I recently had someone ask me a very good question, one that I’d never thought of before.
If it is possible to trigger episodes, why don’t people just constantly trigger hypomanic episodes?
For many folks with bipolar disorder, hypomania is the holy grail of the experience. It is usually the window of time where people who are cycling can kick butt at seemingly any task (usually outperforming at work), appear more confident and collected, and just plain feel great. I’ve had a lot of people tell me that the depression or mania they experience is overwhelming, but is all worth it if they get a chance to experience hypomania periodically.
I think the answer to the specific question above is two-fold.
- There are people that do try to maintain a constant state of hypomnia.
I’ve seen this happen, and it is common for people to try and either trigger themselves into this state or try to maintain the hypomania for as long as possible (or both). The manner in which they attempt to achieve this can be in several different ways, but it just depends on what things trigger that particular individual.
It could be overloading on caffeine, sleep deprivation, manipulating the diet, manipulating medications and/or doctors to receive particular medications, using “street drugs”, and the list goes on and on.
While I’m definitely an advocate for manipulation of different elements in one’s life to try to help maintain stability, I can’t say that the aftermath of these sorts of actions (that I’ve seen anyway) lend themselves to attempting something of this caliber. Again, I try not to judge others on how they attempt to navigate living with bipolar disorder, but having seen the end result leads me to the second portion of my response.
- The result of prolonged hypomania or the attempts to trigger it can have pretty severe, devastating effects.
A recent study suggested that memory is linked to our sleep patterns. People who get more sleep are less likely to develop diseases like Alzheimers. I’m sure most folks who have gone a few days without sleep can attest what kind of immediate effect that seems to have on the memory portion of the brain, so sleep deprivation to attempt to trigger hypomania can be extremely dangerous and have rough consequences in the long-haul.
Some “street drugs” (I hate that term, shouldn’t there be a better one by now?) are also notorious for contributing to delusions, psychosis, & paranoia -even if there was none evident in the person before. Is this going to be less likely for anyone who has experienced those things without the drugs? Probably not.
Also, attempting to trigger a hypomanic episode can have the opposite effect as intended, either triggering depression or full on mania.
Someone with bipolar type II might argue that the risk when playing this game isn’t quite as great because that diagnosis means they haven’t experienced true mania, so that would mean the only negative possibility might be triggering depression. But, just because you haven’t had full mania in the past doesn’t mean you can’t in the future, and it is widely accepted in the medical world that if bipolar disorder isn’t treated or is agitated (like possibly triggering it on purpose over and over again?), it can get worse. Yes, that means the potential introduction of true mania, or even an introduction of psychosis with depression or mania, for someone who hasn’t previously had those symptoms.
On top of that, this tends to be an illness where what goes up must come down. Triggering hypomanic episodes will potentially be triggering depression, once the hypomania abates.
For me? Trying to trigger hypomania is way too much of a gamble. After experiencing a full-on manic episode with psychosis (triggered by medication), I constantly live in fear of reaching that place again. I’m really trying to get my shit together these days, so rocking the boat on purpose seems like it would be a very foolish thing for me to do right now. I also still have episodes occurring on their own, so trying to shake up that rhythm could potentially land me in a bad place.
I know that hypomania can be intoxicating, especially while you’re experiencing it, and I don’t think experiencing it is a bad thing -on the contrary! The bipolar brain seems to be able to accomplish SO MUCH in this state that it is important to get to experience it, I think.
That said, I also know how hard it can be to go very long periods of time without it. My last big episode of depression was a year long, and feeling terrible for a year without one of those fun natural highs was really rough. I understand the desperation, but I hope people will (at least) consider the consequences to their actions before trying to trigger any kind of episode. Is it really worth the risk?