View Full Version : bipolar and mental fugue


sarahsweets
04-14-14, 05:51 AM
I have been meaning to write about this for awhile and My doctor has said she has a number of bipolar patients experience this.

What has developed in me over the past year are these fugue states. Let me explain.
It tends to occur either during a phase of rapid cycling in which I am flipping from hypomania to depression rather quickly. It has also occurred during extended periods of one or the other. What do I mean by mental fugue?

Its like I behave in a way that can seem like I am slightly impaired or not and things like circumstances or conversations and decisions are made with me having no knowledge of it. Christmas was a prime example. My foggy memory of it was that it was a good christmas. My mother an brother were distant in the days to follow and I couldnt figure out what was wrong. They had a sit down with me and told me that at times my coordination was off, like I was drunk and I was combative, loud and seemingly confused at times. My brother is gay and I gave him a beautiful necklace and apparently during the day with family visiting I would holler across the room something like:
" Sam do you like your necklace? I mean its not too gay right? I wouldnt want it to be too gay for you"
I proceeded to ask other family members if they thought it was too gay. I spilled oj all over someone and cursed big time in front of my kids and was altogether inappropriate. I know this has happened many times at home before and my kids or husband would reference it like "well you know when xyz happened you werent 'all there' They have grown to understand that these things happen around once every 2 months or so. I have sent inappropriate pics to the wrong people(not naked but intended for my husband)I have made phone calls and scheduled appts or made trips without remembering it. I will ask about whether or not I gave so and so something back that I borrowed and my husband will be like 'you mean you dont remember this?" I shudder to think that I have driven during some of these periods of time.
I have been checked by a neuro, and my pcp and my p-doc has told me that while this is sort of uncommon she has a few BP patients that this happens too. My therapist told me 2 weeks ago that in the last 2 months he has had 2 other BPII patients experience this same thing. In fact all of the patients that my doctor told me about were all BPII.

Its a scarey feeling. I feel like I ruined christmas and my memory of it is so hazy and I thought things were ok, like it was a good christmas when apparently I was acting the fool.
Has anyone else with BP experience this? Periods where things happen and you only know you did something or behaved a certain way because someone told you about it? My doctor has told me that this is something that I may just have to learn to cope with. I felt like I was going senile or had dementia before I learned what it was. I have been on disability for many years, thank god because I am sure I would have been fired otherwise. The idea that my pieces of short term events are missing or gone terrifies me, and it was good to hear my doctor and therapist tell me that I wasnt alone in this but I thought I would ask my dear friends here at ADDF if they had ever experienced this.
Thanks friends.

Fuzzy12
04-14-14, 05:57 AM
Sarah, that's sounds super scary. It would have freaked me out. I can't say that I've experienced it though. When I'm hypomanic, I can act as if I'm drunk (e.g. saying/yelling inappropriate stuff, etc.) but I do recall it later, mostly. I think, I'm also aware at the time that I'm doing it but it's just that I think, it's a good idea. Or fun. I don't really lose time or can't recall it later, so I think, it's different.

I've heard it happens with BP I so I guess, it's possible with BP II as well. What does your doc say? Is there anything that can help? Do meds help?

BellaVita
04-14-14, 06:27 AM
I don't have the focus currently to read all of that
but sometimes when I'm in an episode, I often don't recall how I acted....

Or am surprised to find out how I did when I thought it was different.

Abi
04-14-14, 07:28 AM
I have experienced this in the past, less so recently.

I even have a record of a full blown dissociative fugue episode that lasted DAYS on my psych record.

sarahsweets
04-15-14, 05:55 AM
I am guessing that meds do help because I cant imagine what would happen if I was med free. Both my doctor and therapist believe this is somewhat common and are trying to help me recognize the "warning signs" at least so I can be watched by my family. And I do sometimes have vague recollections of these things happening but I am hoping to find others who have had this happen in hope there are more things I can do to make it easier. This section doesnt get alot of traffic so Im hoping that people take some sort of notice because ADDF members are the only ones I can think of that may help/support me.

Sarah, that's sounds super scary. It would have freaked me out. I can't say that I've experienced it though. When I'm hypomanic, I can act as if I'm drunk (e.g. saying/yelling inappropriate stuff, etc.) but I do recall it later, mostly. I think, I'm also aware at the time that I'm doing it but it's just that I think, it's a good idea. Or fun. I don't really lose time or can't recall it later, so I think, it's different.

I've heard it happens with BP I so I guess, it's possible with BP II as well. What does your doc say? Is there anything that can help? Do meds help?

salleh
04-15-14, 09:19 AM
.....Oh Sarah .....that is scary ....I am not BP, so I can't relate ...but I can imagine .....( I am kinda good at putting myself in other's shoes) .....what I can't seem to do is find the words to help .....

....But you do have a family who loves you and will help you during these times ....and it is really something that you don't want to keep secret ....at least among people who you are around a lot .....so that they'll understand when these episodes happen .....if they know that occasionally you won't be yourself .....they might be able to deal with it better ....

...One question you might keep in mind .....is there something that triggers this ?.....is it something that you can control ???


.....Oh I wish this weren't happening to you .....and I really hope that there is some way you can find to control it ....you have my unconditional love, and I am only a friend from afar ....a great admirer, I know that you have a wonderful husband who loves you dearly ....and kids who think you hung the moon .....( you do, after all ) ....

...oh this all sounds inadequate.....so I'll just send good thoughts at you ...

fracturedstory
04-16-14, 09:55 PM
I do get some coordination issues. I'm not really sure if it's related. I stumble around like I have dyspraxia. I've been seeing things in my vision too. I don't it's got anything to do with my eyesight. Everything seems to be out of whack. Coordination, executive functions (more so than usual), seeing things, and even feeling well in my body.

I don't tend to remember much about my manic episodes. I just do so much during them that I begin to forget what I did at the first half of the day.

I think with rapid cycling I feel so uncomfortable and out of control because I don't stay in any one mood to know how to cope with them. It hasn't happened for awhile so I'm unsure how much I would remember about what I did during that time.

BellaVita
04-16-14, 11:01 PM
Thing with episodes is your perception is different than what's actually happening....

(At least from my experience)

TygerSan
04-19-14, 11:19 AM
Sounds scary.

I hesitate to bring this up cause messing with meds is never a good idea, and it sounds cyclical, but there is a possibility it could be med-related as well as episode related.

Have you ever had your levels checked? Might be worth it, especially if you're on a relatively high dose of an anti-convulsant (Lamictal/Topomax), or Lithium, as people can go toxic on these meds. Confusion and ataxia can be signs of med toxicity.

I have a relative about whose mental state people were very concerned. It turned out to not be dementia, but rather the consequence of long-term benzo use, as prescribed.

Hootietime
03-27-18, 06:32 AM
Wow, I've expirienced the same EXACT thing on a few occasions and I also have BP2. The closest example is when I was interning at a potential job. It was also close to the holidays and I'd thought I'd had a typical Thursay at work, generally easy going. Stopped in over the weekend to give the co-workers some gifts and they were behaving strangely towards me but they were quirky anyways so I shrugged it off. Tuesday I called to see what time they needed me to come in and I was informed that they no longer wanted me there. Apparently I had gotten into a massive argument with the boss to the point of being belligerent and I was now considered a liability. I didn't know what to think. There have been other times too, typically during prolonged periods of high stress. I've now lost 2 jobs because of these fugue states and I'm terrified to even attempt doing anything that resembles real work because of them. Thanks for the post, it's nice to know I'm not alone in this.

Lash107
03-29-18, 05:41 AM
Hi Sarah,

I also have bipolar disorder and I recently was hospitalized (non-psychiatric, that’s a change!)...your experiences remind me a bit of mine. I don’t have answers but I can share my experiences.

I did a double-take when I saw you typed “fugue.”

My S.O. took me to the ER two weeks ago...I was apparently having extreme short-term memory loss. We decided to go to our favorite restaurant and when we arrived, my boyfriend later recounted to me that I had no idea how we got there.

He said I was acting very out of it and I don’t drink anymore so I was sober. I have a lot of anxiety and I do remember feeling “chilled out,” very atypical for me.

Anyway, I wasn’t nearly as verbally interactive as you described with your family holiday. I was moving more clumsily than normal, uncoordinated.

All my scans, MRI, tests....clear. The doctors were thinking stroke, aneurism....something like that. They kept me there for observation and released me after a few days. 3-4? I ant recall. I didn’t read or watch tv there. My S.O. was with me...but I was .... chilled out? Normally I’d be antsy, totally bored, flipping through the magazines he brought me.

They did a swallow test in order for me to be released. (I ate nothing while I was there except ice.) I had an iv.

Diagnosis: Altered Mental State of Consciousness

My pdoc thinks I disassociated. (I have C-PTSD.). My general doctor was supportive but had no ideas.

This happened to me a few years ago, too, during a horrible time in my life. Same deal. Same diagnosis. No treatment.

Oh, I’d no recent med changes. So nothing there.

Both times I was experiencing a lot of stress and I have anxiety disorders.

Have you ever had depersonalization or derealization? It’s like you can’t get out of your situation so your brain “checks out” for awhile. Very fugue-like, IME.

Thinking of you.

Lash107
03-29-18, 05:45 AM
PS: I am bipolar 1 so tend to be on the elevated side....but no mood episode during either time.

And there was definitely no psychosis either time.

There is no history of dementia on either side of my family.

Lash107
03-29-18, 06:18 AM
I have been meaning to write about this for awhile and My doctor has said she has a number of bipolar patients experience this.

What has developed in me over the past year are these fugue states. Let me explain.
It tends to occur either during a phase of rapid cycling in which I am flipping from hypomania to depression rather quickly. It has also occurred during extended periods of one or the other. What do I mean by mental fugue?

Its like I behave in a way that can seem like I am slightly impaired or not and things like circumstances or conversations and decisions are made with me having no knowledge of it. Christmas was a prime example. My foggy memory of it was that it was a good christmas. My mother an brother were distant in the days to follow and I couldnt figure out what was wrong. They had a sit down with me and told me that at times my coordination was off, like I was drunk and I was combative, loud and seemingly confused at times. My brother is gay and I gave him a beautiful necklace and apparently during the day with family visiting I would holler across the room something like:
" Sam do you like your necklace? I mean its not too gay right? I wouldnt want it to be too gay for you"
I proceeded to ask other family members if they thought it was too gay. I spilled oj all over someone and cursed big time in front of my kids and was altogether inappropriate. I know this has happened many times at home before and my kids or husband would reference it like "well you know when xyz happened you werent 'all there' They have grown to understand that these things happen around once every 2 months or so. I have sent inappropriate pics to the wrong people(not naked but intended for my husband)I have made phone calls and scheduled appts or made trips without remembering it.
Has anyone else with BP experience this? Periods where things happen and you only know you did something or behaved a certain way because someone told you about it? My doctor has told me that this is something that I may just have to learn to cope with. I felt like I was going senile or had dementia before I learned what it was. I have been on disability for many years, thank god because I am sure I would have been fired otherwise. The idea that my pieces of short term events are missing or gone terrifies me, and it was good to hear my doctor and therapist tell me that I wasnt alone in this but I thought I would ask my dear friends here at ADDF if they had ever experienced this.
Thanks friends.

(Snipped your post a bit for easier reading/reply)

Any chance you are type 1? Doing inappropriate (ugh, etc) things, acting way out of character, etc....were you experiencing mania during the family holiday and times when you sent pics, etc.?

My S.O. is also type 1 and we RARELY remember more than tiny bits of fully-blown manic episodes. Fortunately, we tend to NOT have episodes at the same time and therefore the “healthy partner” recalls it all. The other...not much at all. Maybe 10% of the episode lasting a week or so.

Also, I’ve met a lot of folks with bipolar disorder from volunteering locally at a support group. Our short term memory seems to have become poorer after bipolar disorder developed. Some, maybe meds....but I don’t personally think it is always med-related. I don’t think it’s dementia, either. But your fugue experience is on another level. Family holidays can be stressful. Travel.

When I was first diagnosed, my pdoc told me that “stress is the killer for bipolar disorder.” I agree with him and it makes me vulnerable to rapid cycling, usually mixed episodes. However, I’ve never tolerated stress well. That’s how I became an alcoholic. Sobriety helps with stability, right?:)

Type 1, Type 2...labels, in a sense. But I wondered if you “crossed over” into mania and many of us can’t recall those episodes. And I have witnessed it four times with my S.O.’s manias....his always end up with hospitalization but his memory of the episode is “gone” well before that point.

Message me if you need support. Stuff is just weird, sometimes. I’m glad you’re safe and thank goodness for disability, I agree.

Kunga Dorji
04-01-18, 05:41 AM
Hi Sarah,

I also have bipolar disorder and I recently was hospitalized (non-psychiatric, that’s a change!)...your experiences remind me a bit of mine. I don’t have answers but I can share my experiences.

I did a double-take when I saw you typed “fugue.”

My S.O. took me to the ER two weeks ago...I was apparently having extreme short-term memory loss. We decided to go to our favorite restaurant and when we arrived, my boyfriend later recounted to me that I had no idea how we got there.

He said I was acting very out of it and I don’t drink anymore so I was sober. I have a lot of anxiety and I do remember feeling “chilled out,” very atypical for me.

Anyway, I wasn’t nearly as verbally interactive as you described with your family holiday. I was moving more clumsily than normal, uncoordinated.

All my scans, MRI, tests....clear. The doctors were thinking stroke, aneurism....something like that. They kept me there for observation and released me after a few days. 3-4? I ant recall. I didn’t read or watch tv there. My S.O. was with me...but I was .... chilled out? Normally I’d be antsy, totally bored, flipping through the magazines he brought me.

They did a swallow test in order for me to be released. (I ate nothing while I was there except ice.) I had an iv.

Diagnosis: Altered Mental State of Consciousness

My pdoc thinks I disassociated. (I have C-PTSD.). My general doctor was supportive but had no ideas.

This happened to me a few years ago, too, during a horrible time in my life. Same deal. Same diagnosis. No treatment.

Oh, I’d no recent med changes. So nothing there.

Both times I was experiencing a lot of stress and I have anxiety disorders.

Have you ever had depersonalization or derealization? It’s like you can’t get out of your situation so your brain “checks out” for awhile. Very fugue-like, IME.

Thinking of you.

Thanks for your account, Lash.
This is something that has been on my mind a lot of late.
Unlike most here I do have very good memory of my bipolar 1 manic episodes and I have had a number of episodes where I exhibited some of the symptoms without going into a manic episode.
The main symptoms were really pathological sweating, disorientation and disorganisation.
One that comes to mind is last September when I was in china with my S.O. and I had been stirred up by going form a boat on the Yangtze for 5 days, to a bus, to a plane at Chongqing airport, to another bus from Xian airport to our hotel.

I had significant mal de debarquement syndrome, and it looked like the corridors in the hotel were twisting from side to side as we walked to our room.
http://vestibular.org/mal-de-debarquement

I was very disorganised. I spent the next day walking about Xian by myself while S.O. rested and recovered ( I guess she was also affected as we both slept badly on the boat) and got horribly lost (unusual for me as I am normally an excellent navigator).

However- it took me ages to get my stuff together and pack a backpack for the walk as I bumbled from one suitcase to another trying to find the things (like a map) that I needed. Whenever I was interrupted i was irritable- as it took all that I had to stay on track and get out the door. My S. O. was concerned that it might be a relapse of the mania, and to be fair there was an overlap of symptoms. However I was well aware that I had had all my lithium (I would never expose her to another relapse if there was anything I could do to prevent it), and I have never experienced a relapse while on lithium.

Interestingly my sensory processing issues were all off the scale ( they usually do not trouble me) and I had to stick to the quiet back streets as the traffic noise was overpowering.

Now all these symptoms (and those reported by others on this thread) are compatible with dysfunction in the vestibulocerebellar system.

We know that cerebellar dysfunction is associated with both bipolar and ADHD.

The following piece on that problem highlights many of the symptoms that have been discussed here- and being on Wikipedia you can be sure that this is now very mainstream thinking:

http://en.wikipedia.org/wiki/Cerebellar_cognitive_affective_syndrome

The mainstream medical profession has been slow to engage with this information, but I have been fortunate to have received neurological rehabilitation treatment, and these problems are now much less frequent, less severe and of shorter duration than they were.

allesandro1
07-13-18, 02:54 PM
sarah, I think I have had fugue states but that's not what they are like for me. For me it's more about shutting down when I am on overload and not remembering pieces of information or pieces of a conversation which doesn't work in either case. In other words, my not remembering a critical piece of the information screws everything up for me. It's basically because I'm on overload. When I'm hypomanic, I say or do inappropriate things: I fly off the handle, etc. I don't know if that is the same thing as what you are talking about