Sunday, April 10, 2011

Getting mad at the world: I'm a little irritable right now and possibly hypomanic



First off, I am sorry this post is so long, and if you do not have time to read it all, or don't want to, I totally understand that.

I am feeling really irritable right now. I'm not usually like this. I feel on edge, anxious, and ready to smack somebody if they come near me. I'm not a violent person; I wouldn't actually smack anyone. I'm just really annoyed with life and I think part of the reason I'm feeling like this is that my Lamictal dose was doubled, up to 50 mgs, starting last night. I'm sure there is a correlation.

Yesterday, I went to see my psychiatric ARNP and she wasn't there; she had her own doctor's appt. So I saw another doctor, who actually was my first doctor the very first time I ever went to the community mental health center here, back about 14 years ago. He thought he remembered me. He is now the medical director, and no longer usually sees patients. I like him a lot; he seems sharp, intelligent, and on the ball. He immediately stated that I'm on an awful lot of medication, which I know is true. I also know how I feel when I am not on this medication, and it really sucks to be me then, so at the same time I am reluctant to say, "Hey, yeah! Let's take me off some!". But I DO want to go off Seroquel forever, because it caused me the biggest weight gain. So he further decreased my Seroquel, and soon I won't be on it hardly at all.

He also decreased my Wellbutrin, because for some time now I've been on 450 mgs, which is the most they usually would ever prescribe for anybody. I knew that before he told me that, and I was fine with reducing that antidepressant since Lamictal is supposed to be helping me with the depression now.

He asked me why I was on an injection (Risperdal Consta), and I explained that, years ago when I was first put on injections, it was in the hospital after I had been psychotic for years and never stayed on pills even when they were finally prescribed. Then, I stayed on injections because they work for me, and every time I go off the Risperdal shots, the psychosis returns.

I'm not sure he totally understood my history in this brief visit, because he started to say that I seem more Bipolar than Schizophrenic, as of course Schizoaffective is a mix of the two, and he seem to be thinking perhaps I actually am Bipolar. I know I'm not Bipolar. I know my history, and I know my life. Psychosis has been a big part of my life for twelve years. It happens when I'm not depressed. I don't get manic; if I get hypomanic, which I actually may be right now (not sure), it is not a severe thing and I haven't actually been manic as far as I know since around 2003-2004.

In any event, I don't think it could hurt to have a second opinion on the medications I'm taking, so I was pleased when this doctor said he wanted me to come back for him to do a whole psychiatric evaluation on me. My therapist said he might not understand why I need so much medication, because I seem to have "absorption problems" as she calls it where my stomach doesn't take in the stuff enough for it to work. I've been checked for Celiac Disease and told I don't have that, but it seems like it takes a lot of meds for me to feel any effects. I didn't explain this to this doctor, because I honesty didn't think of it at the time. My therapist thinks it's really important that he understand this and that I need to make this really clear to every doctor I ever see. Since she sees a lot of clients with digestive problems, she has a theory that many people have absorption issues and that's why their meds don't work well enough for them. I don't want to get into a disgusting topic of how people have digestive problems, but you probably understand what I'm saying.

Anyway, since he doesn't see patients usually, it's unlikely this doctor will take over my case, but having his input might help. I found out from him that there is a new antipsychotic drug that's only been used for about three months now, and it does not cause weight gain. I forget the name of it, but it starts with "L". I am very interested in trying this new drug, because the Risperdal shots also contributed to my weight gain, and I would really love to be on something that does not slow down my metabolism or make me hungry all the time. That would be such a wonderful change!
I'm not sure if Lamictal generally causes anxiety or irritability, but things and people are really getting on my nerves right now. I have this constant problem of worrying about my family members, who have a lot of problems to worry a person. They: my mom, and the brother and sister who I'm closest too, all have major money problems. My mom goes in and out of jobs every couple of months and she can't pay her bills because of it, since her Bipolar Disorder has never been under control well enough for her to function for long enough at a job even though she is intelligent and capable. And so there is this weight on my shoulders, getting these phone calls about how my mom can't pay her water bill and she doesn't expect me to pay it for her, but she tends to blame other people for her problems, and often times, I am that other person.

Then tonight I went out to a movie with the only friend I have who I ever go to movies with (I do not have a lot of friends), and she was, once again, getting on my last nerve. She is very self-involved and never stops complaining about her money problems. I don't talk about my money problems with her so she seems to assume I have these riches she doesn't have, even though I have pointed out to her on several occasions that my income is no higher than hers is. She is on disability, but she gets a check twice the size of mine, and she doesn't have to work to pay her bills, so she doesn't work. She never gets psychotic, and yet she complains to me about how hard her life is all the time, as if it was soooo much more difficult than my life when I'm trying to manage a job and school, and she's sleeping until 5 PM every day despite having no physical health problems.

Then there is the difference in personalities. We really are not that much alike. She thinks it's funny to throw popcorn at me in a movie theater, or purposely irritate people by smoking near them when they are obviously annoyed with her smoking, and stuff like that which is really juvenile, and I don't get it since she is older than my mother. She acts like she's five years old, but to her this is very amusing. To me, it's really annoying. We're in the movies and she's loudly laughing and talking and I'm just thinking of how embarrassing this is because nobody else is being this loud. Then she's coughing non-stop without covering her mouth which really boggles my mind because most people know it's very rude to cough and cough when you're sitting inches away from someone, and not cover your mouth to prevent spreading your germs. Then there's the fact that she flirts with strangers every time we go anywhere and they are generally thirty years younger than her and not exactly interested. I don't understand that behavior, or the illogical thinking that would lead one to believe a 22 year old will want to flirt with you when you are 56.

Do I sound annoyed yet?

I'm really not a picky person. I'm not usually the type of person to point out everything I don't like in a friend of mine. I really don't do that. It's just that I wish I had other friends to go places with, and the reason I don't is that I have very poor social skills and a lack of ability to make friends. And I guess that's irritating too. Because if I'm going to take the effort to spend time with a person and talk to them frequently on the phone, I want to be able to have that person actually care about my life and not just use me as their sounding board to tell me all their problems without caring at all about my problems. Is that too much to ask?

I have had two friends like this the past few years, and they are the only friends who ever call me, and both of them drive me nuts. The other one is a drug addict and I want nothing to do with her anymore because I'm sick of watching her destroy her life and getting her phone calls where she makes it obvious she wants to borrow money from me, as if I have any money to lend her. I have cut her, for the most part, out of my life for my own sanity and peace of mind.

And that leaves me with no friends around here. I know people in a women' organization I belong to and NAMI but I'm not friends with any of them, really. I would like to be friends with some of the women in the women's organization, but I doubt they would want to be friends with me. Most of them are twice my age and have had careers and hold Bachelor's or Master's Degrees or even PhD's, and they intimidate me. I doubt that I could hold up a conversation long enough for them to be interested in what I have to say. There is one exception to this, as one woman has taken the time to have lunch with me and she was very kind to me and seemed to have an interest in the conversation. It probably helps that she is a therapist! I have shared my diagnosis with her, and some of my history, and she has not seemed judgmental about it at all. I really appreciate that. It would be nice if we had more in common and could be friends, but I just don't know how to make that connection.

All my life, I have had trouble making friends. Always. I have had friends, even close friends, but for the past 13 years, those have mostly been online. I had a group of friends I've mentioned here before who I was very close too, but when my illness was at its worst, all but one of them cut me out of their lives. The one who didn't do that is still a wonderful friend to me, and I care about her and really appreciate her a great deal. But we have never met in person.

I guess my life is just not flowing well right now, and I'm not sure how much of this has to do with medication changes, as my Seroquel has been decreased over the past month, and the Lamictal is still new to me, and just recently increased. I don't know if the irritation I'm feeling is due to that alone, or if life factors are also in play here. If it is my life that is the problem, the fact that I don't know what I'll do if my car needs more expensive repairs since I can't get around without a car, is weighing heavily on my mind, and my problems with college and not being sure what to do about my degree and future is really making me nervous.

I feel like I need tranquilizers and the funny thing is, I'm taking Ambien and Klonopin and Valerian Root and Melatonin and still having trouble sleeping!! Talk about craziness. If I am hypomanic that would explain this.

I  just wish that I could wake up in the morning and feel energetic, which I never do because of my health problems, or feel clear about my goals, which I'm not right now, and this inability to have the energy and the clarity that I need to function well is really getting in my way. I wish I could meditate, but it's something I've never been able to do because I have a lot of trouble quieting my mind and relaxing. It just does not work for me. If I was physically able to do yoga, I'd try that, but I'm not physically able to do it (have tried before).

I know that one thing I need to do is get back into a regular exercise regimen, which I have not been doing for many months, and to make that a priority in my life. I also need to unpack all my belongings that are still in boxes, hang all my pictures, and get my apartment set up properly.

I've been buying discount curtains and other decor to make it look better than the old one looked, and I do enjoy that. I have a lot of trouble making decisions, though, so when I go to buy something I end up going to five or six stores and on five or six websites comparing prices before I make a purchase, which takes up a lot of time and energy, and leads to exhaustion and physical pain from Fibromyalgia. This is something I've done way too much of lately, and I need to stop it. If I cannot make up my mind about things, and don't have the money needed to buy the things, then it is not time to go shopping. Especially not shopping all day long without buying anything!

Well, this has turned into a long, windy post, and I'm not sure it will be clear to anyone what the point of it was, so I apologize for that. I don't feel up to writing anything much better at the moment, so this is what it is. Thank you for stopping  by, and I do deeply appreciate all the people who take the time to write comments. Also, I'm sorry if I sound like a witch with the way I talked about my friend, but that is the frame of mind I'm in at the moment. My friend asked me if something was wrong with me because I seemed angry. This is not the way I normally am at all. She really is a good person at heart, and I would never want to make her feel badly just because her behavior drives me up the wall. And also, I know that not everyone would find me a pleasant person to be around, and I'm sure many people are annoyed by me on a regular basis.

I would like to know a way to determine if one is experiencing hypomania or not, or if I am in a mixed state. I am not sure how to determine this. If you have any opinions on it after reading this post, I would love to hear them. I am wondering if the Lamictal could have thrown me into hypomania or a mixed state of depression and hypomania, or if I've been in hypomania for months and that is why I can't sleep. But I really do not feel manic, in the usual sense of the word. Mental health can be so confusing at times.

12 comments:

Mining for Diamonds said...

Bless your heart! I'm reading your post, and I have to say that I've had many of the same feelings as you about my friends and family...and I have no diagnosed mood disorder! I know it must be so frustrating when you feel like you can't trust your emotions.

I find your writing to be very articulate and I have no trouble understanding your flow of thoughts or your expressions...it is obvious that you are a highly intelligent woman!

My hubby has a diagnosis of Bipolar I, but I just learned about schizoaffective disorder a few years ago, and interestingly enough, as of late at least 2 mental health professionals have suggested the possibility that he has this. He was initially diagnosed at age 16 with schizophrenia but was misdiagnosed and eventually dx'd bipolar I. However, in looking at his symptoms, I really do wonder, because he has had the psychosis without the mania...which perplexed me but in light of reading about SA, it makes sense.

He has been very fortunate to respond well to medications, but his problem in the past was non-compliance. After going through a very dark season a few years ago and almost losing me and his daughter, I think he has been cured of the non-compliance! He did really well on Zyprexa, Lithium, and Prozac until very recently. He started changing...that's the only way I could describe it. I wrote about it on my blog. Even though he wasn't in "crisis", the change was significant enough that it needed to be checked out. Long story short, he was taken off Zyprexa and put on Abilify and he's been on that for about 10 days now. The weird symptoms he had disappeared almost completely and he seems back to himself. So far he likes he Abilify, but I'm watching closely and documenting things. I'm hoping that his next psych appt they will look closer at the possibility of SA because that might take his treatment level up a notch.

I think to answer question as to how you know you're hypomanic, I think it helps to have people around you that know you and can observe the changes. It's good that you have enough self awareness to know that something isn't right...unfortunately, my hubby didn't have that and even though the changes were obvious to me, my mother and even our 7 year old daughter, he thought WE were nuts, lol! He didn't see anything wrong. You are right, it's so subtle and its hard because we are human and go through mood changes and sometimes its so hard to separate what is "human" from what is "mental illness" unless it is really obvious of course.

I hope you will keep us posted on your progress! I will pray that your meds stabilize and that you find peace.

Sairs said...

When I get hypomanic, I am full of ideas and energy, want to spend money or do anything impulsive like chaning my hair or getting piercings and stuff like that. I also get lots done, like once I wrote two 64 page zines in one month, which included putting the pages together, printing it, collating it and binding it for sale. Sometimes it will turn into irritation, where everything will piss me off and this is when it is starting to go into mania for me.

It's good you are trying to keep friends and I know it's hard. I have had a lot of trouble with this in my life. I am lucky that I am married to a wonderful man and have a cute but naughty little cat but I miss having really close friends around.

Anyway, thinking of you, hope you feel better soon. I found Lamictal really good. Maybe it works for some and not for others.

*hugs*
Sarah

Percheronrider said...

Some of your adsorption problems are related to Fibromyalgia. Also your reactions to meds.

I'm hoping to gain some insight into schizoaffective disorder, as I have a friend with it. I know absolutely nothing about it.

In the Pink said...

I often times think that it is not the diagnosis that matters so much as the symptoms and taking the meds to treat the symptoms. Lamictal has been a saving grace for me. I take 300mg of it though so it may take time for it to be effective for you. And in times when you are decreasing some meds and increasing others your body will go into a state of rage...I have experienced that. It is just so much to take in.

Lucida said...

I have been taking lamictal for 18 months now and I'm on 400mg a day which is a substantially high dose. I was very depressed when it was first prescribed and since it initially works best as an anit-depressant, it seemed the most appropriate mood stabiliser at the time. I did find the first few weeks the most difficult. I was agitated and irritable the whole time and had problems sleeping and eating. Also I felt slightly nauseous and had a constant tension headache. i was also taking a lowish dose of olanzapine (5mg) at the same time to surpress any mania or hypomania. I quit this a few months later and experienced a couple of months of mild mania which calmed down as my lamictal dose increased. According to my psych, it takes a few months and a therapeutic dose for the anti-manic properties of Lam to kick in. On the whole I have found it to be very effective in keeping me stable. I do occaisionally use an anti-psychotic when i become too agitated and restless. Lamictal has impaired my short term memory and concentration to some extent but otherwise the side effects are minimal compared to other psychiatric drugs - one being that it doesn't cause weight gain in most people. Of course I can only speak from my own experience but I have heard similar reports from others. I hope things begin to settle for you soon. It sounds as if you have alot to deal with.

Jen Daisybee said...

Mining for Diamonds - I feel for you, as I also know what it is like to be a family member. My mom and one of my sisters have Bipolar Disorder, and I have watched them go through a lot of problems. It's hard to see somebody you love act in ways that are difficult to understand and hard to put up with. I hope your husband gets some answers soon about whether he has the correct diagnosis. Sometimes it's hard to get the correct answers. Thank you for the good wishes.


Sarah - I know it's so hard to make friends for some of us! I also wish I had more close friend, so I understand what you're saying. I don't have any of the extra energy, so I am thinking most likely what I'm dealing with is just some side effects and not actual hypomania. I'm glad Lamictal works well for you. Not sure I've been on it long enough to notice any positive effects.

Percheronrider - It's possible that some of the absorption problems are related to Fibromyalgia. I also have Sjogren's Syndrome, so I'm sure that has something ot do with it. There is a lot of info here on Schizoaffective Disorder, so you might pick up some information in other posts. Also a few people whose blogs are listed on my blogroll have the disorder too. I've found that most mental illness blogs I come across are about depression or Bipolar Disorder. Not many are about Schizoaffective or Schizphophrenia.

Pink - I think that a lot too, that it is really the treatment that matters not the diagnosis. But I know years ago, when I was first told I was dealing with Major Depression, or Bipolar, I never got the right treatment. For me the antipsychotics are a big help. I don't really know about some of the doctors I saw when I was really psychotic though - not sure what they thought my diagnosis was. I just know I didn't stay on the meds long back then for a variety of reasons, so they didn't help. I know that everything changed when I was finallly on antipsychotics for a little while, and I'm just glad they figured out that I needed those, even though at the time they thought I had Paranoid Schizophonrenia and then the diagnosis was changed later. I think sometimes people's diagnoses get changed because the people's symptoms change, which might just be because of the meds, in some cases. I think it's probably the changing in meds that is making me irritable.

Lucinda - I have been having headaches a lot too! Thanks for mentioning that as a sicde effect. I admit I didn't do much research at all on Lamictal. My sister and my mother have both taken it, so I always thought of it as a mood stabilizer. Thanks for your insight on this; I appreciate the information. I'm only on 50 mgs, so it will probably be a very long time before I'm on a high dose, if ever. I've been on 1000-1200 mgs of Seroquel before, though, so I know things definitely change according to dose with a lot of these meds.

shah wharton said...

Thank you for linking up to my blog hop - you apologise for this post wrongly - its what you need and informs other readers. So well done.

Re your issues with friendships - I've found bad people seem to gravitate to me. Human versions of the leech in particular. I'm a awkward person socially too - I'm easily lead and a people pleaser. I hate myself for it and now I@m married I don't socialize at all (except online) but thats how I like it ;D

Re mania - read this - it might help to illustrate bipolar types in brief:http://wordsinsync.blogspot.com/2011/03/did-you-know-there-are-5-types-of.html for you.

I take seroqual - it's all I take now. I'm happy with it, though I have to eat less than 1000 calorie a day to maintain my weight! Not easy and I find even a few days of more than that my weight increases easily - of course age has its part to play in that too now. ;( Let me know the new one you plan to try beginning with L. That would be Heaven.

I commend you for continuing on to educate yourself, to have life-journey in mind - thats more than half the battle I find.

Stay positive and in touch. Shah. ;D X

Stephi said...

I experienced hypomania before my break down...unfortunately I was in such a state that I can barely remember anything that would be of use to you. The best way I can describe it was the feeling you get before you run a race or make a speech. It was an unbearable nervous energy that felt like it was going to explode and rip my body apart. Try not to worry- it is most likely the change in meds that is the cause, if things get continue to get bad go back to the doctor.

It was very brave of you to write this post, I have also struggled for most of my life to make friends. It did get better once I became an adult and I have been blessed with some very good friends. But being ill and living with my parents out in the boonies has taken it's toll on my friendships and I think a lot of them have given up on me. I think being honest with your friend might be best, you don't want being with her to become a chore.

Just hold, this will work itself out.

Chantelle said...

Phew...it sounds like you are dealing with a lot right now! Just keep moving forward! I've been in a similar situation as yours...the whole family thing...nothing is more irritating than 'family' adding to our irratibility.
I also experienced the challenges of making friends while growing up & at 28 yrs. old...my husband is my best friend. I'm content with 2 close friends that I barely see, I've always been to myself...and ever since things got worse years back, going out & friends didn't fit in the picture...I was too busy in & out of hospitals. Certain people I don't think could handle what was happening in my life.

It's great that you want to get active because I found for myself it's amazing therapy! I talk about stuff like this in my blog. About my experiences with medication & studies with light. I believe that doctors should really stress to patients how important food & exercise should be in our lives. My husband & I heard about a father who took over his daughter's care & decided to eliminate medication and just use the outdoors, healthy food & exercise as her treatment for bipolar...and it was a success. I'm not advocating to 'cut out meds' & this would work for everyone...but it's a different way to look at things and how to view being physical & having healthy lifestlye.

I was put on Seroquel XR years back, now up to 1000mg. I can honestly say it has saved my life...along with therapy, 18 ECT treatments and trying my best to lead a positive lifestyle...which is a day to day mountain to climb. She had me on Lamictal, 300mg a day for years as well...just a few months back she took me off. If she did it without me knowing, I wouldn't have even known she took me off of it. But I agree with what 'Lucida' said about it.

The Seroquel at first did cause a lot of weight gain for me too...it shouldn't be the deciding factor in a medication change though because with small changes you can change weight...but I understand because I've done the same thing. I refuse to go back on Lithium because of the fear of weight gain...as well as others. She has kept me on Topamax to keep my weight under control from the medication & from my eating disorder symptoms.

Mania & hypomania people often get confused...I know I did. Sometimes it's hard to know if it's life causing the symptoms or if it's just the illness itself. I usually get sooooo irritable & over sensitive...along with rapid thoughts, restlessness & rapid speech w/ my hypomania. I usually don't make smart decisions...leading to impulse buys, which my husband & I argue about. It all leads to an episode of depression! For my mania, I get tons done...writing for endless hours...before I know it I haven't eating or gone to the bathroom. Sometimes I'll go to bed really late & miss my meds cuz I've been consumed with my 'new projects'. I burn out after days of this & crash!

The days I'm living today I never thought were in my future...just keep believing that they are & confuse mental health right back!

~CC
http://notcrazyimbipolar.blogspot.com/

Jen Daisybee said...

@ Shah - I love your blog hop, and was happy to be a part of it. I posted the image on the bottom of my main blog page. It was a great idea. I hope it keeps going! I find it hard to locate many mental health blogs, except by finding them through other mental health blogs. There are not enough places online that lists them specifically. I find it especially hard to find ones that deal with Schizoaffective Disorder or Schizophrenia specifically.

I'm sorry you have to worry about the weight gain from Seroquel. I personally couldn't stick to a diet while on this drug. I have tried. But 1000 calories a day is a very strict diet. You might know this already, but that is actually considered starvation. I was anorexic when I was younger, and I think some of the health problems I have are a result of that, possibly. I hope you can stay healthy even though you are on such as strict diet. But I totally understand why Seroquel makes it impossible to eat without gaining weight. It's a real problem for a lot of us. Thanks for coming by here, and I hope you come back again! I did read your article on the different types of Bipolar, and though I don't think I am Bipolar, it was helpful information.

@ Stephi - Thanks for your wise words, and you are right; it will get better, and work itself out.

@ Chantelle- I know how hard it is to make friends and keep them. I lost some close friends to this illness, because they couldn't deal with me, and it was very hurtful, espcially since I did not know I was ill at the time.

I think excercise, food and vitamins can be helpful for most people with mental illnesses. But at the same time, I know that medication has saved my life. So I'm one of those people who chooses to take the pills despite the side effects.

I'll definitely check out your blog!

Chelle said...

Jen,

I just found your blog today while searching the WEGO health community. I can so relate to your not having any friends who really seem to care about you and how people disappear when things aren't going well. That's when I always discover who my real friends are. And, to be honest, I only have one good friend who I ever see and she is fighting breast cancer right now and not available much.

I find most of my support online and through my husband. I also blog about being bipolar and you can check mine out at www.lifeonthedomesticfront.blogspot.com. I'd be very happy to talk with you about what hypomania feels like. I have bipolar II and to me, the biggest symptoms of hypomania are irritability with everything and the need to impulsively do things, like spend money shopping online or moving furniture around...stuff like that.

I have put a link to your blog on mine and I look forward to reading your posts and seeing whether the Lamictal was workable for you. I have never found the right med combination that didn't have such awful side effects that I could continue taking it. The most recent med my psychiatrist tried me on was Stratera and I felt like I was horribly drunk for about 12 hours. I only took it once.

I take klonopin for anxiety and ambien for sleep and have been on both for so long that neither works anymore. Getting the right med combination is just so danged hard.

Hang in there! Your blog is a great way to find support and hook up with other people who can relate to what it's like.

amazgractb said...

I've never posted a reply to something like this before, but I feel it "necessary" now. First, I want to say that I found what you wrote very entertaining (I laughed audibly several times, and I needed to) and written well. I do hope you get your med cocktail right soon. I have Bipolar 1, and finally got the correct cocktail after 15 years. And now, my life is amazing! I say this in part b/c I was diagnosed in 1995, but have been depressed about 98% of my adult life. So, to be "normal" for a year and a half is the most incredible feeling. I always wondered what it felt like, and was starting to give up. So, my word to you is: Don't give up! Keep the faith.

But the main reason I'm writing is to thank you for sharing your experiences with having difficulty befriending people. Ever since my diagnosis, I cannot seem to make friends; and I'm thinking it's b/c I'm weird and a problem peculiar to me. So hearing your struggles with this same problem has encouraged me. Thank you for your courage and openness in disclosing this issue...You've made a difference in this life.

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