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1458891 tn?1285647838

The Seduction of Mania

No, this isn't the title of an upcoming theatrical release.  I'm referring here to the seductive power that bipolar mania can have on us sufferers.  The power to make us dispense with taking medication.  The power to make us feel that for us, the laws of universe no longer apply.

Now six weeks after my manic episode in late August, I am still processing it, coming to terms with it - trying to make sense of it.  It had a profound effect on me, because for the first time, I truly realized why bipolars don't take their medication – mania can be very, very seductive.  

I'll be honest here, although now drug free, I've done lots of drugs in my life.  The initial euphoria I experienced in the first few days of that late August episode rivaled any cocaine high, or that of any drug I've done (and as I said, I've done plenty).  I had had a couple of manic episodes prior to that one, but none were anywhere near as powerful.  The euphoria literally had me dancing around my apartment with a smile on my face.  I lost track of time.  I'm sure that if I saw a video of my behavior right now, I would be appalled.  

As for sleep...ha!  Didn't need it!  Three or four hours would suffice.  I would awaken at 3 or four in the morning after having drifted off into a light sleep at around midnight, and would toss and turn for another couple of hours.  But I would bounce out of bed ready to rock and roll despite being unsuccessful at getting back to sleep.  I am not exaggerating when I say that I began to wonder if I hadn't become one of those yogis (I do practice yoga) who had developed superhuman powers and was beginning to dispense with sleep.  I felt like superman!  But as anyone who has experienced mania knows, there is a transition phase before long when euphoria becomes fatigue, the feeling of invincibility becomes one of vulnerability, and supreme self-confidence becomes fear.  I am reminded of the movie Fatal Attraction.  For those of you who have seen and remember it, there is a scene where Glenn Close kidnaps Michael Douglas's kid (I think it's before she roasted the family rabbit!), takes her to the amusement park, and straps her in with her on the roller coaster.  The kid's facial expressions in that scene pretty much mirror the progression of a manic episode.  At first, you can see that she is utterly exhilarated as the wind rushes through her hair and the g forces push back in her seat.  But very quickly, that expression of exhilaration morphs into one of fear, and then one of terror.  That's what a manic episode is like:  it starts out as an incredible rush of energy and excitement, but as you near the 1 week mark without any real sleep, and even sleeping pills have are no better than taking a breath mint before bed, you start to become frightened.  That phantom known as psychosis, at once strange and foreign, something you had only read about in books, starts to seem possible - even close by.  The feeling of being utterly unable to sleep although needing it desperately, is perhaps the most helpless feeling one can imagine.  I cannot better describe insomnia than poet Sylvia Plath, who ultimately became yet another victim of bipolar disorder (suicide) in 1963:

“I saw the days of the year stretching ahead like a series of bright, white boxes, and separating one box from another was sleep, like a black shade.  Only for me, the long perspective of shades that set off one box from the next had suddenly snapped up, and I could see day after day glaring ahead of me like a white, broad, infinitely desolate avenue.”

Indeed, the fear that one may never be able to fall asleep again, or that insanity will manifest before one does, is utterly terrifying, and Plath's description there is one of the best I have read in conveying that terror.  

I have kept a journal since the early 1980's, and since I now find myself between jobs, I got the idea to begin, starting with the very first book, typing up in a Word document, any experience that might be a manifestation of bipolar disorder (either an early sign of mania or depression).  It is turning out to be a herculean, time-consuming task, but one that has been staggering in what it has revealed to me.  I began seeing a psychiatrist at the age of 14 for depression, and so the many entries showing low mood or suicidal ideation were of no surprise.  But what was shocking to me is that there are clearly many episodes of energy (that I described as being at times “overwhelming.”  What's more, true to form in classic bipolar behavior, these manifestations of increased energy were inevitably followed by periods of depression or low energy.  Very, very typical in bipolars.

I recommend that anyone suffering from this disorder start keeping a journal, even if only to document moods of note (particularly high or low).  You will find it to be immeasurable in helping you to better understand and recognize early manifestations of both mania and depression; something that is critical regardless of how well you are managing your illness at the present time.  

Does anyone else feel conflicted about mania - enthralled by the experience on the one hand, but terrified that it will come again on the other?  I apologize for the lengthy post, but hope that you found it helpful.

God bless,
Max
22 Responses
Avatar universal
Beautifully written, Max!  You are obviously born to write and extremely skillful at it.  There are not very many first-person books about bipolar disorder out there (Kay Redfield Jamison comes to mind), and as the parent of a bipolar child, I believe that a work such as you are envisioning would be helpful not only to those who have the disorder but to their confused and hurt families as well.  We can see the external manifestations of mania and depression, of course, but the patient while in the extreme states of the condition has difficulty expressing his feelings in a way that is comprehensible.  If you, while well, could describe what you have experienced and felt in your life, it would be tremendously valuable.
1458891 tn?1285647838
Yarrow -  Thanks for your compliment and support.  I would imagine that it is just as difficult (if not more so) being the parent of a bipolar child as it is being the bipolee (not a word but it works!) :)  Have you considered joining a support group?  I know that such groups exist in all major cities and it might help you to share your burden with others.  Just a thought.

Regarding the book, the hardest part would be knowing when to start submitting it to potential publishers.  At 41, and having only been officially diagnosed a few years ago, I am in no way an expert (more like a novice) in terms of understanding this illness.  Perhaps that is why despite finding the process of reading through the journals (I currently have 13 journal books, each 100 pages) deciding what is relevant/worth including, editing and typing from journal to computer, I do find the process therapeutic.  But again, when do you stop?  My sense is that you pick a point in your life where you feel things have reached an even keel, or you have enough experiences/information to be worthwhile and a benefit to others.  I am still trying to manage without medication - perhaps it will be time when and if I have an experience that makes me realize that medication is necessary.  Let's just hope that that experience doesn't involve jail or the hospital!  (Although it would make for interesting reading!)

Thanks again for your feedback!
Vapor
1255505 tn?1272822715
Yes, that is a lengthy post. Are you manic now? 

“The laws of the universe no longer apply.” During my last bout of mania, I thought I could control space and time with my mind. It sadly wasn’t true…kinda like one of those dreams where you think you’re invisible but are miffed when people can actually see you.

5 hours of sleep is my normal under treatment. Again during my last bout, I was getting 1 to 2 hours of sleep. I think it’s the sleep deprivation that leads to the delusions in part or in total. I’ve never gone to the fear/terror stage. I see the lack of sleep as being more frustrating than anything else, because I know that a normal person SHOULD be able to sleep. It’s just impossible to turn that three ring circus off in my brain. Going to bed seems to be futile, as I just lay there singing, when I could be up and about DOING things.

Last time, I was in a mixed state for about 3 months, then hypo-manic for about 2, then manic for about 1, and then I crashed back into a mixed state. It was then, when I went to the family doctor for a follow up cholesterol check and tore into the receptionist like a monkey on a cupcake for asking me to verify my home address that my doctor really began asking me questions. His first statement was, “you’re dressed VERY nicely.” Hehehe…yeah, shopping sprees will do that. In my HMO, it was a 6 month wait for new patients to get into a psych eval. I was “new” because I had never had treatment in that HMO. He made some calls and got me in in 3 weeks.

I do feel conflicted about parts. The mixed states are the worst. I feel extreme inner turmoil and become very agitated, angry, and provoke fights. In my neighborhood, I’m surprised that as a result no one’s pulled a knife on me or otherwise kicked my azz. Some in my family are forgiving of this behavior…for all I’ve put my mom through, she’s destined for heaven. Others are not so forgiving. Some are a mixed bag, like my cousin who's 5 weeks apart from me and also BP. We’ll tear into each other something fierce, and after a several month separation become best friends forever…until the next time.

Hypo-mania is just brilliant…the creativity, amount I can accomplish, the sociability, but then begins the spending, which is the biggest drawback of hypo-mania/mania for me…especially when I start flying all over the country.

My manias are always self limiting…I reach the edge just before crashing but have never gone over the edge needing hospitalization. The delusions don’t bother me. They’ve never been frightening nor caused me to do anything all that risky…except that time I went to buy a motorcycle…and the amount of sex I’ve had…but that was in the past. The grandiosity and rock-star attitude probably only irritates those around me. Some join me for the ride, but then quickly tire of it. I have had some interesting experiences. How many people can say that they’ve consulted a Catholic priest, Zen monk, Hindu guru, and a Hoodoo doctor all in a week’s time?  Also, who doesn’t like singing and rhyming?

I don’t consider BP as something that I “suffer” with, but rather just something that I have for good and for ill.

PS…not being an expert in BP is no drawback to writing about it. It’s all a very subjective experience, and I think the more you know about it clinically, the more your framing of the experiences will be adversely altered.
Avatar universal
There does appear to be a link between malfunction of our interior clock, the circadian rhythm, and bipolar disorder:

http://www.sciencedaily.com/releases/2007/03/070319175647.htm

Long before it was possible to look at brain chemistry and metabolism, one of the cornerstones of treating bipolar disorder seems to have been getting the patient's sleep cycle as regular as possible.  
1458891 tn?1285647838
Seph - Yes, realizing that you do not, in fact, control of space and time is a bummer!  I completely understand.  :)

I really don't know if I was manic when I wrote that.  There is often an undercurrent of manic energy for me even when not in a full blowing manic phase.  Short of being in that state, I can only say that I am bipolar and variations in energy are common.  At times my mood and energy will elevate for no apparent reason, and at other times, the bottom seems to drop out and low feelings predominate.  Unfortunately, nighttime is often when my mood elevates - which in turn makes me go to bed too late (2 am is all too common), which in turn only puts me at increased risk for mania/elevated mood.  It becomes a vicious cycle.  I am not currently employed so the absence of having to be somewhere at an appointed time doesn't help.  It is for these reasons that I am really struggling with whether or not to go back on the lithium.  As one who practices yoga, I am always worried that lithium/drugs will affect my ability to meditate.

You consulted a Catholic priest, Zen monk, Hindu guru, and a Hoodoo doctor all in a week’s time?  That is impressive!  I am wondering if you were, consciously or unconsciously, trying to seek out help, a spiritual being who could help to ground you, help you find peace, in the midst of a manic episode...

I don't want to scare you, but just because your mania has not brought you to the point of the fear/terror experience doesn't mean that it won't happen.  I'm just saying - make sure you have a support network, someone you can call, in the event that that happens.  I too have yet to be hospitalized for bipolar, although I have heard some folks say that if you don't treat bipolar, it is highly likely that you will end up hospitalized for it at some point.  Following my first full blown manic episode in 2004, I did have to go the family doctor as I was going on 10 days (yes, 10 days!) without sleep.  I was hallucinating - seeing people and things that weren't there...clearly entering the psychotic phase.  I was given a prescription for ativan (also known as lorazepam - 10 times stronger than valium).  It remains the most terrifying experience of my life.

I agree with you that hypomania is "brilliant."  Absolutely incredible - and addictive.  Hypomania is the reason that so many refuse medication.  They just don't want to lose that.  I've always been a big Stone Temple Pilots fan.  Lead singer Scott Weiland, who is bipolar, doesn't take meds for it because he doesn't want to lose the highs and creativity.  Although Kay Redfield Jamison in her book "Touched With Fire" (a great book, by the way) cites many who claim that lithium actually helped their creativity.  I suppose the jury's still out on that one.

I love your comment about bipolar not being something you "suffer" from.  I agree one hundred percent that it is something that is a part of us - even the ups and downs.  Well put.

Also, excellent point about a clinical "understanding" of bipolar skewing one's ability to truly understand it.  This is why I have so much respect for Kay Jamison.  For a professor of psychiatry to write about her own experiences with the illness in such a candid, forthright manner is a tremendous act of courage.  I highly recommend An Unquiet Mind, in which she writes of her harrowing experiences and descent into madness.  It is a riveting read.

I can tell that your mother is an angel.  Mine is too :).  Both she and my brother have been wonderful.  My Dad, although I know that he loves me as well, is having more trouble with it.  He is not really talking with me right now because I am not currently taking lithium, but am trying to manage this holistically, naturally.  My mother wants me to be on lith as well, but is respectful of my efforts.  She reminds me not to try an be a hero, but to be willing to say I tried, but to go back on the lithium if things get to be too much.  

A six month wait for a psych eval?  Are you kidding me?  Don't get me started on the current state of health care in this country.  Are you on meds right now?  Please don't end up in jail (or worse).  If you need meds, do it.  Life is too short - and precious.






1458891 tn?1285647838
I have definitely read about the link between the circadian sleep rhythm and bipolar disorder (as well as other mental illnesses).  It then made sense to be that I often have trouble sleeping - especially when a depressive episode is coming on (or in progress).  Developing the discipline to go to bed at around the same time every night shouldn't be so difficult, but it always seem so!  :)
1255505 tn?1272822715
I had a MANY year period without any treatment…to back up; I began treatment for depression in my 20s. All of the ADs I was shuffled around on (except Wellbutrin) precipitated mixed states (thought at the time by the doctors to be anxiety) and the occasional hypomania…which was just fine with me and so went unreported. But then a clearer bipolar picture began to emerge with harder mixed states and manias and I was put on Wellbutrin again and Depakote and Trilafon was added.

Then lo, I was cured! Not really. But I went off drugs (yes I, like you, think yoga, as well as a lot of exercise and a more Paleo diet is very beneficial).  I was mostly ok after I went off, but later I would shift around in minor mixed states. It didn’t register with me. I was just moody. I was just passionate.

Then after a time the depression crept imperceptibly back in. I was convinced I had Chronic Fatigue Syndrome or “brain fog”. I think I subconsciously thought that it couldn’t be depression, because ADs just don’t work. Then the harder mixed states and manias began to cycle over a period of years. It still didn’t register.

It was when I found myself staying in a room above a bar in Hollywood (mind you I had a place to live and a career back home), shopping out of control, partying until the wee hours, singing, dancing, and rhyming down H’wood Blvd, climbing mountains (I even stayed a couple of nights at an Urban ashram…gotta love LA), and became convinced that I was one with the universe and so special that people should be thankful to just look at me…that things finally clicked. Then I crashed.

Incidentally, the Hoodoo root worker that I had consultant previously told me that something has been following me for many years. In retrospect (and maybe I’m just reading into things) I think what he saw was the disorder following me.

This is where we enter into my previous post.

I was put on Lamictal (now at 400 mg/day) and given Seroquel, which I think I only used 3 times…yuck. I too had thought that the mood stabilizer would blunt my creativity, but it hasn’t. It actually organized my thinking to the degree that I can now organize my projects. Only just now I’ve gone back on Wellbutrin…not because of depression, but because I’ve started smoking again.

My support system is great. My career is going well and has good health benefits and ample time off. Like I said, I can always count on my mom. My cousin who also has BP obviously has a really good understanding and insight. She’s actually also in the chemical dependency profession. My best bud is a hoot, “bipolar huh, so you’re not just an a**hole then.” I have a priest that would move heaven and earth for me. My family doctor is as smart as they come, and my psych nurse practitioner isn’t bad either.
Avatar universal
With the meds I lost my ability to muse. I couldn't think deeply. It bothered me. I reduced one dose and seem to have gotten my muse back along with anxiety. Such choices we are forced to make.

I'm type 2 so I don't get the full blown manias. The begining stage is so sweet. I get things done, I am social, I can do so many things in a day, my brain seems to be sharper than usual. In short life is good and I am happy. Albeit a little too happy. Then it switches. I become anxious, agitated, fearful. I've gotten to the point where I would see things out of the corner of my eyes and it would scare the pants off of me. I remember that state like it was yesterday it imprinted so fiercly on my mind.

There are many days I am tempted to go off my meds. More to test if I 'really have' bipolar though than to chase a hypomania. Hypomania at the high ends scares me so much I don't think it is worth the risk.
Avatar universal
That is the main reason I recently, over a period of months, asked if I could taper off my meds.  I was diagnosed over a year ago and wanted to see if they really got it right.  They did.  I never was totally off the medication but it seemed like once they reached a certain point, they didn't really do anything for me.  Being BP II, I never get the mania, I've spent too much money on frivolous things etc,,,, usually it's more like I realize what lengths I'm going to to be the life of the party.  Doing things I would never do otherwise.  And then  darkness and suicidality hit.  Going back to where I was on the meds, hopefully the same ones will get me back in the road and out of the ditch.
Rogelio
1458891 tn?1285647838
Linda - I'm assuming (hoping) that your reduction in your dose was with your pdoc's blessing?  Or that he/she is at least aware of it...you don't want to start playing self-pdoc (a strange way to word it but you know what I mean).  If you ever (God forbid) end up having to go to the hospital for this, you'll want your pdoc to know exactly what dose you're at.  Otherwise, it could adversely affect attempt to treat you.  Please share everything with you doctor.

I'm glad that you've never gone full blown manic, but that doesn't mean it can't happen.  Not trying to scare you here, but you just need to know what to do if it happens (again, the importance of keeping your pdoc informed).  Having a strong support network is key.  Also, it's good to know some basic breathing techniques.  Full blown mania is no picnic.  After the euphoria turns into panic/terror (heck, even during it), you've really got the tiger by the tail and are sort of just hanging on.  I've described it as being like the switch in your brain that controls your adrenals (and the "fight or flight" response) being stuck in the "on" position for an extended period.  Not fun at all.  Plus sleep is something that you'll never again take for granted.  But it sounds like your experiences with hypomania were enough to get your attention.

1458891 tn?1285647838
Ah, yes - gotta love L.A. indeed.  I lived there for 7 years (was in San Diego for several years before that) but recently moved from CA.  I used to live right off of Sunset Blvd. - the perfect place for manic types - not!  :)

Yesterday I was reminded of the power of a little hypomania.  After a couple of nights of poor sleep, I had to wake up for a job interview. I only got 4 or 5 hours of sleep and felt horrible.  I honestly did not know how I would make it to the interview. I struggled to get dressed, tried to pull myself together, when BAM - it just kicked in. I got a burst of energy and everything seemed to come together. During the interview, the words just came. I have no doubt that I was charming, witty, and quick on the draw. If I don't get the job, it would probably be because I seemed too over the top, but it wouldn't be for lack of energy!

I walked out feeling tremendous! The sky seemed extra blue, colors seemed extra sharp, and every song I listened to on the radio only took me higher. I literally remember thinking to myself, "how on earth can I ever give this up?!" Very, very difficult. But I have not thrown away the lithium because I know that things can turn on a dime...

You have a strong support network and that is a very, very good thing.  Between that and the meds I really think you'll be fine.  I'm still practicing yoga and about to resume a rigorous exercise routine.  If that doesn't work then I'll wave the white flag and hop back on the lithium.  I'm so close to doing that already.  

Totally unrelated, but oh how I miss Southern California!  :)

Anyway, here is a link with very good information on the disorder...

http://www.everydayhealth.com/bipolar/w ... ipt-1.aspx

It is a radio interview with a Robert M. Post, adjunct professor of psychiatry at George Washington and at Penn State Schools of Medicine and head of the Bipolar Collaborative Network in Bethesda, Maryland. Very informative. You have the option to either listen to the interview or read the transcript.

I hope folks find it helpful.
Avatar universal
I like the way you write and describe mania.
Unfortunately for me my mania experiences  have been so extreme that I have been in the hospital 5 times.  I've been stable for 6 years now on Seroquel.  
I remember when I was manic the sky was extra blue, the grass and trees a brilliant green.  Then on another medicine the sky turned gray and the green grass and trees were brown.  
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