Eternal Tiredness

Hello,

I have been struggling for about a decade, I am 25 now and cannot imagine this to go on.

I always feel exhausted, most of the times I get enough sleep but I don`t feel rested even if I am on a holiday. I am always feeling as if I am behind a glass and cannot concentrate well or care enough for most of the things, as if I`m just passing by on a train.

It`s hard to fall asleep as I get anxious thoughts and my heartbeat races. Sometimes during the day I get stuck on events that happen and just think them over and over again for hours.

I have been going to a lot to doctors an doing a lot of tests but so far there is no big concern yet, I do have prolactin level raised and will be checking it again soon, although the doctor says that it`s not raised much.

Besides that, about three months ago I was started on 37.5 mg of Venlafaxine during the day and Quetiapine with Lamotrigine 25 mg each before bed. Finally, I started to fall asleep fast and it became a bit easier to handle day-to-day stress, as I care way less for it. I stopped getting huge mood swings and it became a little bit easier to concentrate.

A month ago, the dose of Venlafaxine was raised to 75 mg per day and Quetiapine and Lamotrigine to 50mg. I started to have a really hard time of waking up and I keep waking up during the night as well, although overall I do fall asleep easier and the quality of sleep is better than without the pills. I`m still as tired during the day and it`s still hard to concentrate, although I started to be interested in more things around me and get stuck on repetitive anxious thoughts less. I am supposed to start working again soon and I don`t know how to be able to do my work well when I feel like this all the time. The other positive from taking these pills is that I don`t want to drink alcohol at all but there is also a huge negative one - it became almost impossible to reach an orgasm and hard to get aroused, even though I love my partner and I want to be intimate but my body just stopped feeing much.

It`s hard to get a good mental health professional in the country where I am, so I decided to leave a message here as I feel quite hopeless by now to feel any better and become less depressed. I eat healthy, stopped smoking, started going to ballet classes and it does help a little bit but still only a bit...

What could you recommend? Is there any other better medication that I could ask my doctor if I should try? Or other dosage? As far as I know, the doctor is treating bipolar disorder, but as I said it`s hard to find a good affordable professional here, maybe I struggle with something else? Borderline personality disorder or obsessions-compulsions or else?

As for my personality, I do work hard ( I am a painter and a musician) and try to go up to perfection, although obsession with schedules does interfere with it at times. I do enjoy the way I look or at least make it look like that for others, leaving my insecurities for myself deep inside to deal with. I read a lot, am interested in cinematic masterpieces and a huge range of music genres, although, I have this deep fear that just ruins me, especially when I am with people that smarter than me - that I have nothing interesting to say. I`ve been in an abusive and manipulative relationship in the past and that person was very intelligent and created a huge complex for me where I feel like I`m not good enough, like I`m not smart enough. He used to yell at me or threaten to leave, or get very restless as soon as I would get quiet. It came to a point where in the current relationship I get extremely anxious even when it`s just a minute since we didn`t say a word and have to remind myself that my partner did say that he enjoys being quiet with me, remind myself that it`s okay not to speak all the time. I do know A LOT but it scares me when a lot of times I literally have no thought in my head, and I cannot understand why that is whith so much that I`ve learned during my lifetime. I think because my depression have been lasting for so long maybe it became a coping mechanism to block any thoughts away as I`ve been living without medication for a long time. It`s almost as if thoughts in my head are kind of emotions, or colors, or images, not actual thoughts. My current partner says that I do have some traits of dyslexia which is not very well studied here as well so I am not sure.

Overall, I really want to get better but don`t really know what else to do from here and if I should be maybe raising the medication I take, or canceling it, or maybe even taking some other medication? I decided to lower Venlafaxine back to 37.5 mg and raise Quetiapine to 100mg but not sure if that`s the right way to go.

I hope that you could give some advice on what I described above and on how I could make my life a bit easier with all this.

Thank you.

I am afraid I don't have a lot of GOOD sdvice to give to you, unfortunately, @letavioletta! My Advice would be to just keep taking your Meds if they're helping you out even just a bit and if ANY problems show up, talk about ALL of this your with your Pdoc or with Your Family Doctor or ANY other professional in this Field who can help! I also DO feel like your Sleep Problems may be related, at least partly, to the Stress who's currently going on in your Life, so I'd keep working on that and on your Self-Esteem AS MUCH AS YOU POSSIBLY CAN, OK? I am not aware of the situation is there in Moscow and Russia in regards to Therapists and Psychotherapists. Have you already tried looking for someone? If it is hard, perhaps you may want to ask your Pdoc if He/She has ANY suggestions about who to contact and if there are ANY Good Therapist near your City! Perhaps you can Ask your Family Doctor as well if there are ANY good, affordable Therapists near Moscow! Other than that, I'm afraid I can't give you too much specific Advice about those Meds, I'm afraid! Hopefully others here will be able to Help MUCH, MUCH, MUCH, MUCH, MUCH BETTER THAN I CAN! Feel free to PM me ANYTIME! I am SURE plenty of others will be glad and happy to listen to what you have to say! THAT'S A PROMISE! I AM SURE OF THAT! I PROMISE YOU THAT! YOU CAN REST ASSURED OF THAT! Sending many safe, warm hugs to BOTH You, @letavioletta, your Family, your Friends, your Boyfriend and ALL of your Loved Ones! KEEP FIGHTING AND KEEP ROCKING NO MATTER WHAT HAPPENS!

As far as sexual side effects go, increasing the dose of Venlafaxine would be expected actually to improve them, not make them worse. So, that's a possibility. You are on some fairly sedating medications, which seem to be helping your sleep overall. But being tired during the day can make it impossible to work or even stay awake. I have this particular thing with my bipolar disorder. Generally, it needs to be treated in order to improve. Most people I have spoken with who are treating this problem are on either something like Adderall (dextroamphetamine/amphetamine) or Provigil (modafinil). Both have worked for me, but I prefer the modafinil, because I have fewer side effects on it than I do on the Adderall. Anyhow, you might look into this and see what you think.

We are not capable of diagnosing someone here at PC. We are just patients ourselves. You would really need to see whatever specialty in Moscow treats things like bipolar disorder to get that nailed down. You could also always look at the criteria for a bipolar diagnosis from the DSM 5 and see what you think. See if it seems to fit, The fact that you indicate you think you are maybe a bit better after starting the meds may tell you something.

At the end of the day, I don't have great advice for you, sadly. I was in healthcare for many years and I traveled the world for what I did, but I unfortunately never made it to Moscow. So, I'm just not knowledgeable. One of my regrets. Anyway, I really think you should do whatever is necessary to see a competent person, preferably a psychiatrist, to nail down your diagnosis and treatment. If that is not possible in Moscow, I would even consider traveling if I were you. It would probably be worth it in the long run. Good luck!!

When did you last have a physical with full lab work???! Also vitamin levels?? If it’s been over 6 months please call and schedule an appt.

Seems like you need to rule out any possible medical reasons for how your feeling. Thyroid and hormonal imbalances are notorious for causing fatigue and depression.

There is always a chance your on too much psych meds. It’s a balancing act to find just the right amounts.