Category Archives: mania

Subthreshold (Hypo)Mania As A Precursor To Bipolar Disorder

The new Bipolar Spectrum.

“There is growing clinical and epidemiologic evidence that major mood disorders form a spectrum from major depressive disorder to pure mania.”

Subthreshold mania can be seen as a precursor to Bipolar Disorder, subthreshold Bipolar Disorder is defined as “recurrent hypomania without a major depressive episode or with fewer symptoms than required for threshold hypomania” (Merikangas et al, 2007). Bipolar disorder should be suspected if prominent behavior problems, anxiety, and substance abuse were present during childhood in someone with recurrent depression and a family history of affective disorders. For example, the prevalence of anxiety in children may be prominent in early-onset Bipolar Disorder and may predate affective symptoms. Children with a parent with Bipolar Disorder are more likely to be at risk for early-onset Bipolar Disorder, along with anxiety, depression and other disorders.

Studies have shown that offspring of people with Bipolar Disorder are at high risk for developing Bipolar Disorder because they have a parent with the disorder and generally have significantly higher rates of subthreshold mania or hypomania (13.3% versus 1.2%) or what is known as bipolar disorder not otherwise specified (BP-NOS); manic, mixed, or hypomanic episodes (9.2% versus 0.8%); major depressive episodes (32.0% versus 14.9%); and anxiety disorders (39.9% versus 21.8%) than offspring of parents without the disorder. Subthreshold episodes of mania or hypomania (those that resemble but do not meet the full requirements for bipolar disorder in terms of duration) were the best predictor of later manic episodes.

It should be noted that the American Journal of Psychiatry has a multitude of studies that suggest that people who suffer from Major Depressive Disorder (MDD) have a higher susceptibility to Bipolar Disorder and that subthreshold hypomanic symptoms that are found in people suffering from MDD should be taken into consideration when diagnosing. Placing these people instead on a bipolar spectrum, hence altering their treatment plan by incorporating a mood stabiliser which can also assist with the present MDD.

 

 

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The Femme Fatale Mania.

Hypomania for me can feel a bit like a power trip, my eyes are glazed with excitement, red dress, red lipstick, legs for days and very provoking eyes – on numerous occasions I’ve been told that I have very intense eyes or ‘sex eyes’. It contrasts a lot to my usual black clothing and asocial nature. After these conquests I usually have to take ownership for the wreckage I’ve left behind, the awareness that I’ve hurt people. I like to fade into the shadows and hang on the outskirts of groups, but hypomania makes me the centre, colourful and full of too much life. I also tend to have a severe need to change and little patience in achieving it, sometimes resulting in more piercings or hair colour/cut changes.

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Anyone else think that Taylor Swift’s song ‘Shake It Off’ resonates with aspects of mania?

I’m not one to listen to mainstream music unless I’m working-out, but for some reason this song just hit some cords when I was hypomanic.

♪♪ “I stay out too late. Got nothing in my brain. That’s what people say…I go on too many dates…Can’t stop, won’t stop moving…It’s like I got this music, in my mind, saying, “It’s gonna be alright…I’m lightning on my feet…I’m dancing on my own, I make the moves up as I go…”♪♪

The song reminds me of a combination of ‘innocent’ and ‘femme fatale’ stages of my hypomania. The differences between hypomania and normality are the fact that I wouldn’t make the same decisions if I had been at my normal baseline.

“I go on too many dates”: At these times I get the ‘come hither’ air about me, usually getting exactly what I want from that person, using myself provocatively to achieve my ends. Manic women can appear extremely alluring when they are experiencing the ‘must have’ mentality in regard to sex, the airs of confidence and self-indulgence in pleasure. At the time it seems like the best possible idea, so excitable and care free.  I always look back on those times of complete confidence with disbelief, seeing how misguided and delusional I was at the time, yet how you are incapable of realisng that it was a bad idea until much later. A lot of people say that you ‘knowingly’ carry out your actions, I disagree, I believe my judgement becomes extremely clouded, my perception of normal has been shot out of a window.

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The song ‘whore’ by ‘In This Moment’ also has some pretty stirring lyrics:
♪♪“I’m the girl you’re thinking about
The one thing you can’t live without
Yeah, I’m the girl you’ve been waiting for
I’ll have you down on your knees
I’ll have you begging for more” ♪♪

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Mania Of The Past Through The Lens Of The Present.

You can’t in any whole capacity understand the mania of the past through the lens of the present. What was originally termed ‘mania’ in the past currently exhibits little resemblance to the ‘mania’ experienced by people with bipolar disorder. Mania has always existed as a form of madness, in contemporary psychiatry ‘mania’ signifies as an episode or as a pole on the affective spectrum. There is a strong need to transform the image of madness, re-framing mental illness as a positive, at least the hypomanic edge that it correlates with. When you’re truly manic the repercussions of your actions never gain much thought, there is a certain amount of ‘glamour’ attached to mania, a sheen that creates easy oblivious actions which have little association to your ‘normal’ train of thought.

The bliss of oblivion. Many people would prefer to be the manic sprite instead of the depressive shade that haunts their homes when darkness encroaches. There are no romantic notions towards depression for those who experience it recurrently; depression is a beast that slowly eats away all the feelings inside, leaving you numb and vulnerable. The clinical terms used to categorise bipolar disorder act like an oversized ad-campaign sign on a main road that reads ‘manic-depressive’. It feels like an endless resistance to the labels, the labels becoming the straightjacket of mental illness, restrictive and confining.

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