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I’m So Tired – Bipolar Disorder and Fatigue

December 8, 2014 Natasha Tracy

For me, fatigue is not just a symptom of an illness listed in a giant encyclopedia of diagnoses; for me, fatigue is practically a way of life. If I didn’t have a day where I was so tired I wanted to curl up in a ball with my cats, I’d be downright shocked.

Fatigue and Bipolar Depression

Of course, “loss of energy or fatigue” is specifically listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a symptom of bipolar (and unipolar) depression. In my view, it’s one of the more disabling, ongoing bipolar symptoms, but that’s just how it presents in me. Because whether I feel acutely depressed or not, the fatigue is almost omnipresent. It’s just one symptom that the medication doesn’t seem to squelch. I’m kind of famous for my naps.

Fatigue and Bipolar Medication

Of course, if you have bipolar disorder and you’re feeling fatigued and you’re also on medication, the fatigue you’re experiencing could be a side effect. Fatigue is a side effect of the following common bipolar medications:

And so on. You’ll find similar side effects noted for most, if not all, antipsychotics for bipolar as well.

How Do I Know if My Fatigue is Bipolar- or Medication-Related?

Determining if something is a side effect generally goes like this:

  • Did the symptom start just after you started a specific medication? Then it’s likely a side effect.
  • Was the symptom there before you started the medication? Then it’s likely a bipolar symptom.
  • Did the symptom get worse when you started a medication? Then it’s likely both.

And if you really want to know whether something is a side effect you can always switch medication but there are oodles of downsides to doing that.

What to Do about Bipolar Fatigue

People with bipolar disorder often experience fatigue. But is your fatigue medication- or bipolar-related and how do you treat bipolar fatigue?

Of course, no matter why you’re feeling fatigued, really, all the matters is that it be treated. If it’s related to a medication side effect, then handling it usually involves decreasing or switching medications. If the fatigue is mood-related, though, what you really want to do is better treat all the mood symptoms. In other words, if you have significant fatigue often, you’re experiencing a bipolar depression symptom often, and we know that partial treatment of bipolar depression is less than ideal and tends to lead to less favorable outcomes. (People in complete remission with no lingering symptoms tend to have better long-term outcomes.)

Common strategies for dealing with fatigue include:

  • Treating the bipolar with a more “activating” medication. For example, while almost all antipsychotics are associated with fatigue, some are more so than others. Aripiprazole, for example, is often considered a more “activating” medication and may have an energizing effect for some people.
  • Treating the fatigue/bipolar depression with a stimulant. One stimulant that has some data behind it is modafinil (as an adjunct) for treating bipolar/unipolar depression, and fatigue specifically. (See: Modafinil Augmentation Therapy in Unipolar and Bipolar Depression: a Systematic Review and Meta-analysis of Randomized Controlled Trials)
  • Exercise. I’m including this one because people swear they get more energy when they exercise. I don’t; I just get tired; but other people swear it’s the opposite.

So, the short story on bipolar and fatigue is this: you don’t have to live with it. Certainly, with the strategies I’ve employed, I’m a lot less fatigued than I was before. The solutions might not be perfect (When are they ever?) but they are available and something you should discuss with your doctor if fatigue is an issue for you.

Please note: no treatment is right for everyone and trying to beat fatigue with something stimulating could increase your risk of switching to hypomania/mania or a mixed mood which means that working with your doctor on something like this is extremely important.

You can find Natasha Tracy on Facebook or Google+ or @Natasha_Tracy on Twitter or at Bipolar Burble, her blog.

APA Reference
Tracy, N. (2014, December 8). I’m So Tired – Bipolar Disorder and Fatigue, HealthyPlace. Retrieved on 2019, August 22 from https://www.healthyplace.com/blogs/breakingbipolar/2014/12/im-tired-bipolar-disorder-fatigue



Author: Natasha Tracy

Natasha Tracy is a renowned speaker, award-winning advocate and author of Lost Marbles: Insights into My Life with Depression & Bipolar.

Find Natasha Tracy on her blog, Bipolar BurbleTwitter, Instagram and Facebook.

carol moger
says:
February, 3 2019 at 3:06 pm
After 40 years of treatment, I'm the one who said,l "Hey. I think I am bipolar!" I have bipolar 2. My most serious complaint is fatigue, exhausting, depleting, fatigue. Last spring I became so weakened, I couldn't walk without assistance, my memory was shot with significant mental confusion. My arms were even weak. I was put into the hospital with the doctors thinking I had had some kind of stroke. After thousands of dollars of testing, nothing showed up. They took me off lamictal, but my psychiatrist doesn't believe it had anything to do with my symptoms. I've had these symptoms in the past (only very milder) and am in a fatigue state now where my hands & arms feel weak and all I want to do is go to bed. I need to push for a definitive dx for these symptoms. At the same time, I remember being 16 and having to push through a wall of fatigue to do what I wanted & needed to do.

I want to encourage everyone. I started treatment in the mid 70"s. At that time, it was still common to have professionals who blamed mothers for their children's schizophrenia. Depression was caused by anger turned inward and and we could all get well if we just wanted to bad enough. And, medication was considered a crutch unless you were absolutely unable to function and the professional didn't know what to do with you. When medication was used, it was much like the brillcream commercial - "A little dab will do it." And then you went through it all again..... At least they know we have neurological disorders that are thought of as life-long. Now there are psychiatrists who truly function in a medical mode.
Jen
says:
January, 19 2019 at 6:50 am
I just came across this page. I am on lamictal, lithium, prozac, an ADD medicine, Rexulti and valium for sleeping. I cannot add another medication to my list. For the past several days all I can do is sleep. I am taking two naps a day and going to bed very early and sleeping until morning. I cannot wait to take a nap as soon as I wake up. It's times like these I miss the mania. At least my house is clean, I am showered and am able to function. I just cannot do this anymore. I can't. There is no point to my comment other than to vent. It is depressing being depressed.
Michelle duCros
says:
October, 16 2018 at 12:24 pm
I’m bipolar type 1 and on a injection of drug to keep taking it. As I have a habit of taking myself off the drug in order to have energy. They took me into hospital in February and forced me to take medication otherwise I wouldn’t be allow to return home. I’ve since had to give up exercise, walking the dog & brain is foggy all the time. Even struggle to put clothes on at times. I’ve got myself a part-time job only 12 hrs but even that feels too much. I’m constantly thinking I wish I could take an injection of medication to combat this and end it... I can sleep 12 hrs a night and still want to sleep.. please tell me this is not just me. It’s like I have memory loss was a competent individual able to over come most things now a waste of space, lazy, in-creative and boring. Any suggestions appreciated
Marie duck
says:
September, 24 2018 at 4:58 am
Its a relief to learn that i am not the only one,,,,i am alwaysracing in my mind with all the stuff i am up against for the week,,,,i am bipolar,,,i get tired very easily and feel this is lead on because i tire my mind and soul with every task i think of,,,i have worked with myself by using a form of meditation,,,i try not to ket it take me over because i have a shortattention span and i get annoyed pretty easily...so i try to help myself to stay calm and try to focus on what im doing at that moment,, i mess up sometimes and i just hate myself for losing my cool,, i usually end up yelling and arguing ,i wish i could find other avenues sometimes,,i believe that people who have bipolarism, we are very sensitive,,with all our senses, and we want everything perfect,,,we are very smart people and we get let down very fast,, because we move in our minds and feel the ending on anything which depresses our" spirit or drive"so quite frankly we work harder than one who does not have bipolorism, i believe it tires your mind,,,,maybe the sleep is actually the best part for this.And the medication i was prescribed is too strong for me,,,does anyone have a recomendation for a med, that has the exact dosage to put one into a better mode and mood?? Ive just been analyzed for the first time and was told i am bipolar, my moods got so bad, i was admitted to a clinic,,with no choice because i wound up in a very irate and wild mood swing....im so embarrassed, but in my own mind i felt it to be justified for the way i was,,, i got lost, the med im on is zirprasidone, is there one thats more popular than the one im on , it needs to be one that will not put me in a stuper mood of wanting to sleep?
Di
says:
June, 7 2018 at 10:58 pm
So pleased I read this. My hubby has bipolar type 2 and is on medication under care of a psychiatrist. He is constantly tired and I have really struggled to understand it and feel as though he is just "giving up" or "being lazy" when he spends so much time on the weekends sleeping. This article has just opened my eyes to the tiredness just being a part of the disorder and that it is so difficult to fight against for the sufferer. Thank you! I will try to be more patient and undertsanding.
Elizabeth
says:
May, 14 2018 at 2:14 pm
HELP! I am a newly sober bipolar schizoaffective diagnosed person who was homeless, a junkie basically, and had lost hope in my ability to have anything even close to a normal life. Long story short I reached out to my father for help to get into treatment and get back on the right track and how grateful I am that he paid for (he is very well off so it didn't put him out or I wouldn't have asked) a rehab and I am now home and trying to live sober and manage the bipolar as best I can, which means cooperating with medication. THIS IS INCREDIBLY DIFFICULT FOR ME as I struggle with having to take drugs, after I got into drug rehab to get away from putting any substances in my body. So I'm already really having to pray my way through the day and focus on the tiniest little victories and my gratitude to stay positive. I take Topomax, Depakote (THIS is the one I am certain, that with Haldol is just a nightmare when it comes to side effects), Haldol, Prozac and sleep aid. My father has let me live with him to get back on my feet and work at his office until I am further in my recovery, more stable, and able to live on my own the right way this time. Unfortunately with the *EXTREMELY* debilitating side effects of drowsiness, Fatigue, Lethargy, Disinterested, my mind is on Slo-Mo, motivation disappears, and I have to pretend I'm coherent and force myself to act like I'm all there or else I just appear lazy and feel the fatigue exacerbated. My concern/question/BEG FOR ADVICE or someone who gets it and can relate... is other than trying new meds (I've been going in for med switches to find what works for soooo many years on and off...and it gets to be so much that I become weak and turn to self medicating in the past) I'm wondering if there's a solution to at least make it easier to explain, show, handle the situation with family who has NO IDEA how hard this is and how bad I feel for being a useless zombie sometimes, cannot predict when, and certainly have no control over it. My dad is supportive, and I'm so grateful really, but it hurts and breaks me down and affects my self esteem when it's obvious he sees this as a choice I'm making and that I am just not trying hard enough or I'm making excuses. OMG! I can't even respond because I know I'll get upset and sick of trying to convince him that I have little to zero control over being able to get up and ready for work, stay awake at the desk during work, and keep up with life and my recovery in addition to the full time job. He assumes that the meds fix the problem and I am better now, and if I don't act like that it's on me. I am losing hope and I don't want to get discouraged to the point of relapse, giving up, having a breakdown, etc. I just want some advice or encouragement on how to make it clear that I am doing my absolute best! Thank you... ;_;
May, 14 2018 at 2:37 pm
Hi Elizabeth,

Congratulations on coming so far and doing so well. You should be very proud of yourself.

It can be hard for other people to understand how hard treatment can be, no question about that. You're right, there is an impression that meds just fix everything. We, of course, know they are challenging, to say the least.

What I would say is that your dad needs some additional information about the illness. He can't know how hard it is for you unless you tell him. You are an individual and while learning about the illness, in general, will help your dad, nothing will help as much as the words coming from you.

If you don't feel like you can speak those words, maybe write a letter. Take your time and fully explain the situation as best you can. It sounds like your dad will listen if you just explain.

Also, suggest that your dad read more about the illness from others. Try memoirs or books/websites that speak to you, personally.

I hope you find a better cocktail. Don't give up. It's out there.

- Natasha Tracy
Diane
says:
August, 15 2018 at 9:51 am
I agree with Natasha. And don't give up on finding the right mix or right doctor. It took me 10 years and a relocation to find mine. Therapy also helps. I would also suggest bringing Dad with you to one of your doc or therapy appointments. There are also family support groups out there. Hang in there. You're on the right path. Try praying and going to church too. Just a thought.
Lynn Clark
says:
April, 9 2019 at 1:12 am
I really like what Natasha and the others have given as suggestions, Elizabeth. Congratulations on your recovery day by day! That’s all any of us has, after all, isn’t it? One day , then one more... you will do great, Elizabeth! You have already reached out here and been proactive in your recovery in other ways. You’re not feeling sorry for you and you are willing to do whatever it takes to stay sober and clean. Simple. You will gain strength with each victory. Hold your head up, Elizabeth! You ARE making it, RIGHT NOW. Way to go, girl!
kuliner nusantara
says:
January, 9 2018 at 10:34 pm
Good article. I'm dealing with a few of these issues as
well..
Miriam Skipworth
says:
November, 12 2017 at 5:30 pm
My GP and I think I have Rapid Cycling bipolar. I have yet to be diagnosed by psychiatrist. I have struggled through life with this daily up and down of moods and energy for 30 odd years. Unexplainable tiredness has been one of the hardest to accept. Thanks for helping me feel less like a lazy person who just can’t motivate herself.
Robert
says:
October, 23 2017 at 5:33 am
Thanks so much for this article - it's great to know I'm not alone. I've been suffering from extreme fatigue since about 2012 - ever since I was diagnosed with Bipolar-2 Disorder. I take Lithium and Latuda - and I have to wonder if it's not the Lithium. I gave up talking to my doctors about fatigue a long time ago because they never offered any useful solution except to tell me to lose weight. (Yes, I have a few extra pounds to lose, but I'm not that overweight, and frankly, I gained weight because I was exhausted all the time and too tired to do anything). I exercise nearly every day - 60 minutes of walking or 30 minutes on an elliptical. It doesn't energize me or help at all - in fact it only makes me more tired. I've been tested for Sleep Apnea, had blood tests, and there's "nothing wrong" with me. Yet day in and day out I'm exhausted. I've learned to cope and I hope to find a solution eventually that will let me feel well and alive again, but until then, it's great to know that I'm not the only one going through this problem, that I'm not just lazy, or that it's not just in my head. Thanks!!!

In reply to by Anonymous (not verified)

Chloe
says:
December, 5 2017 at 9:43 am
I have gained weight while on Latuda. I hate when doctors tell us to loose weight when we are on a medication that makes loosing weight almost impossible. I had a baby recently while taking Latuda and it caused my weight gain to be more rapid and they were always onto me about my weight. It seems almost impossible for me to loose weight now though. Seems no matter how hard I try even before the baby I couldn’t loose weight while on the medication. At one time I lost weight taking diet pills while on Latuda but they make me feel bad so I hate taking them.....glad I’m not the only one tired all the time

In reply to by Anonymous (not verified)

Sian
says:
April, 18 2018 at 3:17 pm
Hi I read your comment about having a baby recently. I am thinking about having a second child but scared out common outcomes with bipolar 2 with birth defects etc. Did you come off your medication?
Phyllis
says:
July, 18 2017 at 11:22 am
I have found that the lithium had a disorder for me called hyperparathyroidism which includes tiredness. Also anemia and a lack of vitamin B-12 as I got older.
Al Anderson
says:
June, 28 2017 at 12:35 am
Wow I feel like I'm am sick I can't do anything stopped going to the gym stopped walking I think my colinopin make it worse I don't no but at times feel very suicidle I geuss just keep trying to do stuff no matter how hard
K
says:
May, 23 2017 at 8:22 am
@Debbie - my psychiatrist has me on Vyvanse for bipolar 2 depression, and I love it. It's actually for ADD. Just letting you know of a possible option in case you and your doctor haven't discussed Vyvanse before
Etta
says:
May, 1 2017 at 9:00 pm
Well well! Finally I see that I'm not weird after all! My fatigue can sometimes be utterly ridiculous, but in reading all of you I see that it's okay after all. Thank you!!!
Debbie
says:
March, 30 2017 at 8:47 pm
Not only am I bi-polar, I also have ADD. They both cause fatigue. It's awful. I too, am known for my naps.
Haley
says:
February, 3 2017 at 9:42 pm
Bipolar medication completely wiresssss me. I've tried to listen to "doctors" putting me on medication that made me want to die everyday. Thankfully my faith kept me going but it was hard. So hard. Thank God I got pregnant and got off those horrible Satan drugs. Do your research people. Think twice about what you put in your body. It's a temple, a holy place. Much love!

In reply to by Anonymous (not verified)

Kimberly Hughes
says:
August, 2 2017 at 1:19 pm
Nothing irritates me more than when people refer to these medications as Satan and 'God got me threw it' great for you. Maybe you were never bipolar to begin with, hence why you were able to get off the 'Satan drugs'. It's a chemical imbalance. My brain doesn't work the same as someone without bipolar. So why don't you do me a favor and keep your comments to yourself. Possibly the only reason I'm here writing this post is because of the 'Satan drug'

In reply to by Anonymous (not verified)

Gabby
says:
August, 27 2017 at 9:57 pm
Well said! Tell somebody without a leg to walk? The blind to drive? Not Sarah drugs.

In reply to by Anonymous (not verified)

Lynn Clark
says:
April, 9 2019 at 12:57 am
I’m so sorry that response was posted, Kimberly! There are many I’ll-informed and ego-driven people out there. Please be encouraged that there are more of us who are compassionate, caring, informed, and educated about this disorder. If anything, God has given us resources to deal the best we can with something He never intended for us to suffer with. ♥️

In reply to by Anonymous (not verified)

Chloe
says:
December, 5 2017 at 9:36 am
I agree that the body is a temple. But our bodies are not holy for we all have sinned. And I believe that God can heal us and allow us to come off medications. And great that he healed you. But there are some people that have to take these medications for life. Please don’t go around calling them a Satan Drug. There really are some people that can’t function normally without the medications. I absolutely hate having to take medication but thankfully God has allowed me to function on the lowest dose of 1 pill Latuda. I still feel very extremely fatigue everyday. I was able to come off my medications several times but stress made me need it again. Without the medication I can’t handle extremely high stressful situations. I am thankful I was able to have a baby while on Latuda and he turned out healthy no problems. No birth defects perfectly healthy. I’m thankful I have a medication that works and I will not change it.

In reply to by Anonymous (not verified)

Lynn Clark
says:
April, 9 2019 at 12:52 am
Please be kind in your responses. People are clinging to life here. Maybe something encouraging and uplifting would be more helpful than a dehumanizing lecture, not at all based upon “much love.” Please be considerate to those who hurt.
Sammyjane
says:
May, 19 2019 at 1:33 pm
That’s right.i feel like I’m dying sometimes My fatigue is so bad I can barely get out of my bed and when I do I just go and sit down and curl up I get so tired I have to clean my house in sections some times I can’t do anything for weeks. With out my medication I am destructive and totally crazy. I can’t live with it an can’t live with out it. It’s so sad reading all these comments. Each to there own but there isn’t a cure to this illness. I think anyone cured by god didn’t have the illness to begin with. Sending love to you all 💗
Wendi
says:
November, 17 2016 at 4:49 pm
I've been on depakote for 6 months now and every time the doctor increased my meds I gained weight and became more tired. I don't work but I'm a stay at home mom and it's hard to keep up with everything. I just don't have the desire. Especially in the Fall/Winter months. I have to start saying no to friend get together because I just don't want to be around people. I could watch movies in bed everyday. My husband might divorce me! It's good to read all of your comments-no one likes to be alone!
R
says:
November, 16 2016 at 8:21 am
Hi Theresa

I feel much the same way only I have bipolar 1 disorder. I'm taking anti seizure meds too. But medication is just one form of the many therapy options out there. I also have a counsellor now but I'm finding that it's not really helping me that much. I'm still tired and depressed most of the time.

Have you thought about seeking out a naturopathic doctor as an adjunctive form of therapy? I'm looking into a naturopath myself but first I wanna to try a light box. I'm off to get one today. My funds are pretty limited but anything is worth a try

R
Theresa
says:
November, 16 2016 at 12:21 am
I have been on tegretol for a few months now for seizures which seemed to be controlled now. However the tiredness is killing me. I used to be mildly border line bipolar. Enough to notice ups and downs but not severe enough to treat. I miss my ups. I am supposed to be doing a degree in social work and I can't help myself. So how can I possibly be of use to anyone else. I'm so tired that I don't spend nearly enough time doing fun things with my kids. I get more sleep than when my toddler was sleeping worse 6 months ago and yet I feel worse now. I forget peoples names who I know well. Forget the names for things or simply descriptive words. I have a tightness in my chest and sometimes my heart feels like it's beating funny. I am so low it feels like I won't live through this and maybe I shouldn't try. I feel like everyone knows I'm a faliure. Different. Not good enough. I have a few people who don't think that but maybe they just don't want to. They have their own problems. I was on a low dose of valporate with the tegretol and I'm sure I didn't feel this bad then. I don't know. I over think everything so much. No expert seems to really know, it's like they are all guessing. I think I felt better being wiped out from seizures. I can't even remember anymore. I miss being able to live on minimal sleep for a few days, get things done then crash for a week. It was better than seizures and medications.
Justin
says:
November, 8 2016 at 2:01 pm
It's just nice to see others like me. I wish I could take all your suffering away. I share it all: the never-ending grinding thoughts, sometimes horrid, violent thoughts; the highs so high you don't sleep for 2 days and tell everyone you're going to run for mayor of New York; the yelling at or around loved ones and then the heart-splitting guilt that follows; feeling like "I'm sorry" and "ill try to make my behavior better" are completely empty promises.... finding the right balance at work between a job you want to do, one you can do, and one you can last in without getting fired. I had to start a company to be able to feel safe and at peace at work.

I just wanted to write and say I get you. All of you. And your pain. I've been there. I'll be there tomorrow. This moment is a peaceful moment so I'll cherish it. I pray for more peace tomorrow. And I'll pray for you and your loved ones as well. May healing and wholeness be ours. Xo.
Kit
says:
October, 23 2016 at 12:58 pm
Hi All,

Just been to hospital for what I thought was heart as feeling tired and heart pounding. Now I am thinking its lithium as this came back very low on bloods. I reckon it's that. Anyone else had anxiety and health problems when lithium is to low. Feeling of exhaustion?
carmen donahue
says:
September, 23 2016 at 6:09 am
im a high functioning bipolar disorder person
JohnT
says:
September, 20 2016 at 4:51 pm
All I can say is hang in there. Exercise helps. Time helps too.
Kathy
says:
September, 20 2016 at 9:56 am
Needing some support today. Reaching out to others who can relate... sending deep hugs out to you all.
Kathy
says:
September, 20 2016 at 9:54 am
I just came upon this post, while searching bipolar lethargy. I am taking lithium, lamictal & seroquel because I was having twirling thoughts, ruminating, round & round. I'm still having the twirling obsessive dark hopeless thoughts.
I'm joining in on the extreme lethargy discussion, to which I can relate. A load of laundry? Cook a meal? Maybe later or another day.
So it's now almost 3 & my big accomplishment is that I walked my dog for 1/2 hr & I managed to eat something fairly healthy. It's a gorgeous day & I'm feeling really low... and deeply lethargic. Trying to find help, support, & inspiration on YouTube videos and on psych sites.
Dixie
says:
July, 25 2016 at 6:50 am
I WISH I could nap. I absolutely cannot sleep during the day. My husband is a night owl. He is up until 1:00 a.m. most nights so the lights keep me up. I get up at Dawn to feed our cats, then go back to bed but rarely sleep deeply after that. Before going on meds, I had Tons of energy & also could nap during the day when needed. I got all my work done (when I had a job) & could help co-workers. I ran, walked, hiked & danced all the time. My meds really really slow me down. I take Depakote for manias & seizures (I am mostly manic). Seroquel (125 mg/night) to sleep, as I have had chronic insomnia leading to hallucinations all my life. Primidone to stop the shaking caused by Depakote. I wish scientists could find meds that do not make you sleepy/tired/fatigued.
BPbrian
says:
June, 20 2016 at 7:58 am
Amy,

I am right there with you. Had the same problem of needing a 2+ hour nap at work and I'm sure my boss started to wonder what was going on everyday. Certainly didn't help my career and I was lackluster at best.

I've been BP-2 for 20+ years and here's what I've found. Routine go is is KEY. You need to go to sleep and wake up the same times 7 days a week. Naps aren't horribly deteriorating if you keep them short (<45 min) and limit to once a day. Also - Jen - BEWARE off going off meds as a diagnosed bipolar 1!!! The sad but true fact of life is we will ALWAYS be dependent on a medical regimen for the rest of our lives. Just a hard fact I guess. I've been on the same three for 15 years and it's worked pretty well.

I did want to ask though - does anyone also suffer from ADD? I'm finding it very hard to concentrate (last 2-3 years) but my Dr says he won't put me on anything for the ADD out of fear that it launch a "major manic episode"???
Jen
says:
June, 17 2016 at 2:19 pm
I was diagnosed with Bipolar 1 with primarily mixed symptoms a few years ago. I stopped taking medication completely 6 months ago after weaning down. I've been trying out natural alternatives, but not so sure how well that is working out for me. Some days I feel fine, others I feel some symptoms creeping back, and the majority of the time I feel somewhere in between. Lately, I am so tired. I am not sleeping excessively, but just unaturally tired by mid to late afternoon each day. I do have a toddler that I take care of all day. So I've wondered if that is the cause. However, the tiredness is accompanied by agitation and some other bipolar type symptoms. The fatigue I'm experiencing is very familiar, like what I was experiencing when I first got diagnosed with bipolar. Back then, they started me on Seroquel. I took it at night, and slept great. An hour or so of morning grogginess was followed by steady energy all day. I would not get tired again until I took the next pill. It was great. Had to stop the medication after a couple years bc I started to get involuntary muscle spasms all over and racing heart. sucks.

So, in my case, the fatigue is purely due to the disease and not the medication.
Ann
says:
April, 24 2016 at 5:48 am
I just started on lithium, been on lamictal for 2 1/2 years. I wish I knew something to increase my memory or mental fatigue. Only 3 days on lithium and I'm really nauseated.
mahogany
says:
April, 20 2016 at 10:36 pm
this is for sick and tired id like to talk with you about some options i had the same problems and some still to this day
Sick & Tired 2
says:
March, 10 2016 at 4:35 am
Hi sick & tired

Every thing that you wrote is EXACTLY what I go through everyday. If only God would help us and cure us so we can lead a normal life! I am SOOOOOOOOOOOOOOO TIRED TOO OF BEING SICK AND TIRED!
Tracy
says:
December, 30 2015 at 2:51 pm
Lamictal is the onlu medication that has helped me with the exaustion. It took twelve years to find the right medication. I used to fall asleep everywhere. Couldn't keep my eyes open when I was driving! I also take Provigil (modanifil). I pretty good throughout the week, however I spend a good part of the day sleeping on Sundays. I have to take two days off of Provigil a week so as not to build a tolerance, and these days are way worse than on the days I do take it.
Fran
says:
October, 23 2015 at 7:34 am
Amy where can I look for a job at home? Most of them have been scams. I have a BS in human services. I was taking graduate courses but had to quit. I was working full time and going to school full time but that has completely changed. I worked part timefor a nonprofit, but teaching parenting skills to those who have had their children removed from their home and we're required to see me to get them back. Also a class to first offenders and their parent. I need another field. These people hate me before we ever get started. Well, maybe I should say that they are really pissed off at everyone and don't believe they need any change in their lives. I take one sometimes two naps a day. If I don't I'm toast. Thank you for your help.
A friend
says:
September, 22 2015 at 8:39 pm
Amy,

I'm sorry to hear that you are feeling so tired. I too go through periods where I quickly get my son ready for school each morning and then am so tired that I lie back down and take a nap for 3 more hours. I feel like depression is always present to a small extent on meds but hypomania is gone. I miss it because I felt so happy about life, so fulfilled, more awake and energetic 7 hrs of sleep was enough vs my usual 12. One thing I thought of for you is if your provider is following your labs at least every 3 months. Lithium will cause hypothyroidism and you will need to take throid replacement medicine. Hypothyroidism can cause fatigue and tiredness among other things. Well just in case, I thought this was worth mentioning.
Amy
says:
September, 22 2015 at 9:20 am
While I wish fatigue wasn't a side effect for any of us, it's nice to know I'm not the only one struggling with having a lack of energy.

I had this type of fatigue even before I was diagnosed as Bipolar II. I have tried to eat well, exercise and it's still there. The only time I can remember not having fatigue is during a hypomanic (and I've come close to full blown manic) phase. Otherwise, it's relentless. I take Lithium and Wellbutrin.

Yes, I do miss those hypomanic phases when I would be super productive, though the mass destruction that followed was not always great. I've lost friends and completely ruined my finances. Especially after my last episode of racking up 20K of debt in 3 months, which I'm still trying to pay off. And after racking up that debt getting fired from my job on a depressive run where I would sneak out during lunch and be gone for 2-3 hours because I had to nap. I didn't tell them I had to nap obviously, but my boss was always wondering where I was, so in part I blame my fatigue.

I find myself getting frustrated I feel this way when my friends don't have this problem and can keep a clean house, stick to social commitments, don't always feel tired, etc.

I kept thinking there was something wrong with me and it wasn't normal to feel tired all the time. I'm only a year into being diagnosed as bipolar. I now have a work from home job which offers me flexible hours. I find this perfect for my situation. Now if I need a nap, I take one and find I'm more productive when I get up. It's still not easy by any means and more of a work around to manage my life.

I don't want to accept or embrace the tiredness. I have hope to find a way out of it. If not, I'm going to continue to work around it the best I can. If anyone finds a magical solution, please share!
A friend
says:
September, 17 2015 at 8:07 am
Dear Sick and Tired,

Hang in there! Take one day at a time! It is hard to head into the fall/ winter time now. I too have bipolar and it sucks! I take lithium and lamictal. I am always tired. Try not to think about what you can't do but rather what you can do. Take naps and don't feel bad about it. Don't compare yourself to others. And drink as much caffeine as you want, definitely helps me.
Sick & Tired
says:
September, 14 2015 at 5:57 pm
I'm so damn tired of being sick and tired always fighting for some semblance of health. It's exhausting and sometimes I get so frustrated that all I can do is cry. I'd give anything just to be normal for a change. It seems that most medications are geared toward mania which can be quite sedating especially the antipsychotics which also come with other nasty side effects like weight gain while there's almost nothing that consistently helps with the ensuing depression. Why is that? It's so unfair. It ticks me off that my doctor won't give me antidepressants because he's concerned I'll become manic again. I wish! I suppose I should be grateful though. I try to eat right and exercise but it's hard to find the energy, motivation and discipline to do that all the time. After work there's not much energy left for household chores, etc and by weekend I'm completely burned out. So I'm pretty much left to my own devices. Lately I've been living off of coffee and protein drinks which help to keep me energized for a while so I can get some stuff done but it isn't very practical in the long run. I'm worried about the Fall and Winter months ahead 'cause I know it's only gonna get worse and there's not much I can do to stop the decline except hold on and ride it out again for the umpteenth time. Seriously I'm so fed up with all this bullshit. Some days I sit there for long periods of time staring into space and wondering how much longer I can keep living like this and is it even worth the effort to keep trying. Then I curl up on the couch and have a nap until I can pull myself together and try to make it through the rest of day praying that maybe tomorrow will be different
Chris
says:
January, 7 2015 at 8:40 am
Yes, fatigue can often be one of the worst things to deal with... It can make damn near everything difficult and the window before EXTREME FATIGUE sets in can often be very narrow. As a bipolar ii person, I do take activators such as Prozac and Wellbutrin in combination with Lithium to stabilize. However that's not a one size fits all solution because with someone Bipolar 1 or even 2 with a different chemistry that might cause them to go Manic or Hypomanic. I'm also one of the people that exercise does not give me more energy. In general, my daily routine is enough physical exertion to put my body to its limits so realistically there is not any energy to spare. I've honestly felt like I ran a marathon before at the end of the day when I didn't do anything that most people don't do on a regular basis.
cindyaka
says:
January, 1 2015 at 7:02 am
Hi! I found I was always tired,no matter what I tried.My md finally sent me to a sleep medicine specialist. Turns out I have sleep apnea. The CPAP machine works like a charm, I'm not tired all the time, and actually feel refreshed when I wake up. Getting a sleep study done might be worth a try, it definitely helped me.
bipolarfred
says:
December, 23 2014 at 4:48 pm
Dealing with the fatigue is probably the hardest symptom I face daily with bipolar. Its been difficult to even determine the source of it all, i'm a high functioning professional and a level of tiredness is natural, but every single day there wouldn't be a time where I didn't want to curl up and sleep and i'm sure that's not a typical reaction. I can get fatigued very quickly when a particular environment drives my anxiety up. Anyone who has experienced this and tried to maintain a relationship would know this is the hardest part to get right.

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