Several weeks ago I saw my psychiatrist and admitted that I had been indulging in activities that I knew were bad for me, because they supported or nurtured my hypomania. My psychiatrist reminded me that I was playing with fire (since for my, hypomania can be a gateway to dysphoric mania, which is risky as well as awful) and that he was not about to prescribe me more or different medication when there were things I could do to help myself.
In fact, it’s a little more complicated than that, because self-care to prevent or address hypomania is often actually about choosing not to do things, and choosing not to do things that feel like fun is really hard. A little hypomania is a slippery thing; like a little alcohol, it disinhibits just enough to make bad ideas seem good. Alcohol in the system helps the person at the bar push the inevitable hangover to the back of her mind and order the extra drink she swore she wouldn’t have. Likewise, hypomanic brain chemistry encourages the bipolar to forget about the risk of mania or the possibility of crashing into a deep depression. Once I let myself behave in ways which enhance my hypomania, I want to engage in more and more behaviours and amplify my mood. Hypomania isn’t always a happy state, yet even though I hate being bipolar irritable, I find it hard not to do stuff that makes my temper worse and worse. In fact, I find that anything that causes emotional arousal – anxiety, excitement or irritability – has the potential to send me higher and higher.
Hypomania is life lived at speed. I start to find it difficult to just watch TV or a film without tweeting along or checking emails. I find it difficult to focus on one social media platform without compulsively flipping between Twitter accounts and then over to Facebook and back again. I rush from one social engagement to another, unwilling to ever say no to an invitation, even when I already have other things planned that day. I want to listen to music with a strong beat and a melodic hook and I want to dance whenever I can. If I exercise, I’m not interested in slow, thoughtful forms like yoga or Pilates; I’m all about running or aerobics. I am quick to panic, quick to anger, and very quick to engage in conflict. To address hypomania I have to make a concerted effort to slow myself down, to choose not to do a second thing when I am already engaged in the first, to choose not to respond to the irritating tweet or the rude person in the bus queue. I have to force myself to say thanks, but no thanks, when I already have something to do on a given day. Because I want to be physically on the move, relaxation and meditation exercises are a useful way to force me to be still and quiet. But I’m not just choosing to sit on the floor or lie on the bed. The drive to be on the go is so great that every minute I am having to choose not to move, recommitting to the decision over and over again as my hypomania pushes from within, encouraging me to move, to fidget, to get to my feet.
While I have been thinking about the power of not doing, I came across a tweet which said something like “Doing nothing is easy, but acting requires courage.” That may be true for most people, but for bipolars in a hypomanic state, it’s the very opposite. Going along with hypomanic feeling of elation or irritation is all too easy. It’s choosing to resist the lure, go against the grain, choosing not to act that requires bravery. And that decision has to be made multiple times, every day. It’s hard work, and it often feels unfair. But if I want to get some control back over my life, I need to not just do something, but sit there.
