Should you treat mild mania?

[SweetSpot086]

I have been diagnosed with bipolar along with some other disorders, but I seriously doubt it...symptoms of bipolar mania as described in the literature are very severe...sometimes resembling schizophrenia...what I have is a mild version or hypomania...but it doesn't last more than a few hours...hypomania, I believe is diagnosed if the symptoms persist for at least 4 days.

It doesn't really effect my life in a negative way, I have other issues. The mania actually helps, I feel happy and euphoric.

Should I be taking mood stabilizers?

There is a theory, it is not widely accepted...but, some consider, mania as brain's defense mechanism against depression, of course it backfires in people with bipolar...but, if its mild, should you really be treating it?

 

[Celerity]

I haven't been diagnosed (yet), but I strongly suspect that I fit the criteria for Bipolar 2.

Based on my experience with what I believe to be hypomania, I think it does need to be controlled.

My symptoms usually manifest on the negative side of things in the form of increased irritability, agitation, and anxiety.

However, I have twice now experienced semi-classic hypomania. My sleep was not as disturbed as it usually is in most descriptions I have read, but everything else was pretty spot-on. My mood could only be described as buoyant, everything "finally all made sense", my productivity skyrocketed, charisma was effortless, everyone was more attractive physically and psychologically than they had any right to be, and I had a sustained hope for days on end that my success in life was assured. My mind raced with ideas and fantasies and hopes nearly 24/7. I felt smarter. Maybe I even was.

Sounds pretty fucking great, right? Looking back years later though, I realize just how much I was blinded to the consequences of my decisions then, blinded to the obvious shortcomings of the people around me and myself, blinded to just how unsuitable my chosen career was personally and practically.

And that year of bliss was followed by the worst depressive episode I have ever experienced as all that deluded hope came crashing down and I began to see my life for what it really was. I don't have a crystal ball or a time machine, so I can't know - but I don't think I would have crashed so hard if I had not been hypomanic, and I would have had more time to plan what to do.

As it was, my family rescued me before I killed myself, and I threw away the efforts of the past 7 years: all that time, effort, and youth down the drain with nothing to show for it.

When I felt that same heightened energy and racing thoughts for a week or two this past year, I popped Seroquel and forced myself to adhere to a strict sleep schedule. Just like that, voila, all the ideas I had that seemed so iron-clad revealed themselves to be paper mache.

So, to sum that wall of text up, I need to control my hypomania because I believe and do unreasonable things in that state. If it's a long enough time and a warped enough perspective, the effects of my poor decisions can be felt for years.

You may find the website psycheducation helpful. I have an even looser interpretation of the DSM than he does, but I found articles by the psychiatrist who founded the site helpful. He takes a spectrum approach to bipolar and has practical advice for how to manage it with less or no medication for those of us in the awkward gray area between major depressive disorder and more prototypical bipolar.

https://psycheducation.org/blog/bipolar-diagnosis-spectrum-or-yes-no/

 

[timf]

You might want to ask some family members or friends to let you know what they think of your hypo mania periods. For example, you may not notice if you make poor decisions with money, make promises you don't keep, or start projects you don't finish.

There could be ways that you are adversley affected, but fail to notice. Ultimately it is your call about what you might find helpful. However, you might find it beneficial to get as wide a circle of information as possible.

 

[SweetSpot086]

So, I discussed this with my doctor...He agrees my symptoms may not fall into bipolar type 1 or 2...but, the broader bipolar spectrum disorder...less frequent, and less duration manic episodes might fall into the spectrum.

So, he put me on Lithium 400mg/day.

What bothers me is that he said, dont worry about the therapuetic serum levels...he told me not to bother with getting my levels tested...he told me just to take 400mg Lithium per day.

My concern is that, with 400mg/day...my serum levels would be between 0.3-0.5, which are considered sub-therapuetic levels...levels between 0.6-1.0 are considered optimal..

The doctor said not to worry about the levels...so, I am guessing 0.3-0.5 would work for me? Because, my symptoms are not that severe?

He had other reasons for prescribing Lithium too..

- Aggression ( I am not physically aggressive, I have been verbally aggressive with my parents sometimes, a few years ago, and I was drunk most of the time, but my doctor still remembers the incident(s) , and keeps shoving that in my face)
- Impulsivity
- Suicidality
- Depression

 

[timf]

Starting with a low dose sounds prudent. If this is all you need, you might not have to worry about the side effects that can arise from larger dosages. It sounds like you do research. This is wise and places you in a better position to make informed choices.