Can I Tell if I Am Manic?

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5 Nov 2012

Someone asked me - "When you are manic, is it was possible to tell if you yourself are manic, or do you just think you are acting normal."

It is a good question.

The answer is - yes, it is possible for me to recognise the symptoms of mania while I am manic. But like everything else, it is a bit more complicated than just that.

I had to teach myself what the signs for mania were. But once I could recognise them, I taught myself to run a sort of ongoing self check every 15 minutes or half hour to see if I was showing any of the signs. It was very much like running down the list of the signs and putting a check mark next to each one I had. If I had enough of them, or a high number of the 'big' signs (such as quarreling with people) I assumed I was manic.

The continuous self check allows me to catch the mania early before it becomes too intense or too high or too much. At the early stage of mania it is easy for me to do something about it, before I've made a fool of myself.

Of course I often forget to do the self check. I'm no better than anyone else in doing this stuff. Therefore I also learned to flag some behaviours - twitching legs or fingers, poor hand coordination, tenseness in my jaw, arguing or shouting with people - as a sort of immediate 'stop and do your self check now!'

And I still didn't/don't notice all the time. However, I have told my family and close friends that I have mood swings and to watch out for the signs and tell me about it. Yup - I did hand out paper lists - you can get away with a lot with your close people. And, very importantly, I made a deal with myself and my family / friends that if they told me I was manic, I was to unconditionally listen to what they told me to do, even if I didn't believe what they was saying was right. That took a lot of trust. It works better with friends than family too - family are often just to close.

That agreement to unconditionally do what my friends said was important. My systems allow me to catch pretty much all of the times I am manic, but knowing I am manic and actually doing something about it are two very different things.

I have been in situations where I knew I was manic, but where I was feeling too good or enjoying myself to bother to do anything about it. And there are times when the manic impulses push me to continue doing stuff, even though I know that I shouldn't be doing it. This is not a good thing because mania almost inevitably leads to me to do stupid things - not necessarily dangerous, but stuff I have to apologise for afterwards or stuff I just wish I hadn't done. For example, I've been thrown out of a cinema for arguing with the ushers - not dangerous or unfixable, but stupid and embarrassing. The manic anger / irritability is particularly bad because of the sensation of rightness while arguing / shouting is very strong, so much so that I cannot see that are better ways to solve the problem.

For me that is why the frequent self checks are so important - if I catch the mania early on, it is easy to take action to stop it from getting out of control. The action could be trying to calm myself - I've got so much practice doing this that it works fairly decently. Or I have medication - Tegretol (carbamazepine) - that works within twenty minutes to completely pull me off a manic high. In the early days I used the medication a lot more, but these days early detection and calming / relaxation methods work well. So much so that I no longer worry about mania as a problem - it's just something to watch out for and deal with.

A quick back to the friends - in the early days, my friends were often the ones who first noticed the mania signs. I told them that if they did - tell me and make me take my medication and carry me somewhere quiet. You realise the trust that has to exist on both sides for that to work, but I do have good friends and it did work pretty well.

So to summarise - (a) Yes it is possible to be too manic to realise you are manic, (b) The solution is to do ongoing checks so that you recognise you are manic before it gets to intense and (c) If you are manic, go somewhere quiet and if necessary take medication. And (d) the final one is to have friends who know what to look out for and who you have given the authority to make you do the things that will lessen the mania.

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