mania and manic episodes

Keeping It Together: Dealing with Hypomania

John McManamy Health Guide June 19, 2006
  • My support group has a rotation of people to facilitate. These days, I am the equivalent of a relief pitcher. I step in when the designated facilitator can’t make it or is in no shape to run the group that night. So when I took over on very short notice just recently it was no big deal, right? Wrong.

    Our meeting starts with a check-in. This involves going around the table as members briefly inform the group how they have fared over the past week. If the attendance is large, we will split the group in two following the check-in. I was really on my game this particular night. Recently, there had been a consensus to speed up the check-in so we could have more time for discussion topics, so I ran a tight ship, keeping things moving and lightening up proceedings with brilliant off-the-cuff remarks.

    Then came time to split the group. We called a break, and I worked with Joe, one of the other facilitators, in assigning topics. Those interested in topics A, B, and C would follow Joe into the other room. Those interested in D and E would stay with me. I had the juicier topics and anticipated a larger crowd.

    Ten minutes passed and I was the only one in the room. No big deal. A lot of socializing outside goes on during the break. I asked my wife Sophy to round up the stragglers. Three people came in. Obviously I had seriously miscalculated the interest in topics D and E. Oh well, carry on.

    After the meeting broke up, in the car on the way home, my wife informed me what really happened. I had been snapping at people during the check-in, I had been too full of myself. In short, I was bad news, and when people had a choice they decided I was not good company.

    Obviously I was mortified, but there was a fire in my brain I had to deal with first. I was hypomanic. A little bit of hypomania for me is good. I get energized, I come out of my shell. I’m a pleasure to be around. But this particular night was too much of a good thing. So what happened? Quickly, in the car, I started putting the pieces together. The last four days had been particularly hectic, work-wise, culminating in a Newsletter I got out that very afternoon. Then it was over to the Apple Store to shop for a laptop as a high school graduation gift for my niece. This was one of the new MacBooks with the dual core Intel processors. I came out of the Apple Store on a high, MacBook under my arm, feeling ever the avuncular good deed-doer, then it was back home for a mad rush of catching up, then back out the door to the meeting.

    Basically, I was like a revved-up five-year-old who needs a few minutes in the time-out corner. In the other room, my wife explained, other people had been commenting on my behavior. The only reason all of three people came into my room was because she had twisted their arms. Thank God this was a support group. The people there understand. We make allowances for weird behavior. We don’t judge. I knew I could come back the next week and all would be forgiven.

    But what if this had been a different venue, with people who don’t understand? Suppose I had behaved this way at the American Psychiatric Association annual meeting I had attended just ten days before? Fortunately, there, I had anticipated this sort of thing, and had scheduled time off during the six days of nonstop sessions. But back home in New Jersey I had let my guard down.

  • What’s frightening to me is I am an “expert patient.” I successfully integrate work with restorative downtimes. I cope well, I manage stress well, and I maintain a fairly healthy lifestyle. I am very good at detecting subtle mood and behavior and energy changes, and can move fast to intercept an episode before it happens. Because of all this, I am able to maintain a single-med low-dose regimen. It’s not a perfect solution, but it does the job for me – well, almost.

    This particular hypomania had slipped past the radar. Luckily my wife picked it up. Lucky for me, I was not too far gone to think the problem resided with her instead of me. A good night’s sleep and a quiet morning and I was pretty much back to normal. Sophy, my live-in reality check, confirmed it.

    I always keep reminding myself that I am just one manic episode away from destroying what has taken years to build. My reputation, my business, my finances, my marriage, my daughter, my personal relationships, the works. I once lost everything due to an intoxicating hypomania that spun out of control into a raging mania. My most recent behavior served to brutally remind me it could happen again, without me even noticing it’s starting to happen. It’s a very sobering thought.

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