With thanks to Chuck Tingle.
Let’s talk about mental health for a minute. Specifically, my experiences, because I can’t really talk about anyone else’s with any authority. I have rapid cycling type II bipolar disorder. It’s a mood disorder. Sometimes I’m up, sometimes I’m down, and when I’m up I’m really up and when I’m down I’m really down. Like the Grand Old Duke of York, right? I have a relatively mild case. I’m high-functioning; never lost a job1 or been locked up or anything because of it. Hell, I didn’t get a diagnosis until I was 30, having developed (not entirely healthy) coping mechanisms of my own.
Everyone has good and bad days, though. What makes mine special?
Maybe 80% of the time, I’m normal. Beige. Happy days, sad days, but nothing outwith the blah blah blah of neurotypical life. The rest of the time is where things get interesting. Anticonvulsants help — before I started taking lamotrigine, normal states were 65-70% at best, and the incidences of abnormal mood could last much longer. I still cycle fairly rapidly, though.
Hypomania is “a sustained state of elevated or irritable mood” which (unlike full mania) is not linked to psychosis or disassociation from reality.
I tend to only flag specifically elevated states as hypo states, because otherwise the term is useless to me. In my particular case, it’s signified by being smarter, thinking faster, needing less sleep, being much more productive, and massive egotism. And yeah, I can get quite pissed off with people who aren’t thinking ten thousand brilliant thoughts a second. ‘Um…’ and ‘Ah…’ are mortal sins. Beyond that, a hypo also does away with my issues of being around people,2 a state that otherwise requires a couple of pints.
Depression is, well, depression. A state of constant low mood, low self-esteem3, insomnia, anhedonia, a general thrum of self-hatred, and causeless suicidal ideation.
Downswings are by far more common than other states. On the other hand, the drugs mitigate them — I haven’t been actually suicidal in a little under ten years at this point, which is a plus. And they’re the only states that get triggered by external stimuli as well as my own buggered brain chemistry. Unlike a hypo, depression leaves me massively anti-social and dulls cognitive faculties; it feels like my thoughts are swimming in treacle.
Many abnormal mood states don’t fit neatly into one little box. Clinicians who study bipolar II generally term these ‘mixed moods’, which is as much use as a chocolate ashtray. I haven’t properly tried to codify the effects of divergent states of mind before, but I might as well give it a shot to illustrate what can be going on sometimes.
Sometimes my brain misfires; a state that’s much like a hypo but without the focus. The thoughts come thick and fast, but they crash into one another and spark off like a Star Trek control panel. Restlessness, a need to do something but an inability to focus on one thing for more than a couple of minutes, massive irritability/anger, constantly being distracted, and a buggered sense of time — five minutes feels like an hour, while the next hour can pass in seconds.
An actual mixed mood blends the fast thinking of the hypo with the negative attitude and anhedonia of depression. Racing thoughts but focusing on everything wrong: mistakes I made twenty years ago, people I’ve hurt, every little thing about my flesh-sack that pisses me off, why the world is a terrible place, and how I am going to die alone and unloved. I get paranoid, and obsess over details and plot out what might happen if I do something — but of course I’m deliberately modelling the worst possible outcome, so I catastrophise like nobody’s business. Insomnia, irritability, and aggression. It’s like depression, but sped up to a hundred miles an hour.
Finally, there’s flow — a state common to people in knowledge-based or artistic professions. It’s what happens when the focus and clarity (and increased smarts) of a hypo show up without the racing thoughts. The world is easier to deal with, everything makes sense, and every problem has a solution. It’s the rarest state, but it’s how I write between three and six thousand words after and eight-hour day, or replace two hundred lines of buggy code with thirty that just work.
I have no idea why I’m writing this or making it public, but it might help people figure out what the fuck is going on in my head on any given day.
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