Dealing with THIS Manic Episode

One of life's little benefits is that you can use your mania to control your mania.

Here's why. With mania, you tend to have high productivity and lots of manic energy. It turns out that you can channel some of the excess energy to monitor how you are feeling and what you are doing.

And then, armed with this information, you can then use your energy / productivity to take action to calm yourself down and reduce your mania.

IF you can monitor yourself and if you can then take action, you can manage your mania. Cool huh! It's like having a snake eat its own head.

But of course there is always fine print.

1» You have to catch the mania when it is mild, at the onset of a manic episode. The more manic you get, the harder it is to calm yourself down, and more importantly, the less you want to calm yourself down. Being manic feels too good.

2» You have to believe that if you are showing any signs of mania, then it is a bad thing. Mania makes you feel that you can handle the situation, so there is a tendency to believe you are doing okay until you realise that things are out of control. If you realise it.

3» Managing mania is not intended to be a solution to being manic. Rather, the goal is to allow you to manage yourself so you remain productive while manic, and to keep you from getting into arguments or other silly incidents.

4» Managing your mania means managing only this manic episode. Big picture solutions for managing your moods are complicated. But at least if you are manic now, you can deal with the immediate problem.

What Do You Do?

Monitor your moods. If you don't know what your moods are like now, you won't know if you are manic and you can't do anything to manage it. And the earlier you realise you are becoming manic, the easier it is to deal with the mania.

Remember, catching it early is the key.

Check out the Knowing When You are Becoming Manic page so you know what signs of mania to look for. Ask other people to tell you if they notice you are showing signs of mania - and listen to them when they mention it to you.

Once you realise that you are manic, your next steps are to Stop, Isolate, and Relax.

Stop

You must stop the following activities immediately.

Stop any argument.

Stop shouting.

Stop any physical violence or threats of violence.

Stop any discussion with anyone.

Stop talking (for now).

Stop volunteering.

Stop spending money.

Stop driving (if possible).

Stop making important decisions.

Stop all of it NOW. It does not matter you are right, or if you think what you are doing is right.

If you are arguing and you continue, you are going to (1) insult someone, or (2) escalate an argument, or (3) hurt someone by saying something you will regret. Or you will scare people you love.

I have been told that I am scary when in a manic mood, which always amazes me because I never think I will hit anyone. But apparently the threat of violence comes across very clearly when I am manic and quarrelling.

You may think your decision making capability is working fine, and that what you are doing is right. It isn't. Well, ok, it is, but it is working in a very narrow way. You are thinking in absolutes, in black and white, right and wrong, good and bad, and in something being perfect or not happening at all, or in things happening your way or no way at all.

There is no room for compromise in manic thinking, but most interactions with other people require compromise. How you are thinking offers no scope for reasonable action or a solution to a problem, and while you may be technically right, whatever you do next is likely to make the situation worse. It is better to just stop.

The steps and sensation of manic anger are very clear. Either something is going wrong, or I have been surprised by a change of plans. What happens next is that the anger rises through me - it feels like a sheet of white flames engulfing me. It happens in seconds, so one moment I am not doing badly and a few moments later I am furious. And although I start shouting, instead of getting irrational, I tend to get coldly logical and narrowly focused.

That's actually a terribly combination, because it places me in a position to be really vicious, deliberately choosing what to say next that will hurt the recipient the most. The narrow focus usually means there is little scope in looking at the big picture to sort out the problem.

Obviously, since nothing good is going to come out of this, it is better for me to stop. One of my current rules is that "Whatever is said cannot be unsaid." I try to remember this when forcing myself to stop an argument, especially with my partner.

Bottom line. Stop quarrelling or arguing or shouting. Now.

I try not to have discussions with people when I am manic because of how easy it is for me to escalate the situation into an argument. In fact, I have been pulled from dealing with clients at work for precisely this reason.

The same things tend to happen in discussions with my partner, to the point that we have agreed not to discuss important things when I am manic. It's not that I don't know the correct thing to do, it's that I don't do it, because I am so quick to anger.

If you are in a good mood, you are likely to be too talkative. Which usually means you will either irritate people with your constant talking, or you will butt into conversations that you are not part of, or you will be rude and interrupt other people when they are talking.

Worse than all that, manic people in a good mood are very good, very entertaining gossips, and later on you'll probably wish you had stopped talking sooner.

In a similar mode, manic people in a good mood tend to be excitable and tend to take on responsibilities or volunteer for activities. There is nothing inherently wrong with this, but it is an easy to overload yourself with too many responsibilities. If you realise that you are impulsively volunteering for an activity, stop and then try to get out of it.

If you realise you are manic, you need to stop spending money too. Here is one rule you must always follow. If you are manic and you are considering buying something that costs more than three times your typical lunch, put off buying it for at least three days.

If you really need the item, you'll still need it in 3 days time.

The more expensive the item, the longer to defer the purchase. So if you are thinking of a new flat screen television or a set of expensive cool-looking plants pots, defer it for 3 weeks. If you are thinking of an expensive new car, wait for 2 months.

There are very very few items that are so critical that you need to buy it immediately. And manic impulse purchases can do very nasty things to your savings, and to your relationship when your partner finds out. Stop and wait.

Yes, you will miss out deals and sales. That's okay. Manic people and sales are a terrible combination. Do not spend the money! If what you are looking at is something you need, it will still be a wise purchase in three weeks, even if it is not on sale. So wait.

It is very difficult not to give into the desire to purchase stuff. I know - I keep on ending up with new laptop computers (or I used to). And the thought of the new item and how much good it will do you nags and nags at you. Resist - and leave the place or website where you can purchase the item.

If needs be, hand over your credit cards and banks cards to someone else. Cheque books too.

Be very careful about making important decisions. Your decision making capability is suspect. This does not mean that you cannot make correct decisions, but you should be careful that the decision that you are making is the right one given the big picture. Never make decisions on impulse / quickly or when you are angry.

Given a chance, I would recommend that you put off really important decisions until your moods are something close to normal.

Never ever decide to break off relationship when you are manic - it is likely to be a wrong decision that you will regret.

Isolate

Once you realise that you are manic and you need to stop, remove yourself from the situation and find a quiet place.

If you are in argument or discussion, and the people involved know you are manic, tell them "Oh gosh. I'm acting manic again, aren't I. Let me take a break." Then walk out of the argument, the discussion, the meeting, the gathering, the party.

If the person you are arguing with says you are manic, then your responsibility is to immediately stop arguing and find somewhere to cool down. Yes, it will feel terribly unfair that you were winning an argument and you suddenly have to stop, but tough. That's one of the rules of managing your mania and this is not a choice issue. Do not escalate the argument by saying that the other person is being stupid.

If the people don't know you are bipolar, then be vague - "I'm getting too excited / angry, let me take a few moments to cool down." Or simply excuse yourself - say "Excuse me for a few moments please" and walk out. You really don't need to explain.

If you are in a crowd or a shop, leave the area with the noise and the excitement and things you want to buy. Turn off the music in your car or on your iPod.

If you are just doing stuff at home or at work and you realise that you have manic symptoms, just stop whatever you are doing and take a time out. You will feel that you don't have time to do this, or that the break will take too long, or that you have too much to do and can't spare the time.

If you feel like this, and you are jumping from task to task, then you are definitely manic and I strongly recommend that you take the time out. There is nothing in the world that cannot wait for 2-5 minutes, even if you feel otherwise.

Look for is a quiet place, where you do not need to interact with people.

Any of the following are possible - a bedroom, an empty meeting room, your backyard patio, or the lunch room. The following are also possible - a waiting room, a restaurant, the ledge on a public fountain, a museum, the neighborhood playground, or even standing in a parking lot. Bathrooms are possible, but feel tacky.

Even your desk at work is suitable if you are able to make sure you are not disturbed.

The quiet space has to be quiet - if there is a hum of activity in the background, or if there is constant movement, or if there is medium to loud noise, or if there are telephones ringing or people talking to you, then the space isn't quiet enough.

Bars and coffeeshops are not useful places to be - drinking alcohol or coffee are likely to make things worse.

My ideal place is a park, preferably one which has bench that is close by water and not too close to noisy activities. But I've used most of the above because it frequently is not feasible to get to the ideal location. Heck, standing in a quiet corridor works.

I'd recommend that you do some advance scouting to know where these "safe" places are, so when you need one, you don't have to think about where to find one.

Relax

Isolating yourself does not calm you down. It does prevent you from becoming more manic and It also provides you with few distractions so that you can calm yourself down.

How to relax?

Start with saying to yourself everything can wait. Say "I can give myself 5 minutes to relax. Nothing will fall apart in this time." You have to mostly believe it also, or else you will be too busy worrying about what you should be doing to relax.

The next step in calming yourself should be to regulate your breathing. My experience has been that feeling panicky or excited or stressed out is often caused by tense chest muscles and an apparently racing heart.

If your regulate your breathing, your gain some control over your chest muscles and your heart rate falls (or seems to fall). To do this, breathe in slowly and deeply, and then exhale slowly and deeply. Amazingly, you don't need to do this for a long time, regulating your breathing for as little as one or two minutes can make you feel substantially less panicky / excited / stressed.

If you do nothing else in your quiet time, regulate your breathing. Alternatively, because this is relatively easy to do, you can use it even if you do not have the ability find a quite place and you will still get some control over your mania.

Similarly, if you can reduce the tension in your muscles, your can reduce your mania. To reduce the tension in your muscles, you can do the standard set of stretching that people who exercise do, concentrating on exercises that stretch your back and chest muscles, and the ones in your neck and jaw.

Useful stretches include, (1) touching your toes, (2) leaning backwards, (3) leaning to the sides, (4) stretching your arms, (5) rotating your neck or leaning sideways, and (5) moving your jaw around. Though if you are going to stretch, you might as well do a full set of stretching (limited by the clothes you are wearing). Remember to do the exercises safely.

If you are not familiar with any of these, consider chatting with someone at a gym, or a friend and ask them to show you a set of stretching exercises. Remember to write them down, so you remember them all. If you know someone who does yoga, ask them for a set of yoga postures also. In both cases, you can get books on how to do simple stretching or yoga exercises. Simple exercises - so you don't need to buy the 300 page book.

Practice the exercises before you try this. You are going to feel like an idiot if you reach your quiet place and then try to figure out what to do next. Similarly, you will probably be doing some of this in a public place sometimes. People are going to think you are a little weird as it is. Looking weird and unsure of yourself is just not cool.

The next step is to organise a plan of action for the next two hours. The mania tends to make everything seem equally important and if you don't have a plan, you will try to do 50 things simultaneously. Now that you have finished your breathing and stretching, you should be somewhat quieter, and you have a better chance of knowing what you really need to get done soon.

Carry a pen and a piece of paper with you when you go to your quiet place, and write down what must get done in the next two hours. Don't write a wish list, write only what must be done. You can include a few "would be nice" items, but that is not necessary. If possible, visualise the order you will be doing them, and write 1, 2, etc. next to the items your wrote down.

Remember, this is for the next two hours only. It can't be for more than a few things. If you have 15 things on your list, you are doing this all wrong. You can't have more than, say, 2-4 tasks and 4-6 telephone calls. This also should not take more than a few minutes. If you are agonising over what you have to do, something is wrong. This is also not a time for making complex decisions on a project - that decision is part of a task.

There is no need for an elegant or high tech solution - writing on the back of a piece of scrap paper works just fine. If you forgot the pen and paper (which is fairly likely), think of what you need to do and then when you leave your quiet, write them down before you do anything else.

If you are taking time out from an argument or discussion, do not use the quiet time to continue the argument in your head, or to decide what you should have done instead, or to remember all the past problems, or to figure out how you could have responded better. If you are doing this then you are still manic and you aren't calming yourself down at all. If you realise you are doing this, stop and go back to the breathing exercises.

Same thing with planning your tasks. This is not the time to find solutions to problems, merely to organise your time management. If you are trying to sort out your projects in your quiet time, stop, and either just organise your scheduling or go back to breathing exercises.

You can try to calm your mental process by thinking of one peaceful moment from your past - visualising the time when you were at the beach looking over the sunset, or the time when your dog was lying quietly against you after you walked him, or the feel of taking a walk in the forest. Whatever works for you. In addition to visual memories, try to remember the physical sensations - the feel of the breeze on your skin, the smell of the sea, the sensation of sitting or walking, etc.

I like to remember swimming underwater in a pool - the absence of sound, the feel of cool water against my skin, the light / shadow ripple patterns on the tiles, and the feel of my muscles as I take occasional swimming strokes.

This method of calming yourself is not as reliable as the previous ones, and it doesn't always work for me. But if you are able to get it to work for you, then you have another tool that you can use to relax.

Consider taking an antimanic mediation if you realise that the exercises above aren't helping enough, or if you simply prefer this solution. There is nothing wrong with using medication as a best solution and it is one I use frequently.

My experience has been that antimanic medications work pretty well in getting me of my manic highs. And for me they take between 20-30 minutes to start calming me down (but I am hypersensitive to drugs, so this may not be true for you). I usually keep my antimanic tablets in my handbag so that if I need them, I have them.

Notice that I use the antimanic medication as if they were aspirin, and take it only as needed rather than continuously. This is not a recommended way to take antimanic drugs, but hey, it works. For me at least. If you are considering this idea, I really suggest that you talk with your psychiatrist about it first.

During that discussion, also talk about which antimanic drug might work best for you, and make sure to test it so that you know how long you will have to wait before it takes effect. Expect to do some experimenting before you decide whether this is a good idea or not and before you find a drug that will pull you off your manic high fairly quickly.

General note. Drugs for mania and depression are a complicated subject. Check out the section on Drugs for more information on my take on them.

Important: If you are sufficiently manic that you cannot calm yourself down, you must seek professional help. Check out this page for more ideas.

Now that you are Mostly Calm

Notice the plans don't go further than two hours. If you are manic, you are going to be manic for a while. The management system allows you to calm down so you don't get too manic and makes you organise your time so that you can actually get things done.

But as stated at the beginning, managing mania is not the same as stopping mania. The goal here is to allow you to remain productive while manic, and to keep you from getting into arguments. It's managing not fixing. So you still have to constantly monitor your mood.

The two hour limit is probably as far as managing mania can work for any one stretch. Assume that every two or so hours you will have to calm yourself down again and plan for the next two hours. For some people, you may need to do the relaxation / planning schedule more frequently than every two hours.

Yes, this is a bit of a patch job. In a perfect world, this would not be needed - there would be a drug combination that prevented you from becoming too manic, and that worked consistently, and that prevented you from becoming depressed at all, and didn't have debilitating side effects. But for most of us, that drug combination hasn't arrived yet.

So sometimes it is useful to be a bit manic and be fairly productive so you can make up for all the time missed while depressed. The tricky part is to gain the benefits of being a bit manic without the problems. That's when managing mania becomes handy - it accepts that you might be somewhat manic and tries to minimise the negative effects.

Yes, managing mania takes constant work. But the benefit is higher productivity, and for us, sometimes that matters most.

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