Heavy Doses of Caffeine with Klonopin

I tried a little experiment a few days back. I was drowsy from the klonopin that I was taking and it was raining out, so I couldn’t get my exercise in. Instead, I tried drinking coffee. More specifically, I tried drinking coffee until I wasn’t drowsy any more. That adds up to a lot of coffee, close to 3 french presses of coffee, though I do have a remarkable tolerance for caffeine so that might be low for me compared to others. Surprisingly, I was still a little drowsy, but I had a new problem on hand. I was hyper caffeinated and sedated. The result was probably something similar to q-balling, which is when one takes quetiapine fulminate (seroquel) along with cocaine. One of them ups you, the other one downs you.

I’ll describe some of the positive aspects of it. I’m not condoning this behavior and am not going to try it again, but there were some positive aspects. The main one was a sense of urgency that was tempered with a relaxation. Things had to be done, now, but there was no anxiety attached to them. Additionally, I had no physical side effects from the caffeine. My hands were rock steady and I was in complete control of my body. I wasn’t manic either, I just felt like doing things.

But that’s about it in terms of positives. The negatives were far greater. Drinking that much caffeine along with a drug that interferes with your short term memory means only one thing, I couldn’t remember anything past 5 minutes ago. Nothing, it was just pure stream of consciousness. Which made it hard to do anything intellectual. I cleaned up the house and did some cooking, shockingly without burning down the house. But without memory, life is just a blur that cannot be organized. The other major problem with over caffeinating is that I lost any ability to focus on a single task. I buzzed around doing little bits here and there and wound up doing nothing. Additionally, because my brain was screaming at the speed of sound, I was unable to enjoy anything. Listening to music was a chore because it didn’t progress fast enough. There was no savoring of the calm lulls that into a crescendo. TV was also unwatchable because 20 minutes was too long to sit and do something.

So I hope to offer this as a minor advisory against combining these two substances. A little bit of caffeine does help with getting things going, but too much makes like unproductive and uninteresting. From a personal perspective, I’d rather take the days where I’m a little sleepy and can still enjoy something like Breaking Bad rather than a hyper mess that doesn’t get anything done either. If you’re wondering what you can do to help with the grogginess of klonopin and you don’t want to resort to more caffeine, I suggest exercise. Doing a few pushups and getting the heart rate up really gives a temporary boost. It doesn’t last long, just around half an hour, but it does work and works a lot better than grabbing another cup of coffee.

As a side note, after doing this I spent a lot of time drinking green tea throughout the day. It provides a lower but steadier state of caffeine and does in fact help.

Caffeine – A Friend At The Gym

So this is a short one. Over at Science Daily they report that researchers at Sheffield Hallam University found that caffeine is a performance enhancer in sports when taken with carbohydrates. The results were two fold, and rather shocked me. First is that caffeine with carbohydrates increases stamina, and second, that it improves overall performance at tasks. This result, in addition to the fact that caffeine helps replace glycogen, the muscle’s immediate fuel source, leads me to now reconsider how I view caffeine.

Now, while staying within my tolerance, I’m definitely adding caffeine to my workout regimin. But I’m playing it on the safe side, since I’ve already researched the link between hypomania and caffeine.

Frustration, Destabilization, and Behavioral Activation

My car broke down yesterday. It was a traumatic experience because I was getting on the highway and it suddenly started lurching and died as I pulled off the highway. That was enough to send me into a mild panic attack. Thankfully, I had cigarettes to calm me down instantly (I don’t recommend smoking to stave them off since it can make panic attacks worse, but it’s all I had since I forgot my xanax). Still, that wasn’t enough. I was hypomanic and frustrated.

For the past few days, my mood has been elevated, but trending back to normal. Yet, this frustration really got the better of me. It’s normal to be a little down as a result of having additional problems and being trapped in a small town for yet another night, but this triggered a mood swing. Today, I was agitated and depressed. I couldn’t sit still, yet I just laid in bed watching star trek, not wanting to do anything except for crawling away to a small corner.

But there were two things that I did yesterday and today that helped enormously. First of which was focusing on rationalization and alternative plans. My girlfriend was there for me to bounce ideas off of, but what really helped was me going over every possible contingency and planning accordingly. Focusing while using a small meditative technique and exploring alternative possibilities helped alleviate the frustration by showing it to be the only rational choice. Even if it wasn’t, I convinced myself that it was, which is enough to defy some of the frustration.

Secondly, I tried some of my behavioral activation therapy this morning. I listed off things that I could get done and ranked their difficulty. The easy stuff I rewarded myself with just a little tv. Calling the mechanic, getting out of bed, getting in contact with people to arrange plans, etc… Now I’m rewarding myself again by reading some blogs and browsing the internet. What’s amazing is that it’s working very effectively. I still have some big stuff to do, and I’m not sure if I can do them, but it’s raised my bare functionality considerably by getting the small things out of the way.

And now lastly, I’m drinking some coffee to get caffeine’s antidepressant effects out of it. The effects seem to be working. I’m getting bare stuff done, maybe will eat soon, and I’m feeling less depressed. Not great, but by getting some of the little things done, I feel an enormous weight off of my shoulders and a small sense of accomplishment. Which is not that bad considering that I was able to rouse myself in just about 2 hours with the above technique.

Caffeine and Hypomania, A Dangerous Mixture

Something brand new happened to me today. I was mildy hungover and sleep deprived (from 1 small beer too! grrr) so I caffeinated heavily today. Something fascinating happened, it triggered a hypomania. At first I thought it was just the caffeine making me energetic, but there was no crash, no sugar low, no nothing. It just kept going and going. And for the past few days, I’ve had fatigue and sleep issues around late at night where I couldn’t stay awake past 10 and I would sleep till 9am. It was troublesome to say the least, but not a horrible depression. Still, I’ve swung out of it into the exact opposite, rather than a hypodepression, I’m hypomanic.

Why is this? Two factors in my opinion. My psychologist pointed them out to me a while ago, but it’s taken until now to really put it together. The first factor is the alcohol. He stated that it has a kindling effect, meaning that it causes mood instability. If I’m swinging down, it’ll make me go further down; going up, it’ll make me go up. For a long time, I thought that this only worked while the alcohol was in my system. So whatever mood I was in previous to the drinking would in fact be what is kindled into a stronger phase.

Now I find that it simply causes instability in general. This morning I wasn’t feeling that great, but the coffee acted as an antidepressant and swung me up. Now, for the record, I’m particularly sensitive to antidepressants. Celexa took a whole 48 hours to put me into a full on mania. So it doesn’t surprise me now to say that I must be sensitive to the effects of caffeine. But I am surprised at the fact that it triggered a hypomania. This hasn’t happened before when I drank coffee. I felt better in the past and had more energy, but nothing that was sustained.

And while I am hypomanic, so I’m not really that concerned, my more rational mind is pointing out to me that this might be very dangerous. I tend to drink more when manic which will only make it worse. Additionally, now that I’ve put two and two together, it seems that I might be trying to trigger manias using this combination. This is particularly dangerous since the stable me doesn’t want manias. They’re dangerous and heavily disruptive to my daily life. It also means that I have to pay special attention to my coffee intake for the next few days to prevent me from going any further. This, however, will be more difficult because I can already feel my impulse control slipping. For all I know, tomorrow I’ll just chug a pot of coffee to try and get the high back. I can’t tell what I’ll do, that’s the scary part of having manias.

Furthermore, while I’m feeling great now, there will be a crash. I don’t get manias without a coup de grace ending of depression that is equal in magnitude. That means that the marathon of stability that I’ve been running, with only mild depression here and there, might be over. And it often takes a while for me to stabilize again after having a quick mania-depression combo.

The only good part of this is that I get to put abilify to the test of stability and depression control. I’ll see soon how deep I go down and how quickly I go there, and then how quickly I bounce back. It should be an informative few days. And the only reason I’m not too worried is that I’m starting to get that hypomanic “I’ll survive anything” feeling. Which is great for now, but my mind is screaming at me to stop this before it gets out of hand.

Self Medication – Caffeine as an Antidepressant

I abuse caffeine. It’s my drug of choice next to nicotine. Nicotine is for some other time, but caffeine is for now. The past 2 days or so, I’ve been mildly depressed. Anhedonia, easily fatigued, excessive sleeping, etc etc. It’s almost ridiculous how quickly I can detect depression. So how do I cope. Well, I turn to stimulants mainly. And caffeine is a readily accessible and delicious one.

What does it do that is so appealing. First it gives me a pick me up. Which is readily needed since I get so fatigued. In fact, this might be one of the most important things. Usually when I’m depressed, I lie around all day and watch tv. I don’t even have the energy or focus to read much when I’m depressed more than usual. Caffeine gives me a restlessness and need to move around that may not lend itself to doing cognitively heavy tasks, but it gets me into needing to do chores and at least moving around. It’s strange, since I hate being restless, but when I’m depressed I’ll take anything that feels different.

Second is that it seems to improve my mood. This is substantiated by some medical research. It acts as an antidepressant that increases both serotonin and dopamine. So in addition to giving me a kick, it also works as a minor antidepressant that helps kick start my mood. It’s no zoloft mind you, but I’ll take whatever works. Along these same lines, it does make me feel better and happier. It’s strange to think of a beverage as doing this, but it perks up my mood and makes me feel more congenial.

Third, it helps with creativity. The increase in the rapidity of my thoughts is beneficial to making the connections for some creativity. When I’m manic or normal, this may not be the best idea. But when my thoughts are slowed down by a depression, this gives me enough of a boost to start thinking again.

So in the end, caffeine is not necessarily the enemy of bipolars or being depressed. In fact, it has its uses in moderating the depression episodes and relieving some of the symptoms. For years now I’ve used it as a pick me up for my depressions. But it’s only been recently that I’ve consciously chosen it to really help me out. And for the past two days, it’s transformed me from a couch bum into a semi-productive member of society. That’s enough for me to get some of my days back from the cycles that abilify is still not powerful enough to stop.

Adventures in Abilify – Day 13 – Focus and Short Term Memory

Wow, 13 days, as I write this it’s been 14 days. Feels like I’ve been on abilify for a very very long time. It’s also made my days seem really long as well. Often, by 11pm, I go to bed simply because I’m bored of being awake. Day 13 was the first oddly productive day. I was able to go through 3 papers of relative depth and work them over into a paper I’m writing for a class. I was also able to write fairly well when agitated, though my writing definitely reflects how quickly my mind is flying. I don’t introduce much at all and I slave over trying to explain the little details. It’s good though, when I calm down I can edit and add, when I’m agitated it’s like I’m actually manic where I just write and write and write.

As for cognition, while my focus is not particularly good, so short term memory is impacted, I’m actually really surprisingly good at taking notes on papers. I slaved through a 48 pager one day in about an hour’s worth of work and I’m surprised now in reading it over just how much I got right in marking it up. But that’s also because my notes are not critical notes, they’re expositional notes, so they act as bookmarks to every argument. Still, I was able to cut through a lot and get to the meat of a critical number of different arguments.

Symptoms have also decreased. I’m not nearly as agitated as I was before. I can tolerate caffeine better (I’m back to a small cup of morning espresso). Yet, in playing for nearly 3 hours of Civilization IV, I noticed quite a few details about how I think. First is that I’m not one for small details, I have a goal in mind and I pursue it without care for other small things. In the game I don’t slave over the little details about how my cities are running. Instead I pursue a particular goal without care about how my little cities are faring. I’m also a lot more aggressive and risk taking, like in a hypomanic state. I start wars and destroy enemies with a particular ruthlessness and elaborate strategy. When I take a second to breathe and calm myself, I get a mild god like feeling. It’s strange to think that a video game can reveal so much of my personality, but it’s another aspect of using my mind, so I’ll take it. I guess this is also the reason why it’s an anti-mania med, I still have manic like symptoms, but I have no paranoia and no delusions. I’ll miss those (or maybe they’ll resurface under a more powerful mania) but the trade off is a mild mania almost everyday. Besides that, nausea has gone down. But this drug does little in terms of helping with anxiety since it prolongs the day and thoughts about undesirable circumstances ferment. But the average day to day anxiety has decreased, so I guess it’s a trade off that I can endure.

With respect to all these changes happening within two weeks, where depression is mainly a sluggish day comprised of mild anhedonia and a need to retreat from everything, I’m starting to like this drug more and more. It’s costly, in both economic and in duration of acclimation, but the longer I’m on it, the more I’m starting to appreciate it’s benefits.

Also, a little math for how much of the abilify is in my system at this point. Summing over the past 13 days, I have a steady state level of approximately 55mg in my system using RXList’s half life of 75 hours, which means that every morning I get bumped up to 70mg. Times longer than this, 14 days, reduces the amount to pretty much negligible amounts in my blood stream since the first day of taking it. Still, I find that number pretty high considering that the maximum dose of this drug is 30mg at a time. But that’s math and half lives for you, the power of summing over a few days can produce some pretty large numbers and I’d hate to try taking 70mg all at once, so I’ll stick with easing into it over 2 weeks rather than in 1 day.