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Is Severe Insomnia With Night Racing Thoughts A Symptom Of Bipolar Disorder?
Question: Hello! My daughter, age 35, suffers from severe insomnia (0-3) hours per night and has nightly racing thoughts about stress at work ( her demanding boss), finances and a significant other in her life. She is currently seeing a Behavioral Therapist to retrain her thought processes to enable sleep to occur (ex. Going to bed at 1:00 am and rising at 6:30am, no TV or computer use after 9:00pm, etc.) She is very anxious, is totally exhausted and has difficulty processing her thoughts at work. She had an appointment with a Sleep Study Doctor today who stated that the behavioral therapy was her only route, as no medications have successfully allowed her to stop the racing thoughts and also to induce sleep. Could she possibly be suffering from a Bipolar Disorder which can cause the aforementioned symptoms? She has not see a psychiatrist to explore this possible disorder. Can you help direct me to any possible doctors to delve into treatment for her? Thank you!
Brief Answer:
Consultation
Detailed Answer:
Hello, and thanks for your question.
I'm sorry your daughter is having these difficulties. Here are my thoughts.
Bipolar disorder is not the diagnosis here. You can rest assured she does not have this. However, your description is concerning for a sleep disorder or possible an anxiety disorder. In addition to the behavioral therapies mentioned, which are all excellent, she may benefit from medication. If it is an anxiety disorder, she would benefit from treatment with an antidepressant. It looks like she is taking Paxil. Her dose may need to be increased to the maximum dose (60mg daily). Also, Klonopin may be helping, and may need to be increased, but this is a dangerous drug that should be used judiciously. Other pro-sleep medications include Trazodone (which I would suggest for her), Melatonin, Rozerem, or Ambien.
A sleep study is very important. A psychiatrist may indeed be able to help her more specifically -- call your insurance company and ask for a list of providers in your area.
Please remember to rate and close this answer thread when you are finished and satisfied.
Consultation
Detailed Answer:
Hello, and thanks for your question.
I'm sorry your daughter is having these difficulties. Here are my thoughts.
Bipolar disorder is not the diagnosis here. You can rest assured she does not have this. However, your description is concerning for a sleep disorder or possible an anxiety disorder. In addition to the behavioral therapies mentioned, which are all excellent, she may benefit from medication. If it is an anxiety disorder, she would benefit from treatment with an antidepressant. It looks like she is taking Paxil. Her dose may need to be increased to the maximum dose (60mg daily). Also, Klonopin may be helping, and may need to be increased, but this is a dangerous drug that should be used judiciously. Other pro-sleep medications include Trazodone (which I would suggest for her), Melatonin, Rozerem, or Ambien.
A sleep study is very important. A psychiatrist may indeed be able to help her more specifically -- call your insurance company and ask for a list of providers in your area.
Please remember to rate and close this answer thread when you are finished and satisfied.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Thank you for your professional input. Unfortunately, she had a reaction to Trazadone and in addition, Ambien does not help her at all. I will ask her if she has ever tried Rozerem or Melatonin. The Sleep Study Center informed her that such a study would be of no benefit to her as the doctor feels that her insomnia is primarily due to anxiety! I will also ask the maximum dosage of Paxil she was taking. On her father's side of the family, her paternal grandmother and great aunts all suffered from post-partum, depression and experienced nervous breakdowns. The cause of the aforementioned were never probed but obviously genetically predisposed. I will be certain to contact you in the future. Thank you!
Best, XXXXXXX Tyszka
Best, XXXXXXX Tyszka
Brief Answer:
Followup
Detailed Answer:
Rozerem or melatonin would then be my first choices. I think a sleep study would still be helpful. Maximizing the Paxil dose is important. And be sure to contact me in the future with any further questions!
For now, please remember to rate and close this answer thread when you are finished and satisfied.
Followup
Detailed Answer:
Rozerem or melatonin would then be my first choices. I think a sleep study would still be helpful. Maximizing the Paxil dose is important. And be sure to contact me in the future with any further questions!
For now, please remember to rate and close this answer thread when you are finished and satisfied.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
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