Watch out for Summer Mania- Or if You’re Down Under- Winter Mania!

Watch Out for Summer Mania

Let’s plan ahead for mood swings triggered by the sun in our eyes and late, bright sky evenings Summer’s sunshine is a notorious trigger for mania. To prevent summertime mania, keep taking your medication—even when it feels like you don’t need to.

Preventing mania takes a lot of self-awareness, especially in summer when it’s so nice to feel good again. Have you ever noticed that your mood is better in the summer? This makes sense when you consider that mood swings often run in cycles, depending on the natural light where you live.

“For many people who have bipolar disorder, too much light exposure can provoke mania and too little can lead to depression,” says John Preston, MD, coauthor of our book and psychopharmacology expert in the treatment of bipolar disorder who teaches at Alliant International University, Sacramento Campus. “This is why hospitalizations for mania peak in the summer, and for depression [they peak] in the late fall.

“It’s certainly tempting to spend more time outside in the summer, so one must make a focused effort to keep bright light exposure at about the same amount of time per day, year round,” adds Dr. Preston. “What matters is the amount of bright light entering the eye, which has been shown to have a significant impact on brain chemistry…so sunglasses help.”

Even though it helps to read a reasonable explanation about why we often get manic in the summer, it’s still hard to take it seriously. After all, summer feels so good. However, this good feeling is often the result of mania and therefore has to be monitored carefully. Mania is so tricky—it can sneak up on you in just a few hours. Before you know it, you’re staying up all night for a week (at the expense Follow Julie Fast’s Blogof your job and relationships), working on a project you just know will change the world. Meanwhile, everyone around you is asking, “What the heck is wrong with you? Have you lost your mind?”

There are two types of mania, depending on whether you have bipolar I or bipolar II. The basic difference between the two diagnoses is that people with bipolar I experience full-blown mania, while those with bipolar II experience hypomania. If not detected early, full-blown mania gets out of hand very quickly and often requires hospitalization. Hypomanic mood swings, on the other hand, can go undetected for years, which is why people with bipolar II are often diagnosed much later in life than are those with bipolar I.

The number one sign of full-blown mania is when you sleep a lot less, but have plenty of energy. It’s especially important that you look for mania symptoms if you have a winter depression that suddenly lifts once there is more light outdoors. People with hypomania have more difficulty recognizing the signs they’re manic than do those with full-blown mania. Rapid speech and over socializing are often signs of hypomania. The more you know about your particular form of mania, the easier it will be to notice the first signs that you need help. I know: It stinks to have to get help when you’re finally feeling good again, but mania is simply the flip side of depression and needs to be treated just as aggressively.

The best defense against summer mania is prevention. This, of course, starts with medications. But as you may already know, while medications are invaluable at preventing the large mood swings, many people with bipolar disorder still have to deal with the smaller manias that slip through the medications and create disasters. There is also the problem of going off medications because you start to feel good and your brain tells you you’re not really sick anymore. This is really easy to do when it’s so nice and sunny outside. You often feel so much better and you think: It’s finally over! No more bipolar disorder for me! I’m cured!

And yet, just as depression creates false feelings of despair and hopelessness, mania creates the false feelings that we are fine and no longer need medications. The treatment window for mania is much less than that for depression, which is why mania must be prevented, instead of merely treated when it happens to show up. If you have even one thought that you “don’t really need those medications any more,” this is a time to talk with your doctor.

I don’t know about you, but I find it a real burden to have to look for mania every time I start to feel good. It’s the reality of this disorder however, and I’ve found there are certain things I say, think, and do every single time I begin to get manic. By learning these signs, writing them down, and then teaching my friends and family to recognize them as well, I’ve finally gotten more control over my mania. You can do the same. Here is a short version of my list:

What I say:

• Do you think I’m manic?
• I don’t think I’m manic!
• This weather is so fantastic!
• I am so happy to finally feel better!
• I’m not manic. I’m just not depressed.
• Leave me alone! You just want to ruin my fun!
• I’m normal! This is the real me!

What I think:

• Am I finally better?
• Is this the real me?
• Was the diagnosis wrong?

What I do:

• Go out every night.
• Drink a lot more.
• Talk a lot faster.
• Join groups or take classes.
• Meet new people like crazy.
• Stop eating good food, or hardly eat at all. Sleep less.

I always try to evaluate myself as soon as I have the first thought that I might be manic. You can do the same.

Ask yourself the following questions: Have I stopped my medications because I feel better? Have I conveniently decided not to tell anyone about doing this? Am I sleeping a lot less than normal and not feeling tired at all? Am I more irritated with people than usual? Am I using drugs or alcohol without thinking of what they’re doing to my brain? Was I depressed in the winter and now feel a lot better? Are things getting done really easily? Have I stopped eating or taking care of the people in my life? Have I become selfish? Has anyone expressed concern about my behavior? If you answer yes to any one of these questions, it may be time to talk with your doctor about mania.

I’ve had too many summer manic disasters and they took a lot of recovery time. I don’t want to go through it again this summer. If you’re well enough to read this article and see mild signs of mania, you have time to prevent a serious mood swing that could land you in the hospital, or cause you to make decisions you will regret. Do now what it takes to protect yourself, your family, your finances, and your life. You will thank me (and especially yourself) when the next winter comes around.

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Watch out for these summer mania triggers

• Extra sunshine (such as staying at a park or beach all day)
• Weddings (including your own)
• Any travel at all, especially to a new time zone
• Graduation (for yourself or your children)
• Visitors to your home
• July 4 (this is often a boisterous, all-day event with a lot of stimulation)
• Summer activities such as water sports or baseball
• Summer break from school

Printed as “Watch Out for Summer Mania”, Summer 2005 Bp Magazine.