Diagnosis

First...thanks to all who commented on my post, "Am I the Only One?" Each of your responses were full of things I think are true in many ways. Very valuable comments.

I have wondered for a long time why the DSM IV does not take a different approach to Depression and Bipolar Disorder. Based on my experience of myself, and my listening to and reading about, other's stories I really believe the way Depression and Bipolar Disorders are categorized is incorrect.

It seems really clear to me that Depression and Bipolar are on a continuum of one illness; that they are not two seperate illnesses. Here is my proposal for the next DSM:

Depression --->Bipolar Continuum

1. Mild Depressive Episode
2. Dysthymia
3. Moderate Depressive Episode
4. Major Depressive Episode (MDD if more than one episode.)
5. Major Depressive Disorder No Cycling (I'm not refering to bikes;>)
6. Major Depressive Disorder Mild Cycling
7. Major Depressive Disorder Moderate Cycling
8. Major Depressive Disorder Major Cycling
9. Cyclothymia
10. BP II
11. BP I

Then the descriptives...chronic, psychotic etc. Of course, I am a layperson and there could be things in between that I haven't thought of...but it seems like depression is connected more closely to BP Disorder than is currently described. It seems people who have had numerous episodes of depression may be more likely to begin cycling at some point. Maybe I'm wrong, but this has definitely been my experience.

When I was young I either cycled between wellness (for me hyperthymic...quite a bit higher/more irritable than the average mood...this definitely runs in my family) and depression. The depressive episodes fairly short and sometimes extremely short, changing from suicidal to extremely high in one day, or every few days.

As I became older the episodes began to get longer and longer, and more severe. They began to really affect my ability to do the things I wanted to do. Now my mood cycles are much worse going between feeling suicidal and going so high I get intense anxiety and agitation...so I begin having difficulty functioning at either end of the scale. Do mood cycles increase both in length and strength as we age, or as we have more and longer depressions? Or did the medications I have taken kick me into some kind of cycling pattern?

It seems I never had the intensity of cycling before I began trying medication. So I wonder if some of the medications initiated some of my cycling? Or did years and years of not sleeping well kick me into my mood swings? Or are they psychological (vs. biological)...do I cycle up so high because I am pushing to get well and I have so much momentum that I somehow manage to push right past the well stage? What about how the world seems to change when I am high? I feel I can see the life force pumping through everything. The colours are intense and it is as if I can see things at the cellular level..intense and more beautiful than when I just feel okay.

Does it matter why? Does it matter "what" I experience? Does it need a label? What would happen if there were only experiences and no labels? What if my cycling were a gift? What if it weren't a gift, but I accepted it as one? Would I be well?

Walking into Walls

I have finally slept the past two nights. Thank goodness. My mood is still really high, maybe too high, as I keep catching myself talking and talking and talking. I need to listen more. I hate when I am interrupting and overwhelming people during a conversation. It is rude, but I cannot seem to stop talking. Every idea sends another to my brain and I am thrilled with the world. Unfortunately, my talkativeness is even annoying to me and I can see it is a bit too much for others. How do you explain what is going on inside your head and how you cannot seem to control your ideas or your voice from expressing all the ideas.

I love that I have energy though. I have been playing with my nieces and can actually keep up with them. When I am depressed I usually burnout and become overwhelmed pretty quickly. I adore them so much. It is good to thoroughly enjoy their energy and to have the same.

I am having a few other problems though. My hands are twitching. Either my whole hand, or sometimes just my fingers suddenly twitch, almost like a twitch when your reflexes are tapped. This morning I almost dropped my coffee a few times when I twitched.

The worse thing...you might find it funny if you were watching me...I am tipping into walls and walking into things. Yesterday I walked quite hard into a sign post while walking with my in-laws...embarrassing. Not sure if it is balance, or spaciness...Regardless, walking into sign posts is not good.

However, tipping and poor balance aside, I will take this good mood and all its energy and tippiness over sadness and lethargy any day. With the Joy comes an intense return of my love for music, movies, ideas and the company of others. I will enjoy this feeling now, and remember it if my mood sinks. I know now joy and happiness are within me. It is possible for me to feel happy again.

Soaring

I am really "over the top". I can see I'm going to fast, but I cannot slow down. It is strange, but in many ways I feel like myself again. I am ebullient, chatty, charismatic, and "on". I have tons of energy and feel really good. However, I can see I might be a little annoying too.

I am catching myself talking to loud, too fast, over speaking people, talkling on and on to people I don't even know (people on the ferry, at the store, etc.) ,interrupting, and too enthusiastic (yes, that is possible). I can see I need to back off a bit, but I try and then I do it again. I both hate and love this side of me...the bursting with stories is good, until I find myself dominating the conversation. My energetic self is good, until I find that energy turning into anxiety, irritability, or worse yet, agitation. My effervescent self is good until I overwhelm people with my thoughts and ideas. My energy to do things is good, until I plan a trillion things and manage to do none.

All in all, while I wish I were a bit calmer and quieter, but I certainly would rather be this way than my depressed self. Right now I want to LIVE. It has been a long time since I have felt up for more than a few days here and there.

I slept last night...I think because I took 1000mgs Tegretol and 100 mgs Trazadone, but now...at 12:14am I am wide awake and can't get to sleep. I have to get up early tomorrow too. Yikes. Here's hoping my energy will subside ASAP (for the night) and will return with the sunshine. (Well the fog actually...it is thick and solid right now...scary to drive in)

Rethinking Wednesday's Session

I am not sure what was up with me Wednesday. I entered my session feeling despondent and down about not being able to hang onto the feelings I had a few days prior about being ABLE to change my life, being EXHORTED by my dream to change my life, feeling SURE the switch had finally flipped and I was magically better.

I recognize today, there is no "switch"...it is more like a light dimmer that I need to turn up very slowly to bring more light into my life. The switch is what I don't want or need. It represents the endless cycling mood states I need to get out of.

I was rereading some of my posts, and I recognize that I do have a lot of cycling to my moods. I also understand what Dr. X. meant on Wednesday when he said he worries my higher moods, in conjunction with less sleep, might be unsustainable. I see it, but I wish they were sustainable. Problem is the higher I go, the more likely I am to crash afterwards.

I also see that when my mood is high, it is generally not a bad thing...I don't go off and buy houses, or gamble my life savings away, or cheat on my husband, or do anything that is potentially harmful to me or anyone else.

In fact, that state is a state of freedom for me; freedom from social anxiety, depression, anger, freedom from all the symptoms that haunt me when I am depressed. I also do not lose my insight into my mood state. I can tell when my mood is high. My high mood is really high, but not pathological in any way.

I don't know what it is, but I am often afraid people are lying to me, or hiding things from, or keeping things from me, or spying on me, or have some secret agenda that they don't want me to know about. I think my concerns about my "real" diagnosis being withheld from me fall into that category.

Dr. X. has told me there is a "bipolarity" to my depression. We have also talked about the tendencies in my family, especially on my paternal side, towards hyperthymic temperaments; how my well might be higher than many people's well. It really does describe me perfectly.

I think I was being weird when I got all concerned about having bipolar disorder and not being told about it. Part of my worry stems from the fact that my cousin has Bipolar Disorder, and though undiagnosed, my Uncle had all the symptoms of it as well.

So I worry I am headed that way. The only way I can see it sometimes becomes a problem is for others in my way when I am really hyper. I know I sometimes overwhelm others. Also, I do worry that my high mood will become so high I won't be able to control myself. I think that worry stems from some of the wild, and stupid things I did when I was younger when I was high.

When high I absolutely could not say no to anything...which frightens me now. What if I go high and cheat on my husband, or cannot control my sexuality, or take off with some stranger. I did do those things when high before. I worry I am capable of that again.

Why does it really matter to me one way or the other. If my treatments are helping me, if the mood stabilizers have slowed the cycling (or at least made it less drastic), if I have a really great therapeutic alliance with Dr. X. who really cares what my diagnosis is. Plus, why would Dr. X. not tell me the truth? In my experience he has always been forthright, open and honest about everything during my treatment.

I think part of the difficulty is that I see things in black and white. Grey areas are difficult for me to understand, to conceptualize. I am the product of a very black and white upbringing. My home was very top down authoritarian. My Dad being a policemen lived by very strict rules/laws. I like to think I am open minded and able to understand life is not so simplistic, but some of my belief systems are so hard wired in me it is difficult to change, grow, and understand concepts that sit outside of strictly laid out guidelines and rules.

It is really funny though:

...what I love most about my therapy with Dr. X, and Dr. X. himself, is his refusal to see things from a dogmatic perspective. I love that he challenges the status quo. He feels like the perfect role model for me; the person who is best able to challenge my strict adherence to rules, the person most capable of helping me learn to both see, and accept that life, like a beautiful drawing, is full of many, many shades of grey.

Getting Rid of Those Labels

Over at the Shrink Rap Blog Dinah has written a very interesting post called "True Emotions".In the post she describes a patient:

"...the patient was floridly manic. I don't remember the details, what I do remember was that she was running on empty, high as a kite, going 99 revolutions per minute, you name the cliche. There was a reason why she was on an inpatient unit and not being seen by an out patient doc. She wasn't getting better and, as is often the case with people suffering from mania, she had no insight that she was ill, she was feeling good-- really good-- and oh so energetic, and even louder than that, and so what's the problem here?

...I'm trying to reason with her, and finally, she screams at me in a way that stays clear long after her name and the details of her life have oozed from my memory, "You're problem is you're not Italian! You don't understand TRUE EMOTION!!" She had a point."

The post is really important for me and probably for other people who are receiving psychiatric treatment. When I read Dinah's post I felt so understood, like I do with my pdoc, but not like I do around other health professionals, or my family, especially my husband. I do it myself too: Dissect every tiny mood change like I'm going to go crazy either too high, or too low. It's hard to get better when I'm constantly worried about "how I AM".

When I read Dinah's post it reminded me of a situation I was part of a number of years ago. I commented the following below Dinah's blog, and I should remember this anytime I worry I might become manic...

" What a great post. Two other pdocs have given me the label "bipolar", but the one I see every week says I have MDD and a hyperthymic temperament. This I believe, but I can't help but worry every time my mood skyrockets. I am so scared I am going to go manic.

Even before someone tried to label me my friends would make fun of the hyper energy I have when I am well; my million ideas, my rapid speech, how loud I get (very loud...because I get so excited with all the ideas), how excited I get, how wild I get.

I almost bought into the labels until I went to my Great Uncle's funeral and met my Grandma's side of the family...every single one of them was like that...So "On" it was absolutely amazing. It was like being in a room with twenty people just like the well me.

We weren't Italian, and certainly, statistically, we cannot all have been manic at the same time: we just are a family of people whose personalities are exuberant, jovial, high, full of ideas, like to do a million projects at once, can fly from one idea to another and understand the connections between all these ideas with ease. Maybe everyone else was just "slow?"

The experience of being surrounded by so many people just like me was breathtaking and eye opening. I recently had the pleasure of meeting three more members from that side of the family; people I had never met before.

At a family wedding this little old lady came up to me and said, you must be "B's" daughter. I just had to meet you (she's talking really loud, and is exuberant, and excited, and very, very talkative). We have to stick together us "Family name".

No one is like us, listen to the din, the room, listen to how loud everyone is, they are excited and energized. We've always been this way. You stay here I have to grab "M" and "R" They are going to fall over when they meet you. They are just like us...and with that this 85-90 year old lady ran off to look for my new found relatives.

They all showed up, along with my uncle, my cousin, and my second cousin. The din was unimaginable. Everyone talking really loud, everyone butting into everyone else's conversations. Ideas flowing like rain pours in a monsoon, and all of us are keeping up with all the conversations. Never a pause to catch our thoughts or to let someone else speak.

Then suddenly we all went silent, looked at each other and burst out laughing. We are all just like Grandma was...it is too bizarre: Loud talkers, so excited about the world and all the things in it, a bit pushy, speaking a mile a minute, and no patience for people on the outside who don't get what is going on.

Almost the entire side of my paternal Grandma's clan have hyperthymic temperaments. When "on" we are more than on, when happy, we are beyond happy. I think that is why I have such a hard time with my depression...because when I am well I feel like I am completely in control of my life, I absolutely love being alive and I think this world is the most amazing place in which to exist. To lose that to depression is beyond devastating.

Ascension

My second painting: "Ascension"

I am so creative right now it feels like the old me has come back. I feel like myself for the first time in 6.5 hellish years. I have a hyperthymic temperment and when well I can do a million things at once, but remain extremely focused on each task. That is how I have felt for 4 glorious days.

In those days I have completed 2 paintings (One yesterday and one the day before), and I have began two others. It is remarkable. I sat down to paint yesterday at 10:30 am and finished at 7:30 p.m. I was so engrossed in what I was doing.

This painting is titled "Ascension". Fitting that I painted it on Easter Sunday. I was thinking of lots of things as I painted it. it is a mixed reference to my increase in mood. The obvious portrayal is a cross, yet the Christ figure is a female. She is descending into the ocean (This is the way I would like to commit suicide).

I called it "Ascension" because of the belief that Christ had to die, before he ascended. (The woman is drowning). Sort of a metaphorical description of how I often see my only hope in suicide. I feel in suicide I will at the very least end my suffering, which is better than life when I suffer. Not that I see myself as a Christ figure. According to the bible his death ended others suffering. Suicide would end only my suffering, not others;>)

While I am not really religious I am very interested in religion and probably obsess over it.

I like the idea of the unknown woman under the shroud, chained and bound by something outside herself. Maybe also a reference to how I find it difficult to know who I am. If you look closely the chains around her neck are clasped with a padlock that repeats the cross in the place where the lock would be.

I know there are errors of perception in the painting, and the colours in the picture do not do it justice. The original has more yellow and blue in it. Despite seeing things I need to change in the painting I love what I did here though. It is approximately12 inches my 36 inches.

High and Full of Creativity

This is only the second painting that I have ever completed. I'm just learning to paint, but I think it turned out pretty well and I feel good about my attempt. For me to even say that I must be feeling better.

Dr. X adjusted my medication yesterday and today I have been feeling so incredible. He increased my Dexedrine to 10mg spansules (time release capsules) twice a day, once at 8am and once at noon. It did wonders for me today.

Before I was taking a 10mg Dexedrine spansule in a.m. and then a 5mg regular release Dexedrine at noon. I was crashing big time at 3pm. I had to sleep for 2-3 hours and had no energy or motivation to make dinner, eat dinner, clean-up. It was awful.

Today I didn't crash like I have been doing. In fact, I painted all day and only noticed it was 7:30pm when I was finished my painting. I even forgot to eat. That is a sure sign I feel better. Whenever my mood goes up I get creative and I stop eating.

This painting is a rendition of a picture I found months ago in the newspaper when the Myanmar riots were going on. I changed the original picture, but used its idea as a reference. I loved the idea of the peaceful resistance vs. the armed guards, the dark vs. the light, the good vs. the evil (and/or the difficulties in deciding what is right/wrong). I am sure the soldiers believe what they are doing is right, as do the Buddhists.

I also thought the picture reminded me of the yin and yang of life. I was also struck by the dichotomous nature of the physical government authorities and authorities of the soul being combined in one picture.

Surging Creativity

Over the past week I have felt my mood and energy lift immensely. This feeling has produced and overwhelmingly intense surge of creative energy. I say overwhelming because the ideas are coming faster than I can even begin the paintings.

I took a class the other day where I learned how to stretch my own canvases for painting. Yesterday I went out and spent a small fortune on the tools, canvas, stretcher bars a staple gun, a few ready made canvases, more paint (even though I have lots of paint) and anything else at the store I decided I "needed".

I have so many great ideas for paintings, today, before I start a new one, I am going to actually try to finish the one I'm in the middle of (and have been for the last 2 months). I love this feeling. It feels like I am back. The real me is creative and energetic, and passionate and excited about everything around me.

The real me sees intense beauty in all the little things that surround me, the puddle of water being used as a birdbath by a robin returning for spring, the willow tree buds popping up each day turning weeping branches of the tree a beautiful shade of light yellow/green, the crocuses popping through the lawns, the mountain's winter water runoff racing down the river searching for the sea, the bald eagle soaring above the farm, climbing to heights that seem impossible and coming together to mate mid air, falling to the ground faster than Icarus fell as his wings melted in the sun. The eagles manage to part ways before hitting the ground and then soar higher and higher and begin their dance again. It is beautiful.

Despite this beauty, and despite my lift in mood I am thinking a lot about suicide, maybe a better description is having suicidal imagery stuck in my head. These ideas are fixing themselves into my artwork. I do not understand why, when I feel so much better.

Whisperings about the Word that Cannot be Spoken

On Thursday Dr. X. and I decided to add a stimulant to my medication regime and continue of with my lowered dose (600mgs) of Tegretol, 30mgs Prozac and 10-20mgs/day Valium. We added 10-20mgs Dexedrine. He left it up to me to decide how much was helpful. I started at 10mgs and by the next day I felt a lift in mood and I felt much less tired and fatigued.

I actually feel like doing things again. This is a huge change. The 10mgs right now seems like enough, because even at that small amount I am having difficulty sleeping. I feel a bit wired, but last night I slept a bit better, so maybe it was both a withdrawal effect from the Clonidine I have recently stopped and my mind learning to accept a bit more stimulation.

Could this be the magic potion that helps me? I am afraid to even think that thought, let alone write it lest the query magically destroys the effects of the medications; just like when I was a kid and writing the name of the boy I loved, immediately destined the relationship to fail.

You will not hear me whisper those words again. It has been 4 days of feeling pretty good I am going to try to accept each good day as a blessing and try to forget that these days always seem like transitory moments for me.

I am Flying High

I went to see my pdoc this a.m. and this is how I described myself: "I feel like I am vibrating". "You ARE vibrating" is Dr. X's response. It's true. I "danced" in my car the whole 45 minute drive to my appointment. Red Hot Chili Peppers, "Stadium Arcadium" cranked as loud as my stereo can manage, tapping my fingers, bopping my head, rocking to the music.

A symptom of feeling better: I want to dance. I am singing all the time. I LOVE loud music. I love people. People LOVE me. There was a girl at the gas station yesterday. I could tell she was hitting on me. She couldn't stop talking to me. Even though I had no intention of following through I led her on because she was captivating and I loved the attention. The pharmascist was the same today. Usually he says a salutary, "Hello". Today he spoke with me about my pdoc, about the drive out to the University, about other Dr's and their handwriting. He joked with me the whole time like he was my friend. I liked him.

This is not me when I am depressed. When I am depressed I shrink. I hide. I pretend no one sees me. No one likes me. When happy I am BIG: big voice, big smile, take big risks, big wide open arms to everyone.

In my appointment I had some concerns that I might be switching into mania. This "vibrating" for instance. I am literally wired for sound. I have constant snippets of piano music (Schumann in particular) running through my head. Imagine them in real time...mine are racing through my head at mach speed. I tried to hum it to my sister the other day and she said it was incomprehensibly fast. The music will not stop. It is going on even when I am talking to others, when I am sleeping it wakes me up. It's been like this for almost 2 weeks now.

Which brings me to another worry about getting manic. I am not sleeping. I sleep for 2-3 hours and then at 2-2:30 I wake up and am awake until 5-5:30, then fall asleep for 1 or 2 hours if I'm lucky. I don't miss the sleep at all. I have tons of energy.

I asked Dr. X. if I should be concerned and he pointed to the fact that I have never been manic. (Although he has told me there is a bipolarity in my mood disorder and that my highs look very much like hypomania). I asked him if I would have insight that I was manic if I was. He said that's the problem with mania. People do not have insight. I am going to trust him that this is just a high mood. I am sure he will let me know if I am too high.

I thought about it in my appointment today and I thought maybe this mood is just so foreign to me that it seems too high. Maybe it is really just a good mood and I'm not used to that. I've been so depressed for so long that I forgot what good feels like.

I do remember that my good mood always seemed to display itself more intensely than other people's good mood. I was always the one who couldn't stop dancing, singing, swearing (blush!), talking loud, getting excited and excitable. Even as an adult I was like a delighted and ebullient child when happy. Right now I am thrilled to be alive, I see my potential, and I feel so happy, even with the annoying music in my head.

Is it me? You know that hypomanic charisma...

I'm not sure what's happening, but today two separate men at the studio where I volunteer and do my art at started talking to me about how I "have a sexy figure", how "hot" I looked in the clothes I was wearing....jeans and a t-shirt...go figure.

While it is nice to be noticed, I feel really uncomfortable with their comments. The Studio I go to is a place for people with mental illnesses to go and do their art in a safe and comfortable place. It is bringing up issues I have had previously. Issues that almost cost me my marriage.

A few years ago I was in group therapy and one of the men was coming on to me in a big way. I guess because I was having marriage troubles, and because I hadn't had that kind of attention in a long time, I played along with the flirting. I thought it was harmless and had no intention of acting on the flirting. Then it got totally out of hand and the person threatened to commit suicide if I didn't see them. My pdoc recommended I completely cut contact with the person for my own safety and well-being. I did, but not before my husband caught wind of what was going on and went ballistic.

Now I try to be more clear about my intentions and boundaries, but one of the people today seems to want to push the subject. I have made it clear that I'm married. As well, I do not think I am acting flirty or anything to attract this kind of attention.

I don't want to make a big deal out of it. I just want them to stop saying those things to me because it makes me feel a bit scared of going to the studio and I don't want it to stop me from going.

I'm not sure how to deal with it because one of the people has confided in me that he says things sometimes, pushes the limits in a conversation and then feels intensely bad about it afterwards. I do not want to make him feel bad. I just want him to understand that I am not comfortable with the way he talks to me. What do I say?

If he says something again I was thinking maybe I could say, "because I am married, I feel uncomfortable with that kind of comment from another man"...but then I may hurt his feelings as he might feel like he has done a bad thing. I think if he says something again I will just jokingly say...hey, that kind of talk makes me uncomfortable...please stop it...or I'll have to beat you up...ha, ha!!"....or something "funny...so he gets the point, but saves face.

What is Happening to Me?

I don't understand what is happening to me right now. I haven't slept more than 2 hrs straight and and average of 3-5 hours total a night. I have more energy, but it is BAD energy. I am feeling so much anxiety that today I began panicking at the laundromat. I couldn't breathe and I began feeling like my body was swirling and I was going to faint and then I just felt dissociative...like I was outside myself, or covered in foam or something was between me and reality.

I went on a trip to a dude ranch/spa last week. I did lots of things that should have been relaxing and fun; horseback rides, hayrides, ATVing, massages, facials, body wraps, swimming...all things I would usually enjoy and find relaxing. I went with my sister and her kids who I always love to be with. This time it was different though. I did not feel anything good at all.

I could not feel any of the enjoyment...all I felt was intense anxiety and bad energy surging through me. I felt disconnected from every thing I did and everyone I did it with. I enjoyed nothing. I was so anxious the whole time I couldn't sleep. If I did manage to fall asleep it was for an hour here and there. I would wake up having anxiety attacks all through the night.

I can't take much more of this. I don't know what to do. I feel like I have tried every medication out there...like all has attempts to become well have failed and there is nothing that will help me. I feel helpless, hopeless and lost.

My husband is after me for not enjoying anything anymore. I tried to explain that is a symptom of my depression and anxiety...the joy disappears from life. He keeps talking to me like I'm choosing to be this way. Get a job and you will feel better, he says. He just doesn't get that I am ill and if I felt like I could manage a job, I would be the first one to go get one, but I can barely manage to get out f bed, or do the dishes, or the housework. How can I get a job when all I want is to die?

I am trapped. All I want is to die, but I cannot hurt my sisters by allowing myself to die, so I stay for them. I am trapped in this hell forever. God I hate this existence...please just let me die.

Hypomania? Benzodiazepine Withdrawal? or Just a Messed Up Personality?

I did not sleep again last night. I went to bed at 10:00pm and tried . At 11:30 I was still wide awake, tons of energy buzzing through me. Then the rest of the night I would fall asleep for 1/2 hr to 1.5 hrs and each awakening couldn't get back to sleep for 1 hr or more.

By 5:30am I was freaking out about not sleeping, but fell asleep for 45 mins sometime after 7am and then was wide awake and, once again, full of energy, albeit extremely anxious energy.

I feel this drill seargent inside me....go, go, go!!! I am flitting from task to task, rushing, pushing myself to go faster. I walk the dog, try to read the paper to relax, can't focus on any one story so I skim and get no relaxation and no information, check my e-mail, write a this quick, but very long (is "pressure to speak" through writing viewed as pressure of speech???), blog and get out and garden. I am high, irritable, anxious and untrusting all at the same time

As I was walking the dog I started to think of my last therapy session. Thinking of how Dr. X., asked me if I thought I was hypomanic, but he didn't allow the energy I have right now to be seen as something negative. "Use this energy to push ahead", he said. I like that he does not pathologize everything.

I have mixed feelings about one thing though. When I gave up my hoarded meds it was with the belief that he would help me if I had trouble sleeping or with anxiety. I feel a bit annoyed that I trusted him enough to give those meds.

He knew I had no sedatives at home. He knew that I had , over the previous week, stopped taking all of the 15-20mg Valium I had been taking. I'm sure he knew I was going to be anxious and have trouble sleeping. The first week of no sleep I recognize I was probably having some withdrawal, but I wonder if that is still happening? Or am I hypomanic?

What I would have liked is for him to acknowledge I was having, or going to have withdrawal symptoms. I guess what I'm trying to express is I would have liked to know this is what would happen if I went off Valium too quickly. He did try to get me to go off it slowly, but I always fell back and ended up increasing, because I would get so stressed out and not sleep. I would have liked an open/honest discussion about my "addiction" to Valium.

I would have liked him to express what I suspect he was thinking...that now that he had all my hoarded meds, I had no sedatives to sneak into, to "self-medicate" with, and now was an opportunity to get me off Valium for good.

Which is what I want...even though I'm whining and freaking out about not having any...it really is what I want. I suspect wants me off the Valium too.

What's my point? I just want him to talk to me, about me, like I am a colleague. I want to know exactly how he sees me, exactly what he thinks my diagnosis is, exactly what he would tell another health care worker about what is stopping me from getting well.

Why he is letting me go through all this mixed high, both intensely powerful and horrible at the same time. Powerful, because finally, I have leaped out of my cocoon like bed and started doing tons; horrible because of my mounting anxiety/irritability and no sleep.

I am glad he stood his ground and did not give me sedatives, but at the same time I feel like I really need to sleep. Is he doing it to see if I do have bipolar? Maybe before I was always sedating my hypomania, so I never went up and stayed up for an extended time? I just want to know what he is thinking when he makes these decisions...but I feel it is not my place to ask, or I feel like he is not telling me the whole truth.

Next day...
I'm scared too because I'm going away with my sister and her kids next week and I can't be totally psycho around them. Plus I want an enjoyable holiday, not one filled with the agitation I was feeling all day today. I just lost it today. I feel explosive inside...so anxious I feel like I'm being suffocated by someone squeezing my chest shut.

I am so irate I am mumbling and talking to myself in angry tones (even in public!!)...how embarassing. My mind is on high speed, I can't concentrate. I kept messing up at my volunteer job last night...dropping thing, distracted, miscalculating things, missing what people were asking for, just not getting it at all. All day I have been ready to blow up at everyone around me.

We have a house guest right now and this a.m. I went from excited and energetic (but really anxious), to severely anxiousand agitated in the same hour. Within the next hour I became so agitated I could not sit still. He started noticing my behaviour was getting bizarre and he came up to me to try to calm me down and help me relax with some type of yoga relaxation technique...as I was doing the exercise I just broke down crying and having the worst anxiety attack. I have way to much raging, racing energy inside me for how little sleep I have had. I'm scaring myself.

I won't last like this for 2 more weeks. I can feel that any "elation", caused by finally having some energy over the past week or so, is quickly disintigrating and becoming an anxious and agitated depression.

I don't want to ask for sedatives. I don't want to start or ever take any benzodiazepines again. I don't want to lose my energy. I just want the energy, without all the bad feelings. I want to enjoy my time with my sister and neices next week when we go horseback riding. Is that too much to ask? And what do I ask for? A new brain?

You Won't Die From Not Sleeping!

My pdoc said this to me, jokingly, this morning. I am WIRED for sound right now. I cannot sleep. Last night I went to bed at 9:30, because I had a busy day ahead of me today. So much for "sleep management" at 11:30 I was still awake, 12:00, still awake, somewhere around 12:30 drifting of and then 2:30-ish WIDE awake and could not, no matter how hard I tried, get back to sleep.

It has been awful...all week I finally fall asleep only to wake 2,3 or 4 hours later (one day 5 hours...WOOHOO!!) I maybe drift off for a few minutes here and there, and although I don't seem to be sleeping, a couple times I dreamt, so I must have been....but I look at the clock...and barely any time has gone by. By the third night of not sleeping I took some muscle relaxants to try to help me (thus the 5 hrs sleep)...but tried again the next night, and then again last night, and nothing.

On top of it I have so much more energy, but it is just racing through me. I don't feel like I am appearing/acting that odd, or that my actions are expressing the amount of energy I feel inside. I'm still having motivation problems....but inside I am explosive, heart racing, anxiety ridden, irritable to raging angry and then depressed, but the depression is not laying on me like a fog, it's coming at me like a raging river, pouring out of me at inopportune times. In between I feel elated, excited, energized...even with no sleep. I don't know what's going on?

Withdrawal from Valium might explain some of the symptoms...like maybe I am having rebound sleeplessness, irritability and anxiety. I was taking 10 mg for almost 10mos and then about 1-2 mos ago I increased it to 15 and then sometimes 20mg. I started taking more because I just couldn't face how I was feeling.

I did come off 15-20 mg rather quickly (over a week period), but I knew, psychologically I could not go off slowly...I have tried and always fail. I believe I have had excessively happy hypomanias years ago...where I did not sleep and did some bizarre things that I cannot imagine myself doing now. This is different though.

I am really wondering if this might be my first "true" hypomanic state, since I started to see a psychiatrist. Usually, when my mood has gone up, it only lasts 1-2 days and most of my other symptoms just disappear...no anxiety, no irritability...still no sleep, but basically the depression disappears and I am replaced with a joyous counterpart who exudes strength and charisma.

This time I am all over the map, and it is not making sense to me that I have this much wild energy racing through me, but still feel so many bad feelings...(depression, guilt, sadness, anger, anxiety). All I want is to sleep, but I asked my pdoc what to do and he said he did not want to take all this energy away from me. I was hoping he would give me something to help me sleep...Why can't I ask more directly?

He said he did not want to sedate me when I finally was feeling more energetic. He wants me to look at it and use it in a positive way, because I have been so depressed for such a long time with no break in my mood.

He said, he doesn't want me to feel like he is not supporting me, or dismissing how difficult not sleeping is, by saying that, but he wants me to really try to use this time to push forward.

I understand what he's saying, but I feel like I'm losing my mind. I don't really have a choice though, unless I go get some OTC sleep aid.

It just so happens I "gave up" my hoarded old meds to him last week...trusting I would get medication if I felt I needed it. If I had not given them to him I could be sleeping right now as I had some trazadone. I do recognize that OTC's and/or "self medicating" with old meds would be counter-productive to what my pdoc is saying...I just don't know if I can keep up this racing pace, with no sleep, for another week. Argh...God, please...let me be normal again!!!