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Episode warning signs. What are yours?


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This has come up kind of tangentially in a few threads lately. So, especially given the importance of trying to squash episodes ASAP, I thought giving it its own thread might be helpful. I know in the past, learning what other people saw as their warning signs definitely helped me figure out some of my own.

I've gotten pretty good at recognizing the early signs of a hypo/mania. When not even seroquel can make me sleep, esp. for two days in a row, that's not good. Then there's the overwhelming desire to shop, increase in goal directed activities that are in no way actually productive, in the context of my life, Sometimes the thing where every single thing anyone else does annous the crap out of me. Including things like, you know, breathing. Then there are a couple of weird ones. First, my subjective sense of time gets all whacked. I'll think maybe 15-20 minutes have passed, when in fact it's been more like an hour. My tolerance for alcohol goes way, way, up. No idea why. And I start getting way more sexual attention than usual, even if I'm not dressing differently, going to different places, hanging with different people, or anything else I've ever been able to figure out.

Depression is harder. Compared to an upswing, the beginning of depression can feel almost restful to me, so I won't recognize what's going on until it's pretty bad. In theory, I know that when I start sleeping insane amounts, can't get interested in anything at all, which translates subjectively to this overwhelming boredom, start socially isolating myself for more than about a week, start going around looking like utter hell, and not caring, and find the notion of just, you know, throwing on some jeans and finding some shoes to go to the grocery store completely overwhelming, things aren't good. I'm still working on translating that theory into practice though.

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Guest Vapourware

I haven't had a hypomania episode in a little while, but I remember when it first started, one of the signs was less need for sleep. I also felt restless all the time - I would have several competing ideas in my head on what I wanted to do but couldn't decide. My speech also tends to come out faster and more pressured; I would feel like I have a lot to say.

Depression, on the other hand...the main warning signs for me are fatigue and apathy. I would feel constantly tired and would want to sleep the day away. I would feel apathetic about everything - socialising, self-care, my life, my hobbies - and it would take an effort to get started on things. When I start feeling that way, I know it's time to contact my healthcare team and get myself sorted out, because my depression can spiral into some nasty places if I'm not careful.

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Mixed episodes are the easiest to feel coming on. Physically - I feel like I need to bite down on tin foil and shake and be completely still at the same time. Mentally - I start feeling really high and excitable.

Manias for me comeon out of nowhere, haven;t had one in a while. Its just like a lightbulb tunrs on and I am crazzzzzeeeeee/

Depression - no real physical symptoms, just a gradual slowing down and failing to give a damn about anything or anyone

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my temper and irritability levels are a warning sign

when I start talking a LOT, a LOT, and interrupting people and making a lot of jokes, well that is bad

sleep loss of course, and paranoid thoughts such as "I left my water bottle on the table at Starbucks while I went into the bathroom. Maybe I should not drink the water because someone put poison or an hallucinogenic in my water..................." that is not a good sign

if I stay in my pajamas all day, and only dress if I have an appointment, and when my thoughts turn suicidal, that is all bad

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These are mild to start.

Circular, repetitive thinking. It's a precursor to racing thoughts. Slight grandiosity, in an angry way if mixed, especially about work. Difficulty falling asleep, staying asleep, and/or early morning waking. The combo of these three no matter how mild means a hypo is brewing. From there, I become distractible. My sense of time changes. I have more energy. Social everything becomes very easy or aggravating. Impulse control diminishes. Etc.

Depression is a sinking feeling in my chest. Everything is pointless. I have no energy. I suck.

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When I'm going towards mania I get irritable and snap at people. I'm usually very quiet. Also, I isolate even more than usual. I have this sense of urgency, that things have to be done "right now". I get aggitated, then paranoid. It's a very uncomfortable feeling.

As far as depression that usually goes along with anxiety for me and I'm real jittery and crying a lot.

Sleep isn't a reliable indicator for me. I am very tired most of the time and when I don't sleep it doesn't seem to correlate with my mood.

I keep to myself a lot and I think it's hard for people around me to recognize that anything is wrong. Once I'm to the point of hallucinations/delusions it's very difficult to convince me that anything is wrong and I think the people around me have the problem.

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Most of the time I don't even realize when I'm having an episode until people start telling me something's not right, but I've noticed a few things.

As far as mania, I lose almost all impulse control, I have random sex, do crazy things I would not normally do. I get big ideas for my future, thinking I can do anything. I spend money I can't really be spending. I have this overwhelming euphoria, I feel like the world is beautiful and everything in it is beautiful, including myself. Everything just feels so nice. I have a lot of trouble getting to sleep, I feel restless, lay there just tensed up. I talk a lot, start talking so fast I "trip" over my words and then lose what I was saying. My thoughts will race, and sometimes they will slow down so much it's like I'm hearing it in slow motion, then it will speed up again.

When I'm getting depressed, I start out irritable, snapping at people, don't want to be around anyone, avoid them. I'm mostly in denial at this point, don't want to believe I'm getting depressed. Then I start to feel like I can't do anything, don't want to do anything, just want to sleep my life away, and then I do, start sleeping for 12 hours, on and off, taking naps all day long. I eat more than usual, it feels like all I can do, so bored and so tired. Always during depression I have suicidal ideations, and if it gets really bad, SI comes in to play.

With both, I can lose touch with reality, depersonalize/derealize, and have strange anxiety attacks.

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I don't know what my warning signs for hypomania are, I just realize one day that I am pretty happy. as for depression, sometimes I don't realize right away what is happening, but then sometimes I go. I get irritable, snap at people, stop showering regularly, stop eating during the day, binging at night, picking my skin more excessively than before, isolating, feeling hopeless and worthless, feeling like a failure, getting gown over the littlest things, etc.

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Clues (for me) for depression: Weeping at everything (often genuinely upsetting things, but over-reacting), sleeping more, exhauston, lack of motivation to run errands, no matter how short, eating more. I start developing agoraphobia, and I feel like I have a constant flu. The faux flu symptom is usually the one that makes me figure out what is going on. If I have a "flu" that isn't that bad, but seems to linger for weeks, that is probably when I should make the call to my p-doc.

Hypo-mania: Stop sleeping, eating less, cleaning, and other frenzied goal directed activities, especially new short-lived hobbies, and feeling physically in overdrive, vibrating with energy. Way too enjoyable, but they often turn into ME.

Mixed Episodes: Irritability, crying angrily, instead of because I am sad (I cry a lot in general; but still not as much as John Boehner). I start feeling like I want to crawl out of my skin, and while I don't SI, I feel like I want to start pulling my skin off, to GET OUT OF MY BODY. Usually, pressured speech and irritable outbursts and rage are the combo that my husband picks up on faster than I do. But I have figured it out once or twice myself.

My doctor described my conversational style during both hypo and mixed episodes, pointing out in both cases I was visibly impatient, just waiting for other person to stop speaking, so I could start talking again.

Mixed episodes suck with such suckitude.

P.S. My migraine is making me type as if I have dyslexia, so there may be egregious errors in this post.

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manic: less sleep, i put makeup on, talk and joke a lot, can't sit still and shake, very impatient. It's like I'm vibrating on the inside. I also interrupt people and talk fast and louder than normal. The life of the party.

Mixed: All that plus major agitation and rages. Negative thinking, sad but energetic.

Depressed: Sooo sad. Like nothing will be able to help me feel better. Sometimes I will start to think about hurting myself or taking drugs to make it all go away. Tired all the time, no motivation to shower or leave the house.

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mania/hypo: lack of sleep, vivid emotioins and feelings, intesity of external stimulii, crying at things, usually in car but sometimes elsewsehere, feeling driven to do things, racing thoughts, eventually feeling too connected to god and feeling in control/like things are 'speaking' to me, patterns, eventually psychosis.

depression; extra sleep, feeling amotivational, feeling blah, having trouble getting tasks done staying organized, trouble organizing thoughst, eventually paranoia and severe anxiety fear about self performance. others.

fun.

Anna

but good to post for self, i'd say.

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I don't know all my own stuff yet, but it's so nice to read others, because I can see some of myself in many of the posts, and I think it will help me to start to be more aware myself.

Just for me, here's what I general notice once I'm sure I'm going up or down:

Up - racing thoughts; feeling sexy and noticing that people notice me; thinking of what I would do *when* I win the lottery (not if, but when, like it's a given that if I just buy a ticket, I'll win), in the past, this has never lasted long, it almost always leads to....

Mixed - there have been times I thought that this was my baseline, that I was just a moody bitch; easy to anger, which becomes rage - like when my loving husband doesn't get what I'm saying (he's the type who, if you say the sky is blue, he'll reply that the sky is colorless, and the atmosphere filters all but the blue spectrum....you get the idea) I find I totally fly off the handle, cry, scream, try to run away - which leads eventually to suicidal ideation; I also have racing thoughts, but they're not productive, they tend to all be negative (just lovely, staying awake all night with my mind going around in circles re-living my latest rage-fest); feeling worthless and hideous (:Trigger:my mom taught me a song when I was kid that sums it up "you are U G L Y ugly, D U M B dumb, you are U G L Y, D U M B, you are ugly dumb" - that song tends to circle in my head :Trigger:)

Down - just plain down, not mixed, is new to me. I think I'm there right now, though, so what I'm feeling: slow, like everything I try to do takes a huge extra effort; tired, but not exactly sleepy, maybe worn down is a better term, like I could just hide in bed all day, but not necessarily that I need the sleep; feeling completely unattractive, but not repulsive (if that makes sense); feeling worthless, and replaceable

This made me really think, thanks for starting the thread.

edited because one part might be a trigger - just realized it was for me, fun!

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Guest mcjimjam

I haven't been dx'd with BP but when I got hypo last time... I was very depressed, basically how you all describe it. I didn't shower, ate almost nothing, stayed in bed all the time, then I took WB and basically overnight my depression vanished, I became a functional person straight away, had a shitload of energy, slept 3 or 4 hours a night, decided exactly what I'd do with my future and got a job straight away. That's how it started. Towards the end I was binge shopping, snorting Ritalin and dancing in the streets. I got paranoid and thought I was better than everyone so they could just go fuck themselves.

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It's interesting to read everyone's posts.

hypo/mania: I interrupt people often, I feel like my thoughts are brilliant and should be shared to the world, I smile a lot, my eyes are brighter, colors are more vivid, lights are brighter, I get very motivated, and I start researching careers that I couldn't possibly do, the quality of my work goes up when I can get my head on straight enough to do some (I can be very distractable), I want to talk to everyone I see, I have a strong interest in spirituality and finding meaning

depression: I cry at the drop of a hat, my chest aches, I start noticing a lot of muscular pain, exhausted, suicidal and parasuicidal thoughts (those come quite early)

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