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What Causes Suicidal Ideation And Insomnia In A Patient With Bipolar Disorder?
Question: I have bipolar and treatment resistant depression, hospitalized 10 times plus every treatment option and med you can think of. I currently feel I might be in a mixed state. I have been depressed (no pleasure in anything, flat, unmotivated, suicidal ideation) but also at times wound up, edgy, insomnia, racing and obsessive thoughts. Do you think I am in a mixed state? if so, how dangerous is it and what if anything can I do about it?
Brief Answer:
Consultation
Detailed Answer:
Hello, and thank you for your premium question.
Given your history of bipolar disorder and the symptoms you describe, including both depressive and manic symptoms, I do believe you are currently in a mixed state. Mixed episodes are very treatable. The treatment of choice for a mixed episode is Depakote or Tegretol, although I see you are already on lithium which is also adequate. Another addition I would consider making to your current regimen is an atypical neuroleptic such as Risperdal or Zyprexa. The Klonopin may also need to be increased in the short term. These are the treatment suggestions I have for you.
The symptoms you describe are highly dangerous. If you are having suicidal ideation, you need to either call your psychiatrist immediately, or if they are not available, to visit the nearest emergency room. Your safety is the #1 concern and if you are having suicidal thoughts you need to be in a safe environment. Call 911 or visit your nearest ER.
In the future, for continuity of care, I encourage you to contact me at my direct link below. We receive a significantly higher payment from this website for direct questions, so I prefer this venue in which to work with you. It would be my pleasure to be your personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (XXXX). For a personalized comprehensive evaluation, treatment recommendations, or individual therapy, ask me at HealthCareMagic at this private link: XXXX
Consultation
Detailed Answer:
Hello, and thank you for your premium question.
Given your history of bipolar disorder and the symptoms you describe, including both depressive and manic symptoms, I do believe you are currently in a mixed state. Mixed episodes are very treatable. The treatment of choice for a mixed episode is Depakote or Tegretol, although I see you are already on lithium which is also adequate. Another addition I would consider making to your current regimen is an atypical neuroleptic such as Risperdal or Zyprexa. The Klonopin may also need to be increased in the short term. These are the treatment suggestions I have for you.
The symptoms you describe are highly dangerous. If you are having suicidal ideation, you need to either call your psychiatrist immediately, or if they are not available, to visit the nearest emergency room. Your safety is the #1 concern and if you are having suicidal thoughts you need to be in a safe environment. Call 911 or visit your nearest ER.
In the future, for continuity of care, I encourage you to contact me at my direct link below. We receive a significantly higher payment from this website for direct questions, so I prefer this venue in which to work with you. It would be my pleasure to be your personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (XXXX). For a personalized comprehensive evaluation, treatment recommendations, or individual therapy, ask me at HealthCareMagic at this private link: XXXX
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
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