[Happy Camper]

With mania there are obvious behaviors that go along with it, but also some physical/biological symptoms you can't really fake (energy and insomnia for example). For arguments sake, let's say you're all alone or otherwise don't have people around to tell you when they sense something is off. How would you know when you're manic, and how would you be able to rate its severity?

________________________________________________

I was hospitalized earlier this year simply for making a grandiose statement in front of a therapist I had seen for only 10 minutes. I was not a danger to myself or others, and my stay in inpatient really was to no benefit at all. The inpatient pdoc said I was manic on my discharge papers, but I'm not so sure. It took me a while to realize how I did fit most of the dsm criteria for mania, but the fact that the several month period I was supposedly manic, I had no sleep irregularities or sense of energy/euphoria or irritability brings me to question if it was even mania.

I first experienced a flight of ideas, all of which sounded so good to me at the time I became obsessively goal oriented, which quickly became unrealistic and downright delusional (first it was revolutionizing our understanding of the human brain, then I decided I could figure out how the universe works, later I thought I was the reincarnation of some biblical character, or perhaps even an alien from another time or dimension, and I seriously thought I was going to save the world or start walking on water any day (ok grandiose was an understatement)). I started making extremely loose associations between words and their sounds, thinking there was some sort of hidden logic behind it all that only I could comprehend and make use of, but ultimately could teach others to see. I also started worrying that a terminator was after me or that the sky would spawn a tornado and suck me into it before I revealed the secret nature of our reality.

At the hospital I think I might have hallucinated, as I started faintly seeing writing of some sort on the surface of various things, though it wasn't vivid enough to read or even interpret. I actually shrugged it off and ignored it because I was so focused on writing at the time. When I was in there I thought that there was going to be an earthquake or outbreak of war which would allow me to get out of there. There was another 19 year old in there who had ADD and drug problems, but he started listening to the things I had to say and even found some of it to be profound. I had it in my head that I was super convincing and that anyone who listened to me would become a follower. I had him reading my journal expecting him to become mesmerized by it, and on one page I wrote "take me hostage". I wanted him to interpret that message as "hold a pen to my carotid artery and get us the **** out of here, also, hot wire a car for me when we get out of here". Luckily he felt too distracted to read to the part where I suggested it. I also thought he was a young version of Santa Claus or destined to become him for some reason.

It sounds ridiculous and pretty severe when I write about it, but I still question if it was true mania since I wasn't talking a mile a minute or having trouble sleeping. I don't recall feeling giddy or euphoric at all, either. I'm a year out of high school and live with my parents, and during all of this time they had no idea anything was going on with me. I kept all of this to myself until it passed. If the pdoc in inpatient thought I was manic, I still managed to keep 90% of it from him (I seem able to portray a rational demeanor when I'm anything but). It wasn't until weeks after it passed I started getting some perspective on it all. I questioned my sanity but thought it was perfectly fine to be psychotic and delusional as long as you kept expanding and reworking the delusions so they can't be proven impossible.

This was so strange because my mind had never been hijacked like that before. I already had a BP1 diagnosis prior to this, but I think I was having hypomania and reactive mood swings to stress. Part of me just wants to attribute it all to my tendency towards obsession and a subconsciousness attempt at escaping boredom, but I need answers, even if they're just opinions.

[sheltielover2013]

My psychotic manic episodes are similar to what you describe. Did you remember the episode or were you told about it later? I never remember my severe manic episodes. I'm usually so cognitively impaired that my psychiatrist has to fill in the pieces for me. I had an admission 2 years ago that lasted 6 weeks. 4 of those weeks I have no memory of. My psychiatrist had to fill me in on what I did and said. It was a WOW moment. He kept me alive and safe while trying to resolve an extremely psychotic episode. So, to your list I would add cognitive impairment. Bye the way, I still do not remember those 4 weeks. He said I may never.

[faerie_moon_x]

One of my primary gauge tools iSync pressured speech. When more manic I can't shut up, even if I am by myself. I talk and talk, or write very long for posts.

Also my obsessive thinking is much worse & drives me. It's very hard to stop. I don't always have insomnia necessarily, but I sleep without resting.

Because my mania is dyspeptic, it can be harder to track.

[Happy Camper]

Originally Posted by sheltielover2013

Did you remember the episode or were you told about it later?

I should say that I was only in inpatient for 8 days, and that my body can't tolerate very many medications, so I was put on verapamil which did nothing, and the episode escalated then slowly fizzled out over the next few months.

My behavior wasn't too strange and I was either in my journal or on my computer writing my thoughts almost everyday, so no one really noticed, and I didn't want them to. I thought I was creating some grand message for the world and that I needed to keep refining it before I showed anyone, and my desire to make it perfect kept people from seeing how off I was.

A year earlier than this I had a severe rapid cycle stint with dissociation and couldn't remember most of it until weeks and months later. I don't think I had any memory lapses with this recent episode, but the sheer volume of thoughts makes it hard to recall all that I was thinking at the time. There was no one to "tell me about it later".

Originally Posted by faerie_moon_x

When more manic I can't shut up, even if I am by myself. I talk and talk, or write very long for posts.

I think I've done this, talking to myself and writing very long posts. I know one post I written on another forum was over 10 pages long.

[BipolaRNurse]

I have a lot of memory loss with manic episodes......I lose parts of days, like an alcoholic blackout. I don't get delusional, but am occasionally grandiose. I do have the flight of ideas, racing thoughts, clanging (where you think of a word like "mouse" and then "house, spouse, blouse, louse" etc.) and coming up with new lyrics to old songs, can't stop moving, can't stop talking, can't eat, can't sleep, don't care, clean everything in sight, even pressure-wash the porch for hours on end. I also spend money like there's no tomorrow and bite peoples' heads off with any or no provocation.

I think that probably crosses the line from hypo to mania. YMMV.

[Happy Camper]

Originally Posted by BipolaRNurse

I have a lot of memory loss with manic episodes......I lose parts of days, like an alcoholic blackout. I don't get delusional, but am occasionally grandiose. I do have the flight of ideas, racing thoughts, clanging (where you think of a word like "mouse" and then "house, spouse, blouse, louse" etc.) and coming up with new lyrics to old songs, can't stop moving, can't stop talking, can't eat, can't sleep, don't care, clean everything in sight, even pressure-wash the porch for hours on end. I also spend money like there's no tomorrow and bite peoples' heads off with any or no provocation.

I think that probably crosses the line from hypo to mania. YMMV.

Hmm, about a month before I thought the episode started I rewrote part of the lyrics of a Queen song.

I never thought I had the capacity to become delusional. I like to keep my thoughts private and so I'm not the type to go boasting about how I'm the messiah, and I probably would have even denied it if questioned about it, which is why I can't bring myself to believe I was truly delusional or psychotic, but then maybe that's lack of insight and thus I truly was both of those things.

I developed extremely loose and even random word/sound associations. I remember thinking it was somehow important to decipher and compile everyday words into alternate meanings. I destroyed or deleted all of my manic writings so I can't remember it all. At one point the word vampire to me suggested that all Irish electricians are vampires. Celebrity names started taking on meaning, Robin Williams became "I am robbing [your] will", Natalie Portman became "Now tell me, poor man", other words became acronyms, and even the shapes of letters and numbers seemed highly relevant.

I also seem to experience deep emotions much easier when I'm like that. At times I thought I was feeling god, other times I thought I was god, and I eventually thought I was bigger than god. The whole episode started with a basis in science, but it quickly became very religious, yet I never go to church and consider myself agnostic.

___

For the 3 or 4 months this went on, I never really had a problem with eating, sleeping, speaking rationally or at a normal pace, and I could certainly sit still.

My normal mood swings (which I think are reactive and cognitive rather than chemical) that occur over days and sometimes weeks completely ceased. I didn't feel euphoric or like bouncing off the walls, but I felt motivated, I wasn't bored for the first time in what seemed like years, I felt important, and I was consistent. It was actually like a break from reality and a break from my typical mood swings, which are exhausting. Even though I had some paranoid thoughts they never evoked a sense of fear or panic like a lot of psychotic people have, I only experienced anxiety and some upsetting thoughts.

[BipolaRNurse]

Funny, how I posted earlier about hypo/mania, and then this afternoon my pdoc and I got into the subject because he's concerned that I'm going to go high now that it's summer (like that's ever happened before, LOL). He knows I love the highs a little too much, and is insisting I call him the minute I even feel a teensy bit manic.

I was also surprised to learn that he doesn't think my highs are hypomania at all, or if they start out that way, they progress to full-on mania very quickly. IOW, what I thought was hypomania is actually more serious than that. And he's right, I don't call until I literally can't stand myself another day, so I obviously don't yet have a good grasp of what I'm experiencing during a period of elated or irritable mood.

Now in retrospect, I think he might have seen something in me today that I don't see, or he wouldn't have been quite so insistent on making me swear I would call him if I felt myself ramping up. I've felt really good for several weeks now, but not hypo---just healthy. But seeing as how I apparently don't know when I cross over from hypomanic to manic........oh well, hell, I'm not gonna sit here and over-think a joyful state of well-being and the fact that life is finally going pretty well for me. I'm just going to enjoy it!

[Happy Camper]

@BipolaRNurse

That must be confusing not knowing which is which. I think it's definitely important not to pathologize every thought and feeling, a bad habit I can't seem to shake, but just be aware that mania is a possibility.

In my last episode I was aware that it was likely mania and I even suggested that if I started talking about my sudden goals and ambitions that they would say I was manic....that was exactly what happened when I opened up. They would not have noticed otherwise which drives me crazy---it's like I have to act out or say something I know sounds ridiculous just to get a confirmation but at the same time I question if I'm really manic or whatever, seeing as my feedback to the people treating me is the only basis they have to go on. My speech is fine, I'm not giddy around them, or otherwise manic in appearance.

I simply don't have manic behaviors or a history of them. I also think I'm borderline but I don't date or act out, which again makes it so frustrating to figure out.

I will say that this last episode I didn't care at all about the mania. It was in the back of my mind, I remember saying "I'm manic as **** gotta put a man on mars" to some random person on the internet, but other than that I was too focused on my writings and enlightening the world to care. I notice in particular when I feel really good especially for no reason, I seem to be much more accepting and willing to believe I'm bipolar, and when I'm neurotic and dysphoric and moody "I can't be bipolar, it's all my personality". Usually when I get a flare up of mood swings I drive myself crazy about whether or not it's bipolar, if I'm an ultra rapid cycler, if I'm actually just experiencing severe emotional dysregulation, or if I have some metabolic/physical problem. I also have felt like I've had ocd for years but they always shrug off my suggestions or make me feel like it's not worth discussing with them.

I just don't trust myself, especially what I report to my pdoc and therapist, and I feel like an odd ball with no clear diagnosis or ideal form of treatment.

[BipolaRNurse]

You know, now that you mention it........maybe I was a little expansive in detailing what-all is going on in my life right now. I'm starting a new job; I'm tending to my elderly sister's health issues; I'm losing weight; I'm also in a blogging contest (30 posts in 30 days---I've got 9 more days to go). Hmmm.......

Sometimes I can be hypo and just sit still (mostly when I haven't eaten or when I've smoked weed ). But I feel light-headed, irritable, etc. and all the rest. So it feels like hypomania with less energy. And I sweat. I think I can be this quiet even when I'm not high or starved? Memory is a problem so IDK.