I Want to Talk About Dysphoric Mania (or Mixed States)

Before I begin, I’m going to try to reel this blog back in and let it be a lifestyle blog, talking about whatever is going on in my life, whether that’s the writer side of things the student side of things or what have you. Put simply, I’m going to try and let this blog flow naturally from whatever I feel is relevant to talk about at the time so as not to alienate those who have been reading this blog for a little bit. I’d also like to try and blog a bit more regularly, but there are no promises.

The last time I blogged was at the beginning of April, probably a week or two before I started slipping into a little bit of depression; however, it was relatively mild compared to what I was used to. I still had some motivation to do things, even though it was less than it usually was (so I had zero motivation for work, just for school), my appetite was unchanged, and I didn’t have the usual fervent desire to sleep in really late and go to bed as soon as I could. (But I was binge drinking on the weekends, so there’s that.) It was just feeling down and grouchy and irritable and a little bit burnt out. A busy work day made me more irritable than it usually would–I railed against it, in fact, screaming in my mind, “I don’t want to do this! I can’t stand this,” but being able to do it anyway, so could it have really been depression?

In fact, I thought it was all just mere burnout. Once the semester ends, I told myself, and I get some breathing room, I’ll be back to normal.

Of course, that didn’t exactly happen. Even when I started precalculus I still had some of the depression, but it was starting to dip more into anxiety at that point, so I thought of speaking with my psychiatrist about getting put on an anti-anxiety medication. And, no, I didn’t call her right away. I didn’t feel it urgent enough and told myself I could wait until August to have it taken care of. I simply thought I just needed a chill pill so the pressures of getting into a DPT program didn’t seem so much.

Then, out of nowhere, I started feeling good. Really good. Things were falling into place. I was doing great in precalculus and doing much better than I expected. Things at work were going great–my clients were building back up again, my Pilates class was building up since it was moved from Friday to Wednesday. Observation hours were going great. I started at a skilled nursing facility, so three settings in the bag. I was able to fit in more physical activity.

I thought I was just gaining a new lease on life and finally accepting that I was not a fraud and that I really am an awesome person capable of doing awesome things so there is absolutely no reason for me to feel insecure or worry about how intelligent I am to handle the hard sciences and so on and so forth.

After four good days though, four days that felt perfect, I began journaling my thoughts, and I realized what it was: hypomania. It makes rational sense since such an episode can precede or even proceed depression. And so it was then I had to admit my depression was bipolar depression. It also explained my ability to suddenly be on the AMT for a lot longer than 30 minutes and then following it up with a session of resistance training and still having energy left over to do more and more things.

Prior to this, I’d been stable for a little over three years. I thought I had put bipolar disorder behind me. I thought I had finally developed the strength to be able to overcome any ensuing episodes. Turns out I was really just in remission and was tipped over the edge from all the stress in my life. I’d argue it’s positive stress, but even good stress is still stress.

So I’m on week six of this roller coaster of hypomania/mania/dysphoric mania, and I’m not going to lie and say it’s all awful–some parts are just really freaking awesome. I’m almost done with a rough draft of a contemporary YA novel, and I’ve been on a hiatus for over two years! Granted, I’m on medical leave, but even if I weren’t, I still likely would have started writing a novel. Even when I was at work I wrote enough poetry to make an anthology. You’ve gotta do something with the manic energy, after all. You can’t just let it get pent up.

So the jarring reality that I’m a bipolarite for life is daunting when the future, that is me being in PT school, will allow for no slip-ups.

But I don’t want to talk about depression or hypomania or even mania. I want to talk about dysphoric mania because I don’t think it gets spoken about enough. I’m going through a little bit of dysphoric mania right now, luckily without any suicidality–but I feel down and want to cry but with the energy to do things (I didn’t want to come home from biking and would have biked all day if it weren’t for the fact that I’m married and have a husband who needs me. And if it weren’t biking, I would have wandered off somewhere else, likely blowing more money from my savings or going to bars or something. I really did not want to come home).

Depression gets enough attention. I believe most people have experienced some sort of depression throughout their lives, whether it’s situational or clinical. The percentage of people with bipolar disorder, however, is small (2.6%) and may be bigger since a lot of people don’t seek diagnosis for it or are often misdiagnosed because they are unable to grasp when they’re manic. In contrast, 6.7% of people experience a major depressive episode at least once in their lifetimes. But 15% of people will experience some form of depression. So while there are those out there who believe you need to suck it up, pull yourself by your bootstraps and move on, no one really talks about dysphoric mania because it is so unlike depression.

It is the type of mixture of mania and depression that can get you typecast as crazy.

It is the type of state that made me attempt suicide by trying to drink myself to death (I didn’t even get to the point of throwing up since you can drink so much more and be fine when you’re manic, but not like I knew that!) and being absolutely ambivalent that I failed. I did wind up, for the fifth time, in a psychiatric ward convinced I’d be healed of the mania by the time I got out. I’m so used to being more depressive than manic, but when I think about it, there was a time when I was hypomanic for three months when I was on Abilify, but it never ping-ponged because I was blissfully unaware. I simply thought I had developed a hyperthymic temperament. If I had been aware, my mood likely would have started undulating the way it has been.

In my normal depressive episodes, I wouldn’t have even had the energy to do something like that. Or it’s more like I wouldn’t have had the motivation. I could think about it, even make plans, but I never would have followed through with any of them because dying itself takes a certain amount of energy. But with dysphoric mania? All those dangerous impulses you’ve had cycling in your head are suddenly a manic hamster on a wheel, and you just choose the most appealing way of hurting yourself to stop the insanity.

Your flights of thoughts are not fun anymore. My flights of thoughts include biking, writing, studying, reading, writing, writing, writing, more reading, wanting to go out biking but it’s too late, listening to music on full volume pretty much all day, occasionally coloring, cooking, cleaning–there’s always so much to do, do, do, and never enough hours in the day. I don’t want to slow down. What is slowing down anyway? It’s all about speed! Also, sometimes impulsive spending. My bike was an impulsive purchase, but one I made knowing I still had plenty of money in my savings.

Yet, during dysphoric mania, the thoughts darken to slitting your wrists, drowning yourself, jumping from a tall building, drinking yourself into a stupor, doing something absolutely reckless that makes you high but also has the potential to kill you, speeding really fast while raging against all that is slow and crying that you’re like this and why do you have to be like this and wishing you were just plain-old depressed because when you’re down it’s actually burdensome to be full of energy and you wanna claw off your skin and cry while exclaiming everything is so wonderful and jump of a cliff while realizing you have a book to finish and–

My dysphoria today makes me feel down and sad, but it doesn’t preclude me from wanting to do something about the energy. That can be a blessing and a curse, but I made it a blessing because I went out and biked for several hours instead of hopping on over to a bar and drinking myself into a blissful slumber. I cried a little bit (tears mostly leaking from my eyes) when I found myself at a creek and started wading through it because the sadness is just so profound, but I got back on my bike and continued on a journey that was still thrilling. There were times throughout this little trek that Iwished I could bike so fast I’d go flying, so I took a few calculated risks to get that rush, but there were times that I did temper it when I came upon an especially rocky area that could damage both me and my bike.

I have been very fearless as of late. I know I’m still at it when I wake up in the morning and ask myself if I’d still like to go skydiving, and if the answer is yes, then I know I haven’t found my way back to the rational world.

Sometimes dysphoric mania, however, can leave you not wanting to do anything, so the energy is a winding buzz of caffeine x100 that makes you want to scream–so you sometimes do–and tear your skin off because all you want to do is sleep but you can’t without downing a higher prescription of your sleep medication than what you normally would take. It was this type of dysphoria that made me try exceedingly hard to die by overconsumption of alcohol.

It’s not fun. It’s moments like these that make me want to reestablish some semblance of normalcy. I’m going to be honest: Hypomania is absolutely fun, even with the rage and irritability. Mania itself isn’t so much because the energy is too much, and when you’re in a situation where you have to temper it (it’s much easier to control when hypomanic) you might appear bizarre to the people who know you: you cannot stay still so you pace or rock on your heels or snap your fingers, you’re not controlling your rapid speech, you’re an excess of you (my morbid sense of humor was slightly out of control when I was observing at the VA), you scream in your car to release some energy, you sing really loud to release some more, and when you are in a situation where you can indulge the energy, you’re looking for thrills that will tear the most out of you, even if you are aware you will look absolutely absurd.

You can also survive on much, much less sleep. I nearly went the entire night without sleeping but decided I should probably try because the energy was starting to become unbearable; however, I survived on roughly four hours of sleep without any issues. Even hypomanic I still have some sense to try and get in at least six or seven hours. Normally, I need more than that because the Seroquel takes longer to drain from my system, but it drains from my system within 30 minutes to an hour upon waking versus the three hours it normally takes so that I stop feeling groggy.

I get mixed at least once a week, sometimes more depending. Last Wednesday threatened to do me in with a mixed state, but I biked like a maniac and was able to ward it off. I even brought myself down to hypomania the next day from having done so. So of course I went out and bought my own bike. What a great coping mechanism!

I become a completely different person when I’m mixed.

Right now I am sad and want to cry and am silent and when I do speak it’s in bursts of short chatter, but I am also thinking about how much I freaking love mountain biking and my mind is obsessively fixated on practicing on the mountain biking trail at the Augusta Canal so I can then go mountain biking at Bartram Trail of Clark’s Hill and I desperately want to do it tomorrow but I also want to mark out the path I’m going to take to work and need to bike that so that way there are no screw-ups that make me late for work or put me in any kind of danger and I bought myself a mountain biking outfit that I’m really thrilled to get and really want to start a mountain biking club and–

And that is the state of my mind right now.

Some days I simply feel crazy.

 

 

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