I Have Bipolar Disorder. This Is What My Manic Episodes Feel Like.
There are a lot of misconceptions about mania, or the ‘highs’ of bipolar disorder. Here’s what it’s really like, writes Kimberly Zapata, who has the condition.
I was first diagnosed with bipolar disorder more than 10 years ago, so I’m no stranger to the symptoms. Since being diagnosed, I’ve learned that while many people are familiar with depression — one of the mood extremes of bipolar disorder — there are many misconceptions out there about mania and hypomania.
Some mistakenly think of mania as the “fun” end of the bipolar mood spectrum. “It is a common myth that the high mood [mania] is always euphoric or enjoyable, but in fact someone can be feeling irritable and impulsive,” says Dana Wang, MD, a psychiatrist and a cofounder of Rivia Mind, a mental healthcare practice in New York City.
“Another myth is that these periods of high mood are benign, but they are quite damaging to the brain,” Dr. Wang explains. “The productivity during the manic mood also tends to be impulsive and disorganized.”
Manic episodes are more scattered than depression episodes and are, in many ways, erratic. They can be quite disruptive to a person’s life.
And I would know — I’ve been there, time and time again.
What Mania Really Means
The American Psychiatric Association defines a manic episode as a period of at least one week when a person with bipolar disorder becomes extremely euphoric or irritable and is more energetic than usual.
Common symptoms can include a decreased need for sleep, faster or increased speaking, being easily distracted, uncontrollable racing thoughts, increased activity such as working on multiple projects at one time, and increased risky, impulsive, or hypersexual behavior.
Hypomania is a less severe form of mania that lasts at least four days and isn’t as disruptive to daily functioning as mania is.
The symptoms experienced during a manic or hypomanic episode vary from person to person.
At First, Mania Can Make Me Feel Good
When I experience mania or hypomania, things often start out as “good.” I am chipper and upbeat. Energized and optimistic. I am chatty. Talkative.
Being a creative person — I’m a writer and editor — I find my mind becomes a flurry of ideas. During my manic and hypomanic phases I write regularly and pitch story ideas to editors frequently. Many of my published works have been developed during these periods.
My need for sleep is decreased. Scratch that — it’s nonexistent.
And, for a while, I feel on top of the world. Life is limitless. I am superhuman.
Then, My Manic Symptoms Escalate
As time progresses, so too do my symptoms. My speech, which starts out as fun and flirty, becomes pressured. I cannot control the words that spew from my mouth. My thoughts, which were once productive and inspired, become erratic. They come so fast that I cannot isolate a single one. And I become agitated. Jittery. On edge.
I stop eating. There’s no time for meals or food. I drink excessively to quiet the intrusive thoughts in my head. Plus, I find pleasure in the “party.” It’s a welcome respite. A relief.
I become impulsive. Once during a manic phase, I started stripping and dropped out of college. I’ve been hypersexual. In the past, I’ve engaged in numerous acts that would make your mother blush.
When I’m having manic symptoms, I am reckless with my body, my being, and my wallet. I’ve booked vacations while manic, gone on online shopping sprees, and made other major purchases. Financially, I am still reeling from decisions I made many episodes ago.
Sounds become louder and lights become brighter. Everything is more concentrated and more intense. I pick up on details that previously escaped my attention. The simplest things become spellbinding.
I feel as if I were — or so I imagine — on speed (amphetamine). My thoughts race. My senses are heightened, and everything buzzes. I cannot slow down. And sometimes, there are tics. I find my body jerks and twitches in ways I cannot control.
If My Mania Goes Untreated, It Can Be Life-Threatening
If things escalate and my mania goes untreated, the final “stage” for me is anger, irritability, and suicidal thoughts. I become extremely snappy and short-tempered. I lash out at nothing and everything: raised voices, off-color jokes, a spilled cup of milk.
And then, in desperation, my mind turns to suicide. I genuinely believe my only way out of the mess I have gotten myself into is through death.
I have made two attempts to take my own life. Fortunately, both failed.
The first time, I lucked out and white-knuckled through a “plan” that I do not recommend. The second time, I received proper help and treatment for my bipolar symptoms. I spoke to my psychiatrist and therapist. Medications were changed. Dosages were increased — though admittedly, I never revealed I’d attempted suicide because I knew I would be hospitalized. Instead, I lied and said I was having suicidal thoughts. Please, do not take that advice, and do seek professional help if you’re having suicidal thoughts. This was many, many years ago, and at the time I was young and naive.
How I Keep My Manic Episodes in Check
As for today, I’m here and well cared for. I am medicated and check in with my psychiatrist regularly. My therapist and I meet weekly, sometimes more, and I have a safety plan, a personalized plan that I can put to use if and when I am in crisis.
Along with that, I have a few other strategies that work for me to keep my moods stable.
I go to bed at the same time every night, even if I don't feel tired. A consistent sleep routine is integral for those living with bipolar. Not getting enough sleep can be a major trigger for manic episodes.
I try to remember to eat regularly, even if I don't feel hungry. Like sleep, it helps keep me feeling balanced and nourished from the inside out.
I avoid stimulating activities, like big gatherings and large crowds, and other noisy, bright environments. These activities are known triggers for me (and for many others with bipolar). Instead, I opt for quieter locales.
I exercise frequently and often. Running is my outlet and my go-to stress relief (stress is another common bipolar trigger).
Finally, the best thing I do to care for my mental health is to be open and honest about it with my friends, family, and my mental health care team. This means keeping close tabs on my mood. It means keeping a wellness journal or diary, and it means checking in with someone immediately when things go awry, even if (and when) I enjoy flying close to the sun, as I often do when mania first appears.
Does it always work? No. I’ve been in the early stages of manic and hypomanic episodes and refused additional interventions, instead telling my psychiatrist and therapist “I’ve got this. I know what I’m doing.” (Ha! Famous last words.) I’ve skipped out on therapy from time to time and neglected self-care. And, one time, I flat-out ignored my crisis intervention plan — which I do not advise.
But I am a work in progress. We all are works in progress. And managing a mental health condition like bipolar disorder is a full-time job, so I give myself credit where credit is due. I give myself grace, and I learn what I can, when I can.
If you or a loved one is experiencing significant distress or having thoughts about suicide and need support, call or text 988 to reach the988 Suicide & Crisis Lifeline, available 24/7. If you need immediate help, call 911.
Important: The views and opinions expressed in this article are those of the author and not Everyday Health.
Angela D. Harper, MD, is in private practice at Columbia Psychiatric Associates in South Carolina, where she provides evaluations, medication management, and psychotherapy for adults.
A distinguished fellow of the American Psychiatric Association, Dr. Harper has worked as a psychiatrist throughout her career, serving a large number of patients in various settings, including a psychiatric hospital on the inpatient psychiatric and addiction units, a community mental health center, and a 350-bed nursing home and rehab facility. She has provided legal case consultation for a number of attorneys.
Harper graduated magna cum laude from Furman University with a bachelor's degree and cum laude from the University of South Carolina School of Medicine, where she also completed her residency in adult psychiatry. During residency, she won numerous awards, including the Laughlin Fellowship from the American College of Psychiatrists, the Ginsberg Fellowship from the American Association of Directors of Psychiatric Residency Training, and resident of the year and resident medical student teacher of the year. She was also the member-in-training trustee to the American Psychiatric Association board of trustees during her last two years of residency training.
Harper volunteered for a five-year term on her medical school's admission committee, has given numerous presentations, and has taught medical students and residents. She currently supervises a nurse practitioner. She is passionate about volunteering for the state medical board's medical disciplinary commission, on which she has served since 2015.
She and her husband are avid travelers and have been to over 55 countries and territories.
Kimberly Zapata is a health and wellness writer whose work has been published on numerous websites, including Health, Healthline, Parade, Washington Post, Huffington Post, Oprah, The Mighty, Mic, and Vice. She is also the founder and creator of Greater Than: Illness, a nonprofit dedicated to empowering teens and young adults struggling with mental illness.
