Need opinions...psychotic features?

So I posted recently about a manic episode or hypomanic, and my pdoc increased my lamictal. Well thurs-sat I was manic again. Then today....was.... HORRIBLE. I have never gone through these symptoms before.
It all started when I got up early and noticed the tree branches outside and thought about swinging in them! Got really happy but later realized i was having aggressive tendencies and was throwing things. Half hour later, Began laughing crazily and sobbing at the same time. Pacing around rooms wanting to do outrageous things. My husband stayed right with me. Attempted to climb the bathtub so I could somehow fly like a bird out the window, get in the shower with clothes on, climb the cat tree, open the window to sit on the roof, did elliptical with my hands, and within everything my husband was there to protect me thankfully.
I felt compelled to dive into our towel hamper bc it seemed like a pool to dive in. Ripped things off walls.. hit, kicked, screamed. Yelled for my husband to help me intermittently bc of intrusive thoughts I was having of breaking glass, bleeding arms, burning our house down. Once he had me in a safe grip he grabbed the phone and got a hold of an on call pdoc. She directed to not take lamictal today, stay indoors with monitoring, and call my usual pdoc tomorrow. Now I am facing the aftermath, which is a horrendous headache from crying, sore throat from screaming, consoling worried family members.

Well if anything, maybe this post will help someone else feel less alone if they are going thru something similar. But I was wondering if these symptoms are related to mania, mixed, psychosis, etc?

Hi Cat,

Gee, sounds like mania, but your pdoc will know. Curious about the Lamictal. It is a mood stabilizer typically used for depression. Not that effective for mania. How much do you take? What else do you take besides Lamictal?

Artista,
I was taking 100 mg lamictal since last june, then increased to 150 about 2 weeks ago. It is my only med right now. I used to be on abilify and wellbutrin, but they stopped working over a few years. Tried latuda last april and it was hell. Became super depressed and suicidal. Switched to lamictal and everything was almost perfect, until the second week of january.

catlover0929, I would your pdoc immediately and let him/her know what you experienced!! Don't hesitate, don't think about it. That's feedback that is needed for your care.

Hey Cat--yes I agree with Blukitty. By the way, if Abilify worked in the past, it might do so again. Good luck!! Let us know your progress.

Thank you both. I called and they are keeping me on the lamictal 100 until I see her on Thursday. I don't know what is going on, but after all that happened, I plateaued a bit mood wise (probably because my body was so depleted). Then Sunday night dipped into a horrific depression. Yesterday I felt like someone had died. I cried sporadically throughout the day, sometimes sobbing uncontrollably, with no trigger. I sat in my online class and the professor just sounded like mumbled mush. The walls in my room looked like gray lines from tv static. I went and laid underneath a corner desk in the floor because I wanted to feel sheltered. I cried inconsolably for a half hour. The whole time the tears kept coming, I remember thinking "what's wrong with me? I don't even feel sad. I don't have anything to be sad about. ISIS is chopping people's heads off, and I'm sitting here crying in my comfortable home in a free country! What the crap? I have no reason." and then about a half hour later I was mentally preparing my funeral. Not suicidal, but believed I was dying. Literally. After lots of prayers and care from my husband, I fell into a peaceful sleep, miraculously. First time I've had sleep that was actually peaceful in some time. Then I woke up with tons of ideas. Now i have lots of exciting goals and plans. Which feels normal but I am skeptical about all this because what if I am gradually going up to hypomania again and then this all happens as a repeat? Arrrggghhh
In the past, I have always experienced longer seasons of moods. This is the fastest and most uncomfortable mood shift week I have had. Ever. My brain feels like it can't handle much more. I honestly feel electrical impulses just like little lightning bolts intermittently in my head. Or maybe that is all my imagination.
*deep breaths* I have made it through this stuff before. I will make it through again.

CatLover,

It seems to me your prescribed medicine is not having the effect intended and needs to be changed or added to.

My older brother had Bipilar I, which is what you are describing. Those strange new perceptions or beliefs about how the physical world works that entice you to do things that are dangerous to you and others are psychotic hallucinations.

It's potentially very dangerous because neither you nor others know what you might do when under the influence of these hallucinations. Bbehavior won't be bound by normal beliefs about right and wrong, good and bad, possible and imposimpos. So, for example, my older bother stole a car and then drove up do a policeman and told him that he was driving a stolen car.

There is no rhyme or reason, although DURING the psychotic break it all seems to make perfect albeit novel sense. The manic person IS aware that his/her perceptions are novel, stunning, surprising, but often delightful to him/her because they are a relief from the normal rules of physics and reality that are so boring and limiting.

The hallucinagenic state is like a drug induced high. Manic person can want to live in this high, and so they may refuse to take any medication to make the high go away. This makes the illness untreatable, until the person is willing to take medication as prescribed.

CatLover,

I see your episode not as hypomanic but as full-on manic, overflowing into psychosis, based on the novel observations and and surprising (even to you) beliefs about physics and the interrelations of the world's contents ("I can fly, etc.).

The blood you shed and the destroyed house are evidence that it's not safe to act on the novel perceptions and beliefs about physics and other realities, so medicine is needed to keep the psychosis from returning.

CatLover:

I have had phases like that before. I also have paranoid schizophrenia- one time I was manic, saw and felt giant bugs crawling all over me, and my hubby had to hold me down so I wouldn't scratch my skin off. Lamictal made my hallucinations worse. My current meds are below.. I know Latuda doesn't work for you. Every person has their own combo of meds that helps them. I hope you find relief and post here so we know you are okay. *hugs*

CatLover,

Even my psychistrist was befuddled when I committed myself to a mental hospital, walked around the waiting room naked and then destroyed an isolation room with a steel bar I found under a bed.

That earned me commitment to a maximum security locked ward with no visits, for six weeks. What I learned from that is to not get so out-of-control that I needed a hospital and, in any case, not commit myself to a hospital, where a day of bad behavior can lead to six weeks of "jail".

That means that I have to be proactive in getting all the different kinds of help that keep me more balanced than I was, before I get worse.

Nobody knows what caused me to behave as I did, what it should have been diagnosed as, or what was needed to treat it. I think maybe I was deeply frustrated with the course of my life and thought acting out would help me. I thought a hospital was the place for someone who feltban irresistible desire to act out. Boy, was I wrong!

Afterward, I changed continents, languages, friends, beaches, food and hemispheres and then eventually life got much better, and has never gotten so bad again as it was in that maximum security lock-up hospital.

So, if your doctor doesn't know what medicine you need, you might get a second opinion about the meds or change doctors if you can.

Doctors, like meds, can "peter out". I was under the care of two different collaborating psychistrists when I was working on my professional degree. I needed all that help.

Thank you all for your responses and insight. As it turns out, you all were correct in your observations as I just got out of the hospital yesterday after a week long stay. :( But I am safe and all in one piece which is a huge blessing. I went manic worse than the previously described episode, and I did receive the BP 1 diagnosis. I will start another thread about my story shortly.....

I was worried about you so I am glad to hear you are feeling better. Sometimes we need a short visit to the hospital to sort things out. It's been a life saver for me definitely

Catlover,

Having a proper diagnosis of a serious illness at least means we can take the serious steps that others with the same illness take to do as well as possible. Plenty of people in this forum, including I, have gone through much, if not all of what you have recently experienced. Often, it's what causes us to finally get the right diagnosis and meds.

I've been hospitalized seven times in my life for as much as five weeks, but not at all in the last 14 years.

I well remember crying for hours unconsolably on the foor, as well as having sex with two women in one of my courses in the same week, and STILL thinking of ways to kill myself at every moment. None of my friends was surprised when I ended up hospitalized.

Hospitalization can give a person a much-needed break and a rest from the compulsive behaviors and struggles that are so common among untreated or insufficiently treated bipolars. I needed five weeks away from dating to have any chance of breaking the compulsion.

Because we don't always know if our copious new and wonderful ideas are symptoms of our illness, sometimes it's a good idea to simply do nothing (or nothing new) for a while. Sure, we have great ideas, sometimes grandiose ideas, but almost all of them can be put off fotwot least a month or two.

Certainly, trying to implement several great new ideas SIMULTANEOUSLY will increase our feelings of being out of control, ratchet up our stress and even precipitate the depression that comes with realizing we are overwhelmed and don't know what to do about it.

Better to try doing NOTHING but the essential for a while and then only slowly add activities slowly after reality checking them with several people we trust.

I don't try to implement any plans without first discussing them with trusted friends for a while. I'll sit with an idea for a month or a year, looking at it from various perspectives and studying my own motives before "pulling the trigger" and implementing an idea.

If you do nothing new for six months besides learn about and treat Bipolar I and develop support networks, that will be a great foundation for everything else you will do in life!

I would suggest that if you doubt your moods that you IMMEDIATELY tell your husband and/or a member of your support network, discuss the symptoms, reality check and make decisions together about what steps you need to take to have the support you need.

Be compassionate with yourself, bu without indulging the impulses you have rightfully come to distrust based on harsh experience.

As for medication, I found at the beginning that trazadone slowed down my thoughts and relieved my impulses to immediately do SOMETHING, ANYTHING! It might help you avoid those times when you want to do crazy shrit. Trazadone miraculously, MIRACULOUSLY enabled me to drive at the speed limit instead of driving 90 MPH in the breakdown lane to pass other drivers.

Trazadone also made me sleep peacefully a lot.

If you are like most bipolar 1 people on here, it will take a combination of medicines to prevent the mania, mood swings, sleeplessness, depression, odd impulses, suicidal ideation... For most Bipolar people, it takes a trial and experience-based combination of medicines to successfully quell so many symptoms.

If you can find a medicine that makes you sleep regularly as soon as you take it, (for me it's the combination of Xanax and Seroquel) and (e.g. alprazolam/Xanax, Seroquel/quetiapine, trazadone, or etc.), then just being able to sleep will probably make you feel dramatically better and will reduce the number of hours per day when you have to worry about anything at all.

Best wishes. Please keep sharing.

Oh! Read Kay Redfield Jamison's "An Unqiet Mind"! Best read ever about serious Bipolar I and healthy recovery.

https://www.amazon.com/Unquiet...

Persistence,

Thank you for your helpful insight. I love what you said about trying to do too many things/feeling out of control vs. just doing what is essential and taking care of ourselves by learning about the disorder. I am definitely making self-care and educating myself more about it a priority right now.

I will look into finding out more about the trazadone, because I definitely have had that impulsivity you discuss. Thankfully, the Latuda 80 mg is helping me be a bit more grounded, but man, the nausea! And the cost! Oh my...outrageous. The little coupon card is a joke too because my insurance still makes it to where it only discounts about 100 off the top instead of getting it for the $15 copay. Oh well...I guess we take what we can get haha!

I tried Seroquel but did not have a good experience. They went up to 200 mg in the hospital and I wokeup disoriented, wandering the halls, crying, teeth chattering, and confused. The nurses and security guards came to check on me and I threw my cup and my glasses at them and used unkind and shameful language to ask them why they gave me that terrible pill. I dropped to the floor crying and told them I was trying not to punch them and didn't understand my own momentary anger. Like I said, I was super confused. Thankfully, I never had to take seroquel again after the nurses wrote my pdoc about that incident. I know it does work for a lot of people though, and for that I'm glad! I do need to find something to help me STAY asleep.

I love the Kay Jamison recommendation, as I am actually reading Touched with Fire right now, and plan on going to An Unquiet Mind directly after. Good stuff! I also find that watching Silver Linings Playbook, Infinitely Polar Bear, and episodes of Homeland to be quite comforting as they all include characters depicting life with bipolar.
Of course, being on here and commenting/following everyone's posts is also very cathartic since I often feel alienated and misunderstood. It is sadly so hard to discuss these issues with people that don't experience symptoms on this level. Having a good pdoc, tdoc, and family/friend support system is huge for me, but I also need to talk to people who experience it firsthand.

I would your pdoc immediately and let him/her know what you experienced!! Don't hesitate, don't think about it. That's feedback that is needed for your care.
thanks.
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Catlover,

I'm glad you're feeling better, or at least you wre when you wrote the update above.

It can take a long time to find the medications that work for YOU, to control the symptoms, e.g.

Impulsiveness

Rapid thinking

Intrusive thoughts (that you know you don't want and have them anyway.

SLEEPLESSNESS

Trazadome REALLY helped me with compulsiveness and also made me sleep. I was surprised ALL compulsive people didn't take medicine for it when I found out how much medicine could reduce compulsiveness.

I need a combination of TWO medications to put me to sleep rapidly and then keep me asleep all night.

There are MANY different medications that are slightly different from each other but can have dramatically different results in the same person. You might have to try ALL of them to get the results you need, so you have to be immensely patient and accept that every medication is just a TRIAL, an EXPERIMENT on you until you find what really works.

To get through this, it may help to continually reassure yourself that there IS a cocktail of medications that will help you, but you have to be willing to try fifty or a hundred different combinations to find the one that works.

Each time you try something that DOESN'T work, you have more information, more experience and are getting closer to finding what DOES work.