[justbeingme80]

Does anyone else lack insight into how they are doing, specifically when manic or hypomanic? I'm more likely to notice depression. I hardly ever realize I'm hypomanic or manic until it's pointed out to me. I lack serious insight into when I'm having a manic episode.

Part of the criteria for a manic episode is "lack of insight into behavior", and as I put it to my therapist "crazy people don't know they're crazy". The schizophrenic thinks their delusions and hallucinations are real.

So how do you know? I'm not trying to offend anyone here, but it seems to me if I was really manic or hypomanic I wouldn't notice it, particularly hypomanic. My therapist says it's part of the criteria. So if it is part of the criteria I don't understand how people know they're manic?

I don't ever really know until it's over. "I just feel great. I'm so happy and cheerful today".

So if it is possible to have this kind of insight, how to do you know?

[RefuseNoHope]

Hi there...I'm no expert and am brand new even here but I do understand since it happens to me when I'm manic. I've learned to trust others who know my cycles when they say I'm acting hyper. Only after writing down in journal during up days was I able to see the distinct changes in my thoughts and actions. Hope this helps.

[Axiom]

Lack of insight is common but not universal.
Quick Google search came up with this: Anosognosia - Frequently Asked Questions - Treatment Advocacy Center

"Studies indicate that 50% of individuals with schizophrenia and 40% of those with bipolar disorder report experience moderate to severe impairment in their awareness of illness. Anosognosia in bipolar is most common among individuals whose disorder includes psychotic features."

I don't know why I don't have a serious lack of insight.

[Curiosity77]

Lack of insight is not one of the DSM diagnostic criteria for bipolar disorder, but it is often a feature. I tend to know that something is wrong with me during an episode, but i don't appreciate the severity until i am out of it.

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[Nightside of Eden]

Lack of insight certainly isn't universal. I didn't automatically have insight into my hypomanic and mixed episodes, but once I was diagnosed with bipolar and studied the symptoms, it wasn't difficult to recognize the symptoms in myself. It's only during my very worst depressive and mixed episodes that I start to lose insight now. That's when it gets dangerous, buy my medication prevents this so I pretty much always know how I'm feeling these days.

[BipolaRNurse]

Originally Posted by Curiosity77

Lack of insight is not one of the DSM diagnostic criteria for bipolar disorder, but it is often a feature. I tend to know that something is wrong with me during an episode, but i don't appreciate the severity until i am out of it.

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Exactly. I've been going a little ape**** like I do pretty much every year around this time, but didn't think it was BP-related until several of my friends and my husband said something like "You're ramping up." I don't FEEL like I'm ramping up, I'm just so stressed that I feel like running away and starting over again fresh someplace else. I won't, of course, but I do want to get a job that doesn't require more intellectual capacity than I have, I want a more affordable place to live and I want less hassle and a less-complicated life. I want an authentic life, and this ain't it. Maybe I am talking crazy, I don't know.

[Happy Camper]

During my last inpatient stay, there was a 60 something bipolar 1 man that had been awake for 5 days, and he was very aware that he was manic.

Part of the reason I was "undiagnosed" bipolar 1 is because I actually had a psychiatrist that listened to me explain the events that lead to my diagnosis, and the thoughts I had during those times. She said I had an unusual level of insight, and that hearing it from me, I did not sound like a bipolar 1 patient at all, so she took it off my record because it was too misleading and wasn't what she expected.

[venusss]

Apparently, I lack insight into what is exactly going on. I thought it was a depressive episode, so I ramped up on my saint john's wort tincture. Not sleeping and restlessness shoulda warned me it's rather some weird manic state :/

I keep getting told I have very good insight into my illness. I havent been hypomanic for years so I dont know if I have the same level of insight then aas I do in depression.

[lonelychick]

I'm type II and have been told by my docs and therapists for years that I have a really high level of awareness. My problem is that I don't always care or, like Curiousity77, appreciate the severity. For example, "Yeah, I know I haven't eaten in 2 days, but that's really not that long. Who really makes up those rules anyway?" Stuff like that.

[Hbomb0903]

I think that for me I get very insightful when I'm depressed, but its through sooty glasses. And when I'm feeling good I find myself wondering just what exactly all these meds are fixing anyway? I mean it's like a crapshoot with how many types I see that many people are on and they switch you around a lot.

I'm very determined in this state that I need to be stabilized because I'm completely ineffectual right now.

[cashart10]

I am always worried if I seem the least bit hypomanic to me or to my husband. This is because the handful of times I've been manic, I have been completely unaware (and maybe that is because I am usually also delusional). Thank goodness for family. Anyway, I seem to know when I am hypomanic but not manic and tend to always know when I am depressed although I don't tend to realize if I am delusional and depressed.

[Mickey4333]

For me, it depends on what symptoms I am having with it. I get hypo-manic/depressive mixed episodes, of which, I have a lot of up and down moods with restlessness and muscular twitches/tremors so I know something is wrong. Now that I have had these episodes many times, I know what they are when I get them. Usually, with my hypo-manic symptoms, I have the pressured, rapid speech, of which I know (now that I have done it a few times) that I am having an episode. Normally, I am fairly quiet. I know when I am depresses when I (want to) cry and do nothing all the time.

[justbeingme80]

Thank you all for your replies. I didn't know it wasn't really a criteria. It's just my therapist made it seem that way.

Does anyone have any tips on how I can become more self-aware? I am usually aware when I'm depressed, but when I get hypomanic or manic I usually don't notice a thing is wrong with me. I do notice when I'm having a mixed episode because it's usually terrible--no sleep, extreme agitation, suicidal just to make it stop.

Will I be self-aware over time? I hope.

[Hbomb0903]

All you have is the ability to keep trying today. I have much more awareness of myself, but I still can't control this disease process. All I can do is try to manage it.

[Axiom]

Even though I have insight I don't give a crap when I'm really hypo.

[grandmaof3]

I have unusually high insight but it doesn't hit me until day 2 or 3 of being manic. I'll realize I haven't slept in a couple of days and then I start to hallucinate. Ill hear voices in an empty room and I know its time to break out the Haldol and Zyprexa.

[Capriciousness]

I feel like maybe because of past manias I am gaining better insight. I hope. I have to remind myself and look out for the very first signs. like for me when things have to happen NOW NOW NOW. Or when I am magically super productive and on top of things. sigh.

But yeah i am still looking back on my most recent mania and connecting dots and realizing things and it makes me smack myself in the forehead and shake my head and apologize to my friends. It is so truly astonishing to me. I was sure at the time that everything I was doing made perfect sense. No one could tell me it didn't. No one could tell me it seemed like mania. And if i had an inkling there was something manic happening it just seemed like "well yeah nobody understands mania, mania is actually AWESOME, and I'm just given this gift by god to be so AWESOME like this and those haters just don't understand. and who is to say this magical ability is called mania or bipolar. who makes these stupid rules (yes lonelychick) anyway? I'm just different and gifted and..."

you get the picture

[Capriciousness]

When I am getting depressed I am the first one to know. When I am getting manic I am the last one.

but

yes recently in more mild cases and diff kinds of mania i might know i'm getting hypo but i wanna do what i wanna do and i just don't care. None of the bad consequences really seem to matter or be such a big deal which is what I keep telling people.

[Capriciousness]

"Does anyone have any tips on how I can become more self-aware? I am usually aware when I'm depressed, but when I get hypomanic or manic I usually don't notice a thing is wrong with me. I do notice when I'm having a mixed episode because it's usually terrible--no sleep, extreme agitation, suicidal just to make it stop.

Will I be self-aware over time? I hope."

For me it has just been time. Things i never would have thought were hypomania two years ago I am now learning are indeed symptoms of my bipolar. I can't think of anything else. Though good friends and family who can kind of give you an outside of your own head perspective has been very helpful in getting me to realize some things.