Bipolar check-in #48

I have spent most of the day catching up on tv shows. not really ther most productive, but I suppose it was nice to relax and watch some of my favorite things

in fibro pain too. today's one of those days where it's gradually getting worse as the day goes on. I hate those days, and would rather it constantly be at the same level from the beginning (at least I then know the worst to expect)

My pdoc and I have an appt. to discuss seizures and my personality issues. Unfortunately, since I am obviously manic yet again and once more did not recognize it, we may have to spend that visit discussing how I can possibly be manic--again--on 1500 of lithium and 1500 of Depakote. Trust me, that is the kind of thing only the sickest of the sick in our state hospitals live with. I just cannot begin to express how sad and frightened I am. I will never, ever give up, but my future is looking bleak. Maybe I should just go back to the hospital and live out my days there.

Day 3 of feeling alright and having my anxiety and moods under control. I haven’t felt this stable in weeks. I haven’t looked at the news since Friday. That is huge. I was looking at the news constantly and watching The Today Show. Yesterday was the first time I didn’t check the CDC website in weeks. I stopped asking for updates too from my mom.

My husband is helping his friend with a project at his friend's house. It's kind of nice to have some time to myself.

I finally see (via video session) my psychiatrist in a few days. It's been a very long time. It was fortunate that I was mostly well during that period.

I wrote a reflection that I wanted to post on my blog, but it was on a sensitive topic. I sent it to my sister asking if it was OK to post. She discouraged me and provided a strong argument to support that, though she completely agreed with its content. I won't post it then. I'm glad I asked for feedback, rather than impulsively putting it out there. I do disagree with one thing she wrote, but there's absolutely no good in arguing that point.

Last night woke up multiple times but I must have gotten enough sleep overall to do some good as I’m not nearly so tired and cranky today. Tired yes but not draggy tired. Hugs to all.

Hello bpcyclist. I'm a big fan of Dr. James Phelps and his website. Though he has a focus on bipolar type 2, he writes a lot about his research and observations that pertain to bipolar type 1, and other bipolar spectrum disorders, as well. What he wrote on the following page of his website may or may not be new news to you, but it is on the topic you bring up.

Lithium and seizure threshold - PsychEducation

On Neurology.com I found the following article Impact of Psychotropic drugs on Seizure threshold (P6.311) | Neurology that states that a study found "Bupropion, Imipramine, Clozapine, Olanzapine and Haldol" as the medications with the most propensity to lower seizure threshold. Some others, but to a lesser degree.

It's a coincidence that you bring up the topic of possibly having seizures, as a person with bipolar disorder. I had a discussion with someone recently on this. If ever you are interested in comparing notes, I'd be happy to do so. In any case, my possible seizure activity occurred primarily during the most severe period of my bipolar illness (my 30s and early 40s), but not prior to that, to my knowledge. A neurologist did give me a diagnosis of Simple Partial Seizures (a type of focal seizure or Temporal Lobe Epilepsy). An epileptologist later said it was not definitive. I chose not to follow his recommendation to have a 6-day inpatient EEG. I suppose I should have. The fear was that by lowering my anticonvulsant that my bipolar itself would worsen again. That scared the heck out of my husband, and me. The possible seizure symptoms I had, have long since mostly disappeared. The only times I have hints of them are when I'm severely manic, which I haven't been for over 2 years. According to my email records, I saw the epileptologist in Jamuary 2014, but the seizure-like symptoms also preceded that four to six years, or so. [My detailed electronic journaling started only in 2012. Yea, I'm that type.] A MS Word document shows that in that month (January 2014) I took the following medications, simultaneously:

Lithium ER - 900 mg
Tegretol XR - 1,400 mg *
Lamictal - 100 mg *
Geodon - 160 mg
Navane - 5 to 10 mg
Seroquel XR - 50 mg *
Klonopin - 0.5 mg *
PRN Ativan - 1 to 3 mg *

Also Inderal * and Synthroid *

I think the mix above was just too much! I often wonder if some of the meds (or the cocktail as a whole) exacerbated my situation, especially in regards to the seizure-like symptoms. It had even been worse, before the Lamictal replaced Wellbutrin XL (Bupropion ER). Wellbutrin XL was highly destabilizing for me (ultraradian cycling) so was removed quickly. That was the very last time I was prescribed an antidepressant. All of the other times were prior to (prescribed alone) and during (prescribed with minimum 1 moodstabilizer AND 1 antipsychotic) the worst years of my bipolar illness.

My current medication cocktail is almost half the size of the one I list above, and I've been the most stable in recent years. I mark my current meds above with asterisks *, though some current doses are different (i.e. Seroquel XR is now 650 mg).

I'm probably hypo-manic as I'm off my meds for 5 or 6 weeks now. I'm managing to control around people but when on my own they come alive and I struggle to shut down. I'm having to live 2 lives. 1 life being around people and 1 life being alone.

-Talkative have urges to just talk forever
- Diddling my feet and moving around and pacing
- Irritation people irritate me
- self harming slightly
- 10 + hours sleep a night
- Talking to myself and people I see
- Listening to loud music
- Writing lots
- Loud (apparently)
- Singing/whistling/humming
- Singing hymns, saying prayers, looking them up on Google and YouTube
- Feeling gooooood
- Hyper
- Little obsessed over things

I had a talk with my team and they say they can't force me to go back on my meds but advise I do. I just can't, I've been gagging on my meds prior to stopping them. I have tried talking things through with my friend but she is ignoring me. So I give up. Oh well another one bites the dust

I feel, as my daughter put it when she was a pre-schooler a million years ago, "all rabbled up."

If my hair color would get delivered by Amazon today instead of tomorrow I'd feel a lot less rabbled up, lol.

Speaking of seizures when I was in my late 20’s early 30’s I was diagnosed with tonic-clonic nocturnal seizures. It was after an attempt. I was on meds for it for about ten years. Although they were supposed to be nocturnal severe stress could set one off. They got better and I’ve been seizure free for decades now.

I spent about 80% of the day coloring because I couldn't pick which activities to do, and the remaining 20% was me pacing around because I couldn't sit still (I think cogentin has stopped working!). I had all sorts of activities on my mind and so many things I was thinking of that I just got overwhelmed by it all. Coloring seemed to calm me down quite a bit because it forced me to sit down and focus on one thing. Now I'm back to being bored because I've stopped coloring and I'm indecisive yet again. I suppose I'll just color some more and literally spend the whole damn rest of my evening coloring.

I've actually been WANTING for Monday to come so that I can do actual work. I don't even like working, but it gives me a distraction while I figure out what to do with this akathisia and indecisiveness.

This is exactly what I was thinking... Maybe the high dosing of the APs for psychosis or some of the other drugs are exacerbating the seizures. It is worth discussing. I've found the same in my research and I think my docs keeping me on such low doses and only one at a time is perhaps why I've avoided more repeat episodes.

ETA: I haven't run across a big concern for lithium, but Trilafon lists it as a complication more than once in their own documentation.

I get these urges to take 15 milligrams of melatonin because it makes me feel really freaky for half an hour and I start like hallucinating real good and it’s pretty cool. And then I like crash for an hour. How bad is this problem exactly?

Hallucinations are an indicator of abnormal brain activity. Inducing that on purpose can be risky for people like us. I would be concerned about inadvertently triggering psychosis at some point and for some it is hard to stop the flood once the dam breaks. You could be doing damage.

Melatonin | Mental Health America
'In the absence of better science, consultation with the health care professional providing care for an existing seizure disorder is essential if considering using melatonin. Mood changes have been reported, both highs and lows, and even psychotic symptoms such as hallucinations and paranoia.'

It also apparently interacts with benzos and antidepressants if you're on those.

I would stop taking it and report the effects to your doctor.

Hello! Checking in. I’m having ups and downs but those may be situational. I’m pretty much living at the pool. It’s miserable being out of the water or out of the A/C.

Tomorrow starts my diet from the news. I tape the news all day and catch up at night. I can tell you all the stats on COVID. I’m high risk and terrified of getting it. I’m pretty much housebound aside from floating and groceries. I’m even cancelling two appointments to rule out breast cancer. So I’m skipping the news for awhile to see if that helps.

My daughter starts on campus classes in about two weeks. I’m praying for her. I’m glad I’ll get to see her before she starts. She’s worked in Gatlinburg all summer with no problem and I hope she has no trouble at school.

Hugs to all.

Feeling ok.

I’ve noticed funny looking lumps on the side of my tongue. They go all the way around giving my tongue a scalloped edge. I’m a bit worried. I’m wondering if it is related to my sublingual Saphris (Asenapine)?

I saw my new psychologist for the first time on Thursday. She seems really nice and more importantly she seems competent. She really listened. She’s interested in working in collaboration with me. We are going to be working on my panic attacks first and then my agoraphobia. And then anything else that needs working on. I’m relieved that she realises how debilitating and life-limiting the panic-attacks and agoraphobia are for me. I’m tired of not going anywhere and doing nothing. I’m currently having a panic attack once every 8-10 days which is a huge improvement on having them daily. But the ones I have are huge and I’m looking forward to not having them at all.

BeyondtheRainbow, I’m sorry about your cat.

Christina, so pleased to read that Steve is doing better. Also, well done on starting up your meds again. It can’t have been an easy decision.

Big hugs to those that need them.

Hope this link works

Yep going to take forever LOL

Paint by Numbers Kit - Colorful Tree – BlingPainting

You no AC and me no hotwater ( week 3) I;m glad you have your pool and get to see M soon

Holy cow!!! That’s an intense picture to paint. Wow.

SO glad you found someone you like and will work WITH you instead of them driving the car all the time !!!!!

Ive heard other say that about Saphris .. I took it twice and had a hell of a asthma attack so that got dumped quick. Call yoru Pdoc about that

Thanks!!!! yes Steve is finally getting back on his feet slow but that is fine.

I know right ???????????

Feeling despondant about mean, selfish, cruel people in this world.

Well back to no sleep. Didn’t sleep until 3am. I tried but no luck. I watched a few episodes of my 600 lb life (if that’s not inspiring for weight loss I don’t know what is) and a crazy hilarious new show I found on Hulu called sex sent me to the ER. Lots of crazy stories lol but not for the more conservative crowd. During the day I’ve been reading. I read two to three books a day. Right now I’m stuck in the foster caring memoir genre. Not that I would EVER be a foster parent. I just like reading how the children overcome their horrific abuse and neglect and move on to have productive lives (for the most part). I’ve read all of Cathy glass, Casey Watson, and now I’m on to Angela hart.

I’ve now run out of depakote as well. For some reason the pharmacy won’t fill it. Haven’t found out why. I halved my dosage for the next two days so I’ll only be without it for a day or two, I hope. I’ve read withdrawal is a *****. I hope I can get it before it kicks in. I think it will be fine. Just ****ing annoying. If my ****ing pdoc hadn’t canceled on me two weeks ago I wouldn’t be in this predicament.

Still having physical symptoms. Often I feel like something is wrong in my chest and I am short of breath, but it’s not exactly that...I just can’t describe it. I bought a pulse ox to monitor my pulse. It’s mostly in the 90-105 range. Just over the edge of tachycardic. I know the cardiologist is going to tell me I’m too fat and sedentary. I am working on the fat part. I’ve been counting calories diligently. I’ve lost seven pounds in six weeks, not so bad if you ask me. If I can keep it up it will probably be about a year before I am in the healthy weight range. Sigh. But it’s all about slow sustainable progress.

I do need to get more exercise, but it’s just been so hot! Heat index 105 today.

I have to reschedule my cardiologist appointment anyway. It’s supposed to be Tuesday while my son is at camp but there’s a tropical storm coming. His camp is outdoors. There is a pavilion but that won’t help if there’s 50 mph winds driving the rain sideways. I’m sure I can get another one for next week.

At least I’m not having any mood symptoms. Still dwelling on the past a lot but trying to forget about it.

Lately the hyper vigilance has been bad. I’m reactive and on edge. The exhaustion has been the same. At least it’s not getting worse. Tomorrow I’m getting a Stellate Ganglion Block injection. It calms down the sympathetic nervous system so should allow my PTSD symptoms to ease. By doing this my exhaustion might ease too.

It’s a day patient procedure. I’ve filled out all the forms. Just need to rock up at midday tomorrow after fasting from midnight tonight. As I’m on Lithium I will be thirsty. I just can’t wait to have it done. It worked well last time. Although, I did have a horror day of flashbacks a few days after the last procedure before totally calming down for a few months. Studies show it only works on some people with PTSD. I seem to be one of them.

Depersonalization sucks! I can't think of a single way to prove myself wrong.

@Wander: I hope your procedure goes well and that you're not too thirsty. Very interesting, your injection. Hope it works as well as last time. PTSD is so grim.

@wildflowerchild25: Glad you are trying to forget about the past even tho it continues to bother you. I think of my past too often also. Grats on the weight loss! You are doing awesome!

@Pookyl: Glad you found a competent psychologist who is willing to work collaboratively with you. I've given up trying to find someone competent. You're lucky.

@Jennifer 1967: The news can be overwhelming. It's good to take breaks. I haven't watched all weekend and i haven't missed it. Our local weekday evening newscasts are much better anyways. The female anchor cried on-air last week when they did a tribute to a fallen member of their team. It was charming, especially how loving she seemed and how refreshed she was after.

In my other news today, i got a slow start on a rainy day. We were under a tornado watch for a few hours. Thunder scares my dog. She goes under the table and pokes her head out at me, so cute! I had lots of nice games of Scrabble today, really enjoying the new non-competitive method i've switched to. I like to take my time. I got my second-highest play ever at 149. I won't write the word because it is a bit upsetting and i don't want to trigger anyone. I felt miserable but perked up in the evening. Tomorrow's supposed to be nice and dry and comfortable so it'll probably be a better day.

Hugs to all who struggle!