| Early hypomania can be a pleasurable state of elevated
mood, elation, optimism and confidence. Treatment at this stage is
usually not desired or even necessary. For those bipolars who suffer
endlessly with depression hypomania is a desired and welcome relief.
For others, a euphoric state is never reached, and even in early hypomania
what they experience may be irritability, rapid thoughts which
cause confusion and quick angry outbursts. This dysphoric hypomanic
state can cause problems in relationships, not only personal, but social and
work related relationships as well.
Mania is another story. Usually it begins
insidiously as hypomania and becomes worse with the most striking quality
of the mood state being grandiosity. Manic people have an exaggerated
sense of self confidence believing they are more wealthy, more intelligent,
more talented and more everything than anyone else. This can worsen
to the point where they become delusional - convinced of ideas that are
false and impossible. In the full-blown state for example they may
believe that they have been appointed to some high political office, that
they have been appointed by God for some religious appointment, or even
that they are God. They may become convinced that they are on the
verge of great scientific discoveries, or that they have solved the mysteries
of the universe.
Spending sprees are common and manics sometimes
borrow large sums of money or run up huge credit card debts. Judgment is destroyed.
The manic mood can be described as "expansive"
as manics commonly seek out people and get involved with organizations
in what is called pressured socialization. They talk rapidly to everyone
in sight in a pressurized, driven way.
Sex drive is abnormally heightened leading
to loss of inhibitions and participation in sexual activity that is unusual.
In most patients the euphoric state is short
lived and the mania quickly becomes very unpleasant. Their energy
level is boosted to the point where they feel pressured, driven, and in
a very uncomfortable state of mind. They can become quite irritable,
enraged at the smallest perceived slight. Their thoughts race, their
thoughts come so fast they can't talk fast enough to express them and their
speech can become incoherent.
Paranoia is common. Suspiciousness and
the false belief that one is being persecuted are common.
Mania, contrary to popular belief is not
pleasant. It is obviously an abnormal mental condition, seems to
arise from nowhere, and the person is so changed there is no mistaking
the fact that something is very wrong.
MIXED AFFECTIVE STATE
Mixed Affective State is another mood state
sometimes seen in Bipolar Affective Disorder. This mood has qualities
of both major depression and the manic state. Usually the irritability
and driven, hyperactive energy level are present, but the emotional quality
is that of depression, with feelings of hopelessness and impending doom.
Impact on Relationships
Bipolar disorder, and mania, often strikes
people who are charming, creative and charismatic. Initially it may
be impossible for them and those close to them to admit anything is wrong.
When their behavior becomes outrageous...they
have run up thousands of dollars in debts and put the family on the verge
of, or into bankruptcy, when they have been involved with public brawls
and the police, or when their sexual indiscretions become too obvious to
ignore....the impact on relationships is enormous. Separation and
divorce is common. Even the most understanding partner has problems
understanding the illness and the symptoms are seen and felt as a personal
The anger displayed by the manic creates arguments
and fights in the home. The partner finds it nearly impossible to
defend himself against these attacks. Relationships are poor, and
even after the mania has abated, it is difficult to pick up the pieces
and go on with a relationship.
Partners must realize that mania is an illness,
and that it will get better. They must try not to take the symptoms
of the disease as a personal affront, and to be supportive and protective
until the episode is over. They may need to manage their manic partner....seeing
that they take their medications, or getting them to professional help,
including hospitalization when necessary.
Recovery from a Manic Episode
1. Take medications regularly and as prescribed by your doctor
2. Get emotional support from a supportive person.
3. Talk to a therapist or counselor
4. Tell yourself that you have been ill and that the things you
said or did while ill were not the real "you"
5. Eat regular, nutritious meals.
6. Be kind to yourself.
7. Get plenty of rest.
8. Focus on living one day at a time
9. Use spirituality if desired
10. Reduce environmental stress