First Hypomanic Episode, Questions?

Hey, guys.

I had my first hypomanic episode two days ago (I'd been having recurring depressive/stable rapid cycling moods, but was at risk for hypomania), probably because of the antidepressant that I had to slowly cut down on this week, but I didn't, lest I break down into depression again. (Yes, that was a mistake.)

So the symptoms I experienced were irritability, uncontrollable laughing, giggling and grinning, feeling on top of the world, flirting excessively, increased sensitivity to sounds, and wanting to go out and do risky, 'fun' things like getting drunk and having sex (which I couldn't do, because I'm twenty years old and at my parents' at the moment and have no friends in the city). I think I also experienced some hallucinations, but I can't be sure, because I'd just woken up then and might have confused it for a dream.

I'm waiting to meet the right guy and don't want to engage in any risky sexual behaviour once I get back to college, which - as we all know - is the breeding ground for such activities. But my sexual urges were so bad and terrifying that I couldn't do anything but think about sex pretty much both the days I was hypomanic.

I also threw up repeatedly on the second day and woke up feeling like I had a terrible hangover. I had some symptoms, but not all, and as the symptoms weaned off, so did the vomiting. Has anyone else experienced this hangover symptom? I know it can't be anything else, because I hadn't eaten anything iffy the past few days.

And is this hypomania for sure? My next therapy appointment isn't till July and my self-diagnosis is based off what research I've done in the past few months.

Any advice/info would be greatly appreciated. Thanks for reading, guys!

Swati

I can say it's common to have hallucinations when waking up

Agreed. They're called hypnopompic hallucinations (the "just before sleep" equivalent is hypnogogic hallucinations). They are nothing to worry about and common even with those who have no MI. Hope we've set your mind at ease on that one, Swati. (I worried the same thing when I first experienced them. So vivid!)

I've never experienced getting sick with hypo. Could it be from discontinuing the AD? The hypersexuality is a common symptom. Your other symptoms are too, so it does sound like it might be. Are you continuing to have them?

It sounds like you might be having some symptoms of hypomania, but we can't diagnose and it's so hard to be sure. Do you have a pdoc or just a therapist? I think only pdoc's can make definitive diagnoses, so I would really recommend that you consult one if you haven't already. Maybe your therapist could refer you to one? In some places it can be hard to get in to see one, so I'd suggest you start to try to get an appointment as soon as you can. Best of luck to you!!

for it to be hypomania I think you need more than 2 days of elevated mood too.

Yes, I agree.

To give you examples of hallucinations I've had:

On Friday, I was driving home from my pharmacy when I picked up my Abilify. It was dusk. On the side of the road in the woods, I saw this old, rickety pickup truck with a shoddy teal paint job. The pickup truck suddenly "cut me off" and I had to slam the brakes really hard. Well, it turns out there was no pickup truck there. The pickup had disappeared after it "cut me off".

Then about 3 minutes later, I was driving past a bike trail. There was a crosswalk meant to let people cross from one side of the trail to the other. Well, I saw 2 little boys with sandy brown hair who were wearing red polo shirts. I saw them jumping around and getting ready to run across the street. Again, I slammed my breaks because I thought I was going to hit them! Turns out there were no kids.

In terms of auditory hallucinations, there was one time I had 2 people making fun of me. One guy said, "You think you're the best, but you're actually the WORST..." His voice trailed off and I couldn't make out the rest of what he said. Then some lady was like, "hahaha. Say it again! Say it again!" Then he mumbled something and the lady burst into laughter. It was weird.

Swati, I hope that helps describe hallucinations.

I don't think this is true if you are a rapid-cycler. I am an ultra rapid-cycler, and I sometimes feel like my hypomania lasts only a couple hours. I'm on meds, though, so that probably makes things different.

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Agreed. That's that's why I'm curious if they were continuing.

(Though one time I did have one whose obvious symptoms only lasted a day and a half. Woke and literally jumped out of bed and was bouncing off the walls BIG TIME the whole time. Freaked BF out so much (he wanted to call my psych). Energy was off the charts, talking rapid fire 7 things at once, pretty much impossible to follow, obnoxious as hell, bounced back and forth across bed shouting, "get up! Getupgetupgetup!" at BF (in late forties that must've been a sight, lol), later literally jumping up and down talking to (at) him -- could not stay still at all, couldn't stop laughing even when very inappropriate, thought someone would get electric shot if they touched me etc etc. No situational. No chemicals, not even coffee. No one could have seen this and thought it was even REMOTELY normal. TG it was euphoric! Or he would've hauled me in for sure. Normally, I'd not even consider calling something I had only a day and a half hypomania, but for the sheer intensity, completely untriggered. It may have been preceeded or followed by a lower grade one, but it was not obvious, especially confounded by this stuff.)

But outside of something like THAT, lol, yes, it should last a few days (or more). I know DSM-IV put it at 4 or more. Not sure what DSM-V has to say off the top of my head.

Thanks, guys. Mine's rapid cycling, and with meds, my depressive episodes only last a couple of hours. That might explain why I went hypomanic for only two days.

No, I quit the med on the second day after throwing up... So I'm really not sure what caused it. Any advice on how I can stop the hypersexuality from happening, though? It was agonising, and I'm a virgin, and I don't want to do anything crazy once I get back to college. I can't. I just can't let that happen.

Swati

Hi Innerzone,

You had an intense hypomania going 😀😀😀

Do you know what triggered it or did it just appear? I've had hypomania appear both ways. The ones that came out of nowhere were intense.

Xoxo Rainy

the hypersexuality is my main symptom and yes it is crazy making...I don't know how you feel about masturbation but that is really the only relief if you aren't active already and don't want to be. at least it is for me. I honestly sometimes wish I had the spending problem because I figure, I can take back a blouse from the store...I can't take back behaviors I might have acted on (and I have unfortunately on 1 occasion)...the only thing that helps me when I am in that state is an antipsychotic to stop the mania.

I'm already on Abilify (it is an anti-psychotic, if I'm not wrong...?), but the dosage is very low. I'll talk to my therapist. And for those who were wondering, she's a psychologist. There's also a psychiatrist who's helping her out with my case.

Lol, it was indeed! The only way I've been able to describe it was like a 6 year old majorly hyper on sugar that went on and on. (I was late 40's at the time, haha)

Absolutely out of nowhere. Nothing noteworthy happening, and one morning woke up and boing! Jumped right out of bed (that soooooo is not my usual!!) and off to the races. A few other very memorable incidents during it, but maybe another time. I don't want to hijack. Also, unfortunately, I really need to get ready for work. (Bleh!)

Hi Swati,

The good news is you are ahead of the game, in that you have insight into what's happening. You also have an opportunity to take an action to help to protect yourself from the hypomania/hypersexuality.

Many feel suddenly overwhelmed, even feel ambushed by sudden episodes of hypersexuality. Sometimes, inhibitions are further broken down when experiencing episodes of hypersexuality while also drinking or using other substances, increasing the likelihood of participating in risk-taking behaviors.

You are very insightful. Use this gift to protect your well-being.

Please do contact your pdoc and fill him/her in, while making him/her aware of your concerns. Your pdoc will be able to better assess your symptoms and experiences. S/he may also re-assess your medications. Some of the atypical antipsychotics are more activating than others. Some may contribute to hypomania, while others may interfere with/prevent hypomania. This can also be very different for different people.

Any chance of setting up a "buddy" type of a situation at school, where someone who knows you well might also recognize your mood trends and might help you by supporting you during periods of hypomania and/or depression? Do you have a friend who might "look out" for you in certain situations while you are at school?

You are very wise to know what you do and do not want happening in your life by "accident." Take full advantage of this. I have had friends do significant damage to their own health and to their lives by not asking for help with the hypersexuality or other "impulsive types" of behaviors often associated with hypomanic episodes.

Take advantage of your insights into your challenges.
You will have a much better chance of living life, of making important life decisions, on your own terms.

Wishing You the Best,
WC

Thanks so much for the insightful reply, WC! Yes, I have an appointment coming up and I will absolutely let my doctor know what's been up.

Yes, I had my best friend with me on the phone for the first four hours when I was feeling absolutely brutal. He was a huge help, to be honest, and didn't fall back even when I got absolutely desperate and tried, unsuccessfully, to hit on him. 😂

I've already told my roommate about my episode and she's promised to take care of me and take preventive measures should anything dangerous start to happen. I'm glad I have great support from friends and family... Although I haven't told anything about this episode to my parents or sister, because I'm only 20 and don't want them thinking I'll become a sex maniac or something. 😢

Swati