The scary part (the REALLY scary part) about my most recent manic episode, is that nobody noticed. Not a thing. I was completely batshit, the full Fruit Loops, (literally) certifiable, and nobody suspected anything or thought I was acting oddly. Even when I realised for myself and pointed it all out, no-one can really see any way I acted out of the ordinary or did anything noticeable.
So this means either I’m a very good actor, or (more likely) that people are mostly just so busy and occupied with their own lives and their own issues that it’s very unlikely they would ever be looking closely enough to see the little signs of someone quietly going crazy.This is completely understandable, and I would probably fail to spot the same signs in someone else, for the same reasons. So I need to give out guidelines to help the people closest to me recognise it if I start to get crazy again.
A few points. Firstly, I might never get like that again, because the medication I’m on is meant to prevent it, but it’s probably best to be on the safe side. Secondly, I think there’s a good chance that I’ll recognise the danger signals myself before anyone else does – because I’ve done so much research into the illness, and I’m quite self-aware and intelligent, I do know what to look out for, so it should only become a problem IF I get delusional enough again that what I’m thinking won’t be any help. But I want to spell it all out here, just in case that happens and I go further than I’ve realised for myself.
I know how to recognise approaching depression – I dread it every year, and I’ve been fighting it for about 20 years, so I think I have that side of it pretty much covered.
The hypomania, or whatever this hopeless, frustrated, chaotic, hyper-irritable state that I spend much of my home life in, I know how to RECOGNISE, but I still need to find out how to deal with it. I need help to understand how much of it is down to outside forces (other people mainly), and how to deal with those issues in the best way for everyone, and how much of it is my stress-head just making mountains out of molehills, which I therefore need to learn how to recognise and stop doing it. I was hoping my psychiatrist would be able to advise me on that kind of thing, but so far it hasn’t really come up – the first visit was just me talking and her giving the diagnosis, and the second one was shorter and mainly taken up with just organising the prescription for my pills. She did say originally that when I finish my sessions with her I can move onto a counsellor or psychotherapist to help me deal with day-to-day issues, but that still seems a long way off, and I’m very impatient and want everything sorted NOW.
What she has organised, in the meantime, is for a social worker to come and visit. I was a bit surprised when I got the letter, and I don’t really know exactly what she’s coming for, so I’ll have to wait till I see her. (I tried looking online to find out what social workers visit for, but virtually every link was something to do with Child Protection, which doesn’t really apply here, so I couldn’t find out much.) I know they can do some kind of family counselling, so maybe it’s to help find out what our problems are at home, and suggest ways of working round them. I’ll just have to wait and see, but she’s coming on Thursday afternoon before I go to work, so I’ll let you know after then how it went.
What I DON’T need, at any time, LOL, is being told to “calm down” every time I get the slightest bit annoyed about the normal things that annoy everyone. And “chill out” is even worse. If I knew how to chill out I wouldn’t be getting irritated in the first place! One half of me thinks I want constructive help or advice about whatever it is that’s annoying me. But the other half knows perfectly well that I hate taking advice or being offered help, so that will probably just annoy me more. I know, I’m a hopeless case. That’s why I’m seeing a psychiatrist, I suppose.
So I think the only thing I need people to look out for, in case I’ve missed the signs myself, is signals of impending full mania. It would be hard for someone else to know what’s going on inside my head, but the physical symptoms might be easier to spot. Basically if I have a huge amount of extra energy, hyperactivity, and forceful mood (either happy or pressured or dominant and bossy) – not just for a day or so, because anyone can have a good day or a high-pressure day, but for an extended period of weeks or months without slowing down – then that would be Sign Number One.
Sign Number Two would be that I’m not sleeping much. Again, for a few days that’s not a big deal, but if I’m getting up earlier and earlier for a prolonged period, and most importantly NOT FEELING TIRED despite only having a few hours’ sleep, then that should be a big flashing neon sign to everyone, because for me that is completely not normal. Actually, that should be sign Number One, because that’s the biggie. If I was getting a good workout at work every night it would be pretty normal for me to maintain a fairly high energy level and to feel good about it (as well as feeling frustrated and restless on days when I wasn’t able to do that) – but I would then expect to sleep deeply for at least 8 hours because my body would be tired. If I get all the high energy symptoms and ALSO stop sleeping, that’s the biggest signal that something’s not right.
If I lose weight quite quickly, I’m sad to say that’s a bad sign too. Even though I need to lose at least another four stone to reach what the doctors call a ‘healthy’ weight for my height (and five and a half to reach the ‘ideal’ weight!), so I’m constantly dieting and trying to lose weight, it’s actually hard for me, and highly unusual for me to lose it quickly. The only time I’ve managed it is when I was manic, and it was a combination of the sheer nervous energy I had all the time, and less interest in food, that made it so easy. Over the winter I would expect to put a little bit back on (and now I’m on these pills I might put a LOT on, but so far I haven’t noticed a difference), and come spring I would hope to start losing it again, but in normal circumstances I would not expect to lose as much as I did this year, or so quickly. My metabolism, when it’s not disrupted by mania or medication, is naturally very slow, and there’s not much I can do about it.
I hate that I have to look out for all the things I WANT – feeling energetic and optimistic and successful and getting slimmer – and worry that they’re leading to something bad. And I don’t want everyone else jumping on me and trying to ‘bring me down’ as soon as I accomplish any of them! So all I can really say is that I will be TRYING to be active and happy and slim, and they’re all GOOD things, as long as they don’t become excessive. And as long as I’m sleeping properly.
The other symptoms to look out for, if they appear to be very regular or going to excessive levels, are:
– being unusually talkative, or talking much faster than usual, or more forcefully, interrupting or talking over other people;
– spending more money than usual, or spending it recklessly, on big impulsive buys or grand schemes;
– being much more socially confident than usual, flirtatious, charming, and flamboyantly or provocatively dressed, especially when it’s inappropriate;
– making huge plans for the future, investing in wild schemes, being unusually and recklessly generous, or making sudden drastic changes to my lifestyle, without appropriate levels of planning and consultation.
I would like to think I’ve got enough common sense and enough of a sense of self-preservation to avoid most of the really dangerous stuff, but this illness is sneaky and the mad beliefs creep up on you mixed in with real stuff, and plenty of other really intelligent, and sensible, and normally cautious and ethical people have been led to do terrible things which have devastated their families and careers, so I can never feel fully safe in my own head.
I’m truly sorry I have to place this burden of watching out for me on my nearest and dearest, but I know you all want to do that anyway, so all I’m really doing here is helping to explain what you’re watching out FOR. I really hope the medication will prevent any of this stuff happening again, but we’ll all have to wait and see.
Just remember that none of those symptoms on their own mean there’s a problem, but a combination of several of them, along with the physical hyper-energy and the lack of sleep, would mean I’m definitely becoming manic again. Even that on its own isn’t necessarily a problem, it’s the delusional thoughts that come with it, and the reckless behaviour, which are the real danger. Fortunately last time, I found out early enough that the delusions weren’t real, so I was able to come down before I did any major damage, but next time could be worse.
Or there might not be a next time. Let’s look on the bright side.