Mania: It's like a free cocaine drip

emotional intelligence , emotion

I’ve never taken cocaine, but I did go hypomanic in 2012, and it was glorious. Infinite energy, sharp as a whip, maximum creativity. That’s my subjective reality anyway; the people around me said I was talking fast and jittery. I’ve always described the episode in a positive light, and that’s a trap. Energy like that can go out of control, and it gets paid back with depression later.

I pray these words never become my own. They’re from a friend with bipolar:

What pains me most is I see how crystal clear my illness was in the beginning and how I was surrounded by so much love. So, so many family and friends were desperately trying to intervene, and I spurned them and then reacted despicably. I am so, so sorry. I failed as a husband, a father, a brother, friend, and as a kind human being. It is a hard pill to swallow that I was the Evil one. Why did I fail? Me. My brain. My manic self. I wanted more than anything to prove them wrong. That I could do this. But I couldn’t. You can learn a lot, but you can’t unlearn bipolar disorder. I desperately wanted to believe that bipolar disorder wasn’t real and that I could stop living in fear of it. That all the doubters were wrong.

A wide-eyed raccoon in rainbow glasses, fur standing on end, holds a pen and a microphone at three in the morning, surrounded by pinned-up pages, a tower of mugs and a bed that is still made.

Don’t fool yourself, this is as serious as depression

Bipolar’s worst outcome is suicide. My model for that: a brain attack. For what the manic side costs, read Breck:

The failure modes: Crash your car, spend all your money, have an affair

Crash your car - I hate driving. I’m either on a bicycle or, as of 2023, my car is driving me. Safe.

Spend all your money - Lucky for me, I’m pretty cheap, and I basically own everything I want already.

Have an affair - This is my highest risk. Luckily, at the time I was in terrible shape, and now I know there is nothing more sacred than my family.

What you should do if you sense I’m going hypomanic

The bipolar survival guide says to make your plan for going off-kilter while you’re still stable. Here’s mine, still a sketch:

  • Make me read this.
  • Get me to a psychiatrist ASAP, and check I’m still on my meds.
  • Check I’m still doing my practices.
  • Make sure I’ve checked in with my friends and bipolar support: Ammon and Breck.

My hypomania in 2012

I had been diagnosed with depression and put on SSRIs. I remember it clear as day: twelve weeks to the day after starting them, we were driving back from Oregon and I suddenly felt fantastic.

I told my psychiatrist (I’d only had him for those twelve weeks). He said stop the SSRIs immediately, and prescribed some valium in case it got worse.

I stabilized at high energy for two or three months. In that window I took a poetry class, did a poetry slam, and wrote a very impressive strategy at work. The intervention was lamotrigine (Lamictal), for the rest of my life.

Optimal energy vs Hypomania

Sometimes I’m at my best and wonder if I’m going hypomanic. So far the real tell is how much sleep I need. As long as I get tired and need sleep, I’m probably just operating at my best, and feeling great for it.

Hypomania vs Mania

I liked using the word mania with my psychiatrist. He scolded me: no, you’re not manic, manic is different. Then he told me a story. His client got fished out of Lake Union in a wrestling leotard. What are you doing, the police asked. Oh, I’m planning on pulling this tugboat.

Mania vs Cocaine

Drugs are fantastic till they ruin your life. Mania is like that too. Side by side; sources below:

  Hypomania and mania Cocaine
How it feels Up, elated, wired, more energy than usual. Or just irritable and touchy. Euphoric, energetic, talkative, alert. Or restless, anxious and paranoid.
Sleep You need less of it and don’t feel tired. You need less sleep and less food, while it lasts.
Talk and thought Fast talk about a lot of things, racing thoughts. Talkative, mentally alert.
You vs. them Hypomania can feel very good and productive, like nothing is wrong. Family and friends notice the change first. —
How long it lasts Hypomania: at least four days in a row. Mania: a week or more, or straight to the hospital. Snorted, 15 to 30 minutes. Smoked, 5 to 10. Then you want more.
The comedown Depression can follow. Episodes come back, and without treatment, more often. A crash almost right away: fatigue, low mood, strong craving. After long heavy use the craving and depression can last months.
What it costs Reckless driving, spending sprees, promiscuity: the three failure modes above. Bipolar is a factor in suicide. Tolerance, so higher and more frequent doses. Withdrawal can bring suicidal thoughts.
Treatment Usually lifelong. Mood stabilizers like lithium, plus talk therapy. Antidepressants on their own can trigger mania. No approved medication. Behavioral therapy is what works.

Sources: NIMH, Bipolar Disorder, American Psychiatric Association, What Are Bipolar Disorders?, NIDA, Cocaine, MedlinePlus, Cocaine withdrawal.