Reaching my Breaking Point - Bipolar 2 and TRT.

[Andrew S]

Thanks in advance for any help....

I am 26 years old.  For the past 7 years I have struggled with anxiety, depression, insomnia, irratibility, manicness, mood swings, inconsistency, etc. etc. etc.  Life has been one hell of a roller coaster, but in this time I have managed to graduate college and an MBA, secure and maintain a well-paying and fulfilling business career and marry the love of my life (and hang on to her thus far).

I have seen 3 different family doctors, 2 different psychiatrists and 1 endocrinologist...  I have been diagnosed with it all, and been prescribed just about every drug imaginable for these symptoms:  Anxiety & depression: Effexor, Effexor XR, Cymbalta, Prozac, Zoloft, Lexapro.  Sleep/Insomnia: Sonata, Ambien, Ambien CR, Lunesta, Restoril, Melatonin, Elavil, Seroquel, Provigil, Trezadone, Xanax.  Bipolar 2: Lamictal.  Low Testosterone: Testim.  None of these drugs have solved my problems permanently - some have mitigated some symptoms in the short term.

My current diagnoses and treatments are: Bipolar 2 disorder, insomnia and low testosterone (tested at 104 ng/dl).  I am currently taking the following medications: Lamictal 200mg once a day.  Testim 5g (50mg testosterone) once a day (on this for 2 months now, testosterone levels at 380 ng/dl now).  Xanax 2mg and Melatonin 9mg at night for sleep.

I am suffering.  I am constantly in a daze.  I rarely sleep more than four and a half hours a night.  My mood is up and down in a moments' time.  Anxiety is free floating and depression occurs at least once every day for an hour or so.  I am quick to snap at my wife and our dogs.  I have the shortest fuse.  The smallest annoyances set me off.  I can hardly focus on my work, but manage through it.  I have little motivation to exercise (although few people do), but manage to do 3 days a week of cardio (45 minutes) and 5 days a week of weightlifting.  Exercise helps significantly, but I don't have time for any more than I already do.  Lately, all I have wanted to do is lie in bed and watch TV.  I have lost a few close friends due to my lack of need for social interaction.  I make poor and whimsical financial purchases because they feel good.  My dreams at night are vivid, and I feel like they are creeping into my days now.  I could go one, but I think I have made the point.

Recently I have had a few notably bizarre episodes: About 2 months ago I made a very poor attempt at suicide - I couldn't break the surface with the knife on my wrist (and didn't really want to do it anyways I think).  I've had a number of overwhelming panic attacks recently where I become hot and tingly all over and feel an overwhelming sense of hopelessness.  I have had several episodes where I have "blanked (not blacked) out", curled up into the fetal position, cried and basically become frozen for a period of fifteen minutes.

And lastly, yet most importantly - I feel that my marriage may be suffering.  I am amazed that my wife can still tolerate me at this point.  I don't treat her very well anymore.  My sex drive is non-existant.  I feel so guilty that she has to bare the brunt of these symptoms.  I know she has to tip-toe around me and I hate it.

In summation: I am in a daze.  Life feels fuzzy.  My memory is poor.  I can barely concentrate enough to write this.  I want to be normal, but I am not quite sure what "normal" means anymore.  I feel like I have been over-medicated, poorly diagnosed and victimized as a patient.  I feel like I have reached my breaking point with the symptoms and issues discussed and the constant adjustment to new medications.  I don't have the guts to commit suicide and know that I have a good life, despite my mental issues - so don't worry, I am not going to go that route.  My wife and parents are amazingly supportive of me and want to help.  But I just can't take it anymore.  I'm fed up.  There has to be a solution.

I appreciate those of you who have taken the time to read this rant, and any help or advice you might have to offer.

Thank you,

Andrew

[jcarr2525]

Read all your posts and have suffered near identical issues for decades....have tried every drug you mentioned and I think a few more.  I went from doc to doc to psych to psych for nearly 25 yrs.  I am 56  6'4" 210 lbs retired Wall Street broker....had good career raised family and got out early.  Only in the past year have I truly enjoyed life or even understood what "normal" was.  I am diagnosed BP2 with uni-sprectrum depression which I think means I am either always low or lower.  Never had a manic episode.  No OCD......do have very addictive trait and must avoid all mood altering drugs.  Alcohol does nothing for me except give headache.    What happened in past year was discovery of low testosterone levels for a man of my age which hormone doc thinks was a lifetime problem.....you also seem to have discovered very low testo levels at age 26....I wish I had found out when I was 26 (30yrs ago).

I am prescribed HGH (3mg day) together with dhea, and testosterone cream, melatonon at night, 300 mg lamictal.  Within 8 weeks I began to feel like a real person.  I never slept for more than 2-4 hours at a time...now I sleep 7-8.  My mood is terrific but not hyper or high.  I am not nervous, anxious or overly worried about miniscule things.  I can for the first time say I know what normal is.......it is awesome.

HGH gets a generally bad rap from the press/sports reports etc and is really not understood by most doctors.  It is not a anabolic steroid...it is a naturally occuring hormone in our bodies. Many people simply do not produce enough for "normal" brain/body chemistry.  I was sceptical big time at first but after seeing several hormone doctors who understood I decided to give it a try.   A complete mental health miracle for me.  I tried everything and sufferd for 30 odd yrs.   Regards  Joe C

[PHeal]

Hello,
Sorry to ask my own question on your post Andrew, but I found it while researching the combination of Solal testosterone cream and Lamotrigine/Lamicten & Epilim.  I'm waiting to hear from my psychiatrist about it, but perhaps someone reading this can tell me whether this combination is one that could possibly cause any harmful side effects.  Once I'd been using the testosterone for about a month, while taking 200 mg Lamictin and 200 mg Epilim a day (which I've been on for 9 years for BPD), I started to get very hazy - feeling like I was 'in another place' so to speak. My doctor said to go off it, and I have. It's been a week now, and I still feel strange. Could this have anything to do with the combination of those meds? I've asked my doc, but I was wondering if anyone on this site might know.  I trust her as I've know her for years, but I just want to double check. Thanks, P

[brock303]

Andrew,

I'm a 25-year-old male and my testosterone came back as 105 last year.  I was also diagnosed bipolar type II and have run through the same meds as you for all of my various psych diagnoses.  My story sounds so similar to yours.  

Testosterone medications may be aggravating your depressive, sleepless, or hypomanic symptoms (including any OCD).  I just found a leading endocrinologist with the University of Utah who is interesting in understanding why the testosterone levels are so low, rather than throwing a bandaid on the condition.  I'm waiting for the 3-month period of zero medications to pass before my pituitary gland and hypothalamus can reset... then I can have the correct blood work done to find out what's going on.  It is possible and easy (with the right doc) to find a cause for low testosterone and treat whatever is inhibiting its production.  Your case does not sound like traditional developmental hypogonadism and neither does mine.  

You may have two separate issues with a hormone issue and a bipolar issue, but if you can accurately identify the hormone problem, that may make it easier to treat the bipolar side.  My body had atypical responses to anti-depressants and mood stabilizers, even though I found a few that I could coast on.  

In summary, find an endocrinologist who will look deeper than your 104 test result.  Treat that problem and then revisit your bipolar II.  I'm still awaiting results, but I'm getting closer to a proper diagnoses with the hopes of lessoning the hell.  

Bipolar II presents an issue of regulating energy, and an issue of regulating mood, but slap low T side effects on top and both are certainly amplified.

Good luck and props for completing your MBA,

Brock    

[brock303]

*lessening, not lessoning - sorry guys

[kodarian]

Your in your 20s and your Testosterone was brought up to 380? thats still extremely low for your age and you will have symptoms. The range is 357 to 1100, at your age you should be 950 average. I have friends in their 30's who had levels at 400 and were able to get on TRT and get levels at 950 and they felt much better. You need to switch to T injections  to get your levels where they should be. You will feel tremendously better. contact me, ***@****

[Stinkyruna]

Andrew, I don't know how you have been coping for so long. My situation is similar to yours in that I can't take almost every med I am prescribed (react to everything). The only thing that has worked somewhat is a small dosage of seroquel but that effects my blood pressure. Not sure it's worth it.

[15yrstrong]

I have thyroid issues..I guess that's a hormone thing. I know low testosterone in men can cause depression, low muscle mass and extreme fatigue. At least that is what my dad and ex went through. By taking care of this issue it will help you find out which is testosterone related or bipolar related. Perhaps...depending on how your relationship is with your psychiatrist ...you should look into a new one who can put fresh eyes on your case. Its awesome your family is supportive and take that to heart. You are doing your part to find a solution and they obviously see that. Give yourself credit and also give yourself permission to have symptoms. Its not your fault and it sounds like you are are aware and doing what you can to maintain control. Good luck...you will find peace!