Lithium has held its own over the last five years. Many of the other medications that I’ve tried have come and gone leaving a trail of side effects in their wake. But not Lithium. It’s been a quiet workhorse relentlessly plodding away to keep my manic tendencies at bay. Lithium is in a class of medications called antimanics. It works by decreasing abnormal activity in the brain.
Lithium is prescribed to treat and prevent episodes of mania. Mania is a frenzied, abnormally excited mood state that impacts people with bipolar disorder. Bipolar disorder formerly called manic-depressive disorder is a disease that may cause episodes of depression, episodes of mania, and other abnormal mood states. When in a manic episode people often behave in ways that are very destructive and hurtful to themselves and those they love.
I’ve tried many other medications besides Lithium, but I always come back to the realization that for me Lithium works best and at a very low dose. I’m thankful that I’ve found a tool to help me manage my mood swings. People respond to medications very differently. What works for me may not work for you.You may have to try a few medications and change them around at different times depending on how your life is going – but hang in there - you will find a solution and you will get stable.
This is the last section of a 3 part video series of Kay Redfield Jamison, Ph.D. Professor of Psychiatry Co-Director, Johns Hopkins, Mood Disorders Center John Hopkins School of Medicine talking about ”Mood Disorders and Artistic Creativity”.
Question:
My friend just quit his job and is spending all his money. He stopped taking his medication. He has a plan to start a new international business but he doesn’t know the first thing about it. He isn’t worried about anything though. I’m sure that he is having a manic episode. Does a manic person believe that they are making good decisions and functioning well when they are manic? My friend is destroying his life and no one can talk him out of it. Is there anything that I can do or say to get through to him?
Your friend probably won’t be able to listen to you while he is manic. He’s feeling really good right now and doesn’t want those feelings to stop. He’s most likely convinced that he’s on the right path, is perfectly well, and is behaving and thinking correctly .
Feeling pretty cool and together is one of hallmark features of early mania for many people. In a manic state you feel so sharp and acute. You’re sure that you know everything and you are convinced that you can do anything. You have creative and grandiose ideas like starting a new business and/or maybe saving the world. Mania, especially euphoric mania is very addictive. It’s hard to give up once your enmeshed in it. Don’t bother arguing with your friend. I guarantee that he’ll have 10 counter agruments for every point you make.
Until he’s ready to help himself there’s not much you can do. Some people have to hit bottom pretty hard before they take their Bipolar Disorder seriously. It sounds like he will continue on his manic journey until it winds down on its own, or until he gets the help that he needs to stop the episode. Good luck to you and your friend.
Euphoric mania feels wonderful. At the beginning, it is exhilarating. You have lots of confidence. You can talk your way around, out of, and into any situation. You are on top of the world, in fact, you feel like you own and control the world. It is addictive. Your mind is sharp, your perceptions spot on. Now the mania is moving into the next level and your judgment is diminished to the point that you will do some pretty stupid things and after the episode is over, you will look back, cringe, and think “I can’t believe I did that.” You might lose your family, friends, your health, all your money, and/or your career. But you’re manic and you don’t care, you can’t care. Your prefrontal lobes aren’t working, and you can not process information related to the consequences of your actions. When you are manic you absolutely can not see what you are doing to yourself or to those around you.
Bipolar Disorder makes it difficult to regulate your emotions. “Normal” people tend to react “normally” (within a range of behaviors considered normal) to events in predictable ways. People with bipolar disorder often overreact to events that are triggers for them. For example, imagine going to a show that you really loved and coming out of the theatre elated and happy. Those are normal, appropriate, emotions related to an event that you just experienced. Now take the theatre event away, but imagine experiencing those same feelings (magnified 100 times), and that is euphoric mania. There is no rhyme or reason for the feelings. The overblown emotions are caused by the illness. Euphoric mania is wonderful at the beginning but it can turn dark and scary as it progresses towards one of the inevitable outcomes – the crash.
It was well know even in ancient times, that mania can manifest in several ways or change during an episode. During Hippocrates time, scholars observed, described, and recorded different mental states including mania. Aretaeus of Cappadocia, a famous Greek physician, lived in Alexandria in the first century AD and wrote the following: “Some patients with mania are cheerful – they laugh, play, dance day and night, and stroll through the market, sometimes with a garland on their head, as if they had won a game: these patients do not worry their relatives. But others fly into a rage…” In my experience, I am happy and confident, kind and loving to those who support my mania and allow me to revel in my euphoria. I’m the opposite with anyone who tries to thwart me or tell me that I am not myself, and heaven help them if they try to tell me that I need help.
There is a wide range of emotions and behaviors that typify any kind of mania and they include at least one but usually several of the following:
- euphoric mood (excessively happy but may become angry or irritable)
- high self-esteem
- increased psychomotor activity
- optimism
- exuberant energy
- increased goal-directed activity
- diminished need to sleep
- distractibility
- talkativeness
- racing thoughts
- grandiosity
- disinhibition
- impaired insight
- financial extravagance
- increased risk-taking
- high libido
- sexual promiscuity
Here is how Julia A. Fast an author about Bipolar Disorder describes specific symptoms associated with Euphoric Mania.
“An extreme desire for:
- sex with no thoughts of the consequences
- spending with no thought of the cost
- travel – no matter who you leave behind
- creative projects where you stay up all night with an ‘amazing idea!’
- quick results- the manic person finds ‘slow’ people very annoying
- talking with strangers
People with bi-polar euphoric mania also experience:
- less need for sleep with no tiredness the next day
- excessive ideas that just feel so wonderful they have to tell everyone about them!
- a general sense of well being that is hard to describe unless you have experienced it!
- inability to let others talk.”
A friend asked me about treatments for the manic phase of Bipolar Disorder? I found myself stumbling to answer because there are a variety of medications out there but not all of them work well for everyone. What works for one person may not work for another, and that’s why taking time to work with your doctor to find the right medication or combination of medications is critical. I’ve found a nice combination that is working well for me at the moment, but it has taken me more than five years and lots of trail and error to get to this point. The frustrating thing is that medications can work well for a while and then stop working. When they are working they help function and enjoy life more fully. When they fail to work, it just means that you need to go in and make adjustments to your medications with your doctor, and keep adjusting until you get back on track.
In some of the most recent studies, researchers have found that Lithium is highly effective for preventing relapses in mania. Combining Lithium with Depakote is also effective for many people. If someone is in an acute phase of mania, a combination of one of both of these mood stabilizers along with an antipsychotic can be effective in reducing symptoms quickly.
If you are experiencing a manic episode whether you feel euphoric and happy, or pressured, irritable, and short tempered, please contact your psychiatrist right away and get help. Manic episodes may feel good at the beginning but they usually end badly, and can destroy your finances, your health, and your relationships.
References:
Bipolar Disorders, Mixed States, Rapid Cycling and Atypical Forms, 2005, Edited by: Andreas Marnero, Frederick Goodwin,Cambridge University Press.
Julie A. Fast’s Bipolar Happens Blog
Lithium has held its own over the last five years. Many of the other medications that I’ve tried have come and gone leaving a trail of side effects in their wake. But not Lithium. It’s been a quiet workhorse relentlessly plodding away to keep my manic tendencies at bay. Lithium is in a class of medications called antimanics. It works by decreasing abnormal activity in the brain.
Recent Comments