WHAT IS BIPOLAR DISORDER?
Bipolar disorder (Type I) is a mental illness characterized by having prolonged fluctuations between manic and major depressive episodes, whereas bipolar disorder (Type II) is characterized by fluctuations between hypomanic and major depressive episodes. People who have bipolar disorder experience intense emotional instability and find it difficult to regulate or manage their emotions in a way that’s productive if left untreated. Since mania is often misunderstood and overlooked, it is crucial to gain a better understanding of this fundamental component of bipolar disorder.
WHAT IS MANIA?
Mania is a prolonged, extreme, elevated mood that can last a week or longer. Keep in mind, hypomania shares the same key symptoms with mania, but is generally shorter in duration with less intensity. Mania can present itself in a variety of ways, but common symptoms include:
- feeling euphoric or “on top of the world”
- starting many tasks but not following through
- hyperverbal and accelerated speech
- irritability
- delusional thinking
- thoughts of grandeur
- inflated self-esteem
- easily distracted
- decreased need for sleep
- racing thoughts or difficulty maintaining cohesive ideas/ thoughts
- overconfidence
- risk taking (such as fast driving, thrill-seeking behavior, promiscuity, recklessness, substance abuse)
- poor judgment
- overspending
- impulsivity
- overly suspicious or paranoid
Some people enjoy manic episodes because it feels better than depressive episodes, but mania is self-destructive and can be a nuisance or harmful to others. You might feel good, but don’t let the high of mania fool you into thinking it’s a positive thing. You might push people away, be too defensive, overwhelming to others, or destroy relationships. During manic episodes, you might feel as if you are being productive, but it is likely that you are biting off more than you can chew and aren’t able to follow through with tasks. No one can sustain the mania and the feelings that accompany it, and people will often resort to drugs to try to maintain the high. Eventually everyone ends up crashing regardless if they are using drugs or not, and can easily end up plunging into depression, particularly if left untreated.
There’s little or no self-awareness during mania, so you may not realize the consequences of your actions or how you have affected others until you come out of the episode. When you start to notice these symptoms, seek professional help before you slide fully into a manic episode. Not everyone experiences the same feelings and symptoms, so it’s important to know yourself and keep track of your emotions and behaviors so you can be aware as to when mania is setting in.
EARLY WARNING SIGNS
The transition into mania can be slow and progressive. Therefore, it is crucial to stick to your schedule and keep a log or diary so you can notice changes easier. Coming out of a depressive episode can bring about a sense of relief, but it is important to be mindful of your emotions and behavior, as well as how they are changing. Sometimes people will stop taking medication because they enjoy the high of no longer being depressed, but don’t realize they might be transitioning into mania. Although euphoria or periods of joy are healthy and a normal part of human existence, it is important to distinguish between happiness and mania. Early warning signs of mania include:
- being impatient or easily frustrated
- feeling like everyone else is too slow or not keeping up with your speed
- feeling restless and fidgety
- lacking self-awareness or not being mindful of your behaviors
- not realizing the speed at which you’re moving, talking, or even thinking
- being easily disorganized and distracted
- losing sight of your goals and purpose
- losing sleep or thinking you don’t need sleep
- not keeping to your schedule
- biting off more than you can chew
- having racing thoughts and finding it difficult to keep your thoughts in order
- rambling, pressured speech, and not easily understood
At the onset of mania, you might feel confident and energized. You might feel like you’re getting goal-oriented, but mania can take away from your goals and interfere with your functioning. You’ll take on more tasks and projects than you can handle, and you rarely follow through.
WHAT CAN YOU DO TO PREVENT SLIPPING INTO MANIA?
Even before symptoms start setting in, there are ways to stabilize your emotions and behaviors to prevent yourself from getting out of control.
- Practice self-care regularly, such as exercise, healthy nutrition, psychotherapy, meditation, painting, music, gardening, or anything else that keeps you calm, focused, and mindful.
- Being self-aware about your emotions and behaviors will help you know when you are veering away from your baseline.
- If you are taking medication, it’s important to be consistent. Mood stabilizers and antidepressants (and other psychotropics) are supposed to keep you level or closer to your baseline so you don’t fluctuate into extremes. They are not supposed to take away joy or periods of euphoria. If you are still experiencing extreme emotions and behaviors, aren’t experiencing any moments of happiness, or feeling emotional numbness, talk to your medical doctor about possibly adjusting the dose. Never adjust your dose or abruptly stop use of psychotropic medication without consulting with a professional first.
- Stick to a daily schedule, including nighttime and morning routines. Keep a daily log or a mood chart, which can include: sleep schedule, appetite, energy levels, medication, daily stressors, thoughts, and feelings. Embrace flexibility and spontaneity, but do take notice of your behavioral or emotional patterns and don’t let them interfere with your goals.
- Each day, set small attainable tasks and goals. Avoid huge, overwhelming tasks, even when you’re at baseline. Using a daily planner or calendar can be helpful to keep you better organized.
- Avoid caffeine, energy drinks, and overstimulating environments. Seek out balance and moderation.
Mania setting in? If you notice the early warning signs, here are some things you can do to prevent a total manic episode:
- Pull back and focus on your routines and small goals.
- Adhere to your prescription medication regimen.
- Continue practicing self-care and sticking to your schedule, including your daily sleep routine.
- Slow down and engage in mindfulness.
- Stay in safe spaces and be around positivity. Avoid high risk situations or overstimulating environments.
- Seek out help from a supportive family member.
- If you are in recovery (drug/alcohol), go to a 12-step meeting and talk to your sponsor.
- Report any changes in your thoughts, emotions, or behaviors to your medical doctor and/or therapist.
A little up and down is fine and inevitable, but when you notice the see-saw moving more, reach out for help and ask a supportive friend or family member (who is knowledgeable about bipolar disorder and knows about your diagnosis) for support. Ask them to tell you what they are observing about your speech, mood, and behavior. Ask for assistance with finances/budgeting if overspending is a problem (e.g., hand over your credit card to someone trustworthy during mania as a preventative measure). If you can’t tell how your behaviors are impacting others and are having difficulty being self-aware, attempt to pick up on others’ social cues for guidance. People might say: “slow down,” “can you repeat yourself?,” or “I don’t understand what you’re saying.” These statements might indicate your speech and thought process are accelerated and others might be struggling to follow your speed in conversations and activities.
You can effectively manage manic symptoms if you actively practice mindfulness and seek ongoing consistent help. At Serenity Lane Psychological Services, Dr. Heather Violante specializes in providing therapy to those struggling with bipolar disorder and offers tips on self-care, mindfulness, and techniques for regaining control. Contact Dr. Violante today so you can begin your pathway to living a fulfilled and productive life.