The “Little Things” Before Symptoms

Author: Matthew Palmieri


It’s the Little Things.

Big shifts in our lives can derail us from progress in managing bipolar, but it’s crucial we often look at the little things as well that may cause our symptoms to take over.

Are we ignoring the need to eat food or so overwhelmed by the idea that we start skipping meals?

Do we have a sudden laissez-faire fair attitude towards our sleep routine?

Does music, that film, or a piece of art speak to us on an entirely different and new level?

These may be signs you are nearing symptoms that could put you in crisis mode.

Triggers Left Unnoticed

It’s important for us to notice the triggers we have a more acute sensitivity towards that others may not see as an issue.

I am often at my most vulnerable when I don’t have a support system by my side to point out that I’m behaving strangely or that the stress in my life may cause me to say or do things from a brain having an episode.

Bipolar is often considered an invisible illness. There ultimately is no cure, so it’s our responsibility to pay attention and hold ourselves accountable to the little catalysts that cause the symptoms of a manic, hypomanic, depressed or mixed episode.

By the time I was lucky enough to accept I would have to deal with this illness forever, I finally developed a deeper understanding of the signs that a storm may be brewing.

Goal Oriented Behavior

A big reason it took me a long time to accept my diagnosis was that my manic phases were fueled by an unrelenting desire to achieve and focus on goal related activity. What our work culture values can be an unfortunate danger for someone who suffers from bipolar.

During one particular episode, from the outside looking in, it seemed like I was pursuing a desired future at a heightened state. What felt normal was in fact a symptom of work related stress left unmanaged.

In situations like this, pursuing high level achievements can become conflated with a grandiose level of priority and importance, leading to an eventual disconnection with reality.

While the events often feel isolated, over the course of a decade from my diagnosis, I can now see the pattern.

I thought, if only I could connect these things together it would all come together for my life and I could reach that next level. Unknowingly, that became my mantra during my last full blown manic episode.

By the time I was stable, my behaviors, from what I could even recall, felt like they came from someone else. Like I was temporarily abducted.

As a result, shame and confusion naturally led me to yet another deep depressive phase. How could I have let this happen again?

When I’m in a bout of mania, the ideas are unrelenting, but also intoxicating. The connections are all there. All I have to do is harness.

Routine and normalcy get in the way.

A new endeavor, a new investment opportunity — these can be symptoms of an exhausted and overworked mind, desperate to prove itself in an often ruthless and unreceptive world.

In other words, some basic necessities — food, work, and sleep become secondary to the drive to discover, advance, and show value to the world.

When the fog lifts and these ‘creative’ efforts begin to fall short of any logic or reason, it becomes justification for isolation. The world just doesn’t get it. My peers don’t understand me. And yet again, I’ve screwed up.

By the time I’ve clawed my way out of depression, my bipolar becomes a symptom that says, ‘I will prove myself at all costs.’

And the price tag is high. Manic spending, selfish and destructive behaviors can cause irrevocable damage to the progress I can often make in an euthymic state.

I often picture myself after full blown manic episodes surrounded by debris.

How did I get here again?

It may have been an unwillingness to observe how the little things accumulated and turned into one big conflagration.

Did someone cut me off in traffic? Was I mistreated while ordering my coffee?

What feels like not big a deal can turn into agitation. Agitation can lead to problems with your boss or co-workers which can lead to eventual depression.

Being Vigilant

The good news is we can learn about these triggers. An awareness of an oncoming manic episode can be curbed by adhering to a schedule, a routine that fosters creative impulses but within the confines of a regulated sleep schedule, consistency in medication, and talking to your support system about what you feel you are teetering on the brink of.

The truth is milestones will happen. You will achieve your goals. You can get through these phases by pumping the breaks and being honest with yourself about your limitations, your irritability, and the complexity of your mood shifts, which is vital for any sustained accomplishment.

You may not change the drive to complete goal oriented activity, but you can say, what is my holistic treatment plan? Am I sticking to an exercise routine? Am I talking to my therapist about the warning signs?

Most importantly, am I being honest with myself?

Treat the onset of an episode as an opportunity to play detective.

Are you extra irritated?

Is the world that much more of an ‘opportunity’?

Walk it off, write it down, meditate on it, and remember, you aren’t alone.

Just do your best to pay attention.

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