insomnia -medical or psychiatric?

Hello Sisters!

Sorry this is kinda long but I wanted to get all the info out at once. I am 1-year post op (this week). dVTH/BSO and bladder sling, no HRT. I'm 45.

I, like many sisters here, experience the poor sleep/insomnia post op. Its a pain in the arse but was tolerable until a couple of weeks ago. Then I started sleeping only 4 hours, then three, then...you see where this is going.

I was diagnosed w/ bipolar many years ago and meds have kept things well-managed. I had appointment w/ psychiatrist last week and talked about the sleep issues. He wanted me to stop sleep aid (lorazapam (ativan) which is a benzodiazepine) for a day, then go benadryl, then back lorazapam at different dose. I tried to skip a night but at 4am had massive panic attack (mostly about not sleeping) and at 5am I called it unreasonable and took a lower dose of lorazapam. I slept for 2 hours.

day 2, same **** thing.

yesterday I called my therapist and was told to do the benadryl route. I took 50 mg (dose for allergies is 25-50 every 4 hours). It took close to 2 hours to kick in and then I slept (I use the word slept loosely) for 3 hours. Bing - wide awake This was at 3:30am. At 5am I took another 50mg. 1/2hr later went to "sleep" and was up at 8.

Now I'm cranky from the benadryl, exhausted, and therapist/psychiatrist think I'm hypomanic. Granted I am not sleeping but the other symptoms they are calling bipolar/mania is that I'm irritable, easily distracted, and increased anxiety (about not sleeping!!!). They want to play with my meds. I'm not fond of that idea. I do have an appointment tomorrow morning w/ psychologist and am on wait/cancellation list for psychiatrist.

I know this site and you ladies cannot offer medical advise, however, has anybody else had to guess between medical or mental?

Thanks to you all
Amy

In my experience, once you get a psych diagnosis, everything gets filtered through that. And I guess it's hard to sort out since lack of sleep can either be a symptom of or trigger for manic issues. And pretty much, psych Drs see symptoms as part of what they know----the psych part. But that doesn't really help sort things out. Believe me, if you ask a psych Dr if HRT will help, you'll get nowhere. In a best scenario, psych and the GP consult and decide which type problem it is. So I guess I have no advice or answers. Maybe in future you can keep a log monitoring what all symptoms or events you have, to rule out other non psych issues, if that's possible. I hope you can hit the right med balance to get some sleep, whatever the cause.

Thank you. I have found it very frustrating that drs don't understand psych and psych doesn't understand medical. I think I am going to ask to have blood work done to see what shows up. Could very well be that I have multiple things all pinging off each other.

As for sleep, I really wish mosquitoes weren't out at night. I could get a lot of weeding done!