I have an appointment with my therapist tomorrow. The problem is, I'm totally manic right now.

Basically, Adderall triggered a very paranoid mania, and now I'm getting crazy hallucinations. Like, I'm seeing "lights" coming out of my wall and "shining" on me... But hell, I know there are no lights in my walls! I'm also getting paranoid delusions... I'm able to realize they're delusions... for now. (For example, I'm thinking that someone installed those "lights" to spy on me... but then I was like, "wait. I have no lights, so there's no one watching me.")

How do I bring this up to my therapist without getting committed? My insurance charges $750 per day for IP, which I simply can't afford. If I could afford it, I would go.

I just want my therapist to help talk with my pdoc to curb my mania before I completely lose touch with reality.

Also, I've stayed up for almost 48 hours straight. I don't feel tired yet either. I'm too energetic. I'm going nuts! I want to sleep so that I don't stay up for 4 days and pass out from exhaustion... because that's where I'm heading.

Also, I've only eaten 4 Oreos in the past 48 hours. That's it; no other food. Adderall had murdered my appetite!

Who prescribed the adderall? Probably not a great idea for someone with a bipolar diagnosis. It can set off mania very quickly which is why most very much avoid doing so. I'd say you need to call your pdoc immediately. This really is one of those times that this could be considered an emergency. The sooner you can get you pdoc on board with counteracting what is going on the better or that insight you have is probably going to decrease rather rapidly. Was he the one who prescribed it?

[Nammu]

Since this is a reaction to a drug that then caused lack of sleep and lack of food he probably will wait to see if it gets better when you stop the drug and get some sleep and your appetite back, or he may prescribe something to counter act the drug. I fought he's just going to commit you for symptoms that can come from the lack of sleep and food.

Adderral wears off pretty quickly, so hopefully you'll be better tomorrow. I'd take a xanax if this happened to me instead of wasting all that money on medical bills and all that time.

I'm not bipolar but have seen lights on my walls too a couple of times. Going to netfix and watching something funny might help with the thoughts. Grounding, nature, soft blankets, animals...can help

(((Hugs)))

[Ididitmyway]

If there is nothing in your behavior that puts you and other people in imminent danger, the therapist won't commit you. But you do need to talk about it and to have your pdoc adjust your meds. You can also go for a second opinion to check if Adderall was needed at all.

Actually, technically the therapist doesn't have the authority to commit. What they can do if they believe someone is a danger to themselves and/or others due to their mental state, they could call PET (psychiatric emergency team) to evaluate the person and the psychiatrist on the team would determine if they need to be committed. Psychiatrists as MDs have this authority, non-medical therapists don't. They could initiate emergency psych evaluation but they can't initiate hospitalization.

[growlycat]

I can't improve on ididitmyways comment. Well said!

Originally Posted by seahorse

Adderral wears off pretty quickly, so hopefully you'll be better tomorrow. I'd take a xanax if this happened to me instead of wasting all that money on medical bills and all that time.

I'm not bipolar but have seen lights on my walls too a couple of times. Going to netfix and watching something funny might help with the thoughts. Grounding, nature, soft blankets, animals...can help

(((Hugs)))

I wish it wore off quickly.

At this rate, I will have gotten a grand total of 2 hours of sleep in a span of 72 hours... because I could only sleep for 2 hours tonight... From 1am until 3am.

I took an Addrrall XR at 6am yesterday. It's supposed to wear off within a span of 10-12 hours. That means it should have worn off by 6pm, but it has not worn off. The same thing happened the day before. It's also making me hallucinate, so it's definitely mania.

As of right now, 3:40 am, I still feel insanely energetic and I just don't need sleep. I don't feel an ounce of tiredness. I feel extremely revved up; it's not even funny.

Like I said, I'm going nuts! I can't even sit still because I'm bursting with energy. And it's not normal to have this energy because I basically haven't eaten food in 48 hours and the Adderall is long gone. The only thing I've eaten is 4 Oreos, which is nothing. Having little need for food is also part of mania for a lot of people.

I could try an Ativan, but I don't think it'll help much

Hopefully I explained it a little better. I realize I left some details out of my post, so I'm sorry about that. That's my fault.

Don't forget you also have the effect of the llack of sleep at least with me lack of sleep accelerates the mania.

Originally Posted by BunYip

Don't forget you also have the effect of the llack of sleep at least with me lack of sleep accelerates the mania.

Yeah, that's the best part of it all... knowing that it's a vicious cycle

I'm hoping to get something from my pdoc to wind me down.

I might take some Ativan to see what that does... like seahorse suggested

Do you think you can write what you're experiencing down, just in case things get worse?

That sounds terrible.

Please try to force yourself yo eat, your blood sugar can make it worse.

[Bipolarchic14]

Call you p doc and leave a message letting them know you need to make an appt for a manic episode. They almost always have time set aside for emergencies. The fact that you are able to logically look at your hallucinations as being just that you are not too far gone yet!

And the longer you stay up, the worse it can get. People who aren't even bipolar get hallucinations after not sleeping for so many days.

Why don't you want to call your pdoc to get some help?

[LonesomeTonight]

Agreed that you should call your p-doc--maybe he can squeeze you in and/or call in emergency prescription for you to help. What time do you see your T today?

[LonesomeTonight]

Also, you mentioned you aren't eating. Are you at least drinking some water or other fluids? If you're dehydrated, medication can build up in your system, since you aren't flushing them out (this happened to my grandmother a few times).

I hope you got help, just a little worried about you.

If it helps, here are is one set of clinical guidelines about your issue that may ease your worries about being committed by contacting a psychiatrist. These guidelines don't recommend automatic hospitalization but the longer you wait, perhaps the more likely it will be.

Check in with us when you can. Take good care.

Initial treatment should include medically stabilizing the patient's condition by assessing his or her respiratory, circulatory, and neurologic systems. The offending substance may be eliminated by means of gastric lavage and acidification of the urine. Psychotropic medication can be used to stabilize an agitated patient with psychosis. Because most cases of amphetamine-related psychiatric disorders are self-limiting, removal of the amphetamines should suffice.

Induced emesis, lavage, or charcoal may be helpful in the event of overdose.

The excretion of amphetamines can be accelerated by the use of ammonium chloride, given either IV or orally (PO).

Amphetamine intoxication can be treated with ammonium chloride, often found in OTC expectorants, such as ammonium chloride (Quelidrine), baby cough syrup, Romilar, and P-V-Tussin.
The recommended dose to acidify the urine is ammonium chloride 500 mg every 2-3 hours.
The ingredients in OTC cough syrups vary, and the clinician should become familiar with 1 or 2 stock items for use in the emergency department.
Ammonium chloride (Quelidrine), an OTC expectorant, can be used in the absence of liver or kidney failure.
Administer IV fluids to provide adequate hydration.
If the patient is psychotic or if he or she is in danger of harming him or herself or others, a high-potency antipsychotic, such as haloperidol (Haldol), can be used. Exercise caution because of the potential for extrapyramidal symptoms, such as acute dystonic reactions, and neuroleptic malignant syndrome.
Agitation also can be treated cautiously with benzodiazepines PO, IV, or intramuscularly (IM). Lorazepam (Ativan) and chlordiazepoxide (Librium) are commonly used.
Administer naloxone (Narcan) in the event of concurrent opiate toxicity. Use caution to avoid precipitation of acute opioid withdrawal in a patient who has used high doses of opioid on a long-term basis.
Beta-blockers, such as propranolol (Inderal), can be used in the event of elevated blood pressure and pulse. They also may be helpful with anxiety or panic.
Psychiatric hospitalization may be necessary when psychosis, aggression, and suicidality cannot be controlled in a less restrictive environment.
If serotonin syndrome is suspected, stop all SSRI and SNRI medications.

Medscape: Medscape Access

No lecture, but from experience:

You really need to get food in your system. Force it down. Yogurt, milk, whatever. At this point, nutritional value isn't critical. But you need calories ASAP. And Gatorade, Smartwater...or plain water. This will help your comedown. And you WILL comedown.

Warm bath with Epson Salts. Don't make the bath too hot if your body is already warm from the Adderall. This will help with body aches. Are you feeling those yet?

Do you have an AP like Seroquel that will put you to sleep? If so. Do the above and then take it. Cool, dark room. Relax.

If you can't sleep and start crashing, Ativan will help just don't overdo it.

As for the therapist - if someone isn't driving you then I think you should cancel. You shouldn't be driving with that kind of sleep deprivation.

Stay safe, friend. xo

Well, my therapist appointment went well

My therapist noticed right away that I was manic, but when he asked me about it, I told him I had already talked to my pdoc about it (which I did). I said my pdoc instructed me to take Ativan until I come down.

I told him exactly how much sleep I've gotten. I was totally honest with him.

He didn't try to commit me, but there's a possibility he might try to get in contact with my pdoc. I'm not sure. But, I can't blame him.. it's his job to watch out for me when I'm in a mood like this.


@rainyday107: Nope, no AP. I was on Latuda, but it was causing my cholesterol to rise, so I had to stop.

Seroquel would be great if I had it, but I only have Ativan.

I drove myself to my appointment. I was totally fine actually. Wide awake, alert, etc.. No signs of drowsiness.

My pdoc said to call him on the emergency service line if I can't sleep.

You sound so much better!

Did you say you started Adderall at the sane time you stopped latuda?

Glad you are doing ok! Did your pdoc say no more Adderall?