Dispelling the fear of Hypomania

I sit on the rocks overlooking the Tasman Sea as I write this, watching the waves come in, crashing below me.  Some swells reaching several feet, others a mere ripple, all of them though are amazing and powerful in their own way.  Nature directs their path and intensity, in a similar way our minds guide our modds and how the cycle we are in will affect us.  Hypomania, mania and depression - they come and go, each moment in time.

Do a search about Bipolar disorder and you’ll find thousands of results explaining every aspect from depression to mania, medication, depression and the lesser known hypo-mania.  My partner recently read an article about hypo-mania and how it is often a prelude to either a severe depression or more sever mania.  The beginning of the article reads like a warning label, “Hypo-Mania – Danger Alert,” and while the symptoms listed are correct, it should not be written as a warning of impending doom for those who may be just learning about Bipolar Disorder, whether it is the individual or their friends and family.

 

The reality is hypomania, yes can be a pre-cursor to a full blown manic episode or a depressive episode, there is no denying that; however, let’s look at it from another point of view.

·       Learn what hypomania is and how it is different for each person.  A blanket description only tells you what could happen.  You have to discover for yourself, with the help of a partner, friends and your doctor, what triggers your mood and what symptoms are dominant.      

·      Make a list of your symptoms, how they affect you and those around you.  Both the good and bad.

·      Keep track of how long the cycle lasts and what happens as it dissipates.  This is important as it will give you the information you need if you then become depressed or actions become more intense leading to a full blown manic episode.

a.    To monitor my moods I use a daily chart and track my level of depression, anxiety, mania and sleep.  By looking at these numbers I am able to see when I was up or down and can then correlate that with a particular event or see a pattern evolve over a couple weeks, or if the seasons have changed.  The seasons can play a large part in our mood cycles. 

·      The symptoms of hypomania without a doubt can be harmful, but that does not mean you should be protected from life and kept sheltered.

a.    If you have a history of spending money while manic, have a limit set on your credit cards and bank card, so you can only spend a certain amount.  If you are in a relationship and have a joint account, let your partner know how you are feeling.  This can be one of the hardest things to do, as when mania hits it feels good and the last thing we want is someone to take that feeling away. 

b.    Anger and irritability are common.  Try yoga to relax or writing to help clear your mind.

c.    If there is a tendency for promiscuity, have someone you trust be an accountability partner. If you go to a party, don’t go alone and have someone else drive who is aware of you illness and will be your “wing man” for the evening.

d.    Projects are probably one of the most common signs.  I can’t tell you how many I have planned, started and never finished.  On a good note it shows creativity and that we are alive and capable of many things, however, ideas can get away from us and accumulate quickly, leading to being overwhelmed and confused.  Make a list of your ideas and the steps it would take to achieve them and if you would be able to do it, even after the hypomania ends.  As hard as it may be, pick one or two to focus on for a week.  This makes it more manageable.  If after a week you want to try something else, stop one or both of the previous projects before starting the new one. 

It is important to not look at hypomania, or even mania itself and the ideas and projects that can come from them as all bad, they are things that you are obviously passionate about and are important, the problem is we want to do them all at the same time.  Learning to harness the excitement and energy is key.  It is possible, to use hypomania to your advantage as you get to know your symptoms, triggers and how you react to the cycles.   

As with most things, there is the good and bad, what it important here is to look deeper into the information you are seeking, there will be numerous articles all claiming to have the answer and telling you what to expect, take them at face value and see what works for you.  You are the one who matters and needs to educate not only yourself, but those around you as well. 

Mental Health and the Supportive Partner

In early January 2016, while corresponding with a friend in Tasmania, I told him of my mental illness.  Being that open and honest and sharing my story with someone was terrifying.  Once I hit send, I was more than terrified at the email I would receive in return.  Would we still be friends, would I receive an email back at all?  I feared rejection, but it never came.  Instead  he asked questions and never judged me.  He listened to what I had to say, being more inquisitive than anything.  So, he did his own research and learned all he could on Bipolar Disorder and what he could do to support me. 

Here is what I wrote:  

In, '96 I attempted suicide and spent 3 weeks in the hospital. While there I received the diagnosis of Bipolar Disorder, anxiety and PTSD.  My mental illness is hereditary, my father was paranoid schizophrenic.  He never sought treatment and was a wanderer. My mom tells me I am just like him.  He passed away in 1999, a victim of his illness. 

I need my medication, it's reality and not a big deal to me anymore. There are days that are bad and days when the world is perfect.

Over the next few months, our relationship grew and we made the decision for me to make the move to Tasmania.  There was concern, of course, on how I would handle the change, mentally.  As we talked, we came up with a word, something I would say when I was anxious, depressed - when I needed help.  Our trigger word became, "home." A word that would bring the help I needed to combat the darkness and anxiety that  crept in when I least expected it. 

My biggest challenge was that I was alone and dependent on my partner.  I missed my family and friends, and some days wondered if I had made the right move.  I would go for a walk and see what was around me, the beaches, breathtaking sunrises and the love of my partner.  I knew it would not be easy at first, I had made a major change in my life, disrupted my structure and had to learn a new life.  In the first weeks I learned to drive on the opposite side of the road, a new money system and met friendly people.  Though I think some were more intrigued with the American in town.  

A few days ago I woke up depressed,  I didn't want to be out of bed, all I wanted to do was cry and I felt completely alone.  I picked up my phone and not realizing what I was saying, texted "I love you, hurry home."  Within ten minutes my phone was ringing, I had said "home."   In that moment I knew I wasn't alone, he comforted me and told me to get dressed and go for a walk, get some fresh air.  Two hours later, after a 2 1/2 mile walk, my mind was clearer and I was able to face the rest of the day.   I realized then that everything we had planned for, was working and I could ask for the help I needed. 

The message here is, find people who will support you, whether it is a spouse, friend or other family member.  Talk with them, tell them what you need when things are not going well, make a plan for what to do in those instances.  Plans need to be in place before a depressive or manic episode takes over.  This is when you will need a support person to help you find your way through the cloud of confusion.  

C is for Coverage and Care for Mental Health Patients

Insurance companies love them or hate them, they are a necessary evil and that is never more evident than when it comes to mental health care.  The news is overrun with stories of people trying to find help only to be let down by their insurers or mental health facilities in general.

 

With the push for people to sign up with the Affordable Care Act (ACA), it has become evident, according to NAMI (National Alliance on Mental Illness) that there is a lack of providers in plans for mental health care.  The problem falls not only on the companies themselves, but in some cases the doctors as well.  There are many psychiatrists and psychologists that are not taking new patients with health insurance because they do not receive a high payment rate, add to that the number of sessions, appointments and paperwork, many independent doctors find it easier to shy away from the insurance all together. 

 

Mental health, when it comes to finding inpatient care is difficult.  A paper in Baltimore ran a story of a man in New York who died of an overdose after his admission to a treatment center was denied after it was deemed not medically necessary, within two months he was gone.  The system failed not only the young man, but his family as well. 

 

A personal experience showed me just how difficult it is to use insurance for psychiatric care.  I found out that my plan allowed only 30 days a year for inpatient care, for outpatient is approved only two facilities both of which would not accept me due to the fact I was not “sick enough.”  This series of events left not only me, but my doctors baffled as well and searching for ways to get me the assistance I needed and work around the obstacles that were thrown in our way.  The final outcome was not good; I came away with only appointments with my psychiatrist and psychologist, with those closely monitored as well as to the number of times I was allowed to go. 

 

Denial for mentalhealth care is higher than other type of medical care, leaving high out-of-pocket costs for patients when it comes to care and medications.  According to state and federal laws there is to be equal coverage for both mental health and medical conditions, costs should be no different between the two, though discrimination still exists, and surveys have shown that is much more difficult to find a mental health care provided than a medical doctor, with inpatient care be harder than for any other care. 

 

You get the basic idea of what not only United States, but countries around the world are facing when it comes mental health care.  It is not seen as medically necessary in most cases and until that change there will be more patients not finding the help they need at some of the most difficult times in their lives. 

 

I have Depression and I am alive!

Image via Wikipedia

For those with mental illness, from the time the words come out of the doctor’s mouth it seems to define who you are, the illness becomes all you think about, hear about and write about. It seems to take over your every waking moment – but in the midst of it all, you can’t forget who you are, yet that seems to be the first thing we lose – our identity.

Some of that may come from society in general, mental illness, to them, is who we are. They can’t see past the words, the image, and the actions.

What we need to do is to remind them that we are people, no matter what. We just fight to show people the true face of mental illness – wouldn’t they be surprised if saw the truth.

If you live with severe depression, or know someone who does keep these things in mind – write a note to them, or to yourself to remind you who you are, the person that is inside because there will be days when you will find yourself lost and wondering where your life is going.