After experiencing a manic episode last night with severe racing thoughts, I went to the ER. The doctor paged my pdoc who asked that I see him today. During our appointment he answered some of the questions I had as to why I cycled in the first place. He said this isn't uncommon if someone has been depressed or experienced an event which has upset or excited them emotionally. Since I had been severely depressed for the past 2 days, he said the only direction my mood could go was up. Hence, my rapid cycling. He told me not to be *too* concerned since rapid cycling will always be problematic for me. He also said I shouldn't be discouraged by last night's episode given how well I've been doing on my current med combo. He's proud of how stable I've been and told me not to be too hard on myself for what happened last night. My pdoc also said that typing as much as I did is what was probably responsible for preventing my voices from resurfacing (as well as the Geodon). He would like to see me again in 2 weeks just to make sure I'm not cycling again or experiencing any severe depression. I was prescribed a higher PRN dosage (1500mg) of Depakote. Since I'm on Depakote Sprinkles, he prescribed an extra 1000mg of standard Depakote to be taken and an extra 20mg for my Geodon for whenever I start to feel my moods escalate in the hopes that we can prevent full blown mania like I had last night. The reason why I'm taking a partial dosage of Depakote Sprinkles and regular Depakote is due to the fact that I have trouble swallowing and the latter doesn't come in powdered form. I told him this shouldn't be a problem as long as I'm only limited to taking the regular pills whenever I felt that I was becoming manic. My pdoc is aware of the situation I had with the on call pdoc recommending that I immediately stop my anti-depressant for fear of it causing mania. I was told that whenever I call the clinic, I should inform them that I am only to speak to my pdoc and no one else. My pdoc apologized for the on call pdoc's behavior and told me he was glad I didn't stop taking my anti-depressant because this could have resulted in a much more severe case of depression.
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Atypical Bipolar I Disorder with Rapid Cycling
Meds:
Depakote 1500mg
Prozac 40mg
Risperdal 1mg titrating to 6mg/day
Klonopin .5mg (2x/day)
Trazodone 100mg or 200mg PRN
Kudos for you for jumping on it and getting help, and kudos on your pdoc, too. This guy sounds so attentive, understanding and responsive. And how positive, too, giving you that perspective. And it is truly wonderful how much better you've been recently on the new meds.
You said typing so much was probably the reason - do you think that's an over-stimulation of sorts? May I ask what triggers you as a rule? I am trying to figure that one out for myself, though I know some things already.
I hope this finds you feeling well again, and I am proud of you, too. You continue to be such an inspiration.
It seems that almost anything triggers me into mania, depression, psychosis or paranoia. My pdoc said that isn't uncommon for people who have schizophrenic type illnesses. Dramatic mood changes can set a person off into a psychotic state just as it can set off a person with bipolar into a manic or depressive state.
I actually found typing to be beneficial because I was able to get my mind off of my racing thoughts by thinking about what I wanted to post here. By writing down my thoughts in the spur of the moment I was able to prevent my racing thoughts from getting the best of me and my voices from completely controlling me. Of course, the Geodon could be responsible for the fact that I never heard voices last night, but I actually think it's a combination of these two factors.
My pdoc is absolutely wonderful! He obviously cares about my well-being and is evidently keeping his promise to do everything he can to help me maintain stability. I think he understands what a challenge it is to have rapid cycling bipolar (since he also specializes in atypical bipolar as well) which is why he he tries so hard to help me feel the best I possibly can. I've definitely found a gem in this pdoc and am *so* glad because it has certainly been a long time coming!
How are you feeling today, Seaturtle? I hope you're feeling a little better. Today the weather was rainy and cold, but at least it's allowing the snow to melt. Just think: only 8 more weeks of winter or so before spring is finally here!
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Atypical Bipolar I Disorder with Rapid Cycling
Meds:
Depakote 1500mg
Prozac 40mg
Risperdal 1mg titrating to 6mg/day
Klonopin .5mg (2x/day)
Trazodone 100mg or 200mg PRN
hello. so glad you got better help from your own pdoc rather than the on call one! a good pdoc is worh his/her weight in gold! mine is the best i have found in twenty five years and is usually very kind. i apologised if i annoyed him with my email about my absolute abhorrance of ect and he said he was just under pressure from other things! still only at the early stages of new meds. lamictal, just added lexapro (even though this didn't work for me before, he thinks it will boost the abilify when i start it on saturday. after trying so many different combos i really hope this one helps as i am so tired of this deep depression. i had felt so well, a little manic, before the onset of this over a year ago. he continues to have faith in me but i haven't any left.
very glad to hear that writing helped you so much and fair play to you for going to the er for help. here they dismiss 'mental' patients immediately as soon as they hear the meds list! was treated like a criminal after going there following an od. would not go there again. was definitely treated differently even when in was in general part of hospital for gall bladder removal in september and they completely ignored the safety measures i had in place to reduce my anxiety about the surgery. strangely am phobic about wounds and scars and surgery, kept two of the gall bladder scars covered until about a month ago and still cant bear to look at them! yet i get great comfort from the scars of cutting! no logic there at all! pdoc is amazed by it! this bp mind is a very strange thing and i don't know this person i have become.
I know what you mean about being treated differently. I had an ER doctor last year ask me why I was taking Depakote and Risperdal (at the time), so I told him "bipolar." He didn't say anything, but I know what he was thinking. "Yeah, right. Bipolar. Everyone has bipolar."
The next time I am admitted to the hospital for surgery or another medical procedure, I plan to explain how imperative it is that I be given my bipolar meds. I'm going to mention my psychosis and paranoia even if it makes me look like a freak. I don't care and the last thing I want is to have a manic episode because I wasn't given my meds.
Sometimes you gotta love the medical community. NOT.
__________________
Atypical Bipolar I Disorder with Rapid Cycling
Meds:
Depakote 1500mg
Prozac 40mg
Risperdal 1mg titrating to 6mg/day
Klonopin .5mg (2x/day)
Trazodone 100mg or 200mg PRN
I'm afraid that I'm not doing too well. I still feel severely depressed and even suicidal, so I've decided to go IP this morning. I was going to go last night, but ended up falling asleep after I laid in bed and started crying. I plan to bring my BrailleNote (a PDA for the blind) so that I can continue to update all of you as to how I am doing as well as to keep track of how you are doing as well.
__________________
Atypical Bipolar I Disorder with Rapid Cycling
Meds:
Depakote 1500mg
Prozac 40mg
Risperdal 1mg titrating to 6mg/day
Klonopin .5mg (2x/day)
Trazodone 100mg or 200mg PRN
My meds were increased to 2000mg of Depakote/day, 80mg of Geodon/day and 40mg of Fluoxetine. I'm feeling better today, so I think the med changes have helped. I'm no longer rapid cycling either since I feel a sense of calm and have all day with the exception of earlier this afternoon when I cycled between severe depression and extreme anger. I'll send another update as to how I'm doing tomorrow.
__________________
Atypical Bipolar I Disorder with Rapid Cycling
Meds:
Depakote 1500mg
Prozac 40mg
Risperdal 1mg titrating to 6mg/day
Klonopin .5mg (2x/day)
Trazodone 100mg or 200mg PRN
Hope your not IP too long, but long enough to gt things straight and feel better.
kat
katlin, hope things have improved for you too?? am on day four of no cutting so here's hoping. i think it will go better this time as the first day in the shower i looked at all 200 cuts and thought 'did i do that' and 'omg what have i done' so maybe... the urges are not as strong so maybe the new meds are kicking in a bit. that would be great given nothing has worked before. here's hoping.
Last edited by irishwriter; 02-15-2009 at 04:26 AM.
hi did you go IP? or are you feeling better at home? hope improvement continues maybe the med tweaking will work for you. pdoc put me on lexapro again even though it didn't suit before and i've told him now that i think it increases suicidal urges and agitation. am on day four of not cutting though so maybe lamictal is helping. started abilify the night before last too. so we'll see. take good care of yourself.
