Bipolar I — Quick Reference
“A mental health condition defined by at least one manic episode — elevated/irritable mood, high energy, reduced need for sleep, racing thoughts, impulsivity — lasting a week or more (or any length if hospitalization was needed). Depressive episodes are common but not required for diagnosis. Managed long-term through medication and psychotherapy.”- Claude
The definition from Claude is pretty on the money. Its a funny(or not) funny game of perspective and awareness. When Mania is coming in it comes in like the tide, slowly at first but steadily. The higher it gets the greater the force it pushes. For me it tends begin with a goal that I become fixated on, my concentration for anything but that activity wanes. I become impulsive, never aggressive, annoying I suspect but impulsivity with spending, daily actions, work and hobbies. In the earlier parts of an episode this is the fun time, the hypomania, the one that should be a warning but slips through. It will drive and motivate and enhance creative thought and action without doubt. Sleep becomes over-rated and you find yourself the only person in the house awake at 2am and still be fresh and ready to go.
That’s where things change. When you start to slide into a zone where delusion creeps in, where reality becomes pliable, where you lose perspective. If it were on a curve you would see acceleration, mood lability outstrips time until the peak. There are for me two types of peak, the classic full of life whacky prankster that believes he is the bearer of special gifts and powers. Then there is the other one, the shadow. The shadow side is dysphoric mania; this really sucks. Your brain races, you are physically active, you don’t sleep and you cannot get away from your thought. The thoughts are severe and unrelenting. This is a hospital stay. I’ve had 6 hospitalisations over my life; all but one a “mixed episode” or Dysphoric Mania.
People may think its just a mood swing, but its also never just that as you can only sustain a couple of weeks on micro sleeps. Down you come like a lead balloon, you don’t pass go and you don’t collect $200 either. Every elevation comes with the equal and opposite reaction; a deep, dark desolation. Time grinds to a crawl, you cant be around others, the realisation of your elevated mood and its impact on others hits and smothers you. Bipolar depression is what I would call minimum existence, You lean away from friends and community, there is no self belief. and even getting off the couch is hard. Intrusive thoughts roll in and out, you process them as best you can. Social phobia becomes all encompassing. The curve taken by the depression is much longer than the manic episode that proceeded it, maybe months until you get back to ground state “Euthymia.” There is also another state, as bad as either described, and that is “rapid cycling”. Simply Manic Episodes cycling into depressions and back to mania or hypomania repeatedly, over a week or more, it is draining, saps self esteem. Rapid cycling can last a few weeks and is very destabilising to the psyche.
It is a lifelong illness, it was there before I ever thought it was, but it is manageable if you take the meds. Talking to someone helps but it doesnt always feel safe, and people don’t always know what to say… its all in the listening. They don’t give you full coverage but they just do enough to keep things realistic, have some chances of parenting and keeping relationships together. It undoubtedly saps confidence and self esteem, but it doesn’t close the door to meaningful relationships , nor does it render you an employment liability; it sometimes gives a super high power focus.
There is no magic cure around the corner, not in my time anyway. Until then lean into supports, take the meds, get outdoor as much as you can, sleep eat and repeat.
Prescription:
Lamotrigine 200mg, Olanzapine 10mg
More Info: Black Dog Institute