Bipolar Disorder

Bipolar Disorder - episodes of mania.

Any discussion of the process of bipolar disorder and mania cannot be entirely divorced from a discussion of the depressive response. Within any episode of mania lurks the possibility, the likelihood of impending depression. There are certain techniques and exercises which I have identified while dealing with my own periods of bipolar disorder mania which help temper the mania and thereby lessen the impact and severity of the subsequent depressive response. It is essential that you have read my article on Emotional Thought Stopping and are familiar with the concept and my suggestions for its use, before you attempt this exercise.

I assume that if you are reading this in order to help temper your periods of bipolar disorder mania that this is not your first episode. Look back at your previous situation just prior to those episodes and see if you can identify if there was some event which triggered the episode and begin to identify how you felt at the start of the episode. It is important to be able to recognize these periods as early as possible so that you can begin this tempering exercise before it reaches a crisis stage. This is especially true if you begin your episodes with a euphoric feeling.

Bipolar Disorder (Manic Depression) Theory

I have not always been able to identify a specific event which immediately preceded my bipolar disorder manic episodes, as many times they start as a heightened awareness with increased energy and a euphoric feeling. I think that the episodes are a response to a buildup of stress over time and that the increased energy and awareness are meant to enable us to combat that which causes us stress, it is up to our conscious mind as to how to utilize this increased energy and awareness.

Unfortunately our conscious mind does not understand the processes of the depressive response and we are seldom able to exercise control over that which causes us stress. Consequently our conscious mind many times misuses or misdirects the increased energy and awareness of mania to a point where we may go on shopping sprees, spend food money to buy lotto tickets, or try to make a killing in the stock market. We do things which at the time seem logical and will solve our problems but in retrospect were illogical and ill conceived. As the process advances it is possible that the euphoria is circumvented and we progress directly into a frenzied hyperactive state which may cycle quickly between periods of mania and the depressive response.

This theory presupposes that there is a purpose, a function, even a logic behind the depressive response and episodes of bipolar disorder mania. I believe this to be true, unfortunately due to the constant and unnatural stress our modern society places on many of our people we are stressed beyond the point that our biological processes have the capacity to mediate and these natural functions become maladaptive and dysfunctional.

The basic premise of this exercise for tempering our bipolar disorder mania is that it is possible to utilize the energy of mania, anger, and despair towards a therapeutic end. Traditionally, before I learned to control my mania and depressive episodes, the periods would utilize the energy of mania, anger, and despair toward a frenzied, bazaar, and suicidal state culminating in a major depressive episode. Since I have learned the mechanisms of control these periods have been used to gain insight into the depressive response, do extensive research, and write the pages of this web site, among other things. Of course I don't expect everyone to focus this energy on writing web pages concerning the depressive response. But the focus does need to be something which is therapeutic and I suggest when you first begin that you choose a cognitive based self-help program.

There are four areas of concentration or activities which will become your focus during this exercise, depending on how you are doing at any one particular time.

1. A cognitive behavioral based self help program.

It is best to become familiar with the basic concepts and procedures of the cognitive self-help program before you find yourself in a bipolar mania crisis.

2. A creative endeavor.

This might include writing, painting, poetry, pottery, sculpture, wood working, etc.

3. Exercise.

Including aerobics, a stationary bicycle, or activities which help us focus such as yoga or ti-che. In lieu of physical exercise, relaxation exercises may be helpful.

4. A back-up plan.

Someone to call in case you lose control and need to talk it out. Possibly a supportive friend or family member, your therapist, a crisis help line, the local hospital. Find the phone numbers ahead of time and make sure you have a plan for weekends and holidays.

BIPOLAR DISORDER, STAY FOCUSED

I can only relate to you what goes on in my mind during an episode of bipolar disorder mania, your experience may be different, but I think that if you do not concentrate on what causes your particular pain, and instead concentrate on the basic process, that which we all have in common during an episode, you will benefit from this exercise.

As the episode progresses my mind is racing so fast that it is hard to focus on any one subject. I begin by, let us say writing this article, as my mind switches to possibly the next article I am considering writing, I go with that thought, write notes on any insight or ideas I come up with, and then refocus on this present article. I make a concentrated effort to return to the original task. Your focus will be on the cognitive self help program. You do not concentrate on your life problems, anger, despair, others, or events that have caused you pain. If you find it impossible to remain focused on the self help program, clear your mind by exercising or try a relaxing exercise. Then return to the cognitive self help program.

When I am in the throngs of a full blown episode I begin to have major mood swings sometimes as often as two or three times a day. I moderate these rapid cycles by focusing on therapeutic endeavors and staying grounded in reality during the highs of bipolar disorder mania, and I use emotional thought stopping to protect myself from disparaging and suicidal thoughts during the lows when I experience the depressive response.

I find that I do a lot of pacing back and forth when things get intense. I have identified this as an obsessive compulsive reaction which I have to monitor closely. Pacing and other obsessive compulsive acts are repetitive, mind numbing acts which the biological unconscious uses to block out stress. These acts may include excessive nail biting, pacing, rocking back and forth, hair twirling, counting something over and over again, arranging and rearranging articles, singing and humming or saying the same thing over and over, and to some extent mindless surfing the internet with no purpose, and repetitive games such as solitaire.

All of these repetitive acts where you put your mind on hold, are highly addictive and can become disorders in their own right. They are very difficult to correct. If you find yourself doing anything over and over in a mind numbing way, stop that act and begin exercising. The way to keep a repetitive exercise from becoming a substitute for an obsessive compulsive reaction is to think of something therapeutic as you exercise. I continue to pace, but I now use it as a form of exercise, I am very animated when I do so, and I make sure I am using my mind to solve my problems at the same time.

If you are unable to stay focused for any reason then I suggest you try using the energy of bipolar disorder mania toward a creative endeavor. It can be very rewarding when we use this energy to create something which is uniquely ours. We manic depressives have at our disposal a heightened awareness that for some of us borders on genus. But this potential goes for naught if we do not direct it toward a creative or therapeutic end. Although our creative endeavors and exercise are in many ways comforting and afford us temporary relief, they are not ultimately therapeutic, in that these efforts do not incorporate a plan for the end of depression. Therefore our main focus must remain the cognitive self-help program which does have the potential to end the depressive response, or at least allow us to be more in control.

At some time during an episode of bipolar disorder mania you will hit a wall, that point where all your efforts seem ill conceived and there is no hope that you will ever succeed in your efforts to overcome the depressive response or mania. Traditionally this is the point where you allow your despair and suicidal thoughts to take control and eventually drive you into a deep depressed state. This 'wall' may be the result of real life circumstances where the projects inspired during mania fail or it may be the result of mental and emotional exhaustion. Now, when you hit this emotional wall, you have the tools necessary to combat the emotional downward spiral.

You use Emotional Thought Stopping so that your negative thoughts, your disparaging thoughts, and your suicidal thoughts are not reinforced. The object of your anger is no longer others or events that have happened to you, the object of your anger is now the depressive response itself. Turn the anger into an exuberance knowing that you are able to take control of your emotions. Use the negative energy of your despair to ward off the temptation to stay in a negative space. It does work!

THIS IS IMPORTANT!
The concepts of this exercise, emotional thought stopping, and the cognitive- behavioral therapeutic model are not based on will power or mind over matter, where you are forced to combat the depressive response based on an inner strength that you do not at present possess. These concepts are based on the relationship and interaction of the conscious mind and the biological unconscious mind. When the negative thoughts and suicidal thoughts are not allowed to remain in the conscious mind these thoughts are not reinforced. The unconscious mind will begin to present them to the conscious less often as there is less and less emotion driving them into the conscious. As this happens the conscious mind begins to have more control over our emotions and the depressive response begins to lift. This is a biological process, facilitated by our cognitive imput. In other words, we think and do those things which influence the biological unconscious mind to react in ways which are beneficial to us.

BIPOLAR DISORDER, REMAIN GROUNDED

Acting on solutions to problems inspired during bipolar disorder maina has more than once made me ask myself, "how could an intelligent, educated man such as myself, have done such an unbelievably stupid thing?" This has led to financial ruin twice in my life and over time my resume now reads as if it were a road map used in lieu of toilet paper in the outhouse of life. Making large purchases or major life decisions based on concepts inspired during bipolar disorder mania has led to divorce, financial ruin, and vocational disaster for many people.

At the time, during an episode, the answers to life's problems seem so crystal clear, so logical, and workable. But the mania causes us to form unrealistic expectations, and many times our actions or expenditures are based on assumptions and conclusions which are actually ill conceived. They are motivated more by our attempt to relieve the pain, then they are based on our intellect. At other times our concepts inspired during mania actually are brilliant and workable, but the impending depressive response causes failure of the project as the lack of energy, the impaired memory, hopelessness, the inability to concentrate, etc. all make it highly unlikely the project will succeed.

The consequence of acting on impulses inspired during bipolar disorder mania can take on a much more ominous and sinister tone if one allows mania free reign of the mind. Some of the most heinous crimes throughout the history of mankind have been the result of 'solutions' to the problems of life conceived while under the influence of a mind controlled by mania. One would hope that you and I have enough control so that we do not justify doing harm to others under the guise of an ill conceived belief that it is ok because it is for the common good of all those who are wronged. On the other hand, you and I are not above justifying acts which in the end, do us harm.

BIPOLAR DISORDER AND MANIA CONCLUSION:

1. Focusing on a therapeutic endeavor keeps our mind from being consumed by our problems and our pain. Staying grounded by reviewing and rethinking everything which transpired during an episode of bipolar disorder mania helps us to identify that which is ill conceived and possibly harmful to us and to others. By giving direction and purpose to the episode we do not allow mania free reign of our mind and thereby we moderate the 'highs'.

2. Using Emotional Thought Stopping insures that we do not reinforce our anger and our despair. Also suicidal thoughts are not reinforced by using Emotional Thought Stopping, thereby moderating the 'lows'. Emotional Thought Stopping is a powerful tool when used to protect us from our disparaging and angry thoughts, and helps when we hit that 'wall' during an episode so that we do not crash into a possible major depressive episode.

3. While these tools will help temper the highs and lows of this cycle so that we do not find ourselves in a crisis situation as often as before, probably the most important aspect of this therapeutic equation is the cognitive- behavioral therapeutic model. Cognitive-behavioral therapy helps us to identify those thoughts and behaviors which are maladaptive and dysfunctional and which set us up for further depressive episodes. We change how we think, what we think, and how we react in certain situations in life, so that we find ourselves in situations and mind sets that cause the depressive response much less often than before. We are then less likely to trigger our disparaging, angry, and suicidal thoughts, allowing our conscious mind more control over our emotions, thereby reversing the biological unconscious depressive response.

BOOKS:

Simon, Julian L.GOOD MOOD, The New Psychology of Overcoming Depress--n,Open Court, 1993 (paperback)
Burns, David D. Feeling Good: The New Mood Therapy, New York:Morrow, 1980; also in paperback.
Burns, David D. The Feeling Good Handbook,1989
Burns, David D. The Ten Steps to Self-Esteem,1993
Ellis, Albert, and Robert A. Harper. A New Guide to Rational Living.North Hollywood:Wilshire;revised 1977 edition.
Also by Ellis, Albert. How to Stubbornly Refuse to Make Yourself Miserable About Anything -- Yes, Anything!
Beck,Aaron T. Love Is Never Enough: How Couples Can Overcome Misunderstandings, Resolve Conflicts,
and Solve Relationship Problems Through Cognitive Therapy. New York: Harper & Row, 1988.
Beck, J. Cognitive Therapy: Basics and Beyond. New York: Guilford, 1995.
Emery, Gary, A New Beginning.New York,Simon and Schuster, 1981.
Lewinsohn, Munoz, Youngren, and Zeiss, Control Your Depression1992

Bipolar Disorder Links to Helpful Web Sites.

• Bipolar Disorder, About.com
• Pendulum Bipolar Disorder Resources
• Mental Health Net bipolar disorder resources
• Dr. Ivan's Bipolar Disorder (Manic Depression) page.
• A Bipolar Disorder Guide for Patients and Families
• Bipolar Disorder WWW links

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