Coming down from a hypomanic state and coping skills

[foghlaim]

I have two questions that i'm hoping to get some feed back on.

the 1st is:- how does one know for sure if one is coming down from a hypomanic ep.?


and the 2nd is:-
I'm wondering if anyone here has any ideas on med-less coping skills that might prevent me from "coming down" or going down too far. I have read a various articles on what can happen when one "comes down" but i'm hoping to hear if this coming down can be somehow prevented. maybe some members here have ideas\skills they used?

 

[ThatLady]

Re: how do you know and coping skills ?

I can only speak from the perspective of a mother of a bipolar, but my daughter was never able to control the highs and lows without medication. Once she got on the right medications, and with the help of her therapist, she began to see daylight. Up until then, she was at the mercy of her condition. Some of the lows were pretty tough.

 

[David Baxter PhD]

Fog, the cold truth is that an individual with bipolar disorder is not going to be able to manage the mood cycles without medication.

 

[stargazer]

Why is it that some people seem to stay "up" almost all the time & never come down? I worked with someone like that, and she was almost unbearable at times. Everyone thought she was "manic" though she said it was ADD. Also, I myself have been like that *most* of the time, at least since I came out of my initial episode in 2004, but I admit I have been depressed at times, particularly during the recent job loss and shortly thereafter. It was almost as though I was making up for lost time by sleeping all the time, and I lost direction & motivation. But usually I'm at least somewhat hyper (though it's been curbed by medication) & I tend not to think I'm ever going to "come down."

 

[David Baxter PhD]

Why is it that some people seem to stay "up" almost all the time & never come down? I worked with someone like that, and she was almost unbearable at times. Everyone thought she was "manic" though she said it was ADD.

First, there are other conditions which can mimic at least some of the symptoms of hypomania, among them hyperthyroidism and I suppose possibly ADHD (hyperactive type) for some people.

Second, there are great variations among people as to the number, frequency, and druation of hypomanic or manic episodes. For example, some well known musicians and composers have shown documented manic episodes lasting several months at a time.

 

[ThatLady]

I also wonder how much might be attributed to the "manic" person's desire to be out and about, with people to see, places to go, and things to do while the "depressed" person is more likely to draw into themselves and stay out of the public eye as much as possible.

 

[stargazer]

That's good to know about the musicians and composers, as I have sometimes wondered if I held a record for the world's longest-running manic episode. Also, I think that what ThatLady says makes sense to me, in terms of the differences in people's temperaments and sensibilities.

 

[David Baxter PhD]

Robert Schumann was one composer who had quite extended periods of mania and depression. Scientific American had an article several years ago where they documented his creative output against his depressive and manic phases and the correlation was quite striking.

There are numerous other examples, of course, including Mahler, Handel, and probably Beethoven, although in Beethoven's case there have been other hypotheses about the origins of his mood swings, including lead poisoning.

 

[stargazer]

I read a biography of Schumann recently that said that his mental health problems were due to syphilus. I wasn't sure how that could be. At one point, he dove into the Rhine river in a suicide attempt and was rescued by boatmen. They said that they used mercury treatment on him, thought to be effective for syphilus, in the mental hospital, after which he died of mercury poisoning.

Am curious if he had more output during his manic or depressive phases...

 

[David Baxter PhD]

I thought that was Schubert who had syphilis... in any case, I think Schumann's bipolar was fairly well documented.

In one year during a depressive phase, his total output for the year was 4 works; the following year, with a prolonged manic phase, it was in excess of 30 works.

 

[foghlaim]

I also wonder how much might be attributed to the "manic" person's desire to be out and about, with people to see, places to go, and things to do while the "depressed" person is more likely to draw into themselves and stay out of the public eye as much as possible.

can you expand on this for me Tl.
the depressed state i can understand.. need more clarity of the manic state tho.
I tend to being doing things.. i avoid the ppl part which ever mood i'm in, nothing new in that for me.. and I have managed to stop myself from doing some things that would have been detrimental.. (real over the top stuff), most of the time.


from reading the other posts\threads on this forum and other health sites.. all point to meds.. but surely there is another option.. somewhere??

 

[David Baxter PhD]

from reading the other posts\threads on this forum and other health sites.. all point to meds.. but surely there is another option.. somewhere??

I wish I could tell you there is, fog, because I know that's your preference, but honestly I just do not believe that bipolar disorder is manageable without medication(s). This would be especially true if there is an additional comcomitant disorder such as generalized anxiety or social anxiety.

 

[stargazer]

I thought that was Schubert who had syphilis... in any case, I think Schumann's bipolar was fairly well documented. In one year during a depressive phase, his total output for the year was 4 works; the following year, with a prolonged manic phase, it was in excess of 30 works.

I think there was a lot of it going around in those days. The Schumann biography I read was on Wikipedia. I also read up on Brahms, Bruchner, and Wagner, but haven't gone any further yet. I was trying to see if there was anything these composers all had in common. The main thing I was able to come up with was that their sense of priorities differed from most people's, usually on the practical level. Wagner moved from town to town, constantly eluding creditors, was often bailed out by his friend Lizst, then betrayed Lizst by marrying Liszt's illegitmate daughter, 24 years his junior. Schumann invited young Brahms to stay with him to give him freedom to compose, and as Schumann's disorder worsened, Brahms had an affair with Schumann's wife Clara. Bruchner was a devout Catholic who drank huge drafts of beer and proposed to an alarming number of teen-aged girls. And so on and so forth.

I asked about the creativity with respect to mania vs depression partly because I've spoken with a few people who say they can *only* create when depressed--my daughter being one of them. I find this hard to grasp, because usually I create most when manic. I did compose my flute sonata when depressed, however, and some other earlier works. Since I've been on meds, I haven't composed anything at all yet. This is not to say that I can't, but only that I don't feel compelled to do so, especially at the expense of more practical priorities, at this time in my life.

 

[David Baxter PhD]

Your point about priorities is a good one - sometimes, life takes precedence over art.

Most of the songs I've written were definitely when I was distressed, although some were when I was happy. I don't know if the key is depression versus mania but perhaps the intensity of the emotions involved - and of course one tends to have more physical and psychological energy when not depressed.

 

[stargazer]

Life indeed takes priority over Art at times, however sad but true. I think also that, as you suggest, in the manic state productivity is more motivated. A lot of the time if I compose when in a depressed state, it's out of apathy, and being unwilling to do anything more practical or advantageous. That's what happened recently in San Francisco, if you recall. I sat in one cafe, on one table, and composed day-long, while burning my money carelessly in motel rooms at night. It was pretty irresponsible, but no one could stop me.

Outside of my own experience, I would agree that the intensity of the mood would have something to do with it, for anybody. Often I've run into someone who doesn't write music as a matter of course, and who isn't trained or schooled to do so, but who writes a song all of a sudden because he or she is motivated by a deep feeling.

I was taught to get up every morning and compose, no matter how I felt, until I developed an "addiction" to it. My teacher used that exact word: addiction. The problem there is that I never allow myself to do it. Instead I wait for some compelling force, such as mania, to drive me.

 

[ThatLady]

can you expand on this for me Tl.
the depressed state i can understand.. need more clarity of the manic state tho.
I tend to being doing things.. i avoid the ppl part which ever mood i'm in, nothing new in that for me.. and I have managed to stop myself from doing some things that would have been detrimental.. (real over the top stuff), most of the time.


from reading the other posts\threads on this forum and other health sites.. all point to meds.. but surely there is another option.. somewhere??

I think the key in what you say, Fog, is that MOST of the time you can stop yourself from doing "over the top stuff". The worry lies in the times you can't stop.

Not all people who are "manic" seek out other people. Some go it alone, running from pillar to post with no real direction and no real goal. Some spend money the don't have, or get into legal trouble and end up in jail. It's not that they're bad people. It's just that they've lost control and can't regain it in time to stop bad things from happening.

I can understand why someone wouldn't want to take medications. However, what would happen if a severe diabetic didn't take insulin? What would happen if someone with severe hypertension didn't take medication to help lower their blood pressure? What, for that matter, how many awful things could happen if someone whose eyesight was very bad didn't wear contacts, or glasses? Taking meds might not be the ideal, but in most cases it beats the heck out of the alternative.

 

[foghlaim]

Thanks you guys... i guess the consensous then it's meds or ..... meds!

 

[ThatLady]

Pretty much, Fog. There's really no other alternative. Taking medications is a heck of a lot better than living every day not knowing what might happen, what you might find yourself doing, or how much you might find yourself hurting. That's not a life, it's a nightmare.

 

[stargazer]

I was reluctant to go back on meds, Foghlaim, because my past experiences with meds had been negative. They didn't seem to work, and they had negative effects I could do without. I later found out that those particular meds aren't really effective in the treatment of bipolar. (I'm not sure that this was a known fact at the time, at least not where I was seeking treatment. But anyway, it's past.) The medication I'm on now (depakote) works really well, and there are no noticeable side effects that I've encountered. It's not full-proof, but it's a lot better than where I was before. Also, it's not interfering with my normal enjoyment and appreciation of life and of the world around me, as I'd feared it would, and as other meds have in the past. So there are good meds, and I think you'll be surprised how easy the adjustment is when you get on the right one, and how much better you'll feel overall.

 

[foghlaim]

Thank you SG.. I'm really glad you have found (finally) the right meds to help you. I know from reading\following your thread you have been thru the mill and back again.

I guess i will have to start thinking about changeing my thinking or something...
To say i'm disappointed or disheartened to find no real alternative (yet or maybe ever) would be an understatement.

oh well that's life i suppose, you win some, you lose some.