As I wrote in my last post, I just finished an exceptionally hard mixed episode. I personally define mixed episode as mania and depression combined. This may not be the textbook medical definition, but it does describe my feelings. I experienced mania that kept my mind moving a million miles an hour, with depression. Imagine sitting in one place, legs shaking, nerves on edge, racing thoughts, but without the energy or desire to move a muscle. That’s a mixed episode.
I have listed 5 things that help me deal with mania, and the manic portion of a mixed episode. These work for me, and perhaps they may help you.
1. Be prepared, and watch for the signs, triggers, and recurring episodes. For example, many of us face seasonal manias. Sometimes a mania might be weather related, or triggered by a moon phase, or by extreme emotion. If you mood chart you may be able to predict an upcoming episode. If you don’t keep a mood chart, why not? They can be extremely valuable in helping you recognize an episode. But no matter what, anticipating what is around the corner will allow you to prepare. Have enough medication, let your loved ones know it’s coming, perhaps even warn your friends or employers. The more information we have, and the more advance notice, the better prepared we can be.
2. Sleep is the most important thing for keeping my mania in check, and sleep doesn’t come easily in a mania. The less sleep I get, the more the mania builds. Don’t try to tough this out, ask your doctor to prescribe sleep medication. Without sleep, it’s easy to escalate into a state where hospitalization may be necessary.
3. Anti-psychotics are often necessary when things get unbearable. When the racing thoughts can’t be slowed, or when psychosis is threatening danger, an anti-psychotic may help chase away the danger. I don’t take Seroquel on a daily basis any more, but I ALWAYS have it within reach in case things get to be more than I can handle.
4. Have something to occupy your mind and your free time. I can’t stress this enough. My last mania was a mixed episode, and my depression made physical exertion difficult, if not impossible. But this didn’t slow down my manic mind – it desperately needed an outlet. So to feed my mind’s need, I took a computer program I wrote a few years ago and completely updated it. It kept my mind occupied for the weeks I was manic. I didn’t quite finish it, so it will be waiting for me when the next mania hits. In the past I’ve built web sites, started businesses, undertaken large home projects, began writing books, and started many different projects. The operative word here is “started". I rarely finish a project I start when manic. So before you start that kitchen remodel, or begin rebuilding the engine in your only vehicle, think twice. When you crash you may crash hard. Having an unfinished project like this waiting for you will be detrimental. Make sure anything you start can be set aside when it’s no longer needed.
5. Have an emergency plan. Write down the names and numbers of your doctor, your psychiatrist, therapist, spouse, kids, or anyone else who may have a stake in your wellness. Start from scratch, and cover the most basic to the most far-fetched scenario. For example, if you do “this", that’s OK, but if you do “that", seek medical attention. Remember, if you’re psychotic, you may not recognize the need for medical care, so others may have to act on your behalf. If 911 has to be called, make sure any officers sent are CIT (Crisis Intervention Training) trained. Specify which hospital. Specify what doctors should be called. Make sure everyone involved knows what meds you are taking, when, and in what dosage. Specify what meds you do NOT want administered. Spell it all out, and update it from time to time. Pull it out a couple times a year and review it again. Have your spouse or family review it and ask questions. The odds are at some point in your life you will need this, so don’t put off creating it for too long.
How about others? Any suggestions you may have for living through a mania? Leave a comment and let us know.