This is a dangerous topic if misused that should be explored with caution and should not be attempted without the support and accessibility of psychiatric professionals.
By no means do I encourage any person living with bipolar disorder discontinue taking their medication or change their dosage in order to experience self-management (especially if you have not been medically treated and stable for several years). To suddenly discontinue medication has the potential to be life threatening.
However, it is important that people living with bipolar disorder (and those treating it) know that contained mania can be a gift in a person’s life and permit them to continue to feel like they have not lost themselves.
There are some psychiatrists who prescribe so much medication that the experience of genuine emotion is not possible for a person. I take a stand against over-medication.
I have been stable with bipolar disorder for fifteen years and am in the process of becoming a licensed psychotherapist, what follows is how I experience mania without it becoming a manic episode.
Step 1: The Trigger
You must know your triggers. You learn what they are by paying close attention to your episodes. Not all triggers will be able to be controlled and contained.
I have three types of triggers:
- Stress: that I’ve broken down to be defined as anything that I don’t have the interpersonal resources or ability to handle at the moment. The lack of a plan of action.
- Excitement: Stress with a specific goal, yet I still don’t know what I’m doing, but it is so much fun figuring out how I will reach the goal and having the burst of excited energy.
- Urgency: When I feel the pressure to have or be something right now.
When either trigger combines with URGENCY that is a dangerous mania that I must contain as soon as possible. This form of mania could exacerbate rapidly into an out of control mania that could lead to full-blown mania if I am not paying attention.
The safest trigger for me hands down is EXCITEMENT. However, it’s a catch-22 because if I do not pay attention and respond carefully to the excitement, URGENCY will get involved and then I am in the danger zone.
My least favorite trigger is STRESS because I have no clear goal and no plan of action. I simply don’t know what I’m doing so I’m completely overwhelmed.
URGENCY is so dangerous because it causes us to ACT and those actions can change our lives permanently. URGENCY also causes us to lose control on every level and mania takes over.
I cannot stress this enough. The key is to pay attention. Keep an eye out for URGENCY.
Step 2: The Mania
I only allow myself to experience mania that comes from excitement. Any form of mania that comes with URGENCY is dangerous to me and must be contained right away (see below).
My Actions of Mania:
I think about, research or work on a project or goal for several hours straight (significantly beyond 9 hours a day). I become so obsessed on my goal that I can think about nothing else. Key: I am unable to stop thinking about my project or goal and I cannot stop working towards my goal. I am obsessed.
How do I know when I am in trouble:
I am not able to sleep. I stay up all night with both ruminating thoughts and new ideas. I sneak out of bed to do research or keep working. I do not disclose to people about what I’ve been doing all day because I don’t want them to know how obsessed I am.
How I keep URGENCY away:
Urgency is really hard to keep away. It has taken me years of practice. What it comes down to is throwing away the time-line for when my goal has to be achieved or the project I’m working on must be completed. It requires the will and ability to put down and put away what ever it is that I am working on.
It was very easy to write those sentences, but very difficult to do in real life. It takes me tremendous will power to prevent urgency.
Step 3: Containing Mania
I cannot say it enough how important learning how to pay attention is!
I allow myself usually only one day to experience mania because that is safest for me. In the past I allowed myself a week and I really paid for it. It took me months to recover and feel like myself again.
By giving myself only one day of mania, I notice that the recovery time only a few days and there are minimal consequences in my life.
Here is how I contain my mania:
- I get support. I let everyone close to me in my life know that I am experiencing mania and ask for their support.
- I give myself permission to experience mania from when I wake up in the morning (which is really early since I was probably up all night being obsessed) until 5pm.
- I force myself to stop working on my goal in order to eat and shower. This is not always easy to do.
- At 5pm, I have to completely remove myself from the situation. I disconnect myself from whatever it is that was fueling my mania…the excitement. I do not give myself access to what excites me. If I am not able to do it, I ask for help from my support system.
- I eat dinner and usually with some form of prescribed sleeping aid, I take my lithium and go to sleep for about 10 hours. Otherwise, my mind will not stop thinking.
When I wake up in the morning, often it is as though a reset button has been pushed; however, the manic energy is still somewhat present, but in a weakened form.
With the remaining mania, I do not allow myself to even get close to working on the goal that triggered the mania. Instead, I put it to work in some other productive way (like cleaning etc).
I spend the day doing self-care practices that include both exercise and repetition because it has a calming effect on me.
I continue my self-care practices until I notice that I am no longer triggered and that the fuel that fed the mania has been consumed.
I continue working on my project or goal once the excitement of it has worn off and it becomes “work” again.
This is my story for how to experience mania without it becoming a full on manic episode. I hope this is useful to you.