Never before have I really thought about, been fully mindful of how debilitating the irritability symptom is during a manic episode. Let me first explain that a manic episode sounds like it is a quick episode but it can last for weeks and months! Now I’ll explain how something such as irritability can be debilitating. Imagine feeling as if every task you do is supposed to be done when you have barely begun the task. Your mind races so fast through all of the steps to complete the task that in your cognition you are already done, yet in reality you have to deal with the reality that your body has to actually go through the motions. Once you have come to terms with this fact, your body is so amped up that its nearly shaking and you want to rush through all of the motions. If anything small and simple gets in my way or slows me down even the slightest bit I become so frustrated that I am nearly brought to tears. My limbic system (brains emotional control center) responds as if something detrimental has just occurred and it truly feels like the end of the world. Knowing this reaction is completely out of context my adult mind does everything in its power to calm myself so I do not appear on the outside how my limbic system is acting on the inside.
I have worked with many patients and clients who i have seen this same sort of reaction that I can tell is Neurological. I am a behavior therapist so I know the difference between a behavior that is learned and what is seemingly a neurological reaction. I have seen clients who are children having a tantrum that is so out of proportion and although many times the function of the tantrum is for attention, or access to a preferred item or escape from a non-proffered activity I can tell that sometimes it is almost out of their control and they are just having a reaction to the amount of chemicals in their brain.
Of course there are many factors such as not enough sleep, too much caffeine, life stressors etc., but the bipolar brain during manic episode is one that can be very hyperreactive, and sometimes it is completely debilitating. Sometimes I do not even know what to do with myself, like overactivity seems overwhelming but I have a pressure to get it all done. I want to climb in a hole in the ground but then I know that once in the hole my mind will not even let me rest, or be at peace so it just takes over.
Something that has been suggested to bipolar individuals is mindfulness exercises such as taking deep breaths and realizing the state of mind that you are in and waiting for it to pass. The thing about this for me is that while I do benefit from deep breaths and mindfulness is that when a state of mind and body such as mania lasts for months this feels unrealistic and unhelpful. Daily meditation and exercise helps, but this too can seem overwhelming activities when my manic mind thinks about every step involved from beginning to end in vivid detail and then I have to realize that Im not walking out of the gym, rather I have not even gotten my keys to walk out my front door. Im super frustrated and I hope this lamictal kicks in and does something good for this current manic episode. But I have to wait an entire month before I am at a therapeutic dose while I slowly increase my dose 25 mg at a time, so for now I have to just wait and see if in a few weeks Lamictal will do me any good at all. I just need some sort of relief.