Manic Doesn’t Always Mean Euphoric

After mentioning my medication, I recently told a new friend of mine that I have bipolar. He got this knowing look on his face and nodded, a slight smile appearing on his lips. I might have detected a quick, almost negligible eye roll, but that could have been my own insecurity. Why the little smile? The nod? Was the knowing look because he had a family member or spouse with bipolar? Was it because, like a lot of people, he believes we are overmedicated as a society? Or was it because he thinks we are taught to believe that differences must be labeled therefore most of these disorders are not valid, that everyone gets depressed once in a while and what’s wrong with being really happy from time to time? Why should it have to be medicated?

These are all things that well-meaning people have said to me when I revealed my diagnosis, one that I finally received after years of knowing that something was wrong and being misdiagnosed and incorrectly medicated and suffering off and on for decades. And even now that I have had the right diagnosis for two and a half years and am on the correct type of medication, it doesn’t make the bipolar go away. I still live with it and try to function, which I do better than I would without the medication.

And I’ve noticed that there are a lot of misconceptions about bipolar. Probably the biggest one is the first one below. Of course, there may very well be someone with bipolar who is always euphoric when they are manic. Bipolar is a spectrum disorder, meaning that there’s a lot of ground between depressed and manic and a lot of variance in how people experience it. [Note: Misconceptions are in italics.]

Mania is a state of euphoria. Not always. On rare occasions I’ve been euphoric. I’ve witnessed a few other people I knew who appeared to be euphoric for a brief time. But some people with bipolar never experience euphoria. Often for them manic means what’s called dysphoric mania, which causes extreme agitation, aggression, and angry delusions, which can lead to harming oneself, others, or property, whether accidental or purposeful, with the ensuing arrest and/or hospitalization. This can also happen if someone starts off as being euphoric. Unchecked (unmedicated) mania can lead to acute mania, or psychosis, in which a person can experience hallucinations, both auditory and/or visual. They can be out of touch with reality, delusional, and needing hospitalization. Or the mania might subside on its own, but this is not typical, and often not without damage being done before that point is reached. Being properly medicated can help prevent mania from reaching an acute state.

A person with bipolar goes between the two extremes of depression and mania. After discussing dysphoric mania, it makes sense to continue on to the topic of the various states of bipolar. First of all, different people experience depression in different ways. Sometimes it’s very emotional, with feelings of hopelessness and extreme sadness, as is the stereotype (which is often true). But sometimes depression is very physical. The mental image of a depressed person in bed is not necessarily about them not being able to face the world; it’s often because it takes every effort to move, even a little bit. Making dinner for your kids becomes a Herculean task. Your arms feel like they’re made out of lead. Your brain feels like solidified honey, and it’s incredibly difficult to focus on anything involving mental energy, such as writing. Then there’s agitated depression. You’re depressed but have a little bit more energy, which is caused by a low-grade mania that is definitely not euphoric. Right – dysphoric again. And severe, unmedicated depression can also lead to psychosis, often including paranoia.

In my opinion, and again, this is just my opinion, based on my own experiences, the worst bipolar state of all is the mixed state. Of people who have bipolar, far more suicides occur in the mixed state than in depression. Some say it’s because in the mixed state you’re depressed but you have the energy of dysphoric mania to make you do something about it. For me it would be because I wanted to make the pain stop. Not the pain of my life – the physical pain caused by the dysfunctional neurochemicals in my brain. This is something most acutely felt before I was diagnosed and correctly medicated, not because of the medication itself, although many people feel that their medication makes them feel worse, and I completely respect that. Some people get overmedicated, and that’s just as bad. When I’m in the mixed state, in which I have spent years of my adult life, there is constant churning in my head. It’s painful, and it makes me want to throw my head into a wall to try to make it stop. I feel a rage inside my head that makes me want to yell and scream in anguish. Then there are other days (and even times during the same day) when it’s all I can do to keep myself from crying. I drag myself through the day – work, kids, appointments, and household duties. But I just want to curl up in a corner and wail and bang my head. You don’t “snap out of it.” The best you can try to do is to power through it, to keep functioning. To hold on until you come out of that place where all you do is wish you would die, so the pain would stop.

People who have bipolar can’t be trusted/are sex addicts/take too many risks. Those who know that there are more than two states of bipolar have probably heard of hypomania. It’s an elusive state that causes people to get by with less sleep and still feel energetic. They often are highly productive and creative, as well as social and engaging. You’re probably thinking, That sounds pretty good to me! And honestly, quite a handful of people with bipolar wish they could always be hypomanic. The problem is that it can be very difficult to maintain a state of hypomania without surging into full-blown mania. And because it is a type of mania, it can cause problems on its own. You feel great, so you feel really attractive, and your self-esteem is a bit inflated. You dress provocatively. Your skin and senses are heightened. All these things can lead to hypersexuality. Judgment can be compromised. You put an entire summer wardrobe on a credit card. Some are seduced by gambling and risky investments. Regret can be a big part of having bipolar.

All people with bipolar are alike. People with bipolar are individuals who have a physiological disorder with their brain chemistry. But they are still individuals. Two people with bipolar can have completely different personalities. One might love drama and seek it out in his relationships. The other wants nothing to do with it and minds her own business. Some people with bipolar try to be positive and proactive about the disorder, and some are bitter and negative and uncooperative. Some people with bipolar lie and steal, just like some people who don’t have bipolar and lie and steal. Some people with bipolar cheat on their spouses, just like some people who don’t have bipolar cheat on their spouses. Some people with bipolar have terrible family relationships because of things they’ve done or because their family is unsupportive. Some people with bipolar cultivate loving family relationships and have a supportive family. And both of these scenarios happen in families in which bipolar is not present. Bipolar stereotypes are just that – stereotypes. There may be some psychological symptoms that people with bipolar have in common, which is how bipolar is identified and diagnosed, but even the characteristics of bipolar states themselves can vary from person to person (since it is a spectrum disorder).

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I didn’t ask my new friend what he meant by his reaction to my diagnosis. Some days I don’t have the energy to go into it, or I just want to finish my lunch and get back to work, or I tell myself, Maybe it meant nothing. Maybe he wasn’t sure how to react and that’s why his face went the way it did. Whatever the reason, it spurred me to write this post.

Thanks for reading it.

[Image courtesy of Medical News Today]

15 thoughts on “Manic Doesn’t Always Mean Euphoric

  1. You are amazing Tanya. How you’ve managed to be such a good mama and all around beautiful person, with all you are dealing with. I always see you as so level headed and thoughtful. I respect you so much. xo

  2. A really well balanced and useful piece. It all needs to be spoken out loud again and again until people who have not been there ‘get it’. Thanks for spending your energy this way. Isn’t writing a tonic? D

  3. You too, Michelle. I am proud to know you. Love.

    Thanks so much, Dawn. I can’t tell you how much your support is appreciated!
    And yes, writing is very cathartic : )

  4. Tanya, thank you for writing about this. I can’t imagine how you must feel, but know that you have the love and support of your friends!! Miss you! xoxo

  5. Ann, I’m so happy we are still in each other’s lives! I miss you too! And don’t worry, wishing I would die and wanting to kill myself are two completely different things, strange as that may sound ; ) I am hanging in there, as I do love life, just not the way my head sometimes feels. Your support means the world to me, my friend!

  6. Thank you for posting this and for so thoroughly educating your readers. I learned a lot, here, and I thought I new the disorder pretty well. I, too, so admire you for the grace with which you’ve dealt with more problems than most have in a lifetime. I wish you continued courage and strength, Tanya!

  7. Thank you so much for writing this so vividly. You have given me a better understanding of the diagnosis. I know that I have those depressed days that are hard to get through. You’re just going through the motions, because you really have no choice. I’m sure it’s nothing quite like this.

    I applaud you for dealing with this and still managing to be a good mom, an excellent writer and hold down a full-time job. You are super…woman!

    Love you,

    Karen
    p.s. I will be sharing this on my page and with a friend who’s ex-husband is bi-polar.

  8. I appreciate you, Elizabeth, and I learn so much from your writing as well. Thank you for the wishes! I can always use more of both of those things.

    Thanks Karen, I’m so glad it was beneficial for you, and I hope it is for your friend as well.

    Carrie, love to you also!

  9. A very informative and well balanced piece Tanya. Thank you for writing it.
    I would love to show it to some Irish Doctors who have disagreed over my mother’s diagnosis over the years and resulted in not treating her properly when in hospital for medical reasons.

    xx Jazzy

  10. I’ve always admired your strength, honesty, patience and super-mom skills, Tanya, and reading this post makes me even more so. Makes me feel like a total wimp when I complain of a headache. Thank you for sharing, being open, and giving us a birds-eye view into what life can be like when dealing with Bipolar. I love you my friend…always a teacher…always awesome!

  11. I have always heard that bipolar means swinging between extreme highs and lows, with the “highs” being extremely happy and excited and thinking that you are super important, things like that. With your explanation, it is a lot clearer to me… and I even wonder if I could have bipolar. Some of my depression episodes definitely are closer to the agitated but energetic states that you describe as low-grade mania. Also I’ve heard that a lot of people with autism also have bipolar! Also I wondered, is bipolar the same thing as manic depression?

  12. Thanks, Jazzy. Feel free to show it to the doctors, although I have a feeling that it might be dismissed by them since I’m not a mental health professional. But hopefully they will be open to other sources of information!

    Cheryl, thank you for your immense support over the years. I love you too, and by the way, headaches can be completely heinous and totally complaint-worthy! You, my friend, are anything but a wimp!

    Angel, dual diagnosis definitely occurs with autism and bipolar. Nigel has both (and epilepsy), and it’s very obvious when he gets in the different states of bipolar. And yes, manic depression was the previous term used to describe the disorder. I think it was sometime during the ‘80s that bipolar became the more accepted and official term, although a lot of people still say manic depression. Thanks for your comment!

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