Just a Little Unwell; the Many Shades of Mania


Despite popular belief, bipolar disorder isn’t really about jumping off buildings because you can fly.

Yes, in very extreme cases, it sometimes looks like delirium, bizarre behavior, hearing voices, invincibility. That’s usually when it’s exacerbated by schizophrenia, PTSD, psychosis, and/or some other fun mental combination.

Nor is bipolar just “being moody.”

I'll give you a textbook definition, and then I'll give you the "real life" one.

Bipolar disorder is a disruption in state-of-mind that lasts over a sustained period of time. Usually weeks or months. It’s a cycle of mania and depression, often co-ocurring with anxiety disorders, OCD, attention deficit.

The typical physiology of mania is euphoria, extreme creativity, excitement, boundless energy, new ideas and limitless possibilities (often unrealistic), doing everything with great gusto... I like to call it "pleasantly frenzied."

Doesn’t sound terrible, right?

But as awesome as it sounds (and often feels), it’s not. It substantially impacts your life, negatively. It comes with a cost.

It’s not sleeping (sometimes for days), or only a couple hours here or there, sparsely. It’s a racing mind, an inability to concentrate, pressured speech. It’s extreme risk taking, unrestrained pleasure seeking, unmanageable impulsivity. It’s a near-complete loss of social/sexual inhibitions. It’s intense anxiety, feelings of paranoia. It’s hyper-focusing on things (anything, really), and not being able to stop. It’s binge eating, or not eating at all. It’s irritability that easily (and frequently) escalates to a fury that rivals the savage temper tantrum of a toddler.

It’s emptying your savings and maxing credit cards. It’s quitting your job of many years. It’s impulsively giving things away, selling and/or purchasing things, like a family heirloom or a new car every year. It’s going off all your meds because you feel great, normal, cured. It’s having multiple sexual partners and unprotected sex. It’s obsessing about projects or taking on massive new ones, only to lose interest weeks or months later and moving on to another. It's being "not very nice." Sometimes it's being excessively friendly, over-generous.  It’s being unfaithful, abruptly ending relationships, divorcing. It’s suddenly deciding to sell your home, or leave that rental without a 30-day notice, and moving somewhere new. … and so much more…

And it's not being consciously irresponsible, careless or immoral. Mania diminishes, practically disables your regard for consequence, and it rationalizes everything.

But as always, sooner or later, mania moves along and a new monster shows up at the party.

Sometimes it’s with only a moment’s notice. Or none. Sometimes it’s a slow transition that you recognize but cannot regulate or contain. Like a gradual ride in the ski lift as it sluggishly travels up and down the mountain. If you jump off you die, so all you can do is just hold on.

It’s a sense of complete worthlessness, that your life has no meaning or purpose whatsoever. It’s always feeling cryptic, fatalistic. It’s shutting out your partner and other loved ones. Withdrawing from your friends (if you even have any by this point). It’s sleeping too much, eating too much or not at all. It’s losing interest in everything you love. It's crying for hours, and hours, and hours. It’s being too overwhelmed to do even the simplest of things/tasks, like taking a shower or changing the trash. Or even just getting out of bed. Being too overwhelmed to make decisions, or think clearly, being cognitively incapacitated. Yet somehow, at the same time, it’s thinking waaaay too much. 

And the thinking that does happen is never pleasant...

You are always in a state of painful worry, about everything, but mostly about the few people you love; how can you possibly go on living when they die, what if they’re dying right now, what if they already have, and you just don’t know about it yet.

You’re terrified of your own mortality, yet, ironically, you’re also ready to die.
Your life has plateaued and has nothing left to give you. This world doesn’t need you, there's nothing more for you here. Other than your parents, children, a husband or wife. But they don’t really need you, either, and will be fine when you are gone.

Just as being bipolar isn’t the equivalent of “moodiness,” depression is much more than “feeling sad.”

Switching between mania and depression is cyclical, happening over, and over, and over again. And no matter what state you’re in, you lack the ability to control the shift. Or even influence it. In that moment, you’re emotionally paralyzed.

Sometimes it’s patterned, almost foreseeable; expectedly triggered by events, holidays, times of intense stress, environments, seasons. Sometimes it’s completely unpredictable.

Sometimes the shifts happen more frequently. I once read somewhere that "rapid cycling" is defined as having four or more depressive and manic episodes in a year. I’m not sure who wrote that, because it’s almost always more than that.

And sometimes there are “mixed episodes.” Those are the most fun (note the sarcasm). You’re high and unstoppable, and depressed and despondent, all in the same moment. Day. Week.

And we all joke… I wonder if crazy people know they’re crazy?
I’m not sure.

Sometimes you don't recognize your own mood changes.
But the frustration intensifies during the times when you are aware.
Aware, and powerless. There's that skilift again. You can only try your best to navigate the episode, knowing it will change, but not knowing when. You have just enough sense for your mind to yell– “Don’t trust this! It will change!” To no avail.

When people think bipolars hear voices in their head, that’s usually what it is.
Or we’re just having a conversation with ourselves (imagine nonchalant shrug here).

Regardless, it doesn’t always look like jumping off buildings.

Sometimes it just looks like painting your interior walls (for the fourth time in three years) at 2 am. Waiting for them to dry so you can stay up 3 (4, 5, 6..) more hours putting on additional coats, because who needs sleep! Drinking more than you should. Dancing and singing, positively giddy through four minutes of the song that happens to be playing. And like the flip of a switch, angry, hopeless, sobbing through four minutes of the following song. And then dancing and singing and ... You get the idea. Rinse, wash, repeat.

Washing down a handful of depressants with a glass of wine, because you know that the only way to escape, even if only temporarily, is to go to sleep, be unconscious for a while.

Sometimes it looks like a weekend-long nervous breakdown (literally) before starting a new job. But that's a story for another time.

And sometimes, bipolar looks like nothing at all. For a combination of reasons, probably.
Your current prescription cocktail seems to be more effective than the last few you've tried. Your therapy is helping. It happens to be a “good” day, not an "off" day.

Or you’re one of the affected people who have just enough control to be “quietly bipolar.” You suffer at home, in your car, in the restroom, or any other moment when there is no one around. Unfortunately the suppression leads to a worse situation when you've dropped the reins. But anyway...

You blend in, you're concealed.
You're like a leper pulling down the brim of your cap just enough to hide how hideous, repulsive, and abnormal you are.

Regardless of what it looks like (or doesn’t), it's infuriating, debilitating.
I wish I could think of stronger words.

But I can’t at the moment. My eyes hurt and my thoughts are wandering like a runaway float at the Macy’s day parade. 

Besides, I have to go put on the second coat in the kitchen, and finish the first in the living room.