When Events Spin Out of Control - Is Life Still Manageable?

Ask the Expert Patient Health Guide
  • Rose writes:

    “I'm a little worried, because I'm exhibiting symptoms of lack of sleep and extremely talkative. Things are starting to be more positive, but you know how that rollercoaster rides. It will dip at an extreme level. All I can do is watch and try to steer it in the right direction. These are all encompassing feelings, and it's hard to know if anything will work.”

    Thank you, Rose, for the timely reminder. It’s been about twenty years since I experienced severe mania (not counting an antidepressant-induced mania nine years back). That mania resulted in the loss of a job, ruined my chances of finding another one, and turned me into a social leper.
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    These days, hypomania is as far as I go, but these highs are more cause for concern than cause for alarm. Yes, I had a few close calls in situations of extreme stress, but I never felt as if I were losing my mind.

    Thanks, Rose, for bringing it all back. The feeling of the roller coaster leaving the platform is one of the most frightening in the world. The brain is driving you rather than you driving the brain. There is no bailing out. All we can do is hold on for dear life and pray we have a life to come back to after we crash-land.

    Rose was responding to my last Ask the Expert Patient, which discussed spotting mood triggers and acting on them before the situation got out of control.

    Country Girl, in response to the same article, had this to say:

    “I CAN"T stop the coming of the changes, no matter what. I've tried all the coping skills, all the positive thinking, all the yoga, all the meditation, drawing, music, journaling,etc. But what are we to DO when we recognize them? I mean really I want to so badly to thwart these rapid cycling moods and especially the mixed stages and can feel them coming but nothing seems to stop them....why is that? Is it possible TO stop them?”

    Okay, Country Girl. Let’s answer your last question first. The short answer is no. Even normal people flip, and that is often healthy. Rather than jamming a finger in the dike, often it is more productive to find a safe outlet for your emotions. You mention you have a supportive husband. When you feel you are losing it, you need to give him a heads-up. That way he can create a safe environment for you to go to pieces.

    But you also mention you are a 4.0 masters grad having problems with rapid-cycling in what I must assume is a work environment. Your colleagues there are not going to be as understanding as your husband. Moreover, I assume you are talking about extreme rapid-cycling - what the experts call ultradian rapid-cycling - the type that come on with virtually no warning, that can whiplash you from one mood extreme to the other in a matter of seconds.
    I was in a loving relationship for three years with someone who ultradian rapid-cycled. Believe me, I know where you are coming from.

    And the mixed states - I still experience those. You do not want to know me in a mixed state.

    So here you are, at work. Things are spinning out of control. You have obligations to fill, deadlines to meet. You can’t take a time-out for yourself. You can’t go out and smell the roses. You deserve a career worthy of your talents and all the effort you put in, and something out of your control is sabotaging you.

  • Okay, Country Girl. I’m going to take a stab in the dark. This may or may not apply to you. Our cycling is tied into stress and disturbed sleep. The two overlap. We get stressed, we don’t sleep. Next thing - pow! - flip city. Loving relationships are stressful. So is work.
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    You say you journal. So I’m going to ask you to take a look at your journals and see if you can spot some correspondence between stressful events and disturbed sleep in your life and your cycling. I’m taking you at your word that you can’t stop the rapid-cycling as it is coming on. So now your options are to work at controlling whatever causes your stress.

    I’m going to take a really wild stab in the dark, here. You mention your 4.0 average, so either things come very easy to you, or you are a perfectionist. If the latter, then you are setting yourself up for trouble. You push yourself hard. You sacrifice sleep and quiet moments to get things done. Everyone else is running a six-minute mile, but you push yourself to below four.

    Now here’s the irony: You keep pushing yourself this way, and your six-minute mile colleagues are going to run rings around you. My suggestion is to ease off. Make four-and-a-half minutes your standard and you have a much better chance of going the distance. Life - day-in and day-out - is a marathon, not a sprint. Incidentally, the championship marathoners cover 26 miles at a 4:30-mile clip.

    But even slowing down the pace, you are almost certain to have to put up with rapid-cycling. Not as much of it, hopefully, but some. Okay, here’s what I constantly told my loved one when she cycled, or words to this effect:

    Don’t panic, you will soon cycle out of it.

    Here, we are asking you to be a dispassionate observer of yourself, which is what mindfulness is all about. Mindfulness cannot always prevent an episode, but it is still useful in navigating your way through one. What you have going for you is the knowledge that there is light at the end of the tunnel, that whatever mood you are in, whatever emotions you are feeling, they won’t last long.

    You may not be able to slow yourself down when a cycle overtakes you, but you need to slow down your world. Thus, you may want to think about working on cycling survival kit. For instance, this may be a good time to fake a head-ache or a bathroom emergency. People understand those things. They will cut you some slack.

    As I said, Country Girl, I don’t know if any of this applies to you. Even if it does, change is not going to happen overnight. Breaking old habits and establishing new ones takes time. But I know you have worked very hard trying everything you can, and I have faith that you will give this your best shot if you feel this applies to you. Living with our illness requires us to lead highly-disciplined lives, and your post displays that you have discipline in abundance.

    So please be hopeful. I can feel your frustration, but I can also sense your determination and will.

    And I want to keep hearing from you. You have a lot to offer. Your success - and failures - will help untold people. Please stay in touch.
Published On: March 01, 2008