Expert: Ivan Goldberg, M.D. - 3/17/2008

Question
QUESTION: Hello,I have several "issues" and I'm having a hard time dealing with it.First,I have been recently been diagnosed with having bipolar and have been in and out of doctor's offices for about a year now.What I have been experiencing is blackouts(losing time)and very realistic,disturbing dreams.All of this is really scaring me.My blackouts happen with and without alcohol.I can lose time up to several hours.It seems like on the days that I do have these blackouts is when I have the disturbing dreams.Always based on one subject of me cheating on my husband.I have had a sleep study done that shows that I have too much REM and Stage 2 sleep.No matter how hard I try to remember what took place,it never comes back to me.What could be causing this?In these dreams(I hope they are dreams)I feel like my personality has changed and I don't care about anything.Afterwards,I feel panic and fear.These experiences are always about the day that I don't remember.Like continuations.Does that make any sense?Same surroundings,people,situation,exact time period.Could this be related to Bippolar?My psychiatrist told me that this happens with mood disorders at times but not very common.I just wish I could find a way to get it under control.Thanks for taking the time to read this post and any opinions given.

ANSWER: Hi, Christina . . .

What you describe is something that rarely is seen in people with mood disorder, but is very characteristic of people who have has some sort of early life trauma.
If i had a patient with bipolar disorder who told me of episodes such as the ones you describe I would refer them to a neurologist to rule out the possibility that they have some sort of seizure disorder, and to a psychologist experienced in working with individuals who were traumatized during childhood.

Best regards . . .
Ivan
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---------- FOLLOW-UP ----------

QUESTION: Yes,I have had trauma in my childhood and as an adult.My psyc doesn't seem to think I have PTSD,though.I don't believe I have any seziers(spl?),but this dreaming started around 2006 and has been increasing since then.It's quite disturbing for me.My doc doesn't want to supress the REM, and said that I need it.I've had two "blackouts" since last Friday along with the dreams.Any suggestions for this?It is causing me a great deal of panic and anxiety.

Answer
Christina . . .

PTSD or not, people who describe dreams such as yours often have them as the result of trauma.

When I treat people with such dreams I usually prescribe prazosin (Minipress), cyproheptadine (periactin), topiramate (Topamax), or MAO inhibitors (Nardil, Parnate).

Best regards . . .
Ivan
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