Chasing Hypomania

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?

12 responses to “Chasing Hypomania

  1. 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.

    I have type II, and I am completely against that argument. There is a huge gamble for a number of reasons.

    You are right. It does get worse. When a person is trying to manipulate hypomania, they are playing with fire. Now, I’m going to say that I have never intentionally attempted to spark or prolong hypomania. I have done it though, on a number of occasions, through sheer accident.

    Once was a result of a steroid. I was really upset with the doctor that prescribed it because I warned that I had bipolar disorder. He assured me that I would be fine. Wrong. I was beyond irritable, aggressive, and waffling between euphoric and dysphoric by the second.

    Another was when I started taking certain supplements for depression support and energy support. This happened in October 2011. I’d like to tell everyone exactly what happened. Typically, my hypomanic episodes do not exceed a week to about a week and a half, at max. At that point, a week and a half was my record. Mostly, I would go between five and seven days.

    Anyhow, time went on. I exceeded two weeks, less and less sleep. Until, I had a psychotic break. The first ever. I had such a bad delusion that I actually did start to hallucinate voices and actions that people didn’t do. And a bunch of people will now start shouting, “That’s not type II!” But, it is. I had full on, medically induced, manic symptoms at that point.

    The point is, and just as you said, it will get worse. A lot worse. Like worse beyond anything ever experienced. Hypomania is nothing to mess with. And, even if it remains hypomania, not all hypomanias are euphoric. Some are dysphoric. Dysphoric hypomania is a hell beyond hell. I would actually go as far as to say it’s worse than depression. But, maybe that’s because I’m more experienced in depression than hypomania.

    I would advise against it. I know what it’s like to be in the pit for months at a time, only to have a short there day fit of hypomania, only to plunge back down again. But, when substances start being abused, all kinds of unexpected things happen. I’m experiencing ultradian cycling for the first time ever since I became symptomatic. Days of being up and down, up and down, hour to hour, not knowing where I’m going to land, if I do at all. It makes functioning nearly impossible. My mood stabilizer had to be increased, because that was blamed on the Wellbutrin. Now, I’m in a state of depression. Is this where I’m going to stay?

    Anyway, sparking hypomania is bad, m’Kay?

    • Right! Thank you, I totally forgot to include something about dysphoric hypomania too, so thanks for that note.

      I agree with you that dysphoric hypomania is one of the most agonizing things to experience, and the level of physical discomfort that accompanies those episodes for me is out of control. Would I take the risk of accidentally triggering that?

      Fat chance!

      • I think those that are eager to trigger hypomania haven’t experienced enough of dysphoric hypomania. Honestly. I am the opposite of myself when I go through that. Now, I know I have a temper, which is usually eased by patience. I have a lot of patience. But, when that impulsive behavior starts with the hypomania, patience goes out the window. I am temperamental, aggressive, over-assertive, and I absolutely hate (I will use the word hate, because it’s the only way to describe the strength of the emotion) everyone and everything that defies me. I will go as far as being vindictive at times. I attack people for no good reason as well, and place blame where it doesn’t belong.

        That is my dysphoric hypomania. I wouldn’t attempt to trigger anything that may be related to that, meaning hypomania in general. Sure, euphoric hypomania has great moments. But, there are too many downsides to that. And besides, the way I cycle, hypomania always paves the way for depression. It’s like a road to a bridge that doesn’t exist. You can’t see that the the bridge doesn’t exist, because you’re on the other side of the hill. It’s only until you are on your way down that you notice. By then, there’s nothing that can be done.

        I will avoid depression at all costs. But, if I had a choice between dysphoric hypomania and psychotic depression, I’d take psychotic depression. At least I know that terrain.

    • isn’t dysphoric hypomania considered a “mixed episode”?

      • I would say generally yes, but not all doctors are on the same page here so there is some variation from provider to provider.

    • 4 years too late I realize, but I’m wondering if people could share the specific things that triggered these episodes so others can avoid taking them? I’d love to know which supplement it is or which steroid was prescribed!

  2. “And a bunch of people will now start shouting, “That’s not type II!”” – You yourself have said it. A diagnosis does not change the signs of a disease, a change in signs changes the diagnosis. But it’s a small thing, mostly semantics and billing codes. Most of my doctors have confessed that the treatment for most affective disorders is the same, with alterations for insurance and formularies. Call me BP-I, or call me BP-II, I don’t care as long as when you call me in for dinner your not just a voice in my head.

    • You’ve got the voice too? See, the voice would tell me that I’m a fat POS that shouldn’t even bother going to dinner. In depression. In dysphoric hypomania, it tells me to yell back inappropriate things, and find everything wrong with the meal that I possibly can, and assert I can do it better myself.

      The only real difference, I’m told, between BP I and BP II treatment is the focus. BP I can encompass psychosis and mixed episodes whereas BP II does not. In my personal treatment, the focus has been on alieviating depression. I’m told that the frequency of hypomanic and manic episodes is higher with BP I.

      Recently, I’ve been interested in the occurence of psychotic depression. Nobody talks about it. Most clinicians will deny the existence. I’ve had a few people remark that it might be mixed, but I somehow doubt it. The only symptom that crosses between the two would be the psychosis. *shrug*

      Anyway, my interest is two-fold. On one hand, I want to know if the incidence is higher in Unipolar, BP II, or BP I. Because if it’s in BP II most commonly, then we’re onto a serious defining factor to differentiate between the two. Right now, people consider BP II to be the “Bipolar Lite” of mood disorders. The focus is on mania in this disorder, because depression is just so covered between this and unipolar. Except, that’s not true. I feel there are significant differences between MDD and BP depression.

      The second fold is as to why it matters. Treatment. Psychotic depression incinuates a significantly elevated risk of self-harm and suicidal behavior. It’s dangerous. It’s not garden variety depression. It’s more sinister than that. And that would require more aggressive treatment than just “sleep 8 hours, exercise, and eat this SSRI”.

      Just some thoughts.

  3. Oops, sorry, I’m sooo picky about my grammer. …”you’re” not just a voice…

  4. Also, if I reply more than twice in a row to a post, I know I’m getting too high. Good thing I caught that. Just in time. Know what I mean? Ever felt that?

  5. My hypomania is agitated and angry – a combination of rage with OCD. I wouldn’t wish it on anyone. I joke with my Psychiatrist that I was robbed of the euphoric experience. Seriously, though the risk taking symptoms would not be worth it.

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