Beyond Blue

Beyond Blue


What Does Mania and Hypomania Look Like?

posted by Beyond Blue

trampoline mania.jpg

On Beyond Blue, I focus predominantly on the problem of depression, because 99 percent of the time that’s what I am struggling with, and I figure you, too. However, I think it’s very important to discuss mania and hypomania because they can be just as, if not, more damaging to your health as depression.

The reason why bipolar disorder sometimes takes up to 10 years to be diagnosed correctly is because no one complains to a doctor that she has more energy than usual, is super efficient at work, and for some reason doesn’t need to look at her self-esteem file to feel okay! I mean, seriously, we want those symptoms to last … forever … if we can swing it. So the primary doc or the psychiatrist only gets the depression part, not knowing that it’s the bloody cycling that’s the problem.

Those of you who have experienced mania or hypomania know why they are dangerous: what goes up must eventually come down, and the higher you are, the more severe the drop into the pit. Like having too much to drink, you know you’re going to eventually pay for it – you just hope the payment isn’t going to be too painful.

It’s tough for folks like me to initially recognize their hypomanias because the symptoms are subtle and not listed in the DSM-V under hypomania or mania. For example, I don’t go on compulsive shopping sprees because I hate shopping, and always have. I don’t sleep around because I’m on Zoloft (among other reasons like a great husband whom I would never want to hurt).

Hypomania usually takes a bad habit and multiplies it by, say 100. So, in my case, it’s the verbal diarrhea that’s hazardous and raises the ominous red flag. I have no idea what’s going to come out of my mouth when I open it, and too often I push “send” when I should press “delete.”

Under the best of circumstances I operate with a very thin filter from the brain to the mouth. That is one reason I gave up drinking before I graduated from high school. So when I feel a little high, my very thin filter goes bye bye and I either start apologizing all the time or I wear a sign around my neck that says, “I apologize if I say something inappropriate.”

The good news is that I’m getting better at knowing what triggers my hypomanias–and communicating any upswings with my doctor so she knows that I’m cycling.

Lack of sleep will always do it.

The four days before I was laid off, when I knew I would be laid off but didn’t know how or for what reason, I averaged like four or five hours of sleep–when I require seven or eight to function properly. I was fretting over small details like how I was going to feed my family if my consulting gig got flushed down the toilet.

By day five I could tell I was high, and I got even higher when I reconnected with a favorite professor from college who is helping me on a project that I am excited about, for which I’ve already written 64 drafts.

One reason (among many) that I miss my former Beliefnet editor, Holly, is that she acted as my filter, and would tell me we were going to “hold off for awhile” on publishing a post when she suspected I was manic. One time she wrote me a detailed note listing all the reasons why she thought I might be hypomanic. It’s still in my doctor’s file, gets referenced all the time to determine if I’m doing the same sorts of things: in essence, biting off way more than I chew.

Having been at this thing – bipolar disorder – for five years, I also know I have to do to bring myself down, as much as I’d love to stay up.

If I can, I disconnect from all social networking and emailing because they tend to keep me in manic mode, and it’s better to not have an opportunity to say the wrong thing. I try to be more steadfast in my meditation … if I can. (Meditating is a tad difficult when you’re manic.) I try to ground myself in prayer. I exercise as much as humanly possible, because I figure that working out is a far better channel of energy when I’m manic than engaging in a dialogue with someone who doesn’t get me or why it’s so hard to keep my mouth shut.

Finally, I go easy on myself. I try not to beat myself up for all the inappropriate comments I’ve made when I was high. I remember my favorite line from Kay Redfield Jamison: “Tumultuousness, if coupled with discipline and a cool mind, is not such a bad sort of thing. That unless one wants to live a stunningly boring life, one ought to be on good terms with one’s darker side and one’s darker energies.”

Image credit: ToysRUs

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Elizabeth

posted February 25, 2011 at 9:35 am


I have learned so much about bi-polar reading your blog. Although I don’t have it, my Dad, my brother and my aunt all have it. It helps me to understand what they go thru.



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Mary

posted February 25, 2011 at 10:09 am


Excellent post, Therese.
My Dad struggled for years with what was diagnosed then as manic depression/depressive type. But he did have his manic-y times. My swings are less severe than his, and haven’t merited the heavy duty diagnosis. But I especially recognize the hypomania in my own behavior at times. Currently, I am totally high behind the political situation in my state–Wisconsin. I am obsessively Facebooking, Twittering, emailing, and rushing off to protests. I have gone to sleep two nights in a row watching streaming video of my legislators battling over “the bill,” that many of my fellow citizens and I was to see defeated. Last night, I saw the assembly pass it.
The trouble with all this is that the energy of the hypomania is functional, just now. And it is becoming a communal symptom. I guess the only thing for it at this time is to try to manage the stress that feeds it, and to take some breaks, as your post suggests. I have been trying to unplug for brief periods, to step up exercise and meditation, to eat well, and to avoid going completely off the deep end.
I think many of us are at risk for a pretty serious crash if this fight ends badly, as it seems in danger of doing.
Thanks for your wise words.



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Bob G.

posted February 25, 2011 at 10:54 am


Hi Therese, thanks for sharing some of these experiences. I was diagnosed with bipolar affective disorder 5 years ago and I am still having difficulty believing it. However, hearing others’ experiences helps to ground me in reality so thanks a lot for sharing.



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Ruby McGill

posted February 26, 2011 at 3:44 am


I couldn’t help but smile – my daughter was diagnosed with bipolar disorder at age 12; all her life she had been hypomanic – as a six year old she was in gymnastics two afternoons a week (2 hour sessions) 2 x 1 hour swimming sessions and 1 x 1 hour drama session, and after that she would come home and jump on the trampoline for an hour before teatime! It was not until a couple of years before her diagnosis that we saw any evidence of depression. Now, at age nearly 21, she struggles mainly with depression, but we do get the hypomanic episodes – where her mouth literally runs away with her – I am not sure she even knows what she is saying sometimes – and like you, is usually triggered by not enough sleep. When she is manic, she just wants to talk – to anyone/everyone and she needs to share EVERY thought that comes into her mind. She does not like to be interrupted, or challenged, or advised – just TALK! It can be very trying, and I am making a huge effort to not rise to the ‘bait’ when she is in this mood. Unfortunately she does not see it as her problem – rather I am the problem -. We keep trying.



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Doug

posted February 26, 2011 at 8:25 am


Thanks for this post. I always go up before I come down, and constantly question my behavior and whatever I say or write when I am feeling good looking for signs of hypomania that are so difficult for me to see myself. Often it is my support system that clues me in to it; I have them gently tell me I am very talkative, rambling, ask how I am doing with sleep, and feel me out mood-wise because I need a prod to recognize the symptoms in myself and take action, such as sleeping medication for a while, talking to my doctor, etc. to keep this from getting out of control. Your insights are valuable as always.



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Kirstin

posted February 26, 2011 at 10:38 am


Thanks for your wise words. It’s great to hear from another bipoloar person – when I was last high I was aware of it and also aware that I would probably have an equally sized down – which I did. I’m so aware when I’m high that I try not to do any of the things which are signs – shopping, hypergraphia etc. Sleep with me as well is the key and the trigger. I’ve now got a new career as a teacher, which is incredibly stressful and very long hours. No-one related to my new career knows about my illness so it’s hard. But going OK so far (9 months into my first job).



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Will

posted February 26, 2011 at 11:04 am


Good post. I struggle too with the “highs” as well as the “lows”. The fact I do not do anything really zany does not make the inevitable crash any easier or less painful.



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Janet

posted February 26, 2011 at 2:29 pm


Therese, I was diagnosed with Borderline Personality disorder back in 1998, but one Dr. felt I had BiPolar disorder, and reading your blogs helps me discern the difference. I have both-aren’t I blessed? Right now it’s a crash and burn stage as the weather is snowy,blustery, and I’m alone at home feeling very rejected by my boyfriend who just left to attend a BD party for him put on by his children. I was not invited. I think even under the best of circumstances one would feel badly. He said this was the last time, that it was either the both of us or he would not attend any family functions. I waited 15yrs after a failed marraige to find a man whom I could love, but this really hurts. I’ve done nothing to insult or hurt his family yet he gave in to his 21yr old daughter’s request that I not attend “their party”. Ouch. He says he hurts too, but he had to go. I don’t agree. He’s asked me to marry him, but now I’m having second thoughts. Until he can say to his children that I am his partner for life, and I’, not going away, I can’t marry him. I know you don’t do counseling and I’m not asking for advice. I just wanted to share that when “bad things” rock the boat, we who have this odd chemistry tend to fall into the water quicker than others.Thanks for sharing your feelings- it validates my emotional state of mind.



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Patti

posted February 26, 2011 at 2:33 pm


I am the wife of a rapid cycling bipolar I. We have been together 34 yrs. I am at the moment living with my adult son and family because of my husband’s aggressive unpredictability during this mania. My husband is not a bad person at heart, I know that. He is a product of an incredibly dysfunctional upbringing. I certainly brought my own insecurities and codependent nature to the mix. I wish he took his bipolar as seriously as you and the commenters so far have. He doesn’t listen to me when I tell him he’s cycling too far up. I’m just a giant buzzkill. He is a stranger to me at those times and he has no idea of the damage he’s done to our children and me. He claims he doesn’t remember the reasons I had to call in the police because of his aggressiveness and therefore it should be forgiven. I don’t think there’s much he hasn’t done-infidelity, getting arrested for shoplifting, cleaning out the checking acct. and credit cards, drinking, amphetamines, pain pills, totaling two cars. It’s very sad and I’m not sure I can go back this time. I need a level of peace and safety regardless of my love for him.



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Larry Parker

posted February 26, 2011 at 3:03 pm


No one, including Therese, has mentioned the thing that is most frustrating about having bipolar disorder, or more accurately, FIRST having bipolar disorder:
It’s that the psychiatrists we trust to take care of us almost never diagnose it correctly, or at least until we do horrific damage to our own lives and the lives of people we care about. Even worse, they give us medicines for unipolar depression that THEMSELVES can and often do cause us to become manic.
When we first realize we have depression, most of us aren’t in a place yet to go somewhere like Beyond Blue and read about our different options and different ways of addressing our various issues. Most of us instead put complete faith in our doctors — often if by no means always, to our later regret.
IMO, psychiatrists ought to take a clue from Hippocrates — “first, do no harm.” If you are unsure whether someone has unipolar or bipolar depression, give the person the treatment least likely to overstimulate them.
As for what you do now … you have to slowly reprogram yourself that living life down on the ground is not “boring,” but is where the truest experiences of life are at. Living life on the ledge seems exciting, but we’re not trained trapeze artists. We fall eventually. And after so many broken bones and concussions (metaphorically speaking), there’s no guarantee we’ll get back up.
And a PS to Mary … I sympathize with your perspective on the Wisconsin crisis. But I’m also a recovering political junkie. With bipolar disorder it is far too easy to get caught up in a movement — to believe that you are one of the messiahs who can help save the world from the “bad” guys and gals. Remember that politics itself is inherently bipolar in a democracy. If the “good” guys and gals (to you) win an election, someday soon the “bad” guys and gals will win a future election. And then the cycle repeats.
Involvement in public life (and combatting genuine evil such as anti-Semitism, terrorism and apartheid/racism) is important for all of us, of course. But so is healthy detachment, for those of us with bipolar.



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Paula

posted February 26, 2011 at 8:27 pm


I know all about the zip/splat. It became the wildest after my son was four. He’s my only child. I was finally diagnosed 13 years ago. My husband decided to watch over me rather than have any hospitalizations. He decided to move on three years ago after 30 years.
I rapid cycled up and down several times a week for about 10 years. Then I started lithium and the rate was slowed, the rise was not so high and the fall not so hard.
Unfortunately, I developed lithium toxicity. Seems I have a lower threshold than most of the known universe. So no more lithium and I’m on the road again.
I’m on higher dosages of the medicines I had already been taking. And the honeymoon period has been pretty good. For the first time in 13 years I am optimistic about my future! Hope it will be the same for you.
I hope you have enough…
Paula



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Monica A Coleman

posted February 26, 2011 at 8:38 pm


Great post Therese. So few things written about hypomania and this is such a apt description. And I also agree with Larry Parker about how often people who live with bipolar (especially bipolar II) are often misdiagnosed by psychiatrists and given different meds than they would give if they knew about the hypomania/ mania.



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Belleo

posted February 27, 2011 at 12:07 am


At 33 years old I was declared bipolar.I ws hospitalized put on Lithium . The dosage was too high and i had multiple side sffects .I did endure that for many years and it meant getting out of the workforce . Finally I told my family doctor to find me another psychiatrist or else I would go to another city . I lived in northern Ontario at the time .There was much stress in my life at that time . A therapist told me that it was my dysfunctional living causing me to get sick . It’s impossible to heal when on constant alert because of a stressor . Today I live in peace or just about . I cope and when it gets tumulteous and I see myself running to the corner store I know something is not right and I up the Lthium to 900 mg. Of course I get myself an appointment to see a psychiatrist . What gets me is when I go to emergency because I have a bleeding toe and they start asking me the time. date year . On my bracelet it states I am bipolar . So now I tell them right off that nothing interesting has happened in the last twenty years . The last doctor laughed . LOL



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James

posted February 27, 2011 at 12:56 am


Is manic depression more common or clinical one?



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Nancy

posted February 28, 2011 at 9:53 am


I have been bipolarII for 36 years, though only diabnosed and on meds for 21 years. I’ve had two mega depressions and have been hypomanic most of the rest of the time. For me, drugs have kept me from getting seriously manic, as well as the fact the higher I get the worse anxiety I feel. Luckily I have had the same doctor for 21 years and he can pretty much tell how much trouble I am in my how I talk(pressured speech). For me, sleep is key as is sunlight. Did you know that the time to start using your lightbox is in Aug//Sept, not to wait until darkness really hits in Nov/Dec. I believe we can all learn to better manage our illnesses if we use our own histories to give us guides to our futures



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lusGuirediems

posted March 1, 2011 at 1:37 pm


Hello. And Bye.



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