My Secret Life #1 Going Crazy for Sleep

Join me for a behind the scenes look at my private bedtime medication routine, in which I fight through intrusive thoughts and fears before falling asleep. For me it's a battle with Seroquel and the strange paradox where it stirs up my mind before putting me to sleep.

I talk through what insomnia means for mania risk, why psychosis feels closer in the dark, and how intrusive, even spiritual, panic can crash in before sedation takes hold. We get practical about my 9:15 wind-down, how to read early signs that a backup will be needed, and what the morning after costs in focus, mood, and energy. You’ll hear the honest math of “best available” choices: antihistamines that fog the next day, benzodiazepines that demand caution, and Seroquel, an antipsychotic that delivers sleep but can open the door to racing, violent thoughts on the way there.

If you’ve ever faced the 3 AM question of how long you can keep doing this, you’ll find language and tools for that hour, and a reminder that morning usually brings a different view.

If this resonates, share the episode with someone who needs it, subscribe for more real talk on living with bipolar disorder, and leave a review with your own sleep strategies so others can learn from you.

Transcript

Welcome to Bipolar She. I'm your host, Janine Noel. On this show, we do talk about suicide. If you're ever in need of immediate support, please dial 9-8-8, A Suicide and Crisis Lifeline. In this episode, I don't refer to suicide directly, but I do talk about the fatigue of managing mental illness. I understand how just being tired can lead to wanting to end things.

Three months ago, I taped this episode when I was in the middle of a crisis and couldn't sleep. Like any responsible bipolar person, I did not release it. But I do want to share it now because it will help me talk about a few things going forward on the show. I manage my illness by living on a tight schedule and being vigilant, but taking medication, being in talk therapy, and seeing a psychiatrist.

Is not a magic formula for mental health success. That is a myth. Doing all three may be our best chance for success, but illness can topple these efforts and this is how it crushes me mostly at night, mostly dealing with sleep. Now on with the show,

I thought I would just talk about something that I'm personally dealing with right now, and it may be a story that people don't know or really understand about those of us that have bipolar disorder who are managing it. It may seem like it's really under control. At the same time, there's this very private life going on underneath, and so today I come to the show exhausted.

I had several nights of bad sleep or falling asleep at three in the morning. For regular people, it may not be that big of a deal to have insomnia. For me in my bipolar disorder, if I start to have sleep deprivation, that increases my risk for mania, and once my risk for mania shoots up, then my risk for psychosis really shoots up.

So, I get afraid when I can't sleep. I had this little recording in my head saying, you're not getting sleep. You're not getting sleep. You're gonna get manic. You're gonna get manic. You're gonna be psychotic. You're gonna have to go to the hospital. And that terrifies me. So, when I can't sleep, I fall back on other medications to help conk me out.

By the time I take so much medication to help me sleep, I am so groggy and tired in the morning. It's really, really hard to have a regular day. So, for example, I couldn't have fall asleep two nights ago, and I went, okay, I gotta knock myself out. So, I went and took hydroxyzine, which is, it's a really intense antihistamine.

It's not a psychiatric drug. It's really like taking a huge dose of Benadryl. But then that didn't work. And so for another hour or two, I toss and turn and then I go, okay, I gotta get out the big guns. And I go in and I have, I take Lorazepam or Ativan to help me sleep, and then that doesn't work. Another hour goes by.

I take at least a hundred milligrams of Seroquel to help me sleep. So in the morning, in addition to my lithium and my Lamictal and my regular Seroquel and my regular Ativan, I have so much medication running through me and I'm scared. I'm scared if the next night is gonna be the same. I'm scared that my mind is running fast and kind of raging towards mania, and it's a really fearful, lonely place.

But having to adjust my medication just to keep my feet planted on this earth-it's a job and I don't think people that know me well might understand this, but I don't think others get that bipolar illness. These medications work with us and help us, but they're far from perfect and a lot of it is left to how we're gonna manage it.

During all of this, I am in touch with my psychiatrist and we've walked through ways to handle this at the same time. That doesn't entirely, you know, solve my fearfulness of things going awry. So I have many fearful nights, and when I have those nights, I also start to have some scary thoughts or images come into my head.

I've always had this reaction to Seroquel, which is counterintuitive. Seroquel is a, it's one of the biggest, like anti-psychotics, just about anyone suffering some sort of manic episode may be prescribed. Seroquel been on it for, you know, probably 15 years now. And it's a good drug 'cause it conks you out and puts you to bed.

But for me, it makes me feel crazy when I take it. So, I have to actually sedate myself. With another medication in order to take the Seroquel, but to stop this like heavy flooding and just of horrible, violent thoughts into my head. So this antipsychotic makes me psychotic before I can fall asleep. And sometimes this leads to a super scary panic attack that I have at night.

That is the belief that my soul is being yanked out from me and that I am falling to hell, and it's very hard for me to talk myself out of it. You know, I can say, oh, my therapist doesn't think I'm going to hell, or friends don't think I'm going to hell. I can try and talk myself out of it, but the feeling is so intense.

I do link that with the Seroquel. I don't ever, during the day have an idea that my soul is going to hell. I'm pretty, uh, reasonable about that. But at night, that's what happens. And I do blame that on the Seroquel. So, it's very. The problem is there isn't another medication that has worked for me, so the Seroquel is still the best drug for me, even though I have to kind of endure this onset of crazy thinking before the rest of my night.

So, sleep is a huge production for me. It starts at 9:15, I take half my meds. Half hour later, I take the rest and I can tell if my mind is going to be racing. I'm usually watching Seinfeld. I can tell if my mind is racing too much by 10 o'clock, and I just know if I'm going need a backup, if I'm going to need more Seroquel or what is gonna happen.

So those are this little nightly conundrum. This is just part of my life and this is why I don't feel great some mornings, but it's hard to carry that kind of nightly battle with you into your day. So I just wanted to talk about this because it just seems like an area. I think people with illness would, would understand, but there really is no rest for even the healthy with these illnesses.

It's just for me, a constant battle and. It really, it really tears me down. I feel really sad about it, and I get really upset that this battle is still going on. 30 years later, I get really overwhelmed that I can't do this. Like, how do I keep doing this? How do I keep fighting this like nightly terror?

This exhaustion, this fear of going crazy, this fear of being in the hospital, how do I live with that every night with those fears and I'm tired and my soul is tired, and it's in those moments where I go, I don't know. I don't know how long I can do this. And why is it so hard? Why is this part of my life so hard?

I don't think I can keep doing this. And so I hit a very low place. At night, while this is going on in the morning, I usually have some energy and can see life going forward, but in the middle of the night sitting there, I do ask questions like, this has been a bitch. This has been hard. How long do I have to do this for?

Yeah. So I guess those are unfortunately dark, dark thoughts. It's just. It's been a long time since things were easy and it would be nice if these meds worked well for all of us and that we didn't go through this because it's super hard. And yeah, so I'm walking around with this sort of private, this private life that people don't really see this.

People don't really see what the day-to-day struggle is like with this. So. Thank you for listening to this little interlude before I return to my regular interviews, if medication and that midnight dance of going to sleep is something that you deal with too, I'd like to hear about how you are handling this and how you get through it, and I just hope.

There are better drugs and I just hope that we all kind of forge forward and know that we will make it out. But at three in the morning, it sure doesn't feel like it. Let me see if there's anything else to really say. Not really anything else to say except I'm fucking tired.