Advice Please

hi Everyone

Looking for some advice

Let me say first that when I was working I would do a week of nights in one go and it always sent me up in mood and I would often go off travelling as a result or something else ill advised. I loved working night but that is because they made me feel good by elevating my mood. I dont think I dealt with nights in a healthy way despite working well in them and being productive. I would go high and manage this badly as I was not diagnosed and had little insight into my behaviour.

I am doing some volunteering which involves doing night work. I get in about 3 am and then take my meds but am keyed up by this point and often dont go to sleep. This has an impact on my sleep for quite some time and that has an impact on my mood and I creep upwards.

I love my volunteering- it is looking out for ppl on a clubbing strip where I live and making sure they are OK. It is varied and sometimes intense work but it is really good and I very much enjoy it.

I guess I am asking two questions. one is should I give it up as it is having an effect on my sleep and mood? I would be really reluctant to do this tho. The other is can anyone who works nights give me some advice as to how to do this healthily. I have a lot of experience of working nights but it is not experience where I have handled my mood disorder well. If anyone has any advice I would be very grateful. I really dont want to quit and would rather figure out how to cope with this in a better way.

Thanks so much

Cracked

I am very interested in the answers here as I am going to college to study for a career that will involve nights. So I really hope you find some answers cracked.

Well, I don't really think you should quit, since it sounds like you enjoy very much. I think that's really important for everyone, not just those suffering from MI. To do something we enjoy, that makes us feel useful, where we feel like we make a difference. Otherwise, life just becomes sort of... blah!

I have a few questions, if you don't mind. How many times do you do this? Every night? Once a week? Is it fixed or does it vary?

When you volunteer, do you actually stay up all night or do you go to bed and try to sleep? Can you sleep in the following morning or is that not an option? I ask all this because for me that makes a big difference. To give you an example: my sleep has been way off the past few weeks. Some days I can sleep in in the morning, and that makes my mood a bit more stable. Yesterday I couldn't do that and had a horrible day.

One more thing. If I remember correctly you're on seroquel, right? Is it the XR or the regular? Maybe you could discuss with you doctor starting with the XR and tweaking the hour at which you take it depending on whether you have volunteering or not. For example, if you don't you could take it at dinner or whatever time you usually take it. When you do, you could take it a few hours later. That way, when you get to bed the meds are already working.

Other than that, the only thing that comes to mind is forcing yourself to go to bed. Even if you're not sleepy, even if you don't want to, go to bed. Wait at least a couple of hours before you get up again to see if you fall asleep. I know it sucks, but if you stay up then it's guaranteed you won't sleep.

I don't have anything else. I've never worked nights. Hopefully, someone who has will be able to give you better advice. I do hope you manage to keep your volunteering work, you seem to enjoy it so much!

Thank you both for your replies

Crawling wrote:I am very interested in the answers here as I am going to college to study for a career that will involve nights. So I really hope you find some answers cracked.

Thank you hon - I hope that answers will help you too

invicta wrote:Well, I don't really think you should quit, since it sounds like you enjoy very much. I think that's really important for everyone, not just those suffering from MI. To do something we enjoy, that makes us feel useful, where we feel like we make a difference. Otherwise, life just becomes sort of... blah!

Thank you - I think you are right here. It is important to do things you enjoy in life

invicta wrote:How many times do you do this? Every night? Once a week? Is it fixed or does it vary?

It is meant to be every 3 or 4 weeks tho the way things have worked out i did two weeks in a row this time and they were both difficult shifts

invicta wrote:Can you sleep in the following morning or is that not an option? I ask all this because for me that makes a big difference. To give you an example: my sleep has been way off the past few weeks. Some days I can sleep in in the morning, and that makes my mood a bit more stable. Yesterday I couldn't do that and had a horrible day.

I can if I miss church yes but the problem is that once I start perking up with lack of sleep I find it very difficult to get to sleep even with meds as I feel so wired.

invicta wrote:One more thing. If I remember correctly you're on seroquel, right? Is it the XR or the regular? Maybe you could discuss with you doctor starting with the XR and tweaking the hour at which you take it depending on whether you have volunteering or not. For example, if you don't you could take it at dinner or whatever time you usually take it. When you do, you could take it a few hours later. That way, when you get to bed the meds are already working.

I am yes. I take it as soon as I get in but maybe I could take it say 15 mins before the end of the shift so it kicks in when I get home? Thank you. It is the regular

invicta wrote:Other than that, the only thing that comes to mind is forcing yourself to go to bed. Even if you're not sleepy, even if you don't want to, go to bed. Wait at least a couple of hours before you get up again to see if you fall asleep. I know it sucks, but if you stay up then it's guaranteed you won't sleep.

I think this is something I should maybe try - it is not easy as I feel so wired but I think it is something I should have a go at

invicta wrote:I don't have anything else. I've never worked nights. Hopefully, someone who has will be able to give you better advice. I do hope you manage to keep your volunteering work, you seem to enjoy it so much!

Thank you so much- you have been really helpful, thank you

Hugs to you both

Cracked

I agree that if it is rewarding for you, you should find a way to continue.

How about getting something for sleep PRN? I don't know how your tolerance is, but I seem to have a low tolerance to anti-psychotics, etc. that make me drowsy. I could just never wake up, so they actually made me depressed, so to speak. When I had a spurt of severe hypomania, my doc gave me risperidone PRN. It was much stronger than I could normally do, but if I were high, it was fine. (Since discovering lithium, I don't need those anymore, but it worked at the time.) Perhaps your doc knows of something a little stronger to add just for those nights to make you sleep?

I also don't know if this is just me or whatever, but sometimes (read: sometimes, when I am already medicated and if I catch it early) I can "rationalize" with hypomania. Almost like CBT or something. I had to learn to detect it (as I'm sure most people have to) but now that I can, sometimes I can talk myself down by repeating that it is hypomania, not me, I should try to relax and calm down, take some deep breaths, etc.. I suppose mania is different and stronger than hypomania, but just a thought. And even if my hypomania gets too manic, I have trouble with this myself. But again, just a thought.

Huge hugs and good luck. Let us know how it turns out.

I volunteered for a peer support agency before I was diagnosed and before I understood my bipolar actions and reactions. In other words, I lacked insight.

I liked evening shifts from 8:00 pm until midnight. I would have a snooze before coming in, and I could switch off and sleep when I got home. We had to do a night shift from midnight until 6:00 every 4 months. We were all alone on the night shifts but had the phone number of a supervisor who was on call. I would get wound up; what I came to know as hypomanic. My behavior became noticable and I went outside the boundaries of the organization a couple of times, I agreed to retire. The volunteering was very satisfying and I missed the feeling of "doing good" for a couple hours per week.

Now I'm diagnosed and understand my bipolar behavior much better. I've found a new organization to volunteer for and have just a 2 1/2 hour evening shift each week. I'm not getting hypomanic from the intensity of the shift and I'm home in bed by 10:30 pm on evenings when I do volunteer. Regular sleep is much better for me.

I guess my message is the world is full of people crying out to be recognized. If helping them one way isn't working for you, then try and find a new avenue. There are lots of opportunities to serve people, once you begin to look.

I hope this is quite clear, and you find an appropriate agency to volunteer for.

Take care,

CrackedGirl wrote:I can if I miss church yes but the problem is that once I start perking up with lack of sleep I find it very difficult to get to sleep even with meds as I feel so wired.

Nah, don't miss church! From some of your previous posts I gather it's something that also gives you pleasure and peace.

CrackedGirl wrote:I am yes. I take it as soon as I get in but maybe I could take it say 15 mins before the end of the shift so it kicks in when I get home? Thank you. It is the regular

Yeah, that seems like a viable option! Do you know how long it takes to kick in for you? I remember when I was on regular 25mg it took about 1h to start kicking in. So if you know how long it takes you to arrive home you could take it X minutes before the end of shift.

CrackedGirl wrote:I think this is something I should maybe try - it is not easy as I feel so wired but I think it is something I should have a go at

I know... I really do! I try to think of it this way: if I'm up there's 0 chance of falling asleep. If I'm in bed, there's at least a tiny chance of sleeping. To be honest, sometimes it doesn't work, and I just get up again and go do something. But sometimes it does work and I manage to fall asleep. It takes some willpower, but I just know you have it in you!

I so hope you can manage to keep your volunteer work and stay stable! Talk to your doctor about these options, I'm sure you'll be able to work something out.

Big hugs!

Hi ,

I guess my answer would depend on a couple of things. The first thing is how likely you feel that this sleep disruption will lead to an episode. The other thing is how much joy this work gives you versus the sorrow of an episode.

For me, disrupting my sleep routine (11pm-8am, +/- 2hrs) is likely to lead to an episode. And the trouble my episodes cause are not worth it. Good luck!!

Hi Cracked,
I haven't tried to manage nightshifts before so my advice is hypothetical only.
I would try to keep a regular sleep/wake cycle and try to go to bed at the same time every day.
Try to manage your light exposure with your sleep schedule.
I've heard that melatonin can help to manage circadian rhythms but I'm not sure how it's used.

It would be a shame to give up on something that you enjoy, and something that provides so much satisfaction for you. If you do end up deciding to stop, have a back-up plan ready. I know someone who volunteers in the evening and finishes as 12pm, helping street kids with coffee, food and chat. There might be something more suitable out there for you.

Thank you all so much for taking time to reply and for your advice-I really really appreciate it

gratteciel wrote:I agree that if it is rewarding for you, you should find a way to continue.

How about getting something for sleep PRN? I don't know how your tolerance is, but I seem to have a low tolerance to anti-psychotics, etc. that make me drowsy. I could just never wake up, so they actually made me depressed, so to speak. When I had a spurt of severe hypomania, my doc gave me risperidone PRN. It was much stronger than I could normally do, but if I were high, it was fine. (Since discovering lithium, I don't need those anymore, but it worked at the time.) Perhaps your doc knows of something a little stronger to add just for those nights to make you sleep?

I also don't know if this is just me or whatever, but sometimes (read: sometimes, when I am already medicated and if I catch it early) I can "rationalize" with hypomania. Almost like CBT or something. I had to learn to detect it (as I'm sure most people have to) but now that I can, sometimes I can talk myself down by repeating that it is hypomania, not me, I should try to relax and calm down, take some deep breaths, etc.. I suppose mania is different and stronger than hypomania, but just a thought. And even if my hypomania gets too manic, I have trouble with this myself. But again, just a thought.

Huge hugs and good luck. Let us know how it turns out.

Thank you honey. That is a good idea about something to knock me out after these shifts as the quetiapine struggles to kick in if I am wired. I like your idea of talking to yourself about the hypomania - that is a really good idea. Hopefully I could try that and try to nip things in the bud. Thanks so much for your help.

skilsaw wrote:I volunteered for a peer support agency before I was diagnosed and before I understood my bipolar actions and reactions. In other words, I lacked insight.

I liked evening shifts from 8:00 pm until midnight. I would have a snooze before coming in, and I could switch off and sleep when I got home. We had to do a night shift from midnight until 6:00 every 4 months. We were all alone on the night shifts but had the phone number of a supervisor who was on call. I would get wound up; what I came to know as hypomanic. My behavior became noticable and I went outside the boundaries of the organization a couple of times, I agreed to retire. The volunteering was very satisfying and I missed the feeling of "doing good" for a couple hours per week.

Now I'm diagnosed and understand my bipolar behavior much better. I've found a new organization to volunteer for and have just a 2 1/2 hour evening shift each week. I'm not getting hypomanic from the intensity of the shift and I'm home in bed by 10:30 pm on evenings when I do volunteer. Regular sleep is much better for me.

I guess my message is the world is full of people crying out to be recognized. If helping them one way isn't working for you, then try and find a new avenue. There are lots of opportunities to serve people, once you begin to look.

I hope this is quite clear, and you find an appropriate agency to volunteer for.

Take care,

Thank you skilsaw so much. Thank you for sharing your experiences with me. I am glad you have found something rewarding which works for you. It is wonderful to volunteer helping others I find. I hear what you are saying about perhaps finding something that I am better suited to. I think I will try to figure out how to work with this job but if I cant start looking around for other things- thank you for the advice.

invicta wrote:

CrackedGirl wrote:I can if I miss church yes but the problem is that once I start perking up with lack of sleep I find it very difficult to get to sleep even with meds as I feel so wired.

Nah, don't miss church! From some of your previous posts I gather it's something that also gives you pleasure and peace.

CrackedGirl wrote:I am yes. I take it as soon as I get in but maybe I could take it say 15 mins before the end of the shift so it kicks in when I get home? Thank you. It is the regular

Yeah, that seems like a viable option! Do you know how long it takes to kick in for you? I remember when I was on regular 25mg it took about 1h to start kicking in. So if you know how long it takes you to arrive home you could take it X minutes before the end of shift.

CrackedGirl wrote:I think this is something I should maybe try - it is not easy as I feel so wired but I think it is something I should have a go at

I know... I really do! I try to think of it this way: if I'm up there's 0 chance of falling asleep. If I'm in bed, there's at least a tiny chance of sleeping. To be honest, sometimes it doesn't work, and I just get up again and go do something. But sometimes it does work and I manage to fall asleep. It takes some willpower, but I just know you have it in you!

I so hope you can manage to keep your volunteer work and stay stable! Talk to your doctor about these options, I'm sure you'll be able to work something out.

Big hugs!

Thank you so much for the further advice hon - really appreciated. I will try your suggestion about making myself go to bed. I also wondered whether a hot bath with lavender would help. Quetiapine usually takes half hour to an hour to kick in for me so it I take it towards the very end of the shift that should work. I think it is a good idea to talk to my Dr - thank you. Ooh and I wont miss church <3

stevenmiller0070 wrote:Hi ,

I guess my answer would depend on a couple of things. The first thing is how likely you feel that this sleep disruption will lead to an episode. The other thing is how much joy this work gives you versus the sorrow of an episode.

For me, disrupting my sleep routine (11pm-8am, +/- 2hrs) is likely to lead to an episode. And the trouble my episodes cause are not worth it. Good luck!!

Thank you I am finding that my mood is def getting affected by the lack of sleep but I am not taking off in the manner in which I have whilst unmedicated and undiagnosed in the past. I think it is good to look at how much joy the work brings me vs what happens if my mood badly goes off. I am not sure of the answer to that question atm as I hate not being able to do what I want because of BP so I tend to decide I can do everything. Thanks for your advice and good wishes

bipolarbirdie wrote:Hi Cracked,
I haven't tried to manage nightshifts before so my advice is hypothetical only.
I would try to keep a regular sleep/wake cycle and try to go to bed at the same time every day.
Try to manage your light exposure with your sleep schedule.
I've heard that melatonin can help to manage circadian rhythms but I'm not sure how it's used.

It would be a shame to give up on something that you enjoy, and something that provides so much satisfaction for you. If you do end up deciding to stop, have a back-up plan ready. I know someone who volunteers in the evening and finishes as 12pm, helping street kids with coffee, food and chat. There might be something more suitable out there for you.

Thank you so much I am naughty with bedtime in general and dont have a good routine with it so it sounds like I should work on that. I had not thought about melatonin- that is a really good idea to ask my Dr about. And thank you for the advice about perhaps finding something more suited to me - I will keep that in my head in case I cant work this out

Thank you all for your help and support

Hugs

Cracked