What you think when you’re manic

When you’re manic you hand things like this to your psychiatrist. I did so five years past.

A printout of a webpage you made that explains, clearly, how your brain has been infected by a computer program you wrote years earlier.

Your mania is so infectious that you’re sitting on the floor of a nurse’s office having convinced her to happily print off hundreds of pages of documentation to support your claims.

She thinks this is absolutely necessary.

You convinced her it was.

When you hand it to your psychiatrist, she doesn’t read it. She just makes a note in your chart that says:

..the patient continued to have some overtly psychotic ideation and presented me with many notes which confirmed his psychotic thought process..

Mania sometimes includes psychosis.

Your brain is infected with a computer program?—These things make perfect sense to you when you’re psychotic.

Then, later, they seem irrelevant. I am currently completely disinterested in the possibility that a program has infected my brain. To be rational, I must accept the possibility that one has. But the truth or falseness of this idea is of zero interest to me at the present time. Maybe a program has infected my brain; maybe it hasn’t. It makes no difference to me anymore.

“Bipolar Insights” by Dr. Jay


A funny, forward-thinking, insightful presentation on bipolar

I found this presentation on bipolar disorder by Dr. Jay Carter, a psychologist, which I think is unusually good.

If you have time and interest, watch the video. If not, please consider skimming my notes, below, which quote and summarize some of Dr. Carter’s ideas.


  • “It’s a medical problem rather than a psychological problem.” In 2008, five prominent psychiatrists met and “decided that bipolar disorder was not a psychiatric illness. It is a medical problem.”
  • Lack of sleep (as in mania) would cause irritability and delusion in anyone. “Any one of us in this auditorium who didn’t sleep for a week would be hearing voices and seeing things that weren’t there.” “The worst symptoms aren’t really symptoms of bipolar disorder. They’re symptoms of..sleep deprivation.”
  • “If you want to know what it’s like to be manic, drink seven cups or take some amphetamines.”
  • “The person’s prefrontal lobe goes out, so they don’t see the consequences of their actions. They’re thinking six or seven times faster than normal—so they’re brilliant—don’t argue with them, they’ll win. But they don’t really see the consequences of what they’re doing. They don’t see the bigger picture of things. They don’t have insight, foresight, or hindsight.”
  • “If it’s bipolar disorder, it’s not’s agitation.” You need to know this in case a doctor tries to give you anti-anxiety drugs for your agitation. What will help reduce agitation in a bipolar patient is a mood stabilizer.
  • “Many decades ago we thought that diabetes was a mental health problem. People would have low blood sugar and they’d be acting weird, they’d be acting drunk, they would have fits.” Employers didn’t want to hire anyone who had fits. “Now we know different, and now we have insulin which manages the diabetes very well and the person can lead a normal life. With bipolar disorder, we’re not there yet. First of all, we’re still calling it a mental health problem—a psychiatric problem—and it’s not, it’s a physical problem. And the person might act a little funny or weird, but they’re not funny or weird. That’s just how they’re acting at the moment, just like a person with diabetes. The problem is, for most people with bipolar disorder, the medication doesn’t make everything ok. With insulin, sometimes that insulin’s going to make everything ok. With bipolar disorder..for some people it might, but for most people all it does is manage” the illness.
  • “Anyone who would say to somebody, ‘Well if you just took your medication, everything would be ok’..that’s not really true.”
  • You see three things from a manic person “that really turn people off”: ego, arrogance, and entitlement. (As opposed to esteem, confidence, and purpose.) “With bipolar disorder, through, you cannot tell what a person’s personality is like when you see ego, arrogance, and entitlement. You’re always going to see that. That’s a symptom of bipolar disorder.”
  • His daughter has bipolar disorder. “She’s the most gentle, compassionate, empathetic, and quiet person you’d ever meet. But when she’s manic: ego, arrogance, and entitlement. .. They can’t help it.”
  • The suicide rate for bipolar is 1/5. Counting the percentage of undiagnosed, it’s more like 1/4. Most suicides happen in the first two years of onset of the disorder.
  • 1.2–3% of any population has bipolar disorder. “There are some evolutionary psychologists who think that mother nature is up to something. Because there really are people who think faster than you do. They get impatient with you because you don’t talk fast enough. There are people that don’t require as much sleep as you do. And they can be very sharp and witty and charismatic.” This might be mother nature experimenting with the next evolution of humanity.
  • “A person can be perfectly sane and totally psychologically healthy..and still have a manic or depressive episode. It has nothing to do with a person’s psychological fitness.”
  • “3.4% of families have bipolar disorder. And those are the exact words I mean. I don’t mean an individual has bipolar disorder. It’s genetic—how much more family can you get than that? If you’re in the family and you didn’t get it, you’re just lucky. I don’t know of any families where one person has bipolar disorder [where] it doesn’t affect the whole rest of the family. And that’s the secret to treatment of bipolar disorder. You treat the family. Not the individual. The individual has the poorest outcome, whereas if you treat the family, that has the best outcome.”
  • People with bipolar disorder self-medicate more (60%) than people with any other mental health disorder: cocaine for depression and alcohol for mania.

Those are some of his more interesting points, to me, from the first 20 minutes of the presentation. The whole video is an hour and 40 minutes long, but if you have bipolar in your family, I recommend watching it.

Winter mania post-mortem


What the heck went wrong?

Photo by Reji via under CC BY-NC-ND

From something like October 2015 to February 2016 I was manic. I talked with my mom just now and we both believe this was my worst manic episode yet. For five or six months I slept two hours a night. I became paranoid. I was extremely combative, irritable, destructive with my words—especially to my mom. I have apologized to her several times, but I just apologized one last time, now that my momentary sanity is confirmed by my doctors and her, too.

I want to make a few notes (to myself) about what exactly happened, in the distant hope that if and when I’m manic again I will have learned from this experience and can somehow reach for reason from within the whirlpool of craziness that is psychotic mania.

What happened?

  • What caused it? Perhaps nothing. Nothing need precipitate a bipolar mood episode—that’s part of their nature. But my mom and I were planning and executing an interstate move during this mania, and I have heard another incidence of a similar situation precipitating a mania for a bipolar YouTuber, and others say that stressful situations preceded their manias in some cases. Bottom line is I don’t know and I may never know.
  • I hate that I’m quoting this guy. I hate a lot of what he has to say. I disagree with anyone who argues against treating bipolar symptoms with medicine, as this treatment keeps people alive even if it’s not addressing the (contested, unknown) root causes of bipolar disorder. But he says some things in this video that I couldn’t agree with more. And these things played into the core of my “psychotic” mania this winter: “There is one part of the healing that, while not so disturbing for the bipolar person, can be extremely disturbing for our families. So disturbing in fact that it could motivate them to want you medicated for your entire life. And what is this horrific thing that needs to be stopped at all costs? The truth.” He goes on to talk about family secrets and how the bipolar person is revealing these secrets, talking about them openly to catalyze healing, which almost no one else in the family wants to do. While I find that YouTuber extremely annoying, I find this particular point he makes to be right on. One of the early events in this recent, worst mania of mine was that at lunch with my mother and grandmother my mother said that at least we weren’t the kind of family who talked about each other behind our backs and I said, “Oh. Yes. We. Are.” We totally are! The fact that our family talks about each other behind our backs is indisputable, and I can’t stand for anyone—even my own mother—to say the opposite. I don’t think looking at bipolar disorder through a family systems model is a complete and total way of looking at the disorder, but it clearly has a family systems component, and this annoying YouTuber has hit the nail on the head: the identified patient is declared sick by their family when they go against the system of family secrets. When they tell the truths that we just don’t tell. This is part of what happened between me and my family—especially me and my Mom—during this winter mania. I was compelled by my mania (trust me, it’s not a choice) to say all kinds of things that are absolutely true but we do not say in our family. As Heather with the Foster House says, “Bipolar people tend to see right through bullshit.” Yeah. Like it or not, that’s true. Our inability to not throw your bullshit right in your face during a manic episode is a major component of our disability. No one ever accused a bipolar person of having too many social graces. And the more you tell the truth, the more everyone else thinks you need to go to the doctor. That’s what they’re trying to fix: this broken fire hydrant spewing the truth.
  • Also, I wasn’t taking an antipsychotic at the start of this mania or during it, and I hadn’t been for over a year. An antipsychotic has been useful for me in the past in preventing and dampening bipolar mania. I’m back on an antipsychotic now. It seems to be an essential drug for me.

What did this mania consist of?

  • Hardly any sleep for months and months and months. I didn’t want to sleep. I viewed sleep as the enemy, I hated the thought of getting into my bed. When I did go to sleep, I woke up two hours later, fully rested. But almost six months of this had to be incredibly damaging to my peace of mind and body.
  • “Pressured speech.” That’s how the symptom is listed formally in diagnostic charts. It’s more like nonstop speech in which I espouse every supposedly rock-solid idea in my head, not letting my mother (in this case) get a word in edgewise, and I feel free to express my rawest opinions about my conversation partner, things any normally socialized person would think but not say. Extremely hurtful things. Which I felt were necessary for me to say. As Heather from the Foster House perfectly expresses it: “I’m happy..and you’re worthless.” When I repeated that quote to my mom, she said yep, that’s exactly what it felt like. Fuck.
  • Paranoia. The feeling that people were watching me, that around every corner in the apartment was some human or monster or ghost. Fear to leave my room to go to the kitchen to get food. If I imagined it, it was real. Reduced ability to test the reality likelihood of my thoughts (psychosis). I became convinced my dad was imminently going to take legal action against me for money I owed him. I thought my mom hated me so much she wanted to kill me — I closed and locked my door while in the apartment with her. I was terrified she would kill me in the night or attack me with the intention of doing so.
  • Spending spree. Laptop. Tablet. Phone. Movies. Apps. As the venerable Heather from Foster House says, “When you think it, you do it. The tell-tale sign of mania is there’s no gap..there’s no gap from thinking and doing. It’s”
  • Tons of writing. I wrote like 600 pages in November. I’m hardly aware of having done this. I guess I was doing that when I wasn’t sleeping.

Anyway, it’s late, and I’m going to bed to try to maintain a regular sleep pattern—which is something that is useful for bipolar people to do. Mania causes lack of sleep, but lack of sleep causes mania, too! I am back on a much more regular sleep schedule and in a much more regular state of consciousness, and it doesn’t hurt creativity, in my opinion. I’m not manic now and I still write every day and maintain quality. It’s not necessary to be out of your mind manic to write something good. I try to follow Gustave Flaubert’s suggestion to:

Be regular and orderly in your life, so that you may be violent and original in your work.