even if we only take people with bipolar disorder: how the hell can they go on so few number of hours a night with their brain being manic but not simply breaking down?
Just wanted to tune in on this from anecdotal experience:
My last ever (non-iatrogenic) hypomanic episode started unprompted. But I was terrified of falling back into depression again! My solution was to try to avoid the depression by extending my hypomania as long as possible.
How did I do this? By intentionally not sleeping and by drinking more coffee (essentially doing the opposite of whatever the internet said stabilized hypomanic patients). I had a strong intuition that this would work. (I also had a strong intuition that the depression later would be worse, but I figured I’d cross that bridge when I came to it, even though my depression was life-threatening, because I was cognitively impaired by my episode.)
It worked! It was my longest and most intense (most euphoric and erratic, but least productive) hypomanic episode, and I don’t think this is fully explained by it being later in the progression of my illness.
Did I “not simply break down?” I wouldn’t say that’s the case, even after iirc less than a week of hypomania and ~3 hours of sleep per night.
I would say that the urge to extend my episode was already an obvious thinking error from the hypomania.
I had the worst depression I had ever experienced immediately afterwards, and I would be willing to bet that, within-subject, longer hypomanic episodes in bipolar II patients are followed by more severe (more symptomatic/disabling, not necessarily longer) depressive episodes.
Generally, I would say that bipolar I patients with months-long mania are also “breaking down.” Mania is severely disruptive. Manic patients are constantly making thinking mistakes (inappropriate risks resulting in long-term disability/losses/hospitalizations, delusions, hallucinations). They’re also not happy all the time—a lot of mania and hypomania presents with severe anger and irritability! I would consider this a breakdown. I can’t say how much of the breaking down is because of the sleep deprivation vs. the other factors of the illness.
(Fortunately, I’ve been episode-free for 8 years now, save for a couple of days of hypomanic symptoms on the days I was given new anxiety medications that didn’t work out.)
Just wanted to tune in on this from anecdotal experience:
My last ever (non-iatrogenic) hypomanic episode started unprompted. But I was terrified of falling back into depression again! My solution was to try to avoid the depression by extending my hypomania as long as possible.
How did I do this? By intentionally not sleeping and by drinking more coffee (essentially doing the opposite of whatever the internet said stabilized hypomanic patients). I had a strong intuition that this would work. (I also had a strong intuition that the depression later would be worse, but I figured I’d cross that bridge when I came to it, even though my depression was life-threatening, because I was cognitively impaired by my episode.)
It worked! It was my longest and most intense (most euphoric and erratic, but least productive) hypomanic episode, and I don’t think this is fully explained by it being later in the progression of my illness.
Did I “not simply break down?” I wouldn’t say that’s the case, even after iirc less than a week of hypomania and ~3 hours of sleep per night.
I would say that the urge to extend my episode was already an obvious thinking error from the hypomania.
I had the worst depression I had ever experienced immediately afterwards, and I would be willing to bet that, within-subject, longer hypomanic episodes in bipolar II patients are followed by more severe (more symptomatic/disabling, not necessarily longer) depressive episodes.
Generally, I would say that bipolar I patients with months-long mania are also “breaking down.” Mania is severely disruptive. Manic patients are constantly making thinking mistakes (inappropriate risks resulting in long-term disability/losses/hospitalizations, delusions, hallucinations). They’re also not happy all the time—a lot of mania and hypomania presents with severe anger and irritability! I would consider this a breakdown. I can’t say how much of the breaking down is because of the sleep deprivation vs. the other factors of the illness.
(Fortunately, I’ve been episode-free for 8 years now, save for a couple of days of hypomanic symptoms on the days I was given new anxiety medications that didn’t work out.)