Quetiapine 300mg XL – 5 weeks today.

It’s so difficult to get up in the morning, almost impossible in fact. I don’t think ‘sleep paralysis’ is involved, just that I’m so woozy and sedated that I keep dozing off again. I’m setting the alarm clock for 10am but this is proving futile; 11 is the best I can hope for, it seems.

But today, I’m incredibly woozy. I discussed, often, with my therapist my delusion that nothing is real. Or rather, nothing is real outside myself and that I am probably in hospital, medicated or comatose after a traffic accident or some extreme psychological trauma. There are signs of this I recognise in whatever state of being I’m currently in.

The main one revolves around coincidences. I won’t go into this too much, but I have believed that things are unreal through a ‘logical’ progression of thoughts based around how frequent coincidences make themselves apparent. Frequent and commonplace to the extent that they cannot be appearing naturally. Externally, objectively.

I had a shock ten minutes ago when I realized that I might in fact, at this moment, be dreaming and not awake at all. When I have this delusion I can to some extent control it consciously; I can ‘predict’ or ‘make happen’ some things that happen or more usually words that are said.

So just now I had the idea that the random word butterfly would make itself apparent very shortly – either spoken on TV (there’s no-one here with me) or read online. The occurrence of this word would, I know, almost certainly prove that this current existence is not real but exists only in my own mind. I have had several instances of such [solipsistic?] states in the recent past.

So far, the word hasn’t been spoken, so I am a little more content that I am awake. A look at my Twitter feed had a name including the word butterfly, and while I’m prepared to put this down to coincidence, I’m not 100% certain this is the case.

This is my problem at the moment. I looked online for mentions of sleep/wakefulness blurring in bipolar II but there’s very little at all. It might be part of my dissociative disorder linked to, or existing independently of, my bipolar.

I do realize this piece of writing is muddled and possibly incoherent. I don’t want to ‘tidy it up’. I don’t think I’m hypomanic at the moment, or particularly low. I generally know when these moods are happening. What I don’t know however is when I am in a mixed state, cycling rapidly. That’s why it’s a dangerous mood for me. I worry this delusion is indicative of a current psychotic episode. Hopefully it will settle or run its (usually brief) course. I do feel so very out of sorts today.

An ideation

I am totally alone almost always, so when I’m suicidal there’s only me to stop me, or to force the hand of chance. Oh, the irony of it all.

“How can we know the dancer from the dance?” – W B Yeats

Quetiapine, end of first month.

End of first month, and I have mixed (sic) views. The past two weeks have been Quetiapine XR 300mg at bedtime. (Remember, it was 25mg+25mg+100mg for the first two weeks.)

Straight away, I felt less woozy by the afternoons – although dragging myself out of bed much before 11am has been quite an effort; and a mostly futile one at that. I’ve even taken the car out, one afternoon this past week. A shopping jaunt, much overdue.

I still marvel at the many comments online detailing how 25mg has knocked people out for 12+ hours and solved all their insomnia problems. How come 25 works for them but 300 doesn’t work for me?

The past few days I’ve noticed a difference again; the meds seem to be having less of a beneficial effect on my bipolar II symptoms, particularly anxiety and OCD. Strangely, I think the C part of the latter has been eased a little, whereas the O is as overwhelming as ever. Actually, a bit worse. Having bipolar is bad enough; add OCD into the mix and life can be pretty awful most of the time. Actually, always.

Yesterday I felt so anxious I thought sod it. Sod it, I’ll self-medicate again, and had a couple of small glasses of white wine. Well, it’s helped for decades, and although I’ve not touched a drop of alcohol for a month, I felt it was worth a try. After all, it doesn’t seem to be banned; just not recommended. What’s the worst that can happen? Well, falling asleep, it seems. And that would be a good thing, not bad.

As it was, I didn’t feel at all more sleepy and the wine did seem to ease my anxiety to some extent.

At my last psychiatrist appointment (when the Quetiapine dosage was doubled) she mentioned that when we next meet (at the end of the month) she’ll see if I can tolerate 600mg a day. That’s quite an advance from my initial 150mg isn’t it? I assume higher the dose, the more side effects.

I’ve done some walking, very little exercise bike work, watched what I’ve eaten, and have only put on 4-5lbs during these 4 weeks of meds. It seems I’ve got off very lightly – so to speak – in that respect. There are some horror stories online!

The most successful effect of the meds has been a ‘topping and tailing’ of my moods. Although I’ve sensed some hypomania, until this afternoon it hasn’t made a nuisance of itself. And while my default position as ever is ‘mildly depressed’ I’ve mostly remained at that state. Yesterday and today, with the anxiety making an unwelcome house-call, there have been some mixed episodes – always the most dangerous for me, with all symptoms becoming more acute but especially anxiety, restlessness and the feeling that every cell in my body is buzzing and shaking.

I’m also getting a bit peeved by the frequency of comments on social media saying that ‘hypomania can be pleasurable’. Well, come and spend an hour in my metaphorical shoes when I’m hypomanic and then tell me how good you feel. I’ll wager the answer is ‘not very’.

I have some spare Quetiapine 25mg tablets and I’m tempted to increase my prescribed dose independently. Say, one of those mid-afternoon? I’ll declare it to my psych of course. But for the next two weeks, I feel I need something and obviously wine isn’t going to solve many problems. Is it?