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Bipolar 2 Disorder And Trt, 26 Years Old - Long History

Thanks in advance for any help....

I am 26 years old. For the past 7 years I have struggled with anxiety, depression, insomnia, irratibility, manicness, mood swings, inconsistency, etc. etc. etc. Life has been one hell of a roller coaster, but in this time I have managed to graduate college and an MBA, secure and maintain a well-paying and fulfilling business career and marry the love of my life (and hang on to her thus far).

I have seen 3 different family doctors, 2 different psychiatrists and 1 endocrinologist... I have been diagnosed with it all, and been prescribed just about every drug imaginable for these symptoms: Anxiety & depression: Effexor, Effexor XR, Cymbalta, Prozac, Zoloft, Lexapro. Sleep/Insomnia: Sonata, Ambien, Ambien CR, Lunesta, Restoril, Melatonin, Elavil, Seroquel, Provigil, Trezadone, Xanax. Bipolar 2: Lamictal. Low Testosterone: Testim. None of these drugs have solved my problems permanently - some have mitigated some symptoms in the short term.

My current diagnoses and treatments are: Bipolar 2 disorder, insomnia and low testosterone (tested at 104 ng/dl). I am currently taking the following medications: Lamictal 200mg once a day. Testim 5g (50mg testosterone) once a day (on this for 2 months now, testosterone levels at 380 ng/dl now). Xanax 2mg and Melatonin 9mg at night for sleep.

I am suffering. I am constantly in a daze. I rarely sleep more than four and a half hours a night. My mood is up and down in a moments' time. Anxiety is free floating and depression occurs at least once every day for an hour or so. I am quick to snap at my wife and our dogs. I have the shortest fuse. The smallest annoyances set me off. I can hardly focus on my work, but manage through it. I have little motivation to exercise (although few people do), but manage to do 3 days a week of cardio (45 minutes) and 5 days a week of weightlifting. Exercise helps significantly, but I don't have time for any more than I already do. Lately, all I have wanted to do is lie in bed and watch TV. I have lost a few close friends due to my lack of need for social interaction. I make poor and whimsical financial purchases because they feel good. My dreams at night are vivid, and I feel like they are creeping into my days now. I could go one, but I think I have made the point.

Recently I have had a few notably bizarre episodes: About 2 months ago I made a very poor attempt at suicide - I couldn't break the surface with the knife on my wrist (and didn't really want to do it anyways I think). I've had a number of overwhelming panic attacks recently where I become hot and tingly all over and feel an overwhelming sense of hopelessness. I have had several episodes where I have "blanked (not blacked) out", curled up into the fetal position, cried and basically become frozen for a period of fifteen minutes.

And lastly, yet most importantly - I feel that my marriage may be suffering. I am amazed that my wife can still tolerate me at this point. I don't treat her very well anymore. My sex drive is non-existant. I feel so guilty that she has to bare the brunt of these symptoms. I know she has to tip-toe around me and I hate it.

In summation: I am in a daze. Life feels fuzzy. My memory is poor. I can barely concentrate enough to write this. I want to be normal, but I am not quite sure what "normal" means anymore. I feel like I have been over-medicated, poorly diagnosed and victimized as a patient. I feel like I have reached my breaking point with the symptoms and issues discussed and the constant adjustment to new medications. I don't have the guts to commit suicide and know that I have a good life, despite my mental issues - so don't worry, I am not going to go that route. My wife and parents are amazingly supportive of me and want to help. But I just can't take it anymore. I'm fed up. There has to be a solution.

I appreciate those of you who have taken the time to read this rant, and any help or advice you might have to offer.

Thank you,

Andrew
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replied October 6th, 2007
Extremely eHealthy
Hi Andrew,

Thank you for sharing your story; it must be really difficult to live through this.

Can you describe your manic episodes and anxiety in more detail? I know I am a "nobody", but my first thoughts about your story were along the lines of "why is he diagnosed with BP 2 and not BP 1?"

Best wishes for you...
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replied October 6th, 2007
Birch wrote:
Hi Andrew,

Thank you for sharing your story; it must be really difficult to live through this.

Can you describe your manic episodes and anxiety in more detail? I know I am a "nobody", but my first thoughts about your story were along the lines of "why is he diagnosed with BP 2 and not BP 1?"

Best wishes for you...


Hi Birch,

I appreciate your reply! To answer your questions in as much detail as possible:

The manic episodes aren't too ridiculous. I get a real high out of shopping though (I sound like a woman, haha) - making purchases gives me a rush and sometime euphoric feeling. I haven't run up any debt, but I am very good at spending money unfortunately. I have purchased a lot of things that are completely unnecessary. I am sold VERY easily because I am easily convinced by sales pitches.

On some occassions, I will get very caught up in a work or overly excited about it. I experience a feeling of invincability and prowess that I really crave. I find that sometimes I can easily convince myself that I have done an amazing job on a piece of work when in actuality it's only been OK.

On to the anxiety... I am constantly in a state of worry. My wife is a dentist and I am a business consultant -- we earn a very good living, but I am always worried to death about money. I find myself constantly counting what's in my accounts, how much I've spent, what I earn, etc. Likewise, I can't stop thinking and obsessing about my health condition, from mental to physical. I am definitely a hypochondriac. I find it difficult to focus on things because I am constantly worrying about this. I am also constantly thinking about my wife and whether or not she is going to leave me (she assures me she is not).

During my vicious anxiety attacks I feel incredibly scared - of what, I don't know however. I just feel like the world is closing in on me, and life is too much to bear. I feel isolated, alone and frightened - like the world is too small. It's hard to describe in words, and not really tangible. Maybe a sense of hopelesness would be the right phrase.

I know I fit a lot of the BP2 or even BP1 profiles... But I am just not convinced that is my problem. Likewise, I just can't stand all the medications any more. They haven't solved these problems, and I don't feel like a REAL human being any more. I feel like I am floating around in the proverbial ether and not living my life properly, effectively or fully.

Does that make sense?

Thanks again!

-Andrew
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replied October 6th, 2007
Left a Few Things Out...
Hi Again,

I left out a few things that I think may be important as well (in no particular order)...

I am 6'0", 185 lbs, 10% bodyfat.

When I was 23, I used marijuana and cocaine 7 or 8 times each. None since.

I drink alcohol on average once a week - typically up to 4 drinks. It doesn't really make me feel good anymore, and I get hungover very easily.

I was only recently diagnosed BP2 -- before that it was always anxiety or depression.

I have also been diagnosed obsessive compulsive - which I failed to mention is also a significant "symptom" for me. I don't do rituals or anything like that, but everything must be in a straight line, no clutter, etc.

I eat a clean diet of about 2700 calories a day including lean proteins and whole grains, complex carbs, etc.

I am very doubtful that BP2 is the correct diagnosis for me.

That's all... Thanks again for your time and help

-Andrew
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replied December 7th, 2007
I Know How You Feel
I know this is a little bit of an old thread, but I had to reply. A lot of what you said sounds like me Andrew. My name is Mike by the way.

I'm about to turn 23, diagnosed with BP2, apnea, low testosterone, and a slew of other medical problems. But I'll focus on the part that I hope will help you.

I've never had a full manic episode. I sometimes become hypomanic, but mostly have mixed episodes. My insomnia has been getting worse and worse lately, but it appears not to be related to bipolar (professional opinion, not mine), probably my neurological problems interacting with my apnea. My last testosterone levels were 127, so they put me back on treatment for the first time in a year. I have some decent experience with all of this.

The portion of my cocktail you'll be interested in is:
Lamictal 200 mg qd
Symbyax 3-25mg qd
Provigil 400mg qd
Testim 5g (1% testosterone)

I've found recently that I feel better on the testosterone than without it. BP2 probably doesn't fit me too well either (I'm a psych major, diagnosed before I chose it), but I'm definitely bipolar. I've never been too severe, but every case is different. A sleep study might help if you've never had one. And as for the my main piece of information, the Symbyax has probably been the most helpful thing for me. It's a combination of olanzapine and fluxetine. It's what I've felt best on. I'm just on a lower dose because of how it affected my appetite.

I'm assuming you don't need to hear about how these drugs can affect everyone very differently. I'm just sharing my experience in hopes it gives you some ideas. I can't say "This is what you should do" because that would be irresponsible, and I'm not saying that. What I'm saying is, it may be hard, but you can find a good balance for everything. The problem is, a LOT of BP cases are hard to spot and it can be very vague and atypical. We'll never be guaranteed complete relief, but you can live a good life. Good luck.

-Mike
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