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Reader Question: Bipolar hypomania, dancing and endorphins!

Tuesday, September 22nd, 2009

I just received the following question from Alixana on how a person can know if an exciting and endorphin producing event can cause mania.  Here is the question and my long answer- I try to keep it short, but nothing with bipolar disorder is short!

Dear Julie,

Thank you for being so honest about your battle with bipolar disorder, and for chronicling your experiences so that other sufferers can learn from them.I stumbled upon your blog while googling for a link between endorphins and hypomania. So far, nothing I’ve read suggests that an endorphin rush can trigger off a hypomanic episode, but I’m worried that there might be a possible connection between the two.

 To cut a long story short, I took up social dancing a few months ago – at least two studies have shown that it benefits patients with depression, so I thought it’d help with bipolar as well (I have Bipolar II). I gradually realised that after social dancing, my thoughts would start racing, I’d be unable to sleep, and I’d be slightly more irritable in the couple of days following, even though I’m usually on cloud 9 immediately after a session. I didn’t take much notice of it and attributed it to other causes. However, I quickly became hypomanic at a dance party recently without even realising it. When I crashed back down to earth later, the realisation of how terribly and how uncharacteristically I’d behaved sent me straight into a depressive episode.

 I’m trying to figure out if there’s a direct link between endorphins (from dancing) and hypomania. Or is there another explanation for all this, so that I can still continue to dance. I’m seeing my psychiatrist soon and will ask him about this, but I’d really appreciate it if you could drop me an e-mail if you have any thoughts on this.

 Many thanks,

Alixana

**

 Hello Alixana,

I always say that bipolar disorder is a classic chicken or the egg scenario.  What comes first? Mania and then a euphoric endorphin rush or a situation that causes happiness and then a mania response?

The answer is complicated. Here are some questions:

- Is it possible you were already slightly manic (hypomanic) which is why dancing was appealing?
- What is the weather like where you live?  Is it still sunny?
- What effects does the dancing have on your sleep?
- Did you meet anyone at the dance you were attracted to?

That is one scenario as all of the above can lead to manic type symptoms.

Almost always, sleep is the most important question when it comes to mania. If you have a wonderful time dancing and come home with your mind swirling-  which is very common for anyone in a fun and stimulating situation- are you able to go to sleep afterwards?  If not, this is a big precursor to more hypomania if you’re already slightly manic. 

I love karaoke, but if I stay out past 11PM, there is simply no way I will sleep so I either go home early or know I will take my sleep meds.  Also, in the past when I would get fantastic news such as a book deal, I would have about three hours to celebrate and then I went straight to depression from the stress. Stress can be something wonderful like dancing- it doesn’t have to be a negative thing. The bipolar brain often can’t differentiate.

In terms of your going to a dancing event and feeling embarrassed, I bet that the others there simply thought you were a fun person! We judge ourselves so harshly- well, depression judges us so harshly.

There is no question you are rapid cycling- going up and down  between what you call the endorphins and then the depression simply wears you out.

I would say that in terms of the chicken and the egg, all of the above is going on with you.  It’s easy to confuse endorphins – a quick rush of hormones that cause a sense of well being- and the over the top feeling of euphoria that comes with hypomania.  There is a difference. Endorphins don’t usually make you do something dumb! They are short lived- hypomania tends to persist after the event.

It’s great you’re going to see your doctor-  I am sure you will discuss sleep as that is the biggest issue here.  I use my treatment plan (the Health Cards) to track all of my moods so that I can see the triggers and know what came first- the mania or the event! I was always confused before I started writing down all of my symptoms.

Bipolar disorder is an extremely complicated illness- simply because our brains and its hormones are so complicated.  There is absolutely no reason you have to stop dancing- but you will have to learn to manage the dancing so that you can stay stable. It’s completely possible.

Thank you for writing,

Julie

Here is the reply from Alixana- it’s so interesting!

Hi Julie,

 

Thanks so much for your answer. After reading and re-reading what you wrote, I think I’ve figured out what happened. Basically, I’d not been sleeping for more than 48 hours before the party, and prior to that, sleep has been elusive. So I guess I was already well on my way to hypomania, and the party just had enough triggers to tip me over the edge. It’s reassuring to know that dancing per se might not be the problem. Like you mentioned, I must learn how to handle it so that it doesn’t cause any trouble in future.

 

Thank you so much – your reply gave me a great deal of reassurance.

 

Much thanks,

Alixana

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Posted in Mania, Reader Questions | 2 Comments »

Reader Question: Work and Bipolar Mania

Sunday, September 6th, 2009

Thanks to everyone for your reader comments and questions-  here is one regarding work and bipolar mania.

Hi Julie,

I have been have episodes where I experience mania, wanting to buy stuff limited need to sleep and the inability to concentrate, focus finish an assigned task. This is a real problem at work as I work at a law firm and my hours are billable. I seem to have the episodes the week before and during my menstrual cycle. Do you know hormonal changes can effect my bi polar cycle/episodes? This is a real problem and I have so much anxiety because my Manager has approached me about my job performance and has sad some threatening thing to me regarding my position. I am so anxious and afraid it has a negative effect on my performance, which does not help the situation at all.

BDA Angel

 

Hi,

Mood swings affect work performance. That’s a fact of bipolar disorder. It’s one of the reasons I asked the poll question about whether a person with bipolar disorder would hire someone with bipolar disorder! So you are not alone. But… we can also be the greatest at work once we manage the illness because we can be more creative and self aware than most. It’s so essential that we all have a plan to manage mania when it comes to work. I know that I’m extremely creative when I’m hypomanic- but I can also be a bit over the top. I’ve learned to harness the hypomania while making sure I don’t make the mistakes I made in the past. It can be done, but it takes a lot of practice.

 Menstrual cycles can be very, very influential on mood swings. I suggest that you get a mood swing chart and start charting your moods daily- then you will know your pattern and can prepare for the mania days in advance. I would also discuss meds with an experienced health care professional- bipolar disoder medications can be used at certain times of the month and then stopped when they are not needed. This takes monitoring by a HCP though.  I would also be very careful if you’re taking birth control pills- they can affect your moods as well- sometimes in a good way and sometimes adversely! I know my signs of mania to the most miniscule change in mood- but it can still sneak up on me and I’ve used my treatment plan for nine years solid! It gets a lot better once you have a system.

If the mania is affecting your work- it’s essential that you start something now- I sound like a school marm here- but I can’t say enough about the importance of a plan we use every day! We need our work- but we also need to make sure the bipolar doesn’t affect our work adversely.

 Why does it have to be so hard for us! The facts are that it is harder. We have to be more vigilant. But…. once we learn to manage the illness better, we can be stable in relationships and work. I’m working full time now- and that is a dream come true. You can keep your job and even work more effectively once you chart those moods and start a plan! Take Charge of Bipolar Disorder has a mood swing chart in the back- and example of how I use mine.

And one final comment- what is the first sign you have that the mania is showing up when your cycle changes? Write that down and put it in your desk- and on your fridge- you can also tell the people in your life- when you recongnize the sign- you can say to yourself,”It’s time to put my plan into effect so that I don’t let this mood swing adversely affect my work!” I was not able to work at all in the mid ninties. I now have my own business and work daily.  It’s great that you are working as well!

 julie

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Posted in Mania, Reader Questions | 3 Comments »

Bipolar Disorder II and Psychosis

Wednesday, July 29th, 2009

I just received the following question from Kimbriel,

Julie, I thought that people w/ Bipolar II don’t get psychotic? Or did you have a psychotic depression?

Hi Kimbriel,

Believe it or not, I’m writing an article on psychosis right now. People with bipolar II can defintely get psychotic. I’ve had psychotic symptoms since age 19. Mine are always with depression – as it’s rare for someone with bipolar II to have psychosis with hypomania.

The difference is in intensity- people with bipolar I have full blown psychosis – usually with mania. In fact, 70% of people with full blown mania have full blown psychosis at the same time. This is when most people have to go to the hopsital and often have to be committed by a family member!

I will let everyone know when the psychosis article is ready. It’s for healthyplace.com.

 Thanks for writing!

Julie

PS: Here is an explanation of the difference between bipolar i and bipolar II. If you are new to bipolar disorder terms, I think you will find this helpful.

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Posted in Reader Questions, psychosis | 2 Comments »

Reader Question: Bipolar Disorder and Natural Treatments

Monday, July 20th, 2009

Julie,

I love your book on Loving Someone with Bipolar Disorder.  I am bipolar and my partner and I have been working with it for HOURS since I got out of the hospital (a true hellhole) a few days ago.  I see that you work with a naturopath, but I see no mention of natural remedies that I have found VERY useful, such as Rescue Remedy and other floral remedies, essential oils, homeopathy, and special vitamin and mineral supplements.  Any reason why?

Hi Satina, Thank you for your kind comments.

I’m so glad the book is helping your relationship. That book was born from a lot of pain, but it has helped so many people.I mention natural remedies in all of my other books- Loving Someone with Bipolar Disorder was meant more for the partner than the person with the illness, so direct bipolar disorder treatment was not explored fully.

I mention Rescue Remedy in a lot of my work, especially in Bipolar Happens, as well as herbs and other naturally based supplements. But… I do have to stress that they are best used with medications and a solid treatment plan – and that we have to be really careful as certain supplements can interact with meds or even exacerbate symptoms. I have to be super careful with all supplements, especially those that affect serotonin!

I also feel that yoga and especially yoga breathing is a great tool for bipolar disorder management. I have a yoga mat in my office and do a short session when the anxiety gets bad. I listen to the yoga classes straight from Itunes.

I remember when my former partner Ivan came home from the hospital. He had been through SO much. He was manic and psychotic for over a month. I’m sorry your experience in the hosptial was a bad one- Ivan had a better experience as he really was too ill to manage the illness on his own. It was much easier for me that he was there. I was very scared and had no idea how to help him. I was so happy to have him home, but it certainly took time for him to acclimate back to his old life. He has always used his diet as a way to stay healthy and tried a lot of nasty tasting Chinese herbs!

I often use massage in combination with acupuncture for stress- and see my naturopathic nurse practitioner for my medication needs.  Massage is also a great way to relax.I believe in a combination of western and naturopathic health care. There is a place for both. And I certainly believe that books are an important part of any plan.  (And don’t forget the love of pets!)

One issue is the expense of natural treatments- more insurance plans are waking up and letting people explore their options, but there is still a long way to go. I often trade my skills such as working with an acupuncturist who wants to write a book. 

It helps to get creative. I am so glad your partner is there to help and that you are working together!

Julie

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Posted in Bipolar Treatment Tips, Reader Questions | 5 Comments »

Bipolar Disorder: Relationships and Respect: Reader Question

Sunday, July 19th, 2009

Here is a reader question from my blog on respect in relationships:  

Hey Julie!

Here’s a terrible question.  What if the person who is not treating you with love and respect is your husband of 16 years?  My friends comment on how he treats me.  He’s not a complete ogre – just mostly.  But I’m afraid to address the issues and stand up to him and advocate for what I need.  Any thoughts?

Hi M,

This is not a terrible question AT ALL. It’s essential that we know who exacerbates our mood swings before we can actually do something about it. At least you’re not lying to yourself and that’s admirable.  Here is my advice- the day that you decide you are worth more than the pain- and that you will not longer be treated disrespectfully is the day that you will stand up to him and say-

I love you. But I am no longer willing to allow you to treat me this way. I am changing and doing all that I can to manage my illness. I would like your help and support, but if you feel you can’t give it to me- I will find support in another way. I know who I am and what I want from life.  I choose to have people in my life who respect this. Can we work on this together?

At this point you’re probably saying- Julie, you’re crazy- he will never listen to me! But that is not the point. What matters is that you say it over and over again. I have also found that just being silent helps. If there is no fuel there is no fire. 

My brother is so moody that I literally have no idea what mood he will be in day to day- but I know who I am and how I will react. I am stable and steady around him. He does not control me nor does he have to affect my moods. It took me a long time to realize this. He’s a wonderful man when he’s normal and a mean and yelling man when he’s not. I encourage the normal and don’t react to the meanness- instead I say – This is not ok. I will not be treated this way. I would like to have a good relationship with you, but I won’t put up with this. And then I walk away. Just the other night he got mad at me and yelled about something so stupid! I just sat there until it ended and we went on with the conversation. For most of the time we have a great relationship. He knows full well that he’s unreasonable and he’s not a happy person in many ways- but he’s my brother so I let him be who he is- but our time together is determined by his mood. There are defintely times when I cry and get depressed becuase of his behavior- it’s a typical physiological reaction to our interaction- but it’s  a lot less than it used to be.

It’s hard to do this- but my health is far more important than his anger. He has to deal with that on his own.  You have spent 16 years with your husband. It’s now time to decide if you want to spend 16 more years with a man who treats you disrespectfully. If the answer is yes, then it’s time for you to change and see if he can keep up! :)

Wow, I went off on a tangent, but I hope this helps!  

Julie

PS: I have learned a lot from the book The Four Agreements by Don Miguel Ruiz. My book Loving Someone with Bipolar Disorder is great even when you have the illness. It teaches skills for both partners regarding the illness and the communication problems that can arise!

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Posted in Reader Questions, Relationships | 1 Comment »

Reader Question: Do you have ebooks?

Friday, July 17th, 2009

I just received a question from Michael asking- Do  your books come in ebook format?

Hi Michael,

I started my career with ebooks. My Health Cards Treatment Plan for Bipolar Disorder and my books Tips for Talking with Health Care Professionals and Bipolar Happens are available in ebook form. My coauthor Dr. John Preston has an ebook called The Medical Treatment of Bipolar Disorder.  These books are available on www.bipolarhappens.com. If you scroll to the middle of the page, you will see the ebooks.

My books Loving Someone with Bipolar Disorder, Take Charge of Bipolar Disorder and Get it Done When You’re Depressed were all traditionally published. They are available in ebook form for the Kindle. The Kindle is the new amazon.com hand held electronic book reader. These books are also available in book stores. You can also ask your local mental health organization if they have the books. If they don’t, please let me know how to contact them and I will make sure they have the books for their library.

I’m going to record my bipolarhappens.com ebooks into mp3 files in the next few months. I know that a lot of people prefer to listen to the information, especially when bipolar or the bipolar disorder medications are making it difficult to read. That happend to me when I took lithium!

I love the immediacy with ebooks. Especially when you’re in a crisis or need more information about bipolar disorder as quickly as possible.

There is a pic below of the amazon.com Kindle ebook reader. I have seen one- they are fantastic. I still prefer to hold books, but this is the future. I wonder if it will make it easier for people with bipolar disorder to focus as you can change the size of the font and the look of the screen.

Julie

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Posted in About Julie, Reader Questions | 1 Comment »

Help for bipolar disorder rapid cycling: Answer to reader question

Tuesday, July 14th, 2009

    

A Reader Question for Julie Fast

I just received a comment from Reanna about her rapid cycling that won’t stop. I have been there so I understand! She asked a question about bipolar disorder treatment. Here is the question and my answer:Julie,Reading your posts has been very helpful–thank you! I have been having a horrible time with “mixed episodes” in where I will be up for a few hours, then out of no where, boom, I am down, then up, then down! My dr. ordered blood tests, but any suggestions on coping methods until the tests kick in?Reanna

Hi Reanna, Oh yes, I certainly understand. I have done that rapid cycling. It’s hard to get all of the terms straight with this illness! When you go up and then down- that is rapid cycling. A lot of rapid cycling. We are similar. I can have five or more mood swings a day. I always say it makes me feel like a rag doll someone is throwing up in the air over and over again!A mixed episode (also called dysphoric mania) is not up and down in discrete mood swings- it means that you are depressed and manic at the same time- which is also called dysphoric mania. The best way to describe this is that instead of the rag doll being thrown up and down, it’s begin yanking from all sides. It hurts inside and out!

It’s interesting that you’re getting a blood test- that is always important. It is used to rule out thyroid problems as well as to check the levels of meds you may be on such as checking lithium levels. There is no blood test for bipolar disorder. One day there will be!Also, if you have rapid cycling like this- it’s rarely a good idea for you to take anti depressants- and if you ever do, they absolutely must be with a strong mood stablizer such as Lithium, Tegretol or Depakote- or with an anti psychotic such as Zyprexa, Risperdal or Serequel- you can take them with Lamictal- but Lamictal is often not strong enough to hold back the rapid cycling caused by anti depressants. Also, anti depressants in people with rapid cycling have a chance of causing suicidal episodes. I just went through this with Zoloft! I’m glad you have a doctor to help you with this!

These drugs help- but they can have a lot of side effects- so the right combination at the right dose is essential.As for tips, I really love my Health Cards Treatment Plan, but as you are going up and down so much- I think that Take Charge of Bipolar Disorder is your best choice for now. It has a lot of explanation, but also a lot of tips. It’s an easy read. Remember, even if you just implement a few changes- you can get a lot better.  I use my treatment plan every day- and I stay well enough to have a good life. You can defintely do the same!

Julie

There is more information on rapid cycling and mixed mania in the categories to your right.

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Posted in Rapid Cycling, Reader Questions | 1 Comment »

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