Tag Archives: hypomanic episode

What is Bipolar Disorder? – The dark side of hypomania updated

Okay this is not really an update, more like a repost with a foreword. I’ve been going through my blog and according to WordPress stats, this is quite a popular post. I wrote it roughly four years ago; a year after I was diagnosed. This month marks 5 years of ‘being’ bipolar, so you can’t help but look back and think. Especially after the spectacularly difficult year 2017 that I’ve somehow managed to survive. Everything I wrote in this post still holds true: people still don’t understand dysphoric hypomania, which is actually very common and the episode I talk about here, was still the worse in my life. I am a lot smarter and wiser than I was 5 years ago, so feel free to ask questions. The post follows below, but if for some reason you want to look at the original, you can find it here. Enjoy!

 

In my previous post I explored what it feels like to have depression. As we know, that is only one side of Bipolar Disorder. What makes this illness different from ‘regular’ unipolar depression is that you have the lows and the highs.

As with my previous post, I am not going to list the typical symptoms of hypomania and mania; you can find more information about that here. A note on the two though: Mania and hypomania are not the same thing. Even with all the reading that I’ve done, I sill haven’t found a proper comparison between the two. It is generally said that hypomania is a less severe form of mania. Mania is usually experienced as an episode that lasts for a few days or weeks. As far as I know it does not last as long as a hypomanic episode. Hallucinations, delusions, psychosis and severe paranoia  are experienced during manic episodes. This is not the case with hypomania, although I know from personal experience that paranoia and delusional thinking should not be excluded when talking about hypomania (or I might just be more manic than I realise…). Mania greatly impairs the sufferer’s functioning up to a point where hospitalisation is usually necessary. People who experience mania are classified as Bipolar I, whereas people who experience hypomania are classified as Bipolar II. Suffering from Bipolar I is probably much worse than Bipolar II, but don’t think that if you ‘only’ have bipolar II, it is not serious.

My diagnosis is Bipolar II, which is why will only share my experiences of hypomania and not go into further detail about mania. Various levels of manic states are, in my opinion, largely misunderstood and the part of the illness that intrigue people and lead to their misconceptions. When someone joking refers to themselves as Bipolar because they experience a couple of mood swings, or feel really happy, I have to work very hard to keep myself from flying into a state of extreme rage. That is when I have to remind myself that people are just uninformed and ignorant, and that my talking about it is part of the solution. As the title says, this post describes the dark side of hypomania. Most people think that hypomania is flying on a cloud of endless euphoric energy and creativity. A fun feeling. Even though that is often the shape that hypomania takes (and I’ll cover that in my next post), there is a dark side to hypomania that in my opinion does not get nearly enough exposure.

Dysphoric hypomania (mixed state)

My process of being diagnosed with Bipolar Disorder started 15 months ago. I had been on antidepressants for about a year before that. I wasn’t depressed anymore, but I was something that wasn’t normal. Turns out being only on antidepressants is very dangerous if you have Bipolar Disorder. I didn’t realise it at the time, since I couldn’t recognise my thoughts and behaviour as faulty. When I look back now I don’t know how I didn’t realise earlier that something was very wrong. I had been going through a very stressful time for about a year, and I thought that what was going on with me was severe anxiety. I didn’t feel the happy, ecstatic states mostly described as hypomania. Not then. What I did feel was a sense of being stuck inside myself. It felt like I had ants crawling under my skin and that I had to keep moving. I was usually tapping my foot or standing up when everyone was sitting down. At home I put my headphones in and I would dance non-stop for hours, giving myself over to the music completely. Colours looked brighter, sounds were louder. I couldn’t sleep#. I only ate because I had to (even though I love food) and most of the time I would just feel nauseous when I ate anyway. It felt like the world was closing in on me.  I needed to get out, but  there was nothing physical to get out of. I still had a painful feeling on my chest, like when I was depressed, but I was pumped up. Frantic. My thoughts were obsessive. I obsessed over people. I drove people away. I was completely irrational and often delusional in my thinking. It felt like everyone was against me, even the people in my life who love me the most. The intensity of my emotions were almost unbearable, and I didn’t understand how people can experience something with me and not have the same reaction. I was unreasonable. I was aggressive and frustrated all the time. I had fantasies about bashing annoying people’s heads against walls. I was angry about everything all the time.

I think that my behaviour resulting from all this was a kind of attempt to get away from myself. Describing my feelings are not embarrassing to me. I felt things that I had no control over. My behaviour because of these feelings I do still feel very embarrassed about. I have to share some of the things I did to let this information make sense, but I do want to say that I deeply regret most of it. I spent much more money that I had and made debt that I am still struggling to pay off. I almost bought a flat! It was only thanks to a small admin error that the deal thankfully didn’t go through. It would have completely bankrupted me. I got traffic fines in the double digits. I drove drunk, late at night and to secluded places. When I wasn’t home, I was drinking. I took whatever pills I could find, just to try to shut down my head. I would go jogging in the icy pouring rain (and I don’t jog!). I sent out messages and emails and didn’t think about the consequences. There were things that I said and did that I had no control over. The obsessions and compulsions took over my mind. Once I established a routine or pattern, I couldn’t break it. Eg, if I got into a habit of texting one person every day and I realised that, I couldn’t break the habit, I just couldn’t. Even if I had nothing to say. Come to think of it, it might actually be what real OCD feels like (not the kind where people think you have to arrange your books alphabetically or clean a lot, the actual misunderstood disease). Even though I’m not promiscuous and not one to kiss and tell, my sex drive definitely went haywire. Theoretically it’s a small miracle that I didn’t sleep around and contract a disease or something. All of these crazy thoughts, feelings and behaviour eventually led to very bad physical and emotional self-harm.

This was an awful time in my life. I now know that it wasn’t my first hypomanic episode, but it was certainly my worse so far and landed me in the hospital. I really is only by the grace of God that I survived it. Personally I’m not sure how I didn’t commit suicide. This state of mind went on for months. I was completely lost in it. I look back with such relief and gratitude. Now that I look back, I know that I was severely ill and that has made it easier for me. I don’t blame it all on myself anymore.

Learn more about dysphoria/mixed states.

Can you better explain the difference between mania and hypomania? Have you or anyone you know experienced dysphoric hypomania? How has it affected you as a sufferer or a supporter?

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The bipolar roller coaster

A friend of mine who also suffers from bipolar disorder recently got an absolutely gorgeous tattoo of a roller coaster on her back (of which I am extremely jealous). (She also writes a blog definitely worth reading and much more eloquent and witty than my own) I just realised again today what an appropriate symbol of bipolar disorder a roller coaster is. Just three days ago, and for two or three weeks before that, I was in a completely state of self destruction and hysteria, mixed up with some calm for blissful half hours here and there. I honestly didn’t know how I was going to make it out the other side. The walls around me were not caving in, I was actually pushing them out, and I didn’t know how to stop myself.

What had brought me there? Switching anti-psychotics? Family drama? Recovering from my grandfather’s death? Work pressure? Romantic disappointment?  Probably all of the above to some degree. Especially since it all happened more or less at the same time. And today, not three days after a long series of gut wrenching mini-meltdowns, barely picking myself up each time, I seem to have turned a corner. I had a beautiful calm day, hanging out with friends, going to the beach with the dogs and having pizza and wine. I’m chilled. It was a good day. I didn’t even have to take an Alzam (for anxiety).

So what brought about this turning point in the epic roller coaster that is my bipolar life? The higher doses of Geodon (anti-psychotic) and Epitec (mood stabiliser) kicking in? The calming effect that the Alzams have had on me over the last few days? Getting a good 12 hours of chemically induced sleep last night? Reevaluating my life and realising things were getting out of hand? Having people pray for me? Trying to channel my energy constructively instead of destructively (I even wrote a song!)? Probably all of the above to some degree.

That’s what makes it so tough, isn’t it? Trying to isolate the variables is useless. There is no real knowing what causes what and what different things will trigger or what will bring you back from the edge. When I went off Seroquel and onto Geodon I was extremely hypomanic for about a week. I went away with friends and they kept saying that they’d never seen me that happy. It was true, I was having the weekend of my life. The weekend after that, I had a family weekend and stayed up until dawn two nights in a row. But what goes up most come down (except for Jesus, as my Sunday school teacher friend pointed out), or sideways, or upside down, or through a tunnel, or to some extreme state, if your roller coaster is a bipolar one.

I’ve always known that I just have to ride it out. It becomes the difference between yourself and suicide, the knowledge that it will pass eventually. What I’ve learned this time is that I CAN ride it out, with the right medication, rest, and support from people who understand and/or who care about me. People who just let me be a pretty fucked up version of myself without judging me. I don’t think it will ever be easy. It’s an illness after all, and a pretty terrible one, lets be real. It’s not suppose to be easy. But what I realise when I go through this ever so often is that I am stronger than I even know. I could probably rule a small country by myself. Be it by the grace of God or sheer willpower, I am a ninja, and every time I come back and kick life’s ass, I can confidently give it the finger and say ‘there, you lost again sucker!’ That doesn’t mean that it won’t take some time for me to nurse my wounds and recover emotionally from this ride to the depths of darkness and back. My soul, and my pride, is a bit bruised. After all, I hate roller coasters.

 

Surviving hypomanic episodes

Most of us don’t realise when we are in the midst of a hypomanic episode. Only in retrospect from the depths of depression do we realise that are behaviour was ‘of’ or ‘not normal’. I use to think that because I am stable on my medication, I wouldn’t experience symptoms of hypomania or depression again. Of course this assumption was wrong. People more knowledgeable than I have told me that it takes a lot of self-awareness and experience to realise before it’s too late that you are being pulled into depression or hypomania. Personally I have not reached this level of awareness yet, but I have found a few things that help me when I realise that my mind is spinning out of control. These are only my personal ways of coping and what works for one person might not work for someone else. I have found that the only way I can pull myself out of myself is by distracting my mind and focusing on the things I do rather than the things I think. That is what we are doing anyway when we are behaving in self-destructive ways. Shopping, 100s of projects, speeding, taking risks, drinking excessively, doing drugs, cutting, random sex and yelling at your boss are mechanisms, I think, of distraction. Why we have to turn to the self-destructive is beyond me. Although it is also where intense creativity comes from in some of us.

Most importantly though, you have to contact your psychiatrist immediately when you realise that things are going haywire and that you can’t keep it under control yourself. I usually only realise this too late, but as I’m going along I am getting better at recognising the signs in myself.

Below are a few other things that I have found helpful when I feel the hypomania coming on and I can’t see my doctor or am waiting for the new drugs to kick in.

Do something with your hands.

The best way for me to get out of my head is by doing things that distracts myself from my thoughts and focus me on something I’m doing with my hands. My go-to is doing mosaics, which I learned while I was hospitalised (gotta love art therapy). I can do it for hours and just focus on fitting the different piece into each other. The fact that I get to break stuff is a bonus. I also do puzzles. It’s the same concept and completely distracts me. Of course I need to make sure that the puzzle is big enough to keep me busy for some time.

Another thing that really works for me is origami. Learning how to fold some of the more complicated designs can be frustrating and infuriating, but otherwise you could just see if you could get to a 1000 tiny cranes (the Chinese believe that if you can do it within a year, you get to make a wish). You can do anything where you make something, really. Beading, pottery, wood work, baking, whatever works for you. I know some people go into a complete frenzy about cleaning and I don’t think it’s a bad thing. You distract yourself and have a nice clean house after!

Be artistic

To me there is a definite difference between being artistic and being creative. In certain areas I am very creative, but I am not artistic at all! The other day I said to someone, “I can’t draw!” His reply was, “Of course you can! Anyone can draw. You don’t necessarily have to be good at it.” I realised that he was right. I don’t have to be a brilliant artist to have fun with shapes and colours. So I bought myself some oil pastels and a sketchpad. Even though I’m pretty sure that I suck, I find drawing simple shapes therapeutic and the bright colours make me happy. You don’t have to be Picasso (although that might be a bad example), you just have to do it for yourself and enjoy what you’re doing.

Get active

I’m not big on doing exercise. I’m actually embarrassingly lazy like that. What I have found works for me during especially frustrating and angry times is playing tennis against a wall. I don’t play against anyone else as that will just frustrating and irritate me more, but hitting balls gets rid of a lot of nervous energy and anxiety. I also go for really long walks or especially dancing. That can conveniently be done in your house in your underwear too. Doctors always say that exercise is good for you because of endorphins and all that, and you can’t really argue with that. But more importantly when you have Bipolar Disorder, it distracts you and will hopefully make you tired so you can sleep. Speaking of…

Sleep

This is a tricky one, since during hypomania you can’t and don’t want to sleep. During ‘happy hypomania’ it’s easy to just let this one go without thinking of the consequences, but during dysphoria it’s just that you can’t sleep, even though you badly want to. Being awake is too painful. When I feel like this, the only thing that gets me to sleep is a sleeping pill. Of course only ones prescribed to me by my doctor and only the prescribed dose.

Write

Even though I love writing and write all the time and would write for a living if I could, but it doesn’t work for me when I’m hypomanic or depressed. My thoughts reach very dark and scary places and drag me down further into an abyss. On the flipside, I have these amazing epiphanies where the world and the afterlife suddenly become so clear, which isn’t a bad things, but these thoughts and pieces of writing are of course to important and life changing to keep to myself, so I email them to everyone I think might be touched by my revelations. At the time my friends humour me, but when looking back at what I wrote later, I realise every time that I probably sound absolutely insane. So for me writing is actually a bit destructive when I’m hypomanic or depressed, but many people find it very therapeutic.

Use music

Music can be used as a distraction in two ways, either by playing an instrument or listening to music. I can barely call myself a beginner on the acoustic guitar, but practicing the chords I know, learning new ones or trying to work out the chords for my favourite songs can keep me busy for hours. All I think about then is the music. Learning a new instrument is both fun and much more constructive (and cheaper) than shopping. Again what doesn’t work for me is listening to music. I’m very sensitive to sound and the world gets too loud very quickly. Depending on whether I’m in a euphoric or dysphoric state of hypomania, music will either make me angry and depress or let my mind go wild. I can get so into the music that it feels like I disconnect from the outside world.

Watch TV

Now this one is not necessarily the healthiest one, but when my mind can’t stop spinning often then only thing that works for me is focusing my mind on the lives of characters in TV shows. I can’t watch movies because they are too long and boring and I don’t watch documentaries because I find them boring, but I love stories, so I can easily go through 2 seasons of a show without stopping. This is not what I mean with using it to cope with hypomania though. When an activity hinders instead of helps you, breaks your routine and deprives you of sleep, it because destructive. Therefore when I’m hypomanic I try to avoid falling into this ‘addiction’.

I realised while I was writing the above; and you might have picked it up too; that there is a very fine line between distractions and destruction. The same activity can have opposite effects in different people or even in the same person at different times. The key is to figure out what works for you. I am sure that there are many other distractions and coping mechanisms out there and the ones mentioned here are just the ones I know work or don’t work for me.

How do you distract yourself when you are hypomanic?