Difficulties with Bipolar and staying awake at work.
April 2, 2019 7:55 AM   Subscribe

I’m bipolar and going through a particularly difficult state of mania. I’m not sleeping very much and while most of the time I’m okay with getting though these stages, I’m struggling. I’m falling asleep at work, particularly in meeting. I can’t prevent it. Please give me your best tips for keeping yourself awake in meetings. Bonus points to others that live with BP.

Here’s some of the things I’ve been trying and failing with:
I’ve been drinking tons of water, trying my hardest to sleep but I’m getting three hours a day. I take Ambien and Xanax per doctor’s instructions. I find my eyes closing at work, and others are starting to notice. My medicine doses are perfectly balanced for keeping the depression down, but not really touching the mania. I’ve tried putting pressure on the web between my thumb and forefinger to try to cause pain to keep me awake. I have a doctor’s appointment in a few weeks to go over medication, but want to try some practical techniques in the meantime.
posted by Draccy to Work & Money (17 answers total) 1 user marked this as a favorite
I’ve tried standing for meetings in the past, and that worked better than sitting. One way to avoid disclosing why is to blame back pain (which is why I was standing, but it also served to keep me awake when I was very short on sleep).
posted by dttocs at 8:02 AM on April 2, 2019 [13 favorites]

I am really sorry. I have been there, same deal, bipolar, same drugs. It is SO HARD to stay awake in meetings sometimes.

Things that help me:
*Make yourself cold, either by not wearing a sweater/jacket or by drinking ice water or both.
*Having to pee helps too, basically being as uncomfortable as possible.
*Can you have a fidget in meetings? It might be hard to introduce all of a sudden (I've always had a fidget in meetings since I was hired) but it helps to give your hands something to do. Silly putty, a fidget toy, spinner, whatever.
*Caffeine, duh, but caffeine vs. Xanax/Ambien is like a knife in a gun fight.

I'll keep thinking. I feel you. It doesn't help me that I can fall asleep any time, anywhere, world champion napper.
posted by fiercecupcake at 8:03 AM on April 2, 2019 [3 favorites]

Ooh, standing is a great suggestion. Again with the making yourself uncomfortable.
posted by fiercecupcake at 8:03 AM on April 2, 2019 [2 favorites]

Try taking a lot of notes during meetings to keep yourself engaged. Also — have you considered adjusting when you take meds to meet your work schedule. You should be able to contact your doctor via email/assistant to do this and not have to wait weeks for your next appointment.
posted by caveatz at 8:18 AM on April 2, 2019 [4 favorites]

Is it possible you also have sleep apnea, so the little sleep you are getting is nearly worthless? (Do you have a partner who can tell you if you snore?)
posted by jkaczor at 8:25 AM on April 2, 2019 [1 favorite]

@jkaczor I do have sleep apnea and use a CPAP. Really good catch on something I missed to put up.

Some great suggestions so far, please keep them coming!

posted by Draccy at 8:31 AM on April 2, 2019

A few weeks is too long for mania. Can you attend a walk-in clinic or call the doctor every morning to check for cancellations so you can get medical help right away. I am worried about your safety, especially if you are driving a motor vehicle.

It’s ok to call in sick for this.
posted by crazycanuck at 9:01 AM on April 2, 2019 [16 favorites]

In case you're not aware, if you're in the US and there's something that might help you perform your job (a later start time, working from home, a brief leave of absence, etc.) you can request that as a reasonable accommodation from your work. That's not what you're asking about really so I won't go into a long derail but you can read more here if you're interested.
posted by wuzandfuzz at 9:30 AM on April 2, 2019 [4 favorites]

That is a great line of thought, wuzandfuzz.

You can see some accommodation ideas you might not have thought of at JAN as well.
posted by fiercecupcake at 9:58 AM on April 2, 2019 [1 favorite]

This is gonna sound wacky but it worked for me. When I was on Xanax Ambien combo I had to periodically stop taking the ambien for about a week to get it to work again.

Might be worth talking to the doc about it. And yes, you need an appt now, not a few weeks.

Use FMLA if you have to. It’s a medical condition that your brain chemistry is not cooperating with sleep. Don’t feel bad about taking some time off to get better.
posted by sio42 at 10:14 AM on April 2, 2019 [2 favorites]

Two (not more) tiny very very sour hard candies, wait as long as possible and slip one under the tongue.
posted by sammyo at 10:36 AM on April 2, 2019 [1 favorite]

Drugs you could talk to your doctor about:

Modafinil will keep you awake but may not be great for mania.

For sleep, you can discuss trying diphenhydramine, gabapentin, or haldol.
posted by metasarah at 11:16 AM on April 2, 2019

I pinch the inside of my cheek between my top & bottom canine teeth. Not hard enough to do damage, but enough that the pain focuses me a little.

Keeping cool helps too. Warm stuffy meeting rooms are the worst for making me drowse off.

Taking notes, or even doodling is also useful.
posted by Secret Sparrow at 11:28 AM on April 2, 2019

You're not drinking nearly enough water, even though you think you are. Unless your urine is almost clear? Is your urine clear? No? Drink way more water. Having to pee regularly helps. Even if it takes you out of the meeting for a quick run to the bathroom. Blame it on a medication that makes you have to pee more. People won't care, TBH.

Re: fidgeting, using a device like a spinner can be distracting to others and affect meeting dynamics. Plus, it's mindless, so won't do a ton to keep you awake. Consider alternatively studying the dark arts of pen spinning. Meetings provide ample practice time for this. Requires just enough focus that you will stake woke but not enough that you can't pay attention.
posted by allkindsoftime at 3:51 PM on April 2, 2019

Have dealt with this in the past, my best advice is to call your prescriber and get an emergency appt. 3 hrs of sleep for more than 2 days combines with manic anything would be sufficient for my prescriber to want to see me.
posted by fairlynearlyready at 8:02 PM on April 2, 2019

I pinch the inside of my cheek between my top & bottom canine teeth. Not hard enough to do damage, but enough that the pain focuses me a little.
posted by Secret Sparrow at 1:28 PM on April 2

I've sure done that one also, bit hell out of the inside of my mouth. Especially in one bank that I worked in, downtown Houston, these ppl are all hand-wavey, gesticulating wildly about crap that means pretty much absolutely nothing. Those ppl totally suck. That bank totally sucks, as does any other bank. Ask me some day about "Float Processing" which is the systems written to hold onto other peoples checks, for one day, or two days, or seven to ten days if it's written off a European bank, and the bank floats on that money that isn't theirs, a huge profit center, and these little Poindexter bank vice presidents in their little Poindexter suits and ties are the most boring people on this entire planet, and I'm stuck in a hot, windowless room with them, biting hell out of myself, and smiling at them, and praying that they get polio.

Dave Barry wrote that companies have meetings because companies cannot physically masturbate, and meetings are as close as they can get. I agree.

Melatonin. Benadryl. Both of these are over the counter, both of them can help knock you down at night so you've got more rest. You can head over to the nearest drug store, or even dollar store, and buy the stuff. For the benadryl, for sure; not sure that I've ever seen melatonin in a dollar store. But it's in any/every supermarket or drug store.

I even have some seroquel here, because I. Must. Sleep. Seroquel is for me the biggest gun that there is (aside from opiates but I sure won't suggest them, not to you or to me.) Seroquel sucks it, I wake from it feeling waterlogged as a telephone book left in a flooded basement for seven months. But I'll have had some sleep. And that is vitally important.

I have learned -- and damn sure any decent shrink will tell you the same -- I have learned that I flat out must sleep. Ppl will say that "Hey, it's drugged sleep, you're not getting the benefits of real sleep." and blah blah blah blah. They have no idea what they are talking about. They have no idea what it is to live without sleep. They have no idea what it is to be running manic. They couldn't in a million billion years understand how it is to live with this illness.

They don't need to -- we've got each other for that.

Anyways. You can make this. We get to where we're tough as an old boot, we become remarkably durable -- having lived through what we have gives us strengths out the wazoo. I'm not saying to not go and buy some benadryl and some melatonin and rub that shit all over your head, I'm not saying to not push your way into the door of your shrinks office by hook or by crook. What I am saying is that you can do this. You have a track record. Every one of us in this thread is standing with you, is standing behind you -- we've all done it and you can too, as you've proven many times. Darkest hour before the dawn, et cet. You stand upon the precipice of The Dawning of A New Day, where sleep shall reign. Or something.

Good luck.
posted by dancestoblue at 10:32 PM on April 2, 2019 [4 favorites]

Are your meetings a set time or potentially scattered? When are you taking the Xanax? Is it affecting you more in the meetings? Are you able to safely (with doctor’s approval) change the timing on that? Can you caffeinate before the meeting and either take the Xanax after or take it at such a time as it won’t peak during the meeting?

If you can track consumption of water/caffeine/meds and compare the times for all three against when you get tired. A pattern might quickly emerge.

In the short term: writing poetry like haiku or pantoums has kept me awake in many meetings. The look of concentration while I count syllables apparently seems genuine, and my notes don’t just look like me doodling or playing on my phone.
posted by RainyJay at 2:00 AM on April 3, 2019

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