For the longest time, I have thought that the depression I experience is not unipolar, but bipolar. I discussed this with my psychiatrist at the GIC, who said that my ‘manic’ episodes are not severe enough to warrant a ‘diagnosis’ as bipolar. Although I understand that my manic periods don’t result in hospitalisation or psychosis, they still affect me such that aspects of my life drastically change due to the extreme highs and lows.
Once I started to take Venlafaxine I noticed that I needed to sleep less, I was more agitated and I had a lot more energy. I started Venlafaxine not long before I started taking testosterone, so I struggle to discern from which substance the changes in my physical and mental health came. Recently, a good friend of mine just started taking Venlafaxine too, and talking to her about how it makes her feel has made it clearer in my mind what Venlafaxine is doing to my mind/body/brain.
Before I ever started to take anti-depressants, my mental health went from really low points in winter, to really high points in summer. As time went on, the length of time between the highs and lows became shorter and shorter, until I was swinging from one to the other sometimes several times in a day. It was exhausting. It’s only from talking to my friend that I’ve realised that these extreme “mood swings” (for lack of a better word) have become less intense, less repetitive, more spaced out. However, it appears that although the really deep, dark lows have become much less intense, the highs have become far more concentrated than I have experienced them before.
It used to be that when I was ‘manic’, I would become super sociable, I would sleep less and yet somehow be more energetic. This time, however, I’m not just sleeping less, I’m barely sleeping at all. Whenever I do sleep, it is a half-waking sleep from which I awake feeling irritated, agitated and full of nervous energy. I don’t need to eat, and if I didn’t force myself to have at least one meal a day, I would simply go without. Hunger exists, but it’s like a long-forgotten sock left underneath a dusty sofa. It does not drive me or call to me, but simply hides away, easily forgotten. I cannot switch off fully, but being unable to switch off, I cannot be fully switched on either, existing instead in a fuzzy haze of insomnia, hypomania and exhaustion.
The strangest thing is that it does not scare me. I am aware that the crash will come (and with a really high-high, there follows a REALLY low-low), but somehow I feel that on Venlafaxine it won’t be able to touch me like it has done before. I am, however, concerned. I know that lack of sleep can bring on hypomania, and that hypomania brings with it insomnia, so it’s like a cat chasing it’s tail – the circle goes on repeating itself. The last time this happened to me, I experienced insomnia and hypomania with severe depression. This time, I don’t feel depressed, just vaguely aware that the depression is there, but it’s trapped beneath the surface – by, I think, Venlafaxine. The solution for my insomnia the last time was low-dose sleeping pills, prescribed for only 10 days, to regulate my sleeping pattern enough that I could eventually fall asleep more ‘naturally’.
Maybe I’m putting to much store by the anti-depressant medication that I take, but after doing some research into it, it appears that Venlafaxine can indirectly cause hypomania due to the side effect of insomnia. It’s worth mentioning that I have been through quite a lot in the last 2 months between looking for work and lots of things going on in my personal life. It has been a tough couple of months, with a lot of stress and anxiety, so it’s not really surprising that I worked myself up so much that I am currently unable to sleep for longer than 2/3 hours at a time. I also did some research into why hypomania/insomnia and bipolar disorder are so interdependent, and supposedly people who are bipolar have a sensitive body clock, which is easily affected by irregular circadian rhythms. Where I live, the sun only sets for about 5 hours in the summer. Sleeping without blackout curtains means that I get no sleep at all.
I don’t have an immediate solution to my current insomnia predicament. Currently I have been awake for 24 hours – my head feels fuzzy, my body is agitated and full of nervous energy – yet I do not feel sleepy at all. I intend on staying awake until at least 10/11pm tonight and then I will attempt to fall asleep at a regular hour (i.e. before midnight). Hopefully I will be so exhausted that I will actually sleep through the night, and deeply.