One of the (not the only) more disabling aspects of bipolar disorder for me is fluctuating energy levels. I've learned that this is a key aspect of the disorder and is often (not always) at the root of many of the other symptoms. In an article on MentalHelp.net, energy levels in bipolar are emphasized, though I think this is a comparatively simplified explanation, in terms of causation of various moods and other life complications. It reads:

"Although popular culture tends to equate mania with happiness and depression with sadness this isn't really the best way to think about what is happening in bipolar disorder. Bipolar Disorder involves not so much a swing between happy and sad states, as it does a swing between high and low energy states. When in a high-energy state, people appear happy because they are motivated and excitable, whereas in a low energy state, people feel sad, and lack motivation and enthusiasm. As the energy level of a manic episode increases, the early happy mood tends to degenerate into a more agitated and psychotic state which may be experienced more as terrifying than happy, but which is nevertheless very energizing. Similarly, as a depressive mood state increases, people may go from merely feeling badly about themselves to literally not being able to leave their bed. Thus, the happy and sad moods that are thought to characterize mania and depression respectively are results of different energy states and not necessarily primary features of the disorder."

The above does seem to make sense for me in many cases, but of course it neglects to mention the irritability, agitation, and/or anxiety often experienced in high energy levels. I mean, if I'm charged up, yes I am often elated, but of course also sometimes have aspects of fight or flight or plain mental chaos. The relationship between low energy and depression is also not so straight forward, in my view.

Has anyone else out there had extremely low energy, but not really felt depressed in the sense of feeling hopeless, sad, low self-esteem, or the like? I can say that I've definitely experienced this. I sometimes have extremely low motivation, stay in bed almost all day, want to sleep too much, don't do sufficient self-care, perhaps yearn for more carbs (to "boost energy/self-medicate the low energy*) and yet my mood is...pretty good otherwise. Am I stable in these cases? If so, why am I otherwise incapable of doing things? Disabled feeling fine?!?

Then there are mixed states where energy levels and moods don't match what that MentalHelp.net paragraph describes. I can also have major league energy, but feel hopeless, desperate, frustrated, low self-esteem. Or have zero energy, but my mind is racing, I might be anxious, or even elated or charged up angry. In this latter case, I'm in bed all day with my laptop on my lap typing at 100 mph, sometimes impulsively, with disinhibition. And yet, I definitely don't want to do chores or errands and would become tired or winded, physically (not mentally), if I walked even 1 mile, or even up and down my stairs. Oddly, still disabling to various degrees. At its worst, psychosis could happen.

A kind member here reminded me of something I mentioned on PC a while ago. I had discovered an online article by Dr. Jim Phelps about his and some other experts' theory on this whole chaos of mood-energy continuum. See Rapid Cycling And Mixed States As “Waves” – PsychEducation Actually, Dr. Phelps himself referred me to it. It included a graph that showed an example of how moods and energy levels may not always fit the model that MentalHelp.net describes as "classic". The very interesting thing was that in addition to curves labeled "energy" and "mood", the graph also included a curve labeled "intellect" (meaning speed of thought, creativity, ability to connect ideas...basically cognitive stuff). Hmm? That can sometimes be so true for me, too! I can have low or high energy with either low, high, or even normal mood OR even normal energy and normal mood, and yet NOT feel creative and/or feel cognitively impaired. See this graph as an attached jpeg file. This would explain to me why I may seem otherwise stable and yet be frustrated with my cognitive abilities. Maybe even have memory issues? That can also be a disabling state to various degrees, for me.

Can you relate to any of this?

I do understand that medication side effects (sedation, etc.), co-occurring anxiety issues, and/or other mental health issues can contribute to disability of various levels. I'm not debating that. However, I am saying that I believe my bipolar disorder itself is often (most often) the culprit. I don't see my situation as hopeless at all. Time/healing, the right meds, therapy, and other factors have managed to "tame" the waves on my "graph" to varying degrees, but I recognize my bipolar disorder as being more complex than just "highs" and "lows".

*Note: I believe that my need to self-medicate, at times, is wrapped up in situations represented in the attached graph. Yes, crave carbs or stimulant when low energy. Or crave a depressant like alcohol (or tendency to grind/clench my teeth) when extreme energy is too much to bear. As for when energy and mood are otherwise fine, but my cognitive situations are poor, I guess I just crave the "graph" to readjust. Mental exercises can help. It is difficult! I feel like it's sometimes like juggling with three balls.

[Tryingtobehappy5]

I can certainly relate to some of it. Most of the time mood and energy changes come at the same time however there are definitely times when the energy comes first(exercise or cleaning all night) and then my mood becomes elevated with loss of productivity(main focus on pleasure such as high libido how good exercise and dancing feel, mindless activities focused on how beautiful everything is) and only after that do my thought start racing etc. They then turn bad and only extreme exercise, research and writing along with alcohol help otherwise I am physically and mentally uncomfortable. Medication could probably help as well but I have never turned to that up to this point, I am more likely to go off meds at that point.

Depression I have always described as extreme exhaustion. I would often be so tired that I could physically not deal with things. I would lie down on the floor wherever I was in my house and not be able to get up for hours or fall asleep before my kids bedtime which was dangerous as they were very young then. This was before medication. Some of the time I would have the low mood as well and sometimes mood would be normal other than being upset about the exhaustion. I know this was not a physical problem as I would always go to the dr and get many tests done which would come back normal. In fact when I was on seroquel daily I told my Pdoc it was exactly like being depressed just due to the exhaustion which is definitely my most consistent symptom.

I dont know that I have ever had low energy with racing thoughts or creativity though.

[Calypso2632]

Right now I feel relatively stable all-in-all. I'm not on any major meds. Just topamax, mainly for migraines and xanax as needed for anxiety. Temporary script. But my "energy" has been fluctuating drastically lately. I felt so drained yesterday that I pretty much laid around all day, but not sleeping, just not motivated. And I don't feel depressed or sad. Just don't want to do anything, not even read, text, watch a movie, write. Nothing. Then I have days I want to get everything done. Nice clean house, shower, burn candles and incents.. my friend is determined I'm cycling but this doesn't feel like a mood cycle. I really do feel fine and stable and have since I stopped drinking. It's just that my energy and motivation levels change from day to day so much. I do have a chronic pain disorder. Maybe that ties in to the whole scheme of things? Fibromyalgia. I have a high energy day, do too much, and pay for it the following days? Hmmm...

[USMCBIPOLAR7]

When I’m up I have more energy, can function better and this leads to accomplishing a lot which leads to euphoric mood. When I’m down I have low energy which causes me to function and accomplishing less and that leads to feelings of worthlessness and helplessness and hopelessness. Also when I’m up but not manic my memory , concentration and focus are better than when down. So it’s a cycle and for me a seasonal bipolar 1 cycle

I like the graph -- it is simple but illustrates the importance of understanding that highs and lows and take different forms. My depression has been fluctuated in ways like you described (I tend to feel depressed much more than hypomanic... I still have a hard time realizing when I am). For example, there are times I feel hopeless about the everything, but anxious and feel the need to move around. Or kind of like today -- I feel pretty good, just don't want to do much.


I appreciate you taking the time to write this post -- I think it's important for us to realize the complexity of the human mind and psyche. Thanks again!

[luvyrself]

Yes, you are describing the challenge of mixed states. You don’t know who you are going to be or what you’ll feel like doing from one day to the next. I change a lot within a day, too. I agree totally that energy level is a huge part of this and I like the wave model. My main challenge is to keep the stress levels down with a routine and exercise so they don’t flip me into a different state, and to “collect”positive experiences and relationships to draw on. Hugs,Bird! You’re a lot of pretty birds in one! I can imagine one pecking on a computer!

[~Christina]

My up and downs physically change with my Fibromyalgia and PsA and insomnia .... they all circle and feed off each other. My bipolar can be relatively stable but my pain skyrockets and im in bed for days then it often triggers my insomnia so there is no escape from the pain and it trips my Bipolar

It’s a bit of a vicious cycle. When it hits a 9 I take a few Xanax and hopefully pass out it’s not a sure thing. But at least I have some hope.

Absolutely worse case I take a Thorazine and check out , I just Hate the damn 2 day hangover.

I can go mixed easily

[luvyrself]

Originally Posted by luvyrself

Yes, you are describing the challenge of mixed states. You don’t know who you are going to be or what you’ll feel like doing from one day to the next. I change a lot within a day, too. I agree totally that energy level is a huge part of this and I like the wave model. My main challenge is to keep the stress levels down with a routine and exercise so they don’t flip me into a different state, and to “collect”positive experiences and relationships to draw on. Hugs,Bird! You’re a lot of pretty birds in one! I can imagine one pecking on a computer!

ADDING TO MY RESPONSE:
Ah the frustration of not being able to accomplish as much plus the misery when we go to the down side, yet having disorganizd and sometimes distorted thinking and that nutty feeling when we go above baseline. I accomplish more, yet get in more trouble when I am hypomanic. Going Monday (a positive thing for my bday) to talk about getting rid of the Wellbutrin, which pushs me into hypomania and adding or substituting another stabilizer.

[Sunflower123]

Has anyone else out there had extremely low energy, but not really felt depressed in the sense of feeling hopeless, sad, low self-esteem, or the like? I can say that I've definitely experienced this. I sometimes have extremely low motivation, stay in bed almost all day, want to sleep too much, don't do sufficient self-care, perhaps yearn for more carbs (to "boost energy/self-medicate the low energy*) and yet my mood is...pretty good otherwise. Am I stable in these cases? If so, why am I otherwise incapable of doing things? Disabled feeling fine?!?
==================================================
This is the most disabling symptom for me. It’s important to me to be productive and when I’m in this state...I’m not capable of it. It leads to depression...sometimes extreme.

Thank you for helping me realize the difference. Maybe I can work with that knowledge and avoid some of the depression.

[luvyrself]

Originally Posted by Jennifer 1967

Has anyone else out there had extremely low energy, but not really felt depressed in the sense of feeling hopeless, sad, low self-esteem, or the like? I can say that I've definitely experienced this. I sometimes have extremely low motivation, stay in bed almost all day, want to sleep too much, don't do sufficient self-care, perhaps yearn for more carbs (to "boost energy/self-medicate the low energy*) and yet my mood is...pretty good otherwise. Am I stable in these cases? If so, why am I otherwise incapable of doing things? Disabled feeling fine?!?
==================================================
This is the most disabling symptom for me. It’s important to me to be productive and when I’m in this state...I’m not capable of it. It leads to depression...sometimes extreme.

Thank you for helping me realize the difference. Maybe I can work with that knowledge and avoid some of the depression.

j
—-I hadnt really thought about this, but I think for me, say I experienced a trigger, such as someone I really care about treating me badly. the first stage below baseline might be what you described with lack of energy. Then whether or not I used self care and whether some positive experiences happened would determine whether I would descend into a lower phase of depression that is more commonly known w actual sadness.I think this is compatible with the wave theory of bipolar. Thanks once again BirdDancer for bringing new depth to our understanding of how our mood swings really work. You’re the best!

[Pookyl]

Originally Posted by Jennifer 1967

Has anyone else out there had extremely low energy, but not really felt depressed in the sense of feeling hopeless, sad, low self-esteem, or the like? I can say that I've definitely experienced this. I sometimes have extremely low motivation, stay in bed almost all day, want to sleep too much, don't do sufficient self-care, perhaps yearn for more carbs (to "boost energy/self-medicate the low energy*) and yet my mood is...pretty good otherwise. Am I stable in these cases? If so, why am I otherwise incapable of doing things? Disabled feeling fine?!?
==================================================
This is the most disabling symptom for me. It’s important to me to be productive and when I’m in this state...I’m not capable of it. It leads to depression...sometimes extreme.

Thank you for helping me realize the difference. Maybe I can work with that knowledge and avoid some of the depression.

Yes I experience very low levels of energy in the afternoon, every single afternoon.
On the upside when I was working, I was more productive than my work colleagues at 8am.
I’ve been like this as long as I remember regardless of mood and it occurs even when stable. This predates my bipolar diagnosis. I’ve always just accepted it as part of who I am.
Oh and I used to drink a LOT of caffeine to get through a work afternoon.