Discussions By Condition: Medical Errors

Circadian Rhythm Disorder misdiagnosed as Hypomania

Posted In: Medical Errors 4 Replies
  • Posted By: Sleepless in Phoenix
  • October 30, 2009
  • 00:53 PM

I just went through a very strange experience. I've been seeing a therapist for the last several months after a bout of depression and anxiety which has been ironed out after the situation I was depressed about changed. Due to my anxiety, I made the mistake of trying to commit suicide. I was hospitalized for several days, given a psychotropic drug called Celexa (which I feel I no longer need and would not have been able to get refills anyway since I couldn't get an appointment for so long), and a sleep aid. Due to my being hospitalized, I was informed upon my discharge that I needed to set up an appointment both for counseling and for drug therapy with a local agency that I qualify to receive care from through a state funded care program.

Well, today, after months of asking to get an appointment with a psychiatrist to help me with my sleep disorder, I finally go to meet a nurse practitioner assigned to me, and this pretty young nurse practitioner decides that instead of listening to my current problems with a severe sleep disorder ( of which I described the symptoms of not being able to fall asleep and delaying sleep for sometimes several extra hours), she decides I've got Hypomania (a bipolar disorder).

When I read the symptoms and presentations of this disorder, the only thing it has in common with my situation is sleeplessness or no desire for sleep. Has anyone heard of a diagnosis this far off the mark? I'm considering a complaint to the nurse practitioner's supervisor and a possible lawsuit. She told me I was mildly bipolar. My mate has had direct experience dealing with a bipolar disorder through his former spouse. He has studied the disorder for years, and upon reading the list of hypomania symptoms, he said "that's not you at all". I have no racing thoughts, I have no pressured speech. I am not aggressive at all. I have little desire to place my happiness on career success (I'm not even working right now and have been trying to gain the self esteem to look for another job!). I think this nurse missed the mark with me completely.

For many years, since I was a child, I have had trouble falling asleep. I like being awake at night, although it makes it difficult to perform the type of clerical jobs I usually work. Sometimes I even stayed awake for about 40 hours at a time back in my 30's (no depression, no aggressive behavior, no racing thoughts, no behavior problems at all, I simply felt that was a normal schedule for me and I had the freedom to do it and I liked it). I no longer can stay awake that long as I get older, but, I am able to stay up for about 26 or 27 hours sometimes. I usually sleep on a 24-25 hour schedule that starts in the late afternoon and I go to sleep about 5 am.

Upon reading the information for Circadian Rhythm disorders, it appears that I have what is called Delayed Sleep Phase Syndrome (I delay my sleep patterns) and I have had the freedom for the past several years to sleep freeform, whenever I chose. My rhythm is different from most people.

Several years ago I worked night shifts in the newspaper business, and I liked the hours. I've grown used to staying up late at night. Unfortunately, now that my partner and I are trying to put together a live-in relationship, the differences in our sleeping patterns are becoming more noticeable.

I also think the invention of the internet made my circadian rhythms change more drastically. It appears I'll have to start modifying the times I'm allowed to be online, perhaps change the background color from white on most pages to something less bright as well and stop watching tv and eating at night.

I was prescribed a medication called Seroquel today for the hypomania diagnosis, but that medication treats bipolar disorders and schizophrenia with an off label use for insomnia which I wasn't told it was off label at all. I'm very angry and I don't think I should take this medication (it also has some nasty side effects and cautionary problems including heart problems, circulatory problems and weight gain).

Would you take this drug if it was you or would you demand this agency take a second look at the diagnosis and prescribe something more in line with the circadian rhythm problem I seem to be having?

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4 Replies:

  • I just went through a very strange experience. I've been seeing a therapist for the last several months after a bout of depression and anxiety which has been ironed out after the situation I was depressed about changed. Due to my anxiety, I made the mistake of trying to commit suicide. I was hospitalized for several days, given a psychotropic drug called Celexa (which I feel I no longer need and would not have been able to get refills anyway since I couldn't get an appointment for so long), and a sleep aid. Due to my being hospitalized, I was informed upon my discharge that I needed to set up an appointment both for counseling and for drug therapy with a local agency that I qualify to receive care from through a state funded care program.Well, today, after months of asking to get an appointment with a psychiatrist to help me with my sleep disorder, I finally go to meet a nurse practitioner assigned to me, and this pretty young nurse practitioner decides that instead of listening to my current problems with a severe sleep disorder ( of which I described the symptoms of not being able to fall asleep and delaying sleep for sometimes several extra hours), she decides I've got Hypomania (a bipolar disorder).When I read the symptoms and presentations of this disorder, the only thing it has in common with my situation is sleeplessness or no desire for sleep. Has anyone heard of a diagnosis this far off the mark? I'm considering a complaint to the nurse practitioner's supervisor and a possible lawsuit. She told me I was mildly bipolar. My mate has had direct experience dealing with a bipolar disorder through his former spouse. He has studied the disorder for years, and upon reading the list of hypomania symptoms, he said "that's not you at all". I have no racing thoughts, I have no pressured speech. I am not aggressive at all. I have little desire to place my happiness on career success (I'm not even working right now and have been trying to gain the self esteem to look for another job!). I think this nurse missed the mark with me completely.For many years, since I was a child, I have had trouble falling asleep. I like being awake at night, although it makes it difficult to perform the type of clerical jobs I usually work. Sometimes I even stayed awake for about 40 hours at a time back in my 30's (no depression, no aggressive behavior, no racing thoughts, no behavior problems at all, I simply felt that was a normal schedule for me and I had the freedom to do it and I liked it). I no longer can stay awake that long as I get older, but, I am able to stay up for about 26 or 27 hours sometimes. I usually sleep on a 24-25 hour schedule that starts in the late afternoon and I go to sleep about 5 am. Upon reading the information for Circadian Rhythm disorders, it appears that I have what is called Delayed Sleep Phase Syndrome (I delay my sleep patterns) and I have had the freedom for the past several years to sleep freeform, whenever I chose. My rhythm is different from most people.Several years ago I worked night shifts in the newspaper business, and I liked the hours. I've grown used to staying up late at night. Unfortunately, now that my partner and I are trying to put together a live-in relationship, the differences in our sleeping patterns are becoming more noticeable. I also think the invention of the internet made my circadian rhythms change more drastically. It appears I'll have to start modifying the times I'm allowed to be online, perhaps change the background color from white on most pages to something less bright as well and stop watching tv and eating at night. I was prescribed a medication called Seroquel today for the hypomania diagnosis, but that medication treats bipolar disorders and schizophrenia with an off label use for insomnia which I wasn't told it was off label at all. I'm very angry and I don't think I should take this medication (it also has some nasty side effects and cautionary problems including heart problems, circulatory problems and weight gain). Would you take this drug if it was you or would you demand this agency take a second look at the diagnosis and prescribe something more in line with the circadian rhythm problem I seem to be having? Based on what you are saying, no, I would not take seroquel. I am not a Doctor, but I have been on the bipolar medication rollercoaster for over twenty years and hypomania is my diagnosis. I hear music, I hear voices, mainly my name. I hallucinate the wrong face on people I don.t know. I was on Seroquel for that. Now I am on public health insurance and they wont cover seroquel, which, at my dose would be 600 or 700 monthly. I am on risperdel and not happy about it. Get a second opinion. If you can avoid it, dont mention the previous diagnosis, they will assume she was right and you are having a hypomanic episode. Report her via email, and find another clinic. Good luck
    Anonymous 42789 Replies
    • December 14, 2009
    • 00:11 PM
    • 0
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  • I'm appalled, first of all, that a physician's assistant or a nurse practitioner is legally allowed to prescribe an anti-hallicinogenic like Seroquel. My father took it for demensia suffered as a late-stage symptom of Parkinson's disease. Your prior hospitalization probably affected the practitioner's assessment and diagnosis. That's bunk. I agree with the prior response; go find another clinic, or ask to see the psychiatrist again, that is the only professional that should ever be prescribing drugs like Seroquel. But it will help you sleep - yes, with nasty side effects. I can relate with your sleep/wake habits, and have found that even so-called sleep specialist doctors don't like to address issues with Circadian rhythms. They all know they exist, but there is little research about them or acknowledgement of them in the medical profession. Best of luck to you.
    Anonymous 42789 Replies Flag this Response
  • Get a second opinion! i think it is like trendy nowdays to diagnose people with bipolar. i had many doctors (who wouldnt have a clue) try to say i had that but every single psychristrist and psychologist ive seen says i havent. (and it dont fit me)............. There are MUCH safer things to take for circadian rhythm problem. i used to take Melatonin for that issue.. Melatonin often works well. Melatonin is the hormone our body naturally produces which helps control our body clocks and its natural and safe. See if it's available in your country. *Note to anyone in Australia. 90% of doctors over here will tell you you cant get Melatonin here but that is completely untrue. With a doctors script, it is available in some chemists. i get mine with a script from a normal chemist (but have to inform the doctors myself that this can be done).
    taniaaust1 2267 Replies Flag this Response
  • Second opinion absolutely! I was misdiagnosed as bipolar for nine years before a new pdoc convinced me (and it did take convincing) that I just had really bad ADHD. All of my "symptoms" were side effects of various meds that docs kept piling on top of one another. My manic "episodes" took place during traumatic events like being laid off, 9/11, and my parents' divorce that were only heightened by the meds. I had been shuttling around from doctor to doctor without anyone questioning the diagnosis.Since this has all came to pass, I've been slowly weaning myself off Lamictal, increasing my Adderall and never felt calmer or even-keeled. Another thing I started doing was taking Vitamin D supplements, which has helped with achy muscles and sleep patterns. I recommend everyone do this, especially during the winter. Nutrition also plays a significant role (cut out the sugar).
    Anonymous 42789 Replies Flag this Response
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