Question: Hello,

I was been diagnosed with Bipolar 1 Rapid Cycling in late 2005 after a hospitalization. I've experienced both depressive episode, mixed states and manic states before and after this diagnosis. Prior to 2005, I was mixed diagnosed as having Unipolar Depression. I know this miss diagnoses is a common occurance for people with Bipolar.

Ive always experienced some anxiety along with my Bipolar systems. However, this year, i experience a long episode unlike anything i was used to and unlike my understanding of Bipolar symptons.

I was working at a major financial companies as a VP / Business Analyst. I was hired to work on a strategic initiative but was switched to an ongoing project. I was disappointed by this and I was also disappointed regarding how the project i was on was being managed.

However, I still felt that I loved my job and was grateful to have a full-time position at a company where the majority of workers were contractors without benefits.

One night when my girlfriend was at my apartment, i experienced a sever panic attack. I did not understand what was happening to me but knew that whatever it was would last quite a while and would be far worse then anything i experienced before including the depressive episode that led to my hospitaluzation in 2005.

For four months, my girlfriend had to wake me up, sit me, make sure i had breakfast, make sure I showered and dressed and make sure i keft for work on time.

I had been on clonazapam for years but when this episode went into full swing, my doctor started me on Xanax. I was only supposed to take the Xanax on an as needed basis but since i was experiencing panic attacks on an almost daily basis, i over used my anti-anxiety medications. This one reason i was tired in the morning and required assistance from my girlfriend.

I hide my overuse of my anti-anxiety medication from my psychiatrist for as long as i could. However, one night, the Panic attack was so bad, i could not sit down for hours. I was jyst pacing back and forth in my apartment. I thought about going to the emergency room but could not accept the idea that i would have to sit still for hours before they got to me.

Instead, i slowly started medicating myself, pill by pill, until the symptoms abbetted and i could sit with my girlfriend and watch TV. I hapoen to have Percocet on my due to pain caused by a complete tear in my ACL in my left knee. I wound up taking 7 Percocet, 4 Xanax, 4 shots of Vodka, 2 Benedryl and a sleeping pill. I did not take them all at the same time. I took one pill, waited a short time to see how it affected and then took an additional pill to see how it affected until I reached the amount of medication i described.

My psychiatrist was very upset. Instead of being sent to the hispital. I asked my doctor if i gave control of my medication to my girlfriend could i avoid hospitalization. He agreed. That was in XXXXXXX I still don't have control over my medications. I dont even know where they are.

Like i said, I've never experienced any of the symptoms i had before. The symptoms included depersonalizatio derealization. Instead of being anxious about these experiences, I believed they were some sort of spiritual exoerience. I started creating a whole Theology centered on these experiences.

Also, i experienced a number of instances of Sleep Paralysis. I did not feel an "evil" presence behind me, instead i was kind of fascinated by it. The first time it happened was when I was watching a British show called, "The Thick of It, which is a grat show by the way. In my last "dream" during this event, i thought i had walked into someone ele's apartment. On their coffee table was an iPad with this show playing on it. I always have closed caption on. I became suspicious because, even though i couldnt read the closed captioning, it seemed to be consistent with the dialogue which i could barely make out. I am pretty intelligent but i did not believe that my mind was strong enough to crwate al, these events instantly. Because of this, i started to look around with just my eyes and saw a table of mine with vases on it sticking horizontally from a wall. Since i did not believe the laws of physics had changed, i knew something else was going on. In my mind I shifted everything in mind counter-clockwise by 90 degrees. When i did that, everything feel into place and I realized that i was in my apartmen awake but paralyzed.

My girlfriend was there so i started screaming. Well. It felt like screaming but my girlfriend told me she her nothing for quite a while and them heard i very muffled noise eminating from me. She shook me until I woke up.

Within ten minutes, i fell back asleep and the same thing happened. I experienced this phenomenon 5 times within a 2 to 3 hour period. I have read that this can occur to anyone but it happens very infrequently.

I did research and this experience does not sound directly related to my Bipolar condition. I recently completed a Bipolar Safety Plan and there is nowhere on the form to address this type of experience.

When searched Google, many sites for Panic Disorder were returned. None of these sites mentioned Bipolar or treatments that included mood stabilizes. It apoears that anxiety and depression seem to be co-morbid but i could not find any sites that indicated that Panic Disorder was co-morbid with Bipolar.

Since this episode was different than any episode that ive oreviosly experienced from my Bipolar condition, i was wondering if you thought thus episode was an expression of my Bipolar or was if it was a new disorder (i.e. Panic Disorder) which is now co-morbid with my Bipolar.

BTW, this epusode forced me out of work and onto short-term disability. The insurance company is now considering the possibilty of long-term disability. However, if they believe this episode was a result of my Bipolar condition, then its a pre-existing condition and i will not be covered. If they believe it is a new condition that is co-mirbid with my Bipolar Disorde then i will be entitled for coverage.

I would very much like your feedback as to the nature of this episode. If it is a new co-morbid condition, possibly Panic Disorde, or it is was a manifestationof my Bipolar Disorder.

I very mych thank yiu for taking the time to review this extensive note.

Sincerely,
XXXXXXX