Hypomania Part VII: We Are Not Helpless Bystanders

John McManamy Health Guide
  • Last year I received a request from a publisher to write a blurb for an upcoming book entitled, “The Bipolar Workbook: Tools for Controlling Your Mood Swings.” I’m fairly skeptical of workbooks, but I had heard the author Monica Basco PhD of the University of Texas Southwestern Medical Center at Dallas speak at a conference several years back.

    "I do not believe you should be a passive recipient of care," she told me at that conference. So I gave the publisher the go-ahead to send me a manuscript copy of the book.

    “The era of take your meds and shut up is over,” I wrote after reading the manuscript. Naturally, I didn’t expect the publisher to use my remarks, but there I was six months later on the back cover, featured as the top blurb. “Yes, we need our meds,” I went on to say, “but we also require the personal skills to be smart and vigilant about our illness.”
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    Dr. Basco is a leading proponent of cognitive behavioral therapy. The therapy is used extensively for treating depression, and is starting to come into its own to catch swings into hypomania and mania. The first section of “The Bipolar Workbook” sets the tone: “See It Coming,” says the heading. Emotions such as sadness or euphoria, Dr. Basco says, change the type of things you think about, as well as the quality of your thinking, which affects behavior.

    Her book covers all aspects of bipolar disorder, but what she has to say about nipping baby manias in the bud is particularly apropos. For instance, the euphoria of a brewing mania can bring on the perception of a bright idea and the impetus to take on a new enterprise. This may lead one to stay up all night working on the idea, which sets us up for arriving at our day job exhausted and with racing thoughts. The bullet train to our next serious episode is about to leave the station.

    “The problem was not the project,” Dr. Basco writes. “The problem was the timing … Emotions can set you up to overreact to internal or external events.”

    ”Walk away from the situation,” Dr. Basco advises. Take time to evaluate it. Sleep on it, get the advice of your friends. Count to ten.

    Self-knowledge is the key. Most of us have learned the hard way. We don’t want to go there again. From our bitter experience we can take stock, spot patterns, recognize triggers. Dr. Basco uses various terms, but what she is driving at is mindfulness, the ability to recognize when the brain is starting to play tricks on us. We may personalize, catastrophize, engage in mind-reading and fortune-telling, think in absolutes, and on and on.

    Catch the distortions in thinking as they occur, Dr. Basco advises, Control them by keeping them from influencing your behavior. Correct any errors in your logic.

    Cognitive behavioral therapy is manual-based (no idle chit-chat), time limited (10 or 12 sessions max), and focuses on the here and now (you can’t change what happened in your childhood).

    Because the therapy delivers results, it gets a strong thumbs-up from those in my support group who have tried it. Your medical plan may pick up the tab, but the short-term aspect of the therapy means you can contain your costs if you’re forced to foot the bill.


Published On: April 13, 2006