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Q: Manic Symptoms & Environment
my husband has mixed cycling. He has also had both manic and hypomanic episodes. My question is re: euphoric and dysphoric mania: When he is
in a manic state he is energetic (overly)and productive at work but comes home
and is irritable and angry. The episodes are much less severe now because he is
on medication (lamotrigine and lithium) but.. is it this common for mania to
present itself differently in different surroundings? Of course when he's manic
he says it's because we are so irritating at home. Also would another med help
subdue the irritability more?
Thanks
Dear Karen --
Somebody was talking within my earshot the other day about PMS. She said one
must always remember that sometimes husbands just deserve to be hit over
the head with a frying pan...
Along those lines, we'll have to keep open the
possibility that there are other things (not necessarily you, that's not what I
mean; but any home stressors and other environmental factors) that might make
him act that way at home besides bipolar disorder. However, keeping that
in mind, yes: people's manic symptoms can react very quickly to their
environment. Put someone who's manic in a party, and they can be overgregarious
and hilarious and flamboyantly dramatic; and that same night, put them in an
emergency room with two big security guards, and they can be dangerously
paranoid and irritable/hostile and even assaultive. Then some nice psychiatrist
can come in, sometimes when we're having a really good night perhaps, and kind
of change the tune back to laughing and joking, and the person calms down
(that's the exception, probably, not the rule, but possible I think).
If it's really clear, especially to him, that he's
still having "symptoms", however they are being expressed, then yes: another med
or more of what he's on (depending on current doses; and in consultation with
his doc' first, of course) could help. Good luck with your work on figuring
this out and getting it addressed.
Dr. Phelps
Published March, 2004
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