In order to manage being bipolar, you have to be able to monitor your moods. Of course that is easier said than done. After all, what does monitoring mean? What do you look for?
Let’s just start with mania. Here’s how to know if you are becoming manic.
I’m assuming you’ve read the Being Manic or Hypomanic page. That page has the symptoms divided into Physical, Verbal, Anger / Overreaction, and Mental Distraction signs (there’s a “Mania is Wonderful” section too, but it’s not as helpful in figuring out the onset of mania).
1» In the early stages of being manic, I’ve found the Physical signs to be the most useful signs. They tend to show up early and since they are physical effects, you don’t have to worry if they you are making them up. There aren’t any “it’s all in your mind” concerns – and if you have been recently diagnosed, this matters a lot.
The most obvious signs will be (1) Tense shoulders or neck and / or a painful jaw, (2) tapping your feet or fingers, (3) a tightness in your chess and a sensation that your heart is racing, (4) your handwriting becomes difficult or scrappier than usual, particularly signing your name.
You’ll also find that you have across the board coordination problems with your hands – you’ll be irritated that grasping things or picking up things or placing things down are harder to do than usual.
If you are exercising, you may find that everything is easier than usual, often to your bemusement – “How can I possibly have shaved two minutes off my twenty minute run – that’s not possible.”
Here’s the fun part. Even though these signs are easy to notice, it may actually take you a while to notice them. That’s because the average person doesn’t really pay attention to tapping feet or anything else. After all, your body is just supposed to work.
What you have to learn is to cultivate an ongoing awareness of your body. Practice doing a check every 5 minutes or so with the questions – “Are my back muscles tense? Am I tapping my feet? Does my heart feel like it is racing? Does my jaw hurt? Does my chest feel tight?”
In the early stages of learning to monitor your physical signs, you may not realise that you are tense. That’s because you have gotten so used to having your back muscles tied up in knots that you feel this is normal. Really.
One way around this is to take an antimanic, and monitor your body. Once you experience the difference between relaxed muscles and tense muscles, you’ll be able to tell the difference. You could try a massage too, but it’s not clear that it will show the difference, because we will tense up immediately afterwards – getting back to normal, as it were.
If you are having problems knowing if your muscles are tense, consider monitoring for pain rather than tension. You might not be able to tell if your muscles are very tense, but you will know if they hurt – particularly if your jaw is hurting (or if you are really tense, your teeth hurt). The only drawback with this method is that by the time you register painful muscles, you are already pretty manic.
2» As you are checking on the physical symptoms, you might also want to also check for the Anger / Overreaction signs. This process is slightly different from checking for physical signs and takes a little longer to learn.
Checking for Anger / Overreaction actually requires you to do two checks – you need to (1) keep an ongoing check on what is happening around you or to you, and (2) keep a check on how you are acting and what you are doing. If how you are acting doesn’t match how you should be acting given the circumstances, you are probably manic.
This kind of checking is like having an extra pair of eyes sitting in the back of your head that continuously monitors what you are actually doing and determines if it is appropriate behaviour.
For this to work, you need a benchmark of what normal actions are. Careful here – if you have been recently diagnosed, assume that what you think is normal probably isn’t that normal.
I’d recommend that you observe how other people react in similar circumstances and develop a catalogue of “normal” reactions so you can use them as your benchmark.
This sounds hard, but it isn’t. We all do this; that’s where “normal societal behaviour” – such as not picking your nose in public or joining the back of a queue – comes from. What you are doing is simply becoming aware of something you already do automatically. Here are three examples.
Example 1: You are in a long line at the store. There are three people behind the counter and only one is actively serving customers. So you decide that this is nonsense and it is your duty to fix the situation by stepping forward to criticise (loudly and angrily) the three workers, and the manager when s/he shows up. Except it is not really your job to do these things and you might notice that nobody else is doing it. How you are feeling and acting is out of proportion to the situation.
Example 2: You tell your partner that you would like to leave the house at 8:15 am. At 8:12 am you realise you partner will not be ready for 8:15 and you get angry and mention how irresponsible your partner is and bring up issues going back for the last three years. Your partner would have been ready for 8:17 am, which in practical terms makes no difference, but as far as you are concerned, that would have been just too late. You are overreacting to the situation – and your partner’s perception of acceptable is probably closer to being normal than yours.
Example 3: You are studying. What you are reading is new and interesting stuff, but one or two pages into the paper you realise that you are becoming excited and making connections between what you are reading and topics in completely different subject areas. What you are doing might be great, but you are also going seriously off topic. Your object is to read the paper in front of you, not develop a new theory. If you can’t read the paper, something is wrong with how you are acting.
If all else fails, assume that you should be acting the same way as everyone around you. If you are standing out in a crowd, you are probably manic.
Yes, it takes a while for you to learn to do all this checking for physical symptoms and anger / overreaction symptoms. It requires practice – do not assume that in one week you will suddenly be a pro at this. You’ll simply stress yourself out when you aren’t.
Yes, you will forget to do the checking if you are involved in your work or chatting with people, or excited, or distracted in any other manner. That’s ok. When you remember, make the physical and emotional checks and remind yourself that you need to do it again in the next 5 minutes.
Do not feel guilty if you feel you are doing a poor job of checking for symptoms. This is not a race or a test. You do not have to be brilliant nor do you have to be perfect. We have enough stress without adding on more. Doing a half decent job is okay.
After a while (measured in weeks to months), checking your body for physical signs of mania becomes pretty automatic. The anger / overreaction symptoms of mania are generally harder to catch – even now I usually catch them only after I have been shouting for a while.
3» The other way of monitoring for manic signs is to have someone tell you if you are behaving manic. You’d wonder how they know, but my experience is that people who are close to you can be surprisingly accurate in gauging your moods – I had an aunt who could tell how depressed I was by just hearing me say hello on the telephone.
There are a few rules to this though. People who are in denial about your condition usually can’t tell – or won’t provide you with accurate feedback.
People who are very close to you – parents, partners, children, siblings – are most likely to be in denial. But you really have to take it person by person. My partner, my brother, and my housemate can accurately tell me how manic I am. My mother, um, I know she means well and loves me, but I won’t ask her to give me feedback.
Close friends who know you are bipolar and have taken it in stride can be very good in telling you if you are manic. These are the people I rely on to ensure I stay on the straight and narrow when I’m out in public. My partner used to do the same thing when we went out together.
Other people will tend to see the Verbal and Anger / Overreaction signs first. If you are asking them to help you monitor whether you are getting manic, ask them to tell you if you are (1) Talking louder or faster or becoming less easy to understand, (2) starting to quarrel with either them or other people over petty things, (3) starting to overreact – becoming excessively happy or excited or enthusiastic – compared to what the situation calls for, (4) drinking too much, or spending too much money, or chatting up too many people or otherwise being too excessive in your behaviour.
When you ask them to help monitor you for mania, print out the list of mania symptoms and show it to them, so they have an idea of the full range of behaviours to look out for.
And here is the hard part and a critical rule. When the people you ask to help monitor your moods tell you that you are acting manic, you have to trust them completely. One of the problems of being manic is that we feel too good to believe that anything is wrong. And so we don’t want to pay attention if people say things are going wrong for us. But you have to.
I have been told to stop arguing, stop talking so loudly, calm down, stop acting so irresponsibly, don’t buy junk food, stop drinking, hand over the car keys, that I am being rude, stop trying to monopolise conversations, stop cutting off people who are talking, that I don’t need another computer or a new camera, that I am too excited and boisterous.
It’s all a version of “stop and rein in your mania.”
When this happens, I do whatever my family / friends say. I often would like to argue, but my assumption has to be that I am sufficiently manic that my perception of events and my decisions may be wrong. So I trust the people who I have asked to monitor me and I do what they say.
Gosh, this is a lot of checking, isn’t it. And you have to do it all the time. Isn’t this a lot of work. You might be thinking this sounds complicated and do you really need to do all this. The answer is “Oh yes you do.”
If you can’t tell what your mood is, you are going to do some awfully stupid things you will regret later. We cannot ever forget that we are bipolar.