Every now and again I have these nights when I can't sleep. It's very frustrating to lie awake hour after hour while the husband snores softly and the dog snores softly, both sighing or twitching in their sleep but peacefully unaware of the hours creeping by. It's more than frustrating, though - it's a bit scary. Am I slipping into a manic episode, or am I just having an off night? I revisit in my head the list of mania symptoms, completing a mental checklist in my head, trying to determine whether I'm crossing that line into dangerous territory. It's not clear cut, especially in the type of bipolar I have.
Most people don't know that there are two types of bipolar disorder. Type 1s have very high highs. They usually have higher risk behaviors when manic - such as extreme spending sprees, hyper-sexuality leading to relationship problems and financial problems, and even legal problems. They make decisions based on very little information - they may marry someone they barely know, make large purchases such as a car or even a home. They even have delusions and hallucinations, psychotic features that 2s, like me, do not experience.
2s experience hypomania, meaning we get highs, but not super high highs the way 1s do. When I'm manic, which is an experience I'm still trying to identify, I need less sleep. Whereas I couldn't get out of bed when depressed, or I needed 7 to 9 hours of sleep when "normal", suddenly I don't sleep all night, or I wake up after only 5 hours of sleep, despite my nighttime medications to help me sleep. The worst part, and what I am experiencing tonight, are the racing thoughts. One thought after another runs through my head, some connected, some completely detached from anything relevant to my life at the moment. I also have a tendency to start planning projects that get way out of hand quickly. I also become hyperfocused - meaning I can't let anything go. If I start thinking about, say, reading a book on bipolar disorder, I can't read just one. I will buy or check out several, and I will spend hour after hour reading and taking notes with few if any breaks and feeling like I can't be torn away from it. My thoughts fly through my head something like this:
i need to pick up milk at the store...deposit needs to be made in checking...wonder if Pip is out of food...that was a good show tonight...therapy on wednesday...i need to add cards to my etsy shop...wonder if kyle is going out of town this week...this movie is really dull...it's hot in here...i hate the color on the walls in here...maybe i should paint it all...and if I'm going to paint I might as well pull up the carpet and see what the wood floors are like underneath...I guess I will repaint all the wooden furniture in here because I don't like the way the wood looks...then I can rearrange the furniture just so...
This kind of thinking goes on and on. Sometimes I can let it go. Sometimes it is POWERFUL and directs my thoughts and actions for hours or days at a time. It can be very difficult for me to differentiate between a normal state where I am not depressed and have natural energy, versus a hypomanic state where I have too much going on in my thoughts and actions. I get a little scared at these times. I don't want to venture into the dangerous territory of hypomania. Yet, I don't feel bad. A great deal of the time, manic phases and hypomanic phases feel really good. They can have detrimental consequences, though, and that is why it is important to stop them. They can also get very out of hand very quickly, too.
This means that I have to try to spot a manic episode in its infancy, and keep track of whether it is something to worry about, or something temporary. It's not easy. As I've talked about in other blog posts, my shopping can be my first sign that I'm off kilter. I want to spend spend spend a lot of the time, but especially when I am entering mania. I get a high from shopping that is almost identical to the high that a drug addict gets. Brain chemistry is not very different among addictions, regardless of whether they are chemical addictions or not. Many bipolar people have ended up in financial ruin. Though I've definitely accumulated some major debt, and our budget is extremely tight right now, but I haven't ruined my credit or my husband's and I am thankful for that. Left unaddressed, my spending and shopping would have put us in a much tougher place financially, not to mention the effect it would have had on our marriage.
A few other signs of mania include irritability and quickened speech. I'm always irritable, so it's hard for me to judge whether I'm more or less irritable than usual, but I'm not generally a fast talker, especially since my medications make it a little harder to gather my thoughts. When my speech quickens, it's a big sign to me that I might be enter mania.
No instant solution for a manic episode exists. Generally, I call my psychiatrist as soon as I realize I am experience manic symptoms and she adjusts my medications. People with more severe episodes sometimes require hospitalization until medications are tweaked and the patient's moods even out again. No quick fix exists. Psychiatric medications can take anywhere from a few minutes to six weeks to be effective. This means that for a patient to feel the full effects of a new antidepressant, it can take up to a month and a half. This is part of what makes me soooo frustrated. Therapy also helps, as well as support from friends, spouses, and support groups.
I suppose the part that scares me so much is the unknown. First, it's the unknown of whether or not I really am going manic or not, mixed with dread and apprehension. Then, if I do know I am, I am dreading and apprehensive about the medication changes. It's such a gamble to know what changes are right. Finally, it's a fear and apprehension about losing myself. Which me is the right me? Which me do I lose when I'm on the medications and parts of my personality or characteristics differ a little? It's all a lot to think about.
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