I can has mania?

Mania is addictive.

Well, actually there are different types of mania. Some manias present in the form of extreme irritability. Everything pisses you off. You're likely to fly off the handle at the smallest things. You are the extreme authority, you are right and everyone else is wrong. You don't know what to do with all of this angry energy.

But some hypomania and to a certain degree, mania, can be addictive.

Euphoric hypomanias are wonderful. Everything just feels fantastic. Food is better. Sex is better. Colours are brighter and even scents are more pleasant. Sometimes when I'm hypomanic I'm struck still by how perfect things seem to be.

When I'm hypomanic I have energy. I can run days with no sleep. I am compelled towards goals and am so productive. I will never quit. I can do anything. I have so much creativity and my ideas are coming so quickly that I feel brilliant.

In hypomania I have written some great songs. I've discovered artistic abilities that I would never have found otherwise. I've out-performed, out-lasted. It feels great.

Then you get into mania. The euphoric feelings deepen and you're king of the world. You are in control. Those are the good feelings. It's easy to see how addictive that can be. And once you're staying up all night, you don't want to return to sleeping 8 hours a night. 5 AM is just as addictive. Night time is magical, being the only one awake gives you the feeling that you own the world.

So it's hard to turn your back on all this. It's hard to let go of the superhuman and just be human.

There's just one problem, though.

It's virtually impossible to have good hypomania without any bad. Things tend to go a few ways.

First: Hypomania deepens into mania. Great feelings turn into overwhelming anger, fear, and you feel like you're out of control. Things are too fast, too sharp. Judgement is impaired, you become reckless. In the grips of mania I've turned to sex, incurred large amounts of debt. I've wandered the streets at 2 am, fleeing from some invisible enemy. I've done many things I regret. I drink too much, I spend too much, I put myself in danger. There is nothing funny about mania. So why is it so addictive? I think it's a slippery slope - I know in the past I've started feeling hypomanic and have purposely done things to heighten it, like messing around with my food and sleep and medication.

Second: Mania doesn't stay mania. Mania can turn into a mixed episode. Mixed episodes are defined as mania and depression occuring at the same time, but there are a lot of possible combinations there. When my mania turns mixed, I get really angry. I start wanting to hurt. I feel like crap and like there's no hope and like there's no point, but at the same time I still have incredible amounts of energy to carry out any destructive feelings I may have. I am overwhelmingly angry at myself. It's dangerous. Mixed episodes tend to include psychosis for me. That's when I end up in the hospital. The very first time it happened, I was scared to death, felt ready to hurt myself, felt like I was about to die, got on the subway and all of the sudden I could hear peoples' thoughts, and they were all thinking that I should be dead.

Third: What goes up must come down. Not always, but a lot of the time mania brings on depression. That's usually the case for me, and it happens like a switch. In the morning I feel like queen of the world and by the afternoon I want to die. I described depression a little in my last post. For me, it's just blank. What's the point of doing anything? Everything is just pointless and hopeless. I start to wonder why I'm living. I feel intense guilt. I'm anxious, panicky. I want to scream but really what's the point of that, either?

So that's the deal you make. Hypomania is awesome, but it comes with a price. And the hardest, hardest thing for me to accept is that this is beyond my control. My brain chemistry can throw me a curveball whenever the hell it feels like it. And I have to fight it.

Would I give up every second of hypomania if it meant that I could be stable all the time?

That's a hard question.

The answer is, I don't know. Would you give it up?

university, moods and medication

Today I found out that I've been accepted to university to study psychology. Look out, world, Silla's a student now.

I'm going to talk about mood minding. Because once a bipolar person gets put on medication, that's not the end of the story.

One thing that is very useful is a mood chart. There are lots of them online, and they track things like your mood (give it a number), anxiety, irritability, sleep, medication, external influences and etcetera. You pick what you need to track most and track it. I have my own version, so I can track patterns.

Because medication doesn't mean you'll be fixed forever. Unfortunately, bipolar doesn't go away. Once bipolar is treated the moods aren't as extreme and you have periods of stability but sometimes breakthrough episodes happen. Sometimes meds don't work so well anymore and need to be adjusted. Sometimes life stressors can push you out of your safe mood zone. All three have happened to me recently. (All at once, ouch.) That's where mood charts come in handy. With one, you can track how things affect your mood, what makes it go up, down, anywhere. You can figure out what triggers you. You can see if there are any patterns. Sometimes your mood will cycle at certain times of the year. April is a month where my mood ramps up. January I'm prone to crashing. If I'm not careful to stay on top of my medication while going through a lot of stress I'll wind up manic. I know this thanks to charting and I can take steps to protect myself during this time.

Minding your mood takes work, but it's worth it if you can help avoid major mood episodes.

The other thing I can talk about is medication adherence. It is common for someone with bipolar disorder to go off their meds. For many reasons. It sucks having to take pills every day, the side effects range from uncomfortable to horrendous - weight gain and absent sex drive and slowed cognitive abilities are some of the worst. Also sometimes the medication is working and you're feeling fine so you think you don't have to take meds anymore. This happens with non-bipolar people as well, once you start feeling better you stop taking the medication even if the doctor ordered you to finish the bottle. And sometimes the medication flattens you out so much that it sucks and all you want is to find a little mania again. Hypomania is addictive - who wouldn't want to feel like they ruled the world?

I've gone off meds several times. Once I thought I was better and didn't need to take as much medication. I really should have discussed that with my psychiatrist first. Once in the first few months after I was diagnosed, I felt horrible. The medication made me stupid and tired all the time. I hated it. So I stopped taking it. Unfortunately, not too long after I stopped the medication, I was manic again. Once I was patient enough to stay on the medication I found that pretty much all of the side effects calmed down or went away. But I didn't learn, either. I'd gone off meds just before Christmas and then I crashed on New Years' Eve and wound up hospitalized. Now, ever since I've moved (super stress) I've been hypomanic. It is still hard for me to keep myself on the medication I should be taking. I like the hyperproductivity and the staying up all night and the super confidence. I admit that. But I've also learned that it's impossible to have your cake and eat it too. If I decide to mess with my medication to find some hypomania, it's going to escalate into mania, and then crash. What goes up must come down and oftentimes a high will bring on a low.

Medication sucks. You have to remember to take it, and it has side effects that you hate and you feel like it stigmatizes you and you want to be better, but when it comes down to it, if you want to lead the life you want you probably have to be stable. So it becomes a tradeoff.

I just got into university. It took a lot of work, and there is so much I want to learn and so much I want to do with my life. I could give in to the part of me that wants to go off my medication so I can be on fire again. Giving into that would put everything I've worked for at risk. In mania, people spend and lose fortunes, alienate their loved ones, throw dreams away on a whim.

When I'm on medication, even when I'm not in an episode, I still get fire. I get the same fire and pain and ups and downs that everyone gets. A world of mercurial moods and firey ups and dark dark downs and upheaval and drama is available to me. It's seductive, the power of it. But I'm not willing to throw my life away with the consequences of it. I remember the frightening power of mania, the heavy, suicidal depression, the dark and screaming mixed episodes. It's not as glamourous as my head tries to convince me it remembers.

Keeping myself on an even keel takes work. It sucks sometimes. But I can harness my moods and my powerful emotions and use them to create something wonderful. Me, just me, medicated and dedicated.

Is bipolar a curse, or a blessing? I don't know. All I know is it's a part of my life and if I take care of it, it won't kill me.

3 am muffins and mania

It is three o'clock in the morning and I am baking muffins. Have been for a while. Don't really know why.

So while I'm waiting for the next batch to finish, I will talk to you of mania, at least as I experience it.

Wikipedia says: Mania (from Greek μανία and that from μαίνομαι - mainomai, "to rage, to be furious". (Yes I quite like Wikipedia.) It goes on further to say: Symptoms of mania include rapid speech, racing thoughts, decreased need for sleep, hypersexuality, euphoria, impulsiveness, grandiosity, in some cases psychosis, and increased interest in goal-directed activities.

That's what Wikepedia says. Online definitions don't speak much of the human experience, however.

Increased interest in goal-directed activites. Hmm. Maybe that's why I'm baking tray after tray of muffins in the middle of the night. I've also been getting mad urges to go to Alaska.

But anyway.

I will describe one of my previous manic episodes.

It started out simply with me not sleeping. It crept up quickly and before I knew it I was running almost all night with no sleep and I wasn't even feeling it. I started to feel really, really good. Everything took on a sort of detail, it was like I was experiencing the world through a 50 inch hi-def flatscreen with super surround sound. I felt so in control. It was like I could see everything in my head and could organize it perfectly. I felt like I could control the world.

These feelings scared me at first. I could tell something had changed, I could tell that my world was speeding up, and I mentioned my concerns to my therapist. She thought I was fine. I did not share this view. I was just coming out of a depressive episode (will talk about that next time) and everyone thought it was great that I felt So Much Better.

Things escalated. Suddenly I could orchestrate the world, I could make everything work exactly as I thought it should. By the next week I went to the appointment with my therapist and didn't want to sit down. I wandered the office restlessly and talked a blue streak about everything that popped into my head. The weather. The news. My cat. Last night's television. How wonderful things were. My cat again.

This time she was concerned. I was perfectly fine.

She sent me to a psychiatrist for a one-time assessment. Being the good student that I was, I took notes on what things were like and brought them into my session with the psychiatrist. She wanted me to try Seroquel, an anti-psychotic/mood stabilizer that is good at getting people back to sleep. This is where my mind broke loose from reality a little. When I got the prescription for six little pills filled at the pharmacy I was convinced that she was only humouring me and had secretly told the pharmacy to give me a placebo. I decided not to take the medication. I didn't know what it would do to me and I didn't trust her anyway. Bad decision.

That was the more fun, early beginnings. My memory of what follows isn't exactly clear. Mania tends to give you fuzzy spots.

Pretty soon I went from feeling great to feeling terrified beyond reason. I wasn't sleeping because if I did, something bad would happen, some catastrophe would fall. One night I was so struck with creativity that I spent four hours composing pages of poetry, and then started two new short stories. The next night I spent too much money on paint and more paint and I decorated my apartment with detailed rabbits and random abstract finger paint. I started going for walks at 2 in the morning. Frantic walks that took an hour or more. I stopped going out during the day because the sky was so big and open that I was convinced that the sun would crush me. I pulled away from people. I was paranoid. When I went on my 2 am walks I could always hear people whispering behind me, and shadows flew past the edges of my vision. Probably the biggest personality change is that I started compulsively sex-seeking. I went to craigslist to look for sexual partners. I talked to several guys and made some plans. I was supposed to meet up with the first one after work on a Saturday.

Work was particularly hard that Saturday. I had spent the week hiding in isolation and slowly going crazy. When I had to come out on Saturday all of the sudden I didn't quite fit properly into the world any more. I had to whitewash over myself, to try and keep the illusion that my world hadn't just cracked apart before my eyes. I held it together for most of work.

Something shifted. All week I had been slowly moving from pure mania to a "mixed" state, which is when symptoms of mania and depression both occur. Mixed states are scary. They are dangerous. Gone was the superman feeling. All I was left with was paranoia, extreme amounts of energy, and the idea that maybe I should be dead. I canceled with the guy, and he was angry and stalked me via text message for awhile. That was the day I stepped on the subway and heard people thinking that I should be dead. Everything broke to pieces after that. I was worse off than I was before. But alas, that will wait until I decide to write about depression.

Which won't be right now because I have to go take out some muffins!