I was reflecting on my most recent hypomanic episode, that lasted about 1-2 weeks and questioning why it didn’t turn into full blown mania. And I think I’ve gotten to the bottom of it.
For those who don’t know, hypomania is a form of mania but less severe. For me, hypomania can be quite a pleasant state to be in. For instance, I smashed out a draft of my thesis in no time at all, I wrote a bunch of poetry, saw a lot of friends. Yeah, I suppose I was a little bit agitated and that but I didn’t feel out of control. That’s why it is so easy for hypomania to quickly escalate to full blown mania. Because it feels great, it is intoxicating. Hypomania makes so many promises of greatness. You get addicted to staying up all night and the buzz and getting to so much done that sooner or later you descend into complete madness.
But not this time. This time, through lots of therapy and group work, I was able to recognise what was happening. I remember once a therapist at the Melbourne Clinic put it to me so simply when they said: the difference between hypomania and mania is insight. Yes, hypomania is less severe but the unique thing about it that allows you to get help is that you are still in touch with reality. Once you become all the way manic the only thing that can help you is medical intervention, often involuntarily. I, like many people with Bipolar, don’t want to get to that point. So there is a need to catch ourselves whilst we are showing the early stages of mania, the hypomania, and nip that sucker in the bud.
So it’s about recognising your triggers and your early warning signs. For me, there has been some conflict in my home lately. Conflict is without a doubt one of my biggest triggers for episodes. So already I am alert to the fact that something might go wrong. Then I notice I start staying up later, become more talkative and talk faster, start spending more time chatting to friends on social media (start spending more in general if you catch my drift), start becoming more goal oriented (studying more and working out more). These are the signs I’m on my way up and I need to do something about it.
It can be really tempting to ride the wave out. Like I said, for most people hypomania feels really good. If you’re my friend and you hear me utter the phrase ‘I feel the happiest I’ve felt in ages’ that is a clear sign I am hypomanic. Even for me, someone who has largely dysphoric, paranoid, aggressive manias, hypomania feels dynamite and I often want to stay there. But it is knowing that it will lead to these less enjoyable symptoms that keeps me grounded in reality and motivates me to act.
So with this most recent episode what did I do? I did everything the opposite of what I wanted to do. Instead of being on social media heaps and seeing friends, I turned off my phone and cancelled plans. Instead of staying up all night I saw my psychiatrist and got my anti-psychotics upped so that I could sleep at night. Instead of doing heaps of uni work I banned myself to only doing a small section at a time and then would turn my computer off. I basically switched myself off from the world for a while, went to my partners house (away from the conflict) and sat in bed and watched movies. The entire time I was restless as all hell, crawling out of my skin, but it worked. I didn’t become manic. I eventually mellowed out.
I can’t stress enough that in order to make these interventions you need insight. You need to map what your triggers and early warning signs are and track them. But most of all you are beyond helping yourself when you become fully manic. So you need to have that insight when hypomanic in order to prevent worsening of the episode. When hypomanic we are still lucid, still in touch with reality enough to listen to what our body is trying to tell us and intervene. That is the time to act.
When I become manic it is too late to help myself. I am gone. I am a different person. You can tell me I am manic and I will tell you you’re wrong. Hell, I’ll create a powerpoint presentation about how you are wrong that also demonstrates how I am the smartest, most glorious person in the world. I’ll scream in your face and attack you if you try to tell me I am manic when clearly I am just on a higher plane of existence than you. I’m too far gone. But when hypomanic, I can still be reached. When hypomanic, you can say to me ‘hey, I’ve noticed you’ve been speaking fast and not sleeping, how are you doing?’ and I’ll actually be capable of taking your words on. So it’s not just my insight that matters. It is the insight of my loved ones who know when and how to reach out to me.
I’ll say it again for the people at the back, the key difference between hypomania and mania is insight. When hypomanic I am still in touch with reality enough to help myself and be reached by others. Manic episodes can be avoided with a little bit of insight and a lot of follow through.