Things that Cause Mania

4 Apr 09 | Coping

I am of the opinion that generally the mood swings happen on their own, following a pattern or cycle based on your body's internal rhythms.

I also think that these cycles is fairly resistant to external events or triggers. So the stuff happening in your life is generally not the cause for your mood swings. Rather your mood swings are what are causing your life to go wonky.

Here's the fine print though.

If your mood swings are already tending towards being manic, it is possible for external events to quickly increase the intensity of the mania so that instead of sliding into mania, you suddenly are manic. From your point of view, it will appear that these events caused your mania, even though this is not strictly true.

And there are a few external events that really do seem to trigger a manic episode. But as far as I can tell, very few. Ok, one so far.

Anyway, here are the things that seem to trigger mania or make it worse.

Crowds and Gatherings

I've realised that I tend to become more hyperactive whenever I am in crowds, particularly noisy crowds, and especially noisy crowds of friends.

A typical scenario is that I am fairly alright / calm (i.e. normal to slightly manic)  when I am driving to a social gathering or to a pub. Then I enter into noise and activity and I suddenly become loud and hyper, and I want to be in on every conversation, and I start showing all the signs of mania. I can either come across as lively or as loud and overbearing.

Even though I know what is happening, I cannot control the changes in my behaviour, and my feeling is that I am mirroring (and magnifying) the activity that is happening around me.

The only way to calm down is to find a quiet place and stay there for a few to ten minutes. Then I can reemerge a little better prepared for all the activity around me.

Social gatherings of friends or family seem to cause the worse effects, enough so that I occasionally dread entering the home of, for example, a cousin holding a Christmas party. Public parties or crowds seem to cause a less intense reaction, but are still potential problems.

It doesn't have to start immediately. If the party starts quietly and then becomes more boisterous, like at a wedding, I will also mirror the increase in energy and become manic.

Loud Music / Noise

This is related to being in crowds. I don't need specific noise, just the increasing hum and background noise in any crowd of people can cause a reaction in me.

However, music itself can increase my manic level. I don't think this is a trigger into mania and it won't do anything if I'm fairly normal. Rather, if I'm already tending to be manic, the loud upbeat music can make me more hyperactive, louder, and generally more manic. Donna Summer's music particularly does it for me.

Lack of Sleep

While the other items on the list tend to making an existing tendency to mania worse, not getting enough sleep actually seems to be the only true trigger for  mania.

So if I stay up until 2 am, and then get up at 6 am to organise to go to work, the chances are high that I will start to show some of the manic symptoms that day. If I do it again the following night, I probably will trigger a manic episode.

This sounds like a good thing, but...

I'm actually not getting enough sleep in those days. The manic high tends to fight with my tendency to want to fall asleep, and I get flashes of light headedness all day. And since I'm not exactly at my best, I'm not able to control the mania or all of the energy my mania brings, so I am often not particularly productive and can be quick to anger.

And because I need sleep, there is a tendency to fall asleep on an afternoon, screwing up my schedule and triggering a depression episode.

Bottom line. Triggering a manic episode can be done, but because of the inherent problems, it is best kept as an emergency measure.

Oh, and it doesn't work to bring me out of a depression episode either. So it's useless for the one thing I would really like it to do.

That said, if you are an athlete, if can be handy in increasing physical stamina the following day. Check out my Bipolar Disorder and Sports page.

Changes in Schedule

Any changes in my regular schedule tends to destabilise me. I usually end up depressed, but it's generally not so straightforward - I usually have a day or two of being mildly manic before plunging into the depression episode - which is why this event is listed here.

Perhaps the worst of all the changes in my regular schedule are long weekends and holiday times. There is a reason why bipolar people tend not to like holiday seasons - the combination of disrupted regular schedules and dealing with crowds and noise and hubbub that we cannot escape from without looking antisocial or thankless, create havoc with our moods.

And the effects can last for weeks afterwards. I find it a very high price to pay for trying to appear to be the dutiful son / cousin / in-law, etc.

I like Christmas, but I've stopped trying to do the family gathering thing. I go to work on long weekends like Easter to preserve my weekly schedule. Yes, I can take vacations, but they are carefully prepared for months in advance so they don't cause the disruptive effect.

It turns out that getting the flu or getting sick acts like a change in schedule. Staying home to deal with the illness, or running around to doctors is no different to having a long weekend or visiting family. If you are bipolar, and you get sick, assume that you will be either manic or depressed on the days after you get well and plan how to get your life back on track after the illness.

Stress

I run against conventional thinking on mood swings here, but as far as I can tell stress is NOT a trigger for either mania or depression.

I will explain in more detail in the future, but my experience has been that the mood swings usually start first, and the symptoms of the mood swings then work to increase your stress levels, rather than stress creating the mood swings.

I think the doctors have cause and effect back to front.

Caffeine

My experience is that because caffeine is a stimulant, drinking coffee while manic can make the mania worse, but that caffeine itself is not a trigger for mania.

In addition, some caffeine related actions such as tapping your foot, or drumming your fingers, or feeling as if your heart is racing mimic those of mania, even if you are not manic. Check how many cups of coffee you have drunk recently and check for other symptoms of mania to verify if you are manic or not.

Because caffeine is so good at mimicking mania, I do recommend that you cut your intake of coffee to no more than 2-3 cups per day (super huge cups is cheating). I also recommend that if you know that you are indeed manic at the moment, you should cut down your coffee intake to one cup per day. You'll live.

Caffeine includes coffee, caffeinated soft drinks, chocolate, and for some people, tea. One cup means one cup of any of these, or equivalent.

Disclosure: I am a coffee aficionado. Used to drink 16 cups of coffee per day at one point. Now down to two or three.

Symptoms, Not Triggers

The following are not triggers for mania, but rather symptoms of mania. If you are experiencing any of the following, they are not the cause of the mania - rather you have not being paying attention to the onset of your manic symptoms. Until now.

1» People who do stupid things that anger you may well be doing stupid things. But they are NOT causing your extreme anger. You are manic.

Deal with your mania first before dealing with the person. Unless it is the telephone or cable company - in which case being manic and shouting can indeed be handy in solving the problem.

2» A surprise is just a surprise. If your partner happens to inform that the quiet dinner now includes four other people, it's okay. If someone plays an April Fool's joke on you, revenge isn't required. If someone grabs you from behind, you don't need to elbow them in the stomach.

My experience is that if I am manic and plans and actions don't go the way I think they should be going, I tend to immediately get angry. Or violent. It doesn't even matter if the change is a good one, my immediate reaction is anger and "no thanks." This reaction is not being caused by other people, it is sign of mania. Deal with your reactions and your mania first.

3» Your partner is NOT trying to break up your relationship. No matter how rational you think you are being, or how reasonable your cause of anger, the mostly likely reason for thinking your relationship should be terminated is your mania.

Bipolar people tend to drop relationships for no clear reason whatsoever. And then regret it afterwards. So we have a higher hurdle to jump before deciding a relationship should be over. Do not break up your relationship - rather check to see if you are manic.

4» That is not the coolest car / boat / house / computer deal. You do not need a 3 week vacation time share on Easter Island. You are not the best person to become the chairman of your condominium management committee. Don't be excited by the options opening to you.

Ok, you might be the best person to chair the management committee. But danger, danger. If you are excited by choices like these, then you are probably manic and not in any position to make rational decisions, even if you feel as if you are. Do not say yes to committing your money or your time when you are like this. Spur of the moment choices are not good choices.

If it is a good deal, it will be a good deal three weeks from now. Wait. Get a second opinion. And deal with your mania in the meantime.