For about a week now I’ve felt like someone has gone inside my brain with a hand mixer and is dancing around with it. My thoughts are racing. I’m having trouble concentrating. I’m irritable and anxious and high-strung. I’m moving at a faster pace but don’t really feel like I’m getting anything done. My stomach is upset, my blood pressure is up, my breathing is shallow and I feel like I’m on the verge of a panic attack pretty much all the time. This doesn’t really sound like a textbook mania case, but it’s not all depression either. Could it be a mixed state? Or could it be more related to my panic issues than my bipolar disorder? These are all valid questions. Unfortunately, I don’t have an answer yet.
I have an agreement with my psychiatrist. A few months ago she gave me my first diagnosis of a manic episode. I was diagnosed with bipolar disorder seven years ago, but up until that point I had only ever experienced hypomania. This new episode came with a change in diagnosis from bipolar II to bipolar I. It also came with a new medication that was supposed to treat the current manic episode and also hopefully prevent more episodes from occurring. Unfortunately for me, I had a bad reaction to the medication. I was incredibly sick to my stomach. I wasn’t getting any sleep but also had trouble staying awake. I felt like I was living in a blur. It wasn’t pretty.
So, I was taken off the meds. But what about mania? I made the case to my psychiatrist that I had only ever experienced the one manic episode and since I take care to consistently track my moods I was sure I would be able to notice another one coming. We agreed that I could treat any future manic episodes acutely. That is, I would keep medication (not the same one) on hand and take it for three days in the case of a new manic episode.
Well, that time may have come. Or has it? I’m not fully convinced I’m having a manic episode. Here is the symptom set for a bipolar manic episode. You must have 3, 4 if the mood is irritable and not euphoric. (From the American Psychiatric Association):
- Exaggerated self-esteem or grandiosity
- Less need for sleep
- Talking more than usual, talking loudly and quickly
- Easily distracted
- Doing many activities at once, scheduling more events in a day than can be accomplished
- Increased risky behavior (e.g., reckless driving, spending sprees)
- Uncontrollable racing thoughts or quickly changing ideas or topics
I will give you three. Kind of. And no euphoria. The three of these symptoms I’m having are not significant. They are not affecting my work and have not really been distinguishable from my normal behavior, at least to anyone but me. So where does that put me?
There are a couple of other reasons I haven’t decided that it’s time for additional medicinal treatment yet, besides not being sure of whether or not I’m actually experiencing mania. One is that I really don’t want to have a bad reaction to my meds again if I don’t have to. Granted, this is a different medication and I wouldn’t be taking it as long, but sick is still sick. Second, that would be two fully manic episodes inside six months. That feels significant, and not in a good way. I’m terrified of the idea that I may be getting worse despite the fact that I’m actually high-functioning.
I left a message for my psychiatrist so we can chat. I guess I’ll get the verdict soon.
You can find me on Twitter @LaRaeRLaBouff
Photo credit: Marco Bellucci