Hypomania Part V: How Little We Really Know

Charles

3/22/06 2:54pm

For me, hypomania involves changes in behavior that dramatically affect interpersonal, family and workplace relationships. The cognitive problems that accompany the "situation" and the later confusion compound my ability to function at 100%. True, my moments of brilliance impress many. On the other side is the down side with irritability, rage, cognitive impairments and the inevitable confusion. I do not see anything in my situation that would make seeing hypomania as a blessing in disguise true at all. ************************************* Hi Charles. "I feel your pain." I've been there. See Hypomania Part IV for the kind of horror you describe. Thank you for reading, John

Sue

3/26/06 2:30pm

Research, research, research.* That’s what’s needed here. Hypomania is not mania. And, a hypomanic not on medication is not the same as a hypomanic properly medicated. After discovering John Gartner's book, I do not view myself as bipolar, but now define myself as a "John Gartner Hypomanic." I have worked diligently over the past year to apply his pioneering work to my life. I am happy to report I have found my sweet spot, after consulting with leading psychiatrists. I’m disappointed to report, however, the pdocs I consulted either dismissed Gartner’s hypothesis or hadn’t even bothered to read his book. I persevered, nonetheless, and am doing my part to proselytize Gartner’s work. What's needed in the psychiatric community is some serious study into John Gartner's premise-- that so-called "hypomanics" are a unique, interesting breed. Further, that these individuals are neurologically wired to produce amazing results. I agree that Gartner has been shunned by the psychiatric community, but those of us for whom this shoe fits, we wear it proudly and productively. Incidentally, you’ll find, we’re not a crowd who needs acceptance by authority figures, but it sure would be nice if more of “us” knew there is a way to stay On and Safe. *Why aren’t the pharmaceuticals interested in researching Hypomania? It’s a new, huge market…A large preponderance of hypomanics won’t take meds at all because of the tendency of pdocs to over-prescribe. ********************************* Hi Sue. The good news is I'm confident Dr Gartner will prevail in the end. I have seen massive paradigm shifts in psychiatry since I first started writing about my illness seven years ago. Believe me, Dr Gartner will get a fair hearing in the psychiatric establishment. Sure, they're going to hate him at first, but then they'll all start acting as if they thought of the whole thing first. Give it time. Thank you for reading, John

John

3/28/06 5:34pm

I was diagnosed with bipolar disease last summer after having a manic episode from pushing myself "too far" with stress. I had never experienced depression or any other signs. My friends would kid with me in the past by saying I was OCD, but I am a high strung, highly productive perfectionist. After the manic episode, I was placed on seroquel which made me extremely drowsy. Next, I was placed on depokote and after months of adjusting that my doctor added lamictal. I experienced my first feelings of depression and anxiety on these drugs. I had every side effect in the book from night sweats to insomnia, tremors, tingling in my feet and scalp, depression, anxiety, impotence, decreased libido, etc., etc., etc. I felt like I needed meds for the side effects. I am a dentist and I had tremors in my hands so bad, I thought I was going to have to quit practicing dentistry. I slowly decreased the meds and took myself off in mid- December. I feel "normal" and all side effects have disappeared. Since the manic episode, I occasionally have trouble going to sleep, but usually as soon as my head hits the pillow I am asleep. Also since the manic episode I occaionally feel anxious. But 99% of the time I am highly productive and I always have to have a "project" outside of work. I believe I am a successful hypomanic. I know that stress pushed me into the manic episode and I know now when to slow down. Do I need meds? I am concerned that my doctors do not understand how to treat hypomania. I discontinued the psycotherpy and the pschiatrist appointments because I fear they will not accept my choice to not take the medication. Any suggestions? ************************* Hi, John. Virtually every psychiatrist in the world will say your past manic episode means you have to be on meds. They can cite studies showing that bipolar meds help prevent mania (as a dentist you are firmly grounded in all this prophylaxis stuff). What they can't cite are studies showing how much or how little meds do the trick (especially with the high drop-out rates in these prevention studies), so you are entitled to challenge your psychiatrist to go below the standard dose ranges (which are based on acute phase severe mania treatment). Your psychiatrist may convince you to stay on the standard doses, but that kind of decision should only come after a constructive dialogue between the two of you. You may want to give him/her a copy of The Hypomanic Edge. If you fail to establish a dialogue, don't be afraid to shop around. Thank you for reading, John

Jan

4/17/06 11:57pm

Hello! Finally someone is acknowledging hypomania (with occasional manic breakthrough) as a condition separate from classic bipolar disease. My grandfather and 3 of his sons (including my father) had the condition, but, of course, nobody every talked about it. My father was the only one who went on treatment (lithium) that controlled his symptoms pretty well for about 30 years, until age 80, when he started having major manic episodes after a doctor told him to stop the lithium cold-turkey because of liver toxicity. He died a few months later. But I do want to ask if anyone has information on the genetics of this disease (since it seems to affect only the men in my family; their sister was fine) and it came on them all in mid-life (my dad was over 50 when he started having seizures and manic episodes). Again, thank you speaking out on this poorly understood condition. Jan ****************************************** Hi, Jan. Studies on twins and family groups overwhelmingly demonstrate the illness has a genetic component. But it usually takes an environmental trigger such as stress to set off an episode. The illness often manifests during significant life transitions (such as to adulthood), which may or may not explain the onset in your dad in his 50s (when testosterone starts significantly diminishing). As for the women in your family, odds are an equal number have similar genes as the men, but for various reasons relating to the situation around them and how they handled these situations the genes maybe never got switched on were otherwise put to the test. Thank you for reading, John

Anonymous

3/15/07 7:56am

The Hypomania thoughts never come to fluition, as the depression then sets in that I can never amount and all is too hopeless. The Hypomaniatic spurts come in too fleeting to be able to amount to anything and then feeds to the depression. Or, in cases of overspending leads to worste case scenarios after-the-fact.

Anonymous

3/15/07 7:59am

The Hypomania thoughts never come to fluition, as the depression then sets in that "I can never amount and all is too hopeless." Or, The Hypomaniatic spurts come in too fleeting to be able to amount to anything and then feeds to the depression. Or, in cases of overspending it leads to worste case scenarios after-the-fact.

Stardust

1/19/08 9:13pm

Hi John, you wrote "This may involve careful micro-adjustments with small doses until you and your psychiatrist find the sweet spot. The sweet spot for you may be mildly hypomanic, with room to cycle down as well as shift sideways into occasional grumpy periods - in short, you. It feels right and you feel reasonably safe."

What type of drug are you referring to? Thanks.

Kathy

3/24/09 5:01pm

My son committed suicide. He was very successful in his profession. He was married for nine years when he died. When he lived with my husband and me, we did not detect anything wrong. When he married there were several times, my husband and I saw him very irritable. As time passed, he was always on the computer when we visited. Five days before he committed suicide, he had interrupted sleep. I am bipolar. My psychiatrist said that my son was hypomanic. He left a wife and two young girls. I am afraid that my grandchildren will have what their father had and it will not be picked up. Thank you for your articles. It was very helpful.

Kathy

John McManamy, Health Guide

3/25/09 6:15pm

Hi, Kathy. I'm very sorry for your loss. As a father, I cannot imagine anything worse. Please be assured that the suicide was beyond everyone's control, including your son's. I can assure you that it was not a choice. He did not commit the act - rather, the act committed him.

Most people don't see it this way, but I would submit that your son died of natural causes. His brain failed him, the same way the heart fails those in cardiac arrest.

I know you and those your son left behind will keep asking why. (I still do in relation to the suicide of a good friend of mine.) You can't stop asking why. But please try not obsessing on it.

As for your grandchildren. Yes, there is famial risk, but I can assure you that as they grow older treatments will get much better, along with public awareness. Also keep in mind that your grandchildren are inheriting the same genes that made your son such a vital individual in the first place.

Finally, this is a time to be reaching out. There is a community here that you can count on. Also, please do not hesitate to seek out DBSA or NAMI in your area for live support.

Again, very sorry for your loss.

Jody

6/ 9/09 7:44pm

Thank God someone out there is really beginning to understand this "disease." I was so fortunate to have a brilliant psychologist that diagnosed me with hypomania a few years ago. Having three incidents whereby the wonderfully hypomania state moved into acute mania, I was terrified! I knew there were no psychotic episodes and felt I was in a personal battle with myself to gain control situation. I learned that the key to my success was sleep. The surging ideas were great and yes, I do miss the manic episodes, but know that they can quickly spin out of control (to the point I am no longer in control). It is strange how this disease did not show itself until my 40's. I imagine I had always been a bit manic. I used this endless energy (and still do) to delve into my educational pursuits and other areas of interest. The creativity and ideas are great...but I know to shut them down at 9 p.m. with a small dose of seroquel. Within an hour I can actually feel the numbing of the thoughts and I am ready for bed. I don't always wake refreshed and need quite a bit of java to begin the day, but within 1/2 hour I am in full swing again. One problem I have noticed is some weight gain (which I have read is a side effect to this medication). Is there anything out there that works just as well, without adding extra pounds?

Angela53510

6/14/09 8:01pm

So glad you addressed this topic! I had two hospitalized manic episodes 33 years ago, post-partum, and another 8 years ago from lithium toxicity, which created severe anxiety, which I have mostly overcome. I admit, if I am not dysphoric and irritable, I love hypomania. No, I never want to have another manic episode again, yes I have been depressed over and over, but I do think that hypomania is my "normal" personality. LOL. Although I am classed as Bipolar 1, neither my pdoc nor I believe it will happen again. (In my mid 50's he thinks that I am progressing nicely in the right direction, although apparently some women get much worse at this point.)

So am I really hypomanic? Okay, I admit, I cheat - I take 1/4 of a 150 mg tab of Wellbutrin every morning. Any more than that and I can't sleep. Any less, and I want to jump off a bridge. Before the arthritis hit - this was my life. So maybe the depression is mostly grief over a debilitating, damaging physical illness, combined with Seasonal Affective Disorder from this horrific northern Canadian winter climate, which disappeared in 10 seconds when I went to Texas this winter, woke up the first morning, wanted to die as usual, and then realized it was 75 F, and sunny, and felt overwhelming joy! (Talk about rapid cycling!)

I have always been a extremely productive individual. Some people might call me driven. I was always broken when I didn't get straight A+s in school (A's weren't good enough), and in my MDiv. program I write 20 pages with 50 references for a 7 page position paper assignment, all while exercising 1 1/2 hours per day, playing flute an hour per day, and enough involvement in my church to be termed the "assistant unpaid pastor". Then there is learning languages (French, Spanish German and now Hebrew and Greek), and a huge garden, despite my disability. This year I was in a wheel chair from surgery, and still planted my garden, when everyone told me to rest. What is major surgery and 6 pins sticking out of your toes, when the standards are organic vegetables for the summer and flowers which enhance the beauty of my home?

I talk too much. I write too much. I recently lost my voice after surgery for 6 weeks, and have been the brunt of numerous jokes regarding how much people are enjoying the silence. Esp. my husband. In a moment of dysphoria, I asked him whether people didn't like me, and he said they all love me - why else would they bring meals to my house for two weeks, and come and clean it through my recovery? Point well taken.

For my spiritual journal in a Disicpleship Course, we were suppose to write some short entries. 100 pages later, I began to think about that book I have always been meaning to write, and self publishing if necessary. I really want to document my journey, but I want the focus to be meaningful to someone else - friend, relative, or fellow sufferer.

So I am glad when people point out the positives of being "driven" and that it is possible to live a productive, fulfilling life as a hypomaniac, provided you can keep a lid on the depression, and of course, avoid flying into mania. Other than a penchant for buying books on-line, I am financially secure, sexually faithful, so I don't think that I have damaged my life by a lifetime of this disorder.

For me the biggest issue is the stigma - I hate knowing looks if I tell people, so I hide in the closet. One cultural issue, is that when I told my friends from South America that I was bipolar, they were totally accepting. They seem to like me the way I am - spontaneous and "affective". Yes, I would dance on the table if my feet weren't so deformed, and I know that the "joy of the Lord is my strength", is probably my motto. God allowed me to be this way - yes, my immigrant grandparents were risk-takers. I am also glad none of my children have manifested this wonderful "disease" so far. So some people think it is personality, I am just glad to be up most of the time. And I will get a copy of that book.

Angie

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