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Re: Not finished yet... » Dinah

Posted by SLS on July 17, 2004, at 13:18:11

In reply to Re: Not finished yet... » SLS, posted by Dinah on July 17, 2004, at 10:44:43

Hi Dinah.

Well, you certainly have a lot of stuff going on. No wonder your doctors are fighting! I'm afraid sleep disorders and dissociative disorders are outside my realm.

> > What are your residual symptoms? What are you experiencing right now that still needs to be treated?

> Hmmm.... My mood cycles are still a problem.

What is the periodicity of your cycles? How frequent are they? Is there a pattern? Do they occur spontaneously, or are there always triggers.

> I like the good hypomanias.

I thought the hypomanias were associated only with changes in medication or sleep deprivation. There would be no stress triggers here, right? I think there might be a problem. Which comes first, the sleep disturbance or the beginnings of hypomania? Have you ever kept a mood chart including hours of sleep?

Here's one you can use. It might be of some help to see what's going on.

http://www.psychiatry24x7.com/bgdisplay.jhtml?itemname=mooddiary

or

http://sl.schofield3.home.att.net/medicine/mood_chart_beam.pdf

It's in PDF format, so you'll need the Adobe Acrobat Reader.

http://www.adobe.com/products/acrobat/readstep2.html

> But the meltdowns (sometimes, but not always, accompanied by bad hypomania) are probably my main problem. I get totally hysterical, unreasonable, nonfunctional, shaking crying etc. over some stressor that ordinarily wouldn't bother me. I'm not sure how much that's physical and how much it's a child's temper tantrum when I've had too many stressors. I handle the stressors ok, but then melt down? Or it's physical and related to the mood cycles. I'm not sure which. But it can last a week, or even longer, sometimes shorter - only a few days.

I think charting your mood will help you to see what's what. Also write down daily events as notes along with your mood ratings to get an idea if the stress triggers the episodes or the episodes determine the stress.

> The lesser, but still important, remaining problem is my periods of low productivity. It's hard to stay awake. I'm apathetic. It's extremely difficult to motivate myself to do anything. My brain feels sluggish and stupid (and I *hate* feeling stupid). My family, neighbors, and bosses get angry because everything gets behind. It's not the crisis sort of thing that the meltdowns are, so I might not give this symptom as much weight. But if I lose my job and find it difficult to find another, I expect it'll move up the scale. Moodwise, I don't find it accompanied by any negative thoughts or negative feelings or distress.

Depression has many faces. It presents differently in different people. It is not necessary for there to be present depressed mood, sadness, or negative thoughts. Apathy and loss of interest or pleasure also qualify.

http://www.mentalhealth.com/dis1/p21-md03.html

> If I somehow managed not to answer any question, please let me know. And if you have any ideas I'd be happy to hear them. As I said, I have immense respect for your judgement.

Man, I managed to fool yet another. It's amazing how far a few fancy words will go. :-)

As a layman, I would say first off that you need to be on a real dose of a mood stabilizer. Depakote 125mg just won't cut it. Have you tried Lamictal?

> I'm going to try the Provigil today so that if it has a negative effect, it won't mess up work too much. Thanks for the good luck wishes.

Go for it!


- Scott

 

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