New, lost and drowning...

[jgcr]

Hi, I'm new to this site and hope this will help me cope better as I am completely alone and have nowhere or no one to talk to that could remotely understand what I'm going through. So I went on a search and found you. I recently was diagnosed with Bipolar II and am going through a guinea pig stage (trial and error of medications and treatments) which I'm sure most of you are familiar with.

I have been treated for depression for the past 8 yrs and am on a good dose of Effexor but this medication has been making my episodes higher and lower and very rapid for quite a few months now. I’m still on this medication but am now also on Seroquel I’m guessing to counteract the effect of the antidepressant. Eventually I am supposed to wean off Effexor but we’re just not there yet. Anyone else gone through a wrong diagnosis before and struggled with the rapid cycling? I feel like I’m going nuts and my family, social, and work life is seriously taking a spiral in that deep dark drain….

I’m finding it hard to understand why I feel the way I do and my husband definitely does not understand why I feel the way I do either. As for work, I’ve been on and off and feel like I can’t function, I can’t seem to concentrate enough to make sense of anything in my head. I work in finance, which is definitely making things more complicated. Work says they understand and are being patient with me but the stress of not being able to perform like I used to is really getting to me.

The kids don’t know a whole lot… they just know that mommy is sick at times. My husband thinks I should be able to just snap out of it. He’s read a lot on the subject but doesn’t understand still. He doesn’t understand why everything I feel would be so strong and why I can’t just cope with it, like everyone does. This has caused for some distance between us as I don’t feel like I can talk to him about how I’m feeling anymore.

I see a psychiatrist this upcoming Saturday for a full out assessment and am scared. I feel like I’m all over the map and don’t know how I’m going to manage explaining it all to that doctor…. Ugh… I’m just so exhausted all the time and I try so hard to make myself look like I’m doing ok to the world around me. Which is making me feel so isolated…

Well that’s all for now I guess… just wondering if anyone can relate… maybe give me advice… I don’t know…

[Determined]

Hi jgcr and welcome. I just want to say that I have been through pretty much everything you have described including the severe lack of understanding from those who mean well but have absolutely no idea what it is like to deal with any type of mood disorder. All I can say at this point is do not be hard on yourself. What you are dealing with is an illness that requires treatment and time; not unlike any physical affliction. Seeing the pdoc (psychiatrist) for a full assessment is the best thing you can for yourself at this time. That, and understanding that you are not at fault for what you are experiencing. We have all felt that way; the guilt, the frustration, the pain, and the stress of dealing with normal life on top of a severe and very real medical condition.

This forum is a great place to be a part of. The people here have helped me through a very difficult time. Hearing from those who live with mood disorders has been extremely valuable to me. Only those who are experiencing the same thing can truly understand what it is like.

You will find this a safe place to be a part of. Lots of understanding and non-judgemental.

I hope you will continue to be a part of the forum.

Take care and as of now give yourself the credit you deserve for hanging in there. It does get better.

[AJ]

Welcome to the forums Jgcr. I can relate to much of what you've shared.

I was on Effexor while I was on an antipsychotic and I became manic and had to come off it. In fact all of the antidepressants result in mania, no matter what else I have on board.

I had to go through a few psychiatrists and many different drug regimens before I felt better. Even now I still have my mood swings although the highs and lows are not as dramatic as they used to be, most of the time.

[paul m]

Hello and welcome to the forum jgcr. Mis diagnosis and improper treatment are often the rule rather than the exception when it comes to bipolar. The mean time of diagnosis ranges from 6-7.5 yrs with about 1/3 going 10 yrs or more yrs before getting a proper diagnosis of bipolar. (source http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945875/ ) The full article is an interesting, if slightly disheartening read.

As others have said, antidepressants will make some people with bipolar rapid cycle. The same article( which is an article in the US National institute of health) estimates that 25-50% of the people that have bipolar and who use antidepressants(A/D's) will rapid cycle. I didn't so much rapid cycle as I just stayed manic for a prolonged period and than crashed severely for a short time, then manic again for a long time while on A/D's. or I suffered from mixed states during that time frame.

Seroquel can be a tricky medication to get used to and is well known for interfering with your concentration. I don't know when you take your seroquel, but I found it better to take it in many small doses, as many as 4 a day, rather than 1 or 2 larger doses. I found that the slow release( XR or SR) was the worse. I would take my largest dose of the day with supper.

Rapid cycling can also screw with your brain(at least it did for me) rapid periods of mania alternating with depression, left me exhausted because I had no normal times in between to get caught up on my rest. I either couldn't sleep because I was manic or I had disturbed sleep because I was depressed.

In regards to guilt. I suffered through a lot of that too. Try to remember that you are a good person with a bad illness, not a bad person with good excuses.

How to tell your doc. Between now and Saturday try and write down a short, point form note of what your symptoms have been over an extended period of time. You may want to read http://www.helpguide.org/mental/bipo..._treatment.htm to help you remember some of the symptoms. Also remember that what is called mixed states, where we have symptoms of both mania and depresion is now realized to be quite common. An example of a mixed state might be: You can't sleep and your mind is always racing(mania), but you have no energy and feel extremely sad and unhappy(depression).

Good Luck and Take Care. paul m

[uni]

Welcome to the forum jgcr; I'm glad you found us. Thanks for explaining where you're at with the moods and meds. Others here have given some valuable information. Coming here to get stuff off your chest and ask/answer questions is a great help in many situations. I look forward to hearing more from you. All the best!

[jgcr]

Thanks everyone, it is nice to see that others are like me, makes me feel less alone in all this. It's hard when no one around you understands what you are going through.

The doc has increase my Seroquel and now I've been so drowsy and have so much trougble concentrating. I've missed a few days of work because of this. Maybe, I'll ask him if he can invrease my dosage in smaller increments insteasd of doubling it. I'll be increasing for the next 5 weeks.

I'm very happy to know what is wrong with me, but also so frustrated that it is something that takes so long to help me feel better. Like my husband pointed out to me, I don't even remember the last time I was myself, or even what 'myself' is.

Again, it is great to be able to speak to someone about this who understands and isn't a doctor or someone with a look on their face like I'm crazy.

[jgcr]

Question... is it normal that I feel exhausted and useless and unfocussed with every Seroquel dose increase?

[paul m]

Hello JGCR. When it comes to anti psychotics, unfortunately there is no normal. Some people get hit hard at 100mg of seroquel, I know other people that require 800+ and it just keeps them level. For myself, taking 200mg was a walk in the park and at 400mg I wouldn't know where I was walking and I never got used to that level. At 400mg it stops my mania almost immediately, but I never got used to it. However once my mania was under control, I could switch to other types of meds and I now only use seroquel if I start getting really manic.

I don't know why the doctor has you on seroquel, that's not a criticism as the doc may have a very good reason, but there are at least a half dozen anti psychotics

If you click on http://www.camh.ca/en/hospital/healt...edication.aspx

and scroll about half way down the page you will see a little chart that lists the order in which various anti psychotics can affect us. For example the chart shows that Seoquel(quetiapine) is one of the most likely to cause sedation and Aripiprazole (Abilify) the least likely to cause sedation.

"Sedation (e.g., sleepiness, low energy) clozapine, olanzapine and quetiapine > risperidone, ziprasidone, aripiprazole"

Having said that when I really need to control my mood swings, seroquel works the best for me. BUT, it doesn't work the best for everyone.

Do some reading on the various antipsychotics and talk to your doctor about it. I think I also said before that I absolutely cannot take the extended or slow release type of Seroquel. When I have to take it I get the doctor to prescribe the immediate release type and then I adjust when I take it, sometimes as much as 4 times a day.

A website called crazymeds is a good site for some easy to understand reading about medications. http://www.crazymeds.us/pmwiki/pmwiki.php/Meds/Seroquel for an alphabetical index of many meds http://www.crazymeds.us/pmwiki/Main/HomePage Good Luck and Take Care. paul m

[jgcr]

Thanks for your input. Seroquel is the first antipsychotic the doc put me on... i'll be increasing to 400 within the next 3 weeks. He also says, if this drug doesn't work, he may need to put me on Lithium... I'm not sure what that does... for now the Seroquel makes me pretty much a zombie, but I still get my lows... I haven't got any of my manic phases though, at least not to the extremes so far. I just feel stuck in a rut. I'll definitely have a look at those links. THanks. It seems a lot of educating one self is the best with bipolar...

[jgcr]

Also, for the past few months I haven't been able to attend work do to lack of focus, unable to function, unable to drive, and the overwhelming anxiety of being anywhere all together. The meds aren't helping in the work aspect either as I find I'm much more calm but still useless, unable to drive (safely) feel like I'm in a bubble and everything around me is messy/muffled and looking in, unable to reach me. I haven't lost my job yet, thank goodness... but I'm sure I'm wearing thin on their patience.

[paul m]

Hello jgcr. Nothing that follows is a criticism of your doctor as he may have valid reasons for what he is prescribing. Nor do I have any medical training nor am I qualified in anyway to give medical advice.

But I can tell you what happened to me. I blindly followed my doctors advice, because who knows better than a doctor right! Too often my doctor would tell me "well just try it for a while longer and it may work or the side effects will get better" or the line I came to hate the most "well it works for most of my patients".

I came to learn that rarely do two people with bipolar take the same medication. The illness usually requires medication specific to that person. (and I've met or corresponded with 100's of people with bipolar)

Lithium has it's own problems, but for some of us it works well. I have never understood why docs don't try lithium first on people with bipolar. It either works within about 7-10 days or it doesn't work. Lithium is the oldest and most understood medication used for the treatment of bipolar. Actually it is still the only medication that has been approved just for the treatment of bipolar. Other medications may be used in the treatment of bipolar, but they were not developed for that sole purpose.

Lithium alone does not control my mood swings, I also take a mood stabilizer called tegretol(carbmizepine) and for anxiety I use lorazepam. Only when I'm truly desperate do I take seroquel and then only for a short time.

I will say that it is odd that your doctor would say "well if seroquel doesn't work, we'll have to try you on Lithium. As I have said there are several other anti psychotics that may work well, but that aren't as sedating.

You are correct that educating yourself is the best way. I wished that I knew back then, what I now know about bipolar. I would have gotten better much sooner and not had as much lasting damage.

I'm not saying to argue with your doctor, but when you are informed then you can make suggestions to him and back them up with real information. I've found that most(certainly not all) doctors are open to alternative suggestions form informed patients.

I know it's hard right now, but at least try and read a little bit everyday about your illness and the meds available to treat it. I would start with crazy meds as it is the easiest to read. Take Care. paul m