Manic Monday #2 - UnManic Tuesday

Well this was NOT what was planned for this post at all. I had a specific story that was equal parts shame and hilarity, but my plans changed. Circumstances happened, and I learned a lot about my own brain.

You see, I made a foolish mistake about 3 or 4 months ago. Let me do a quick explanation of my medication regiment. As far as Bipolar maintenance is concerned, I take 2 anti-psychotics nightly - these cannot be missed. I have another one that is to be taken as needed, should signs of mania begin to show (generally sleep disturbances are my cue). It works well, 2 or 3 days taking it and I don't get anywhere near mania. I also have a stimulant drug I take in the mornings for ADHD. It makes a great difference for me as well, it keeps my mind a much stronger and sturdier place. I take it most days, but it's also one that I don't have to take every day if I don't want to/need to.

During my last visit with my psychiatrist, he refilled my maintenance meds, and asked me if I was still good on the others, I thought I was and just said yes. When I went to get them refilled, I saw that my prescription was up on the two "as needed" drugs. Well shit, okay, I guess I better get into the psychiatrist again. I put it off, and put it off. I didn't feel like I was having too much trouble focusing (though I was compensating with MASS amounts of caffeine). I also rode out a few days of mania symptoms starting, and my maintenance meds were enough to keep me from having an episode. I thought this was great, and that I didn't even need the two "as needed" medications.

This was quite a blunder. This wasn't just a blunder, this was a BAZOOPER. I quickly threw together a few graphs to demonstrate what I done gone and did. This first graph is a normal, balanced state. This is where you (hopefully) are. The blue line is emotional arousal, whereas the red line is the mania threshold. As you can see, the average/balanced person gets nowhere near mania with their mood cycling.

Now, when the mind goes into the mania it get's stuck up there. This is when thought and emotional patterns can become completely unreasonable, and we ruin our reputations, and lose all of our friends.

The maintenance medications are designed to keep my baseline in the "normal" range. My baseline will slowly creep up, however. That's why when I feel mania symptoms, I take specific medication just for that. It's essentially the maintenance medications needing a little help, and cracking my brain with a hammer to flatten it back out. I stopped taking it because my maintenance medications were keeping me out of mania. The only problem is that I was leaving myself in what I now call "The Danger Zone".

See, it wasn't bringing my baseline down low enough for me to be comfortable, or "normal". As my baseline was so close to the mania line, my thoughts and emotional reactions to things would sometimes throw my emotional arousal up into the manic zone. So I was popping up into manic thoughts, and then popping back down into a baseline that was technically "stable". The reason this is so dangerous is because you don't realize that your thoughts, your actions, your emotions are manic, because you know that you're not having a manic episode. I also very much struggle to understand and navigate social interactions, friendships, and relationships, so I feel a lot of stress and agitation dealing with them - combine that with a near manic baseline and it's not hard to see why people like myself don't have a ton of close friends. It's easy to go from "normal" to "fuckin freak" in no time flat.

So, two days ago I started my stimulant medication again. I did this in a foolish way - I am a large man, and take a very large dose that took months to titrate up to. Taking my full dose again after not having had it for months threw me into instant mania. I didn't sleep at all that night, and didn't need to. Now, at this point I knew was manic, so I knew I had to be very careful. I am fine at work and everything, I'm not impaired in a way that affects that at all, so that was no problem for me. My thought and emotional patterns were becoming distressing, and they were very familiar. I haven't been truly manic in a long long time, so I didn't realize that was on the borderline of it for months - until I took a high dose of an amphetamine and jumped right back in.

I've always viewed mania as an ON or an OFF switch. Now that I see the way that it creeps, and the way that near mania can almost be just as dangerous as mania, I know that there are certain mistakes that I won't be making again. I am currently in the process of rebuilding myself into somebody that's better than who I have been, and the better I understand some of my demons, the better equipped I am for fighting them.

Mantras are often spirituality based, and most of mine are, as well. I did, however, create a psychiatric mantra that I believe is important: "never stop getting better, and you'll never get worse". I forgot that myself, and I know that I can't do that again.

So remember folks, don't stop getting better. Never stop it. Even when you fall, even when you crumble. Don't give up on yourself.

Thank you for reading.