[emory_]

This will probably end up being a long post, but I feel like I need to give as many details as possible so that nothing is missed. I have questions relating to my medications, diagnoses, and symptoms. I'm posting this in the medication thread because I'm mostly looking for suggestions for meds. If you want to skip the long part and go straight to the questions, I’ll put them in bold at the end for you so you can jump to them quicker.

I’m a 22 year old female who has been diagnosed with Borderline Personality Disorder, Bipolar Type 2, Inattentive ADD, Depression, Anxiety, and a few physical illnesses (Fibro, Endo) that heavily affect my mental health. I’ve received all of these diagnoses in the past 3 years, except for endo, which was diagnosed in 2008. Since the beginning of my treatment, I’ve been on a cocktail of probably 15 different medications while trying to find something that worked for me. I’m no where near healthy or consistently stable, but I’ve had some improvement with my current meds. This is the combination I take right now:
- Trileptal 1200 mg/day
- Invega 3 mg/day
- Cymbalta 90 mg/day
- Vyvanse 70 mg/day
- Adderal IR 20 mg/day

The fact that I’m still having so many issues is what brings me to this thread and to ask these questions. Even though this is the most “healthy” I’ve ever been, the negatives significantly outweigh the positives and I’m struggling so hard that I’ve given up trying to work, keeping a job, or doing anything that requires my 100%. These are the issues I’m still facing (this might be a long one. Most of these things might not be related or from the same illness, but they’re all overlapping and making it hard to process):

- I feel as though my head is in a fog all day, like I’m dreaming, every day, from the time I wake up until I go to sleep. It is incredibly uncomfortable mentally because the more foggy I feel, the more irritable, mean, and unreasonable I become toward everyone and everything. It’s as though my brain, the “I” part of me who is aware of myself, is stuck so deep in my mind that I can’t pull away to focus on the external world. I cannot concentrate, I cannot muster up the energy or motivation to interact with the world around me, despite the fact that in my head, I’m saying to myself, “I need to do this thing that needs to be done. The deadline is midnight, and I have to get it done.” And then it’s as if my body is paralyzed and I cannot, absolutely cannot force my head to focus or care enough about it to do it, no matter how important I know it is, and I cannot physically force my body to get up and do it. School was hell for me because I would sit down to write a paper, and then suddenly realize that I’d been staring at the same spot on my keyboard for 20 minutes stuck in my own thoughts. There is no power source connected to my body, no chemical motivation to get me moving. I have always been like this, and it drove my mother insane for years. I’ve been called lazy, indifferent, ungrateful, spoiled, etc. because I’ve had such a difficult time “getting my head in the game”. It’s as though my entire body and my mind weigh 40000 pounds, my arms feel unsettlingly heavy when I try to move to pick something up, my balance and coordination are horrible when I get really into a fog, and I have a hard time even speaking to and listening to people. When I am especially deep in it, my boyfriend can ask me a question about something simple, like, “How was your day?” or “Where did you put the scissors?”, and opening my mouth to speak feels like it’s draining the energy out of me, and it makes me so irritated that it worries me. I have to try my hardest to force myself make a sound, and when/if I do, it comes out as the shortest answer possible with mumbled words. This is my main problem, because it affects literally everything I do. I would say that for 6 out of 7 days of the week, I’m so bogged down that I’m incapable of interacting socially and incapable of taking care of my own life. I got fired two weeks ago from my job because of this. I was moving too slowly, I was forgetful, I was irritated, I was angry, I was finding it impossible to physically do my job because it always feels like I’m wearing a 2 ton space suit with the helmet. It’s almost feels as if I have the flu every single day, minus the coughing and fever. There are days where I can sit in my house and stare at the same spot on the wall for 30 minutes and just sit inside my own empty head without moving or making a sound and it’s the best place I could imagine being, and once I’ve gotten to that point, I become SO irritated by the person who interrupts me and wants my attention. I also do have inattentive ADD, which could help explain a little bit of it like the distractability, but I feel very strongly that there is something else going on.

- I am tired beyond reason. No matter how much sleep I get, whether it be 5 hours, 8 hours, 10 hours, etc., I am always exhausted all day, every day. For a while, the Vyvanse and Adderal were helping with that (and were also helping with the brain fog), but they’re no longer effective. I take a 70 mg Vyvanse at 8 AM, drink a cup of coffee, am awake and somewhat focused for about 2 hours before I feel myself crashing and becoming foggy and weighted again, then take 20 mg of Adderal at 10 AM. By noon, I’m so exhausted that I have to take a nap in my car on my lunch break. There have been a few times that I’ve stopped taking Adderal and Vyvanse for 2 weeks or so because I needed a tolerance break because they were no longer effective, and during those times, I was a trainwreck of sleep and misery. I was unable to get out of bed to go to work, I was unable to leave my house to go the store because I was so tired and weighed down, I was unable to host friends because I couldn’t stay awake. I think the worst time was when my family and I went to a very popular theme park in my state, about 4 hours from home, and despite the fact that I was SO excited to be on roller coasters and had gotten about 8 hours of sleep the night before, I was still so tired after 3 hours (around 2 PM) that I fell asleep sitting on a bench waiting for my brother to come out of the bathroom and had to go nap in the car in the parking lot. I literally could not keep my eyes open. I slept the rest of the afternoon at the park, the whole ride home, and only woke up to move myself from the car to my house and then slept until 5 PM the NEXT day. This has happened several times (I even slept through my birthday this year because I just couldn’t wake up). It is FRUSTRATING and I’m tired (ha, ha) of it. I can’t go out with my friends, especially not past 7 PM, because I know I’m going to fall asleep soon. No amount of coffee, energy drink, natural supplement, etc. has ever helped with my energy. Working out didn’t help, it just made me tired AND more sore than I already was. I can’t find a solution, so I sleep.

Those two sections are my main problem, they’re the reason I can’t hold down a job, they’re the reason I can’t leave my house or my bed, why I have piles of dirty clothes in my room, why I start projects but get too tired after 3 minutes, why my friendships have been strained.

So I guess my questions are these. Feel free to answer any ones you want.

1. Is there a medical term for feeling like you can’t tune your head in to the real world or like you’re not yourself? Kind of like a separation of mind and body? Or more distinctly, a separation of your brain and the outside world. Or like a dream, or like the external world isn’t real? It doesn’t feel like it’s a “mood” thing, it feels like it is deeply, deeply embedded inside of me, like it is ME, it is EVERYTHING, not just the way that I feel right now.

2. If you know it’s a real thing or if you’ve received treatment for it, what can you say about it? Did you try any medications that helped and brought you into the real world as a functioning person?

3. How do you combat exhaustion and the inability to focus because of it? I’ve tried Adderal, Adderal XR, Vyvanse, and Ritilin. Vyvanse and Adderal worked for some time, but now my tolerance is so high that I’m mostly unaffected by them. Ritilin did nothing good for me, I was just more scatter brained and confused. I’m trying to stop the adderal because it gives me some uncomfortable side effects recently (fast speech/slurred speech, sleep problems, problems in judgement), but I’m having a really difficult time because the 70 mg of Vyvanse in the morning isn’t enough to keep me awake for longer than a few hours. Are there any other alternatives to these meds that have worked for you?

I guess those are my only questions now, but I’m sure another will come to me soon. If you’ve made it through this, thank you very much for taking the time to do so. If you’re able to answer any of my questions or tell me about your own experiences with these things, PLEASE let me know. Thank you all.

[Altered Moment]

That is long. I may be able to answer some questions and others I don't have experience in. I will read the whole thing later and try to answer. Plenty of people here with experience for sure.