomanic, I can take a step back and try some grounding techniques. I really need to work on those anyways.

Originally Posted by BirdDancer

I've mentioned on the forum that I can have "blips" where I sleep relatively normally, and then during the daytime my mood becomes elevated. Then, after I take my evening meds (or even as night approaches) my mood deescalates. I do believe my Seroquel XR plays a huge role in helping with my sleep, despite slightly elevated mood states. When the evening Seroquel XR seems to "wear off a bit" for lack of better words, the mice come out and play. My husband did signal to me that my mood is a bit elevated today. It's very possible that this is a result of me stopping the morning Seroquel XR dose, with my psychiatrist's approval, that I had been taking for some months. I don't believe I should immediately restart the morning Seroquel XR dose. I'll likely give it a couple days to see if things even out. If not, or things escalate more, I'll take the morning Seroquel XR again. In these "mice play" circumstances, my mood usually starts to escalate around 12 noon to 3 pm. I guess that's when my evening Seroquel XR is heading downwards in effectiveness.

If I'm getting quite manic, I do have trouble sleeping. Sometimes my sleep is reduced to 4 or 5 hours in these cases, if well medicated. If I'm ready for l'hôpital, it can go down to 0, unless I'm given an extra horse-sized dose of a sedative. I haven't been full-blown manic for a couple years now. I think that if I become that unwell, an additional antipsychotic will likely need to be added. I've needed two antipsychotics for periods of years, in the past. Plus, my Tegretol has the potential of reducing the effectiveness of antipsychotics (and vice versa), so I need careful doctor supervision for this.

Note: Despite the relationship of Trileptal to Tegretol, I have read/learned that Trileptal does not have such significant drug interactions as Tegretol. I write this so you don't conclude that it does. In any case, bluebicycle, I think you should contact your psychiatrist asap to clue him/her in that your hypomania persists.

Do you take an antipsychotic?

Thanks for your insightful reply, BirdDancer.

I am on an antipsychotic, yes. I take 4mg of rexulti every evening. Not sure if Rexulti is part of the problem though because I don't think it's exactly "advertised" as an AP that effectively treats mania.

I don't think I have ever had that experience where my mood is elevated for a chunk of the day and then calms down at night. In my case, my mood is either elevated or it's not. But it is interesting that you experience such mood shifts for a portion of your day.