Friday, December 31, 2010

How do I cope with the hypomanic or manic phase of bipolar disorder (hypomania or mania)?

Dear Friends,

Thanks for stopping by! Trust you have had a blessed and wonderful weekend. Thank God for the beginning of a new week to walk with Him and serve Him.

Recently, I received an email from one of the readers of my blog. She noticed that I don't touch much on the manic state of Bipolar Disorder and on how I am learning to cope with manic state. I have written much on the Depression phase of bipolar disorder and been sharing about how to identify the signs and symptoms, and what are the coping strategies that I have been learning to use to help me to be more functional besides medical help and looking to God.

I have found some helpful articles on the internet on bipolar disorder and the mania / hypomania phase.

Bipolar Disorder causes dramatic mood swings—from overly "high" and/or irritable to sad and hopeless, and then back again, often with periods of normal mood in between. Severe changes in energy and behavior go along with these changes in mood. The periods of highs and lows are called episodes of mania and depression.
 
What is mania? What are the signs and symptoms?
Signs and symptoms of mania (or a manic episode) include:
• Increased energy, activity, and restlessness
• Excessively "high," overly good, euphoric mood
• Extreme irritability
• Racing thoughts and talking very fast, jumping from one idea to another
• Distractibility, can't concentrate well
• Little sleep needed
• Unrealistic beliefs in one's abilities and powers
• Poor judgment
• Spending sprees
• A lasting period of behavior that is different from usual
• Increased sexual drive
• Abuse of drugs, particularly cocaine, alcohol, and sleeping medications
• Provocative, intrusive, or aggressive behavior
• Denial that anything is wrong

A manic episode is diagnosed if elevated mood occurs with three or more of the other symptoms most of the day, nearly every day, for 1 week or longer. If the mood is irritable, four additional symptoms must be present.

A mild to moderate level of mania is called hypomania. Hypomania may feel good to the person who experiences it and may even be associated with good functioning and enhanced productivity. Thus even when family and friends learn to recognize the mood swings as possible bipolar disorder, the person may deny that anything is wrong. Without proper treatment, however, hypomania can become severe mania in some people or can switch into depression.

Descriptions offered by people with bipolar disorder give valuable insights into the various mood states associated with the illness:

Hypomania: At first when I'm high, it's tremendous… ideas are fast… like shooting stars you follow until brighter ones appear…. All shyness disappears, the right words and gestures are suddenly there… uninteresting people, things become intensely interesting. Sensuality is pervasive, the desire to seduce and be seduced is irresistible. Your marrow is infused with unbelievable feelings of ease, power, well-being, omnipotence, euphoria… you can do anything… but, somewhere this changes.

Mania: The fast ideas become too fast and there are far too many… overwhelming confusion replaces clarity… you stop keeping up with it—memory goes. Infectious humor ceases to amuse. Your friends become frightened…. everything is now against the grain… you are irritable, angry, frightened, uncontrollable, and trapped.


This is taken from an article from the website of National Institute of Mental Health (NIMH). NIMH said "NIMH publications are in the public domain and may be reproduced or copied without the permission from the National Institute of Mental Health (NIMH). NIMH encourages you to reproduce them and use them in your efforts to improve public health. Citation of the National Institute of Mental Health as a source is appreciated."

Read more here.

Another helpful website listed Some ways on How to cope with Hypomania:

1. Get enough sleep. Patients experiencing a hypomanic episode often feel a decreased need for sleep. This is an important warning sign of the condition and stabilization is key. Try your best to return your sleep patterns to normal. If you are unable to sleep, contact a doctor or mental health specialist.

2. Refrain from making important decisions despite the impulsive urge. Wait until you feel normal before rushing into any action you may regret later. Maintaining awareness of your character and patterns are important.

3.  Refrain from excess caffeine, sugar and alcohol because they are stimulants and may keep you from getting the rest you need.

4. Engage in calming activities and refrain from over-stimulating environments.

5. Identify members of your personal support system, such as family members, friends and loved ones, and reach out to them as necessary.

6. Contact your local medical and/or mental health provider for ongoing help.

7. Call 911 immediately for assistance if you are thinking about suicide

Read more here.

Actually, for me personally, my depression episodes have been more severe, prominent and paralysing, and I have been learning intensively how to manage it besides medication and looking to God. So I was able to write and share what I am learning along the way and what are my coping strategies thus far.

As for manic, whenever I am well, I am a little hypomanic but I don't really get very manic. I am still learning to identify when I am hypomanic and what are the things I do when I am hypomanic. So I don't really have much to share yet and that is why I have not written about it on my blog.

My hypomania is partly controlled by medication. I am taking an anti-psychotic (Seroquel 25mg) every evening which helps to slow me down and sleep through the night.

My psychiatrist is training me to identify my hypomanic phase. Keeping a Mood Chart is one of the way to track and see how my mood fluctuates and what may have caused it. I try to chart down my mood for each day, whether it is depression, normal or hypomanic. This way, I can kind of identify the triggering factors and try to work on resolving it from getting worst or do what can be helpful to get better.

Recently, I have been learning to identify that one of my hypomanic behaviour is I tend to write long emails to many people, or make many gifts or buy many gifts for many people when I am hypomanic. I tend also to take on many projects and have many ideas on what to do. These often lead to over-exhaustion, burn out and eventually depression. So now I am learning to cut down on these whenever I notice it. That's if I notice it :) I am learning to let go and set my priority on choosing what I need to do now and what can wait. Thank God also for some friends around me who constantly remind me to slow down when they sense that I am doing more than I ought to do.

Do you know of any other strategies that is helpful in managing mania or hypomania? Do feel free to share with me and my readers. 

Thank you once again for stopping by. Take care and have a blessed week!

Warm Regards,
Nancie
11 August 2010

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