Reader Question: Bipolar hypomania, dancing and endorphins!

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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