5 ms·

Its really important to understand that mania is not optimism, positivism, or much of anything positive really. Its a state of euphoric destruction for bipolar

Its really important to understand that mania is not optimism, positivism, or much of anything positive really. Its a state of euphoric destruction for bipolar folks, and chronic mania seems to spread those patterns over the balance of a lifetime. It is a disorder, and it benefits from treatment. Its not fun for anybody except for the manic.

Erlich_Bachman 6y ago
In other words, the experience of mania is not so much like the experience of MDMA or cocaine, it is more like methamphetamine.
- suzzer99 6y ago
  MDMA has its benefits in moderation. But cocaine will eventually steal your soul.
  - Erlich_Bachman 6y ago
    Yes, probably. I was not referring so much to "benefits", or lack thereof, but to the subjective experience of the kind of high it gives.
bjornsing 6y ago
> It is a disorder, and it benefits from treatment. Its not fun for anybody except for the manic. So whom does the “treatment” benefit? ;P No, real mania is dangerous and the patient surely benefits from treatment. But there is a rather wide gray zone where I sometimes get a feeling it’s not the patient that benefits from the “treatment”, but rather his or her social surroundings. Not entirely unproblematic from an ethical perspective... depending on the reasonableness of those in the social surroundings of course.
- jac241 6y ago
  The patients benefit from the treatment significantly since a lot of time people who are manic are living recklessly, spending all their money, gambling, being hypersexual, trying drugs, getting into fights, committing crimes, tearing up their relationships, and the list goes on. The percent of people with bipolar disorder who die by suicide is 10-15%. Patients who are hypomanic by definition aren't having marked impairments in social or occupational functioning and won't need to be hospitalized. There's nothing forcing someone who isn't currently on a psychiatric hold to take medication, so if they're taking it it's likely because they believe they're benefitting from it.
  - bjornsing 6y ago
    Well as I've said real mania should surely be treated (regardless of cause). But there is an interesting gray zone where I think it's more difficult to say if the problem lays with the patient, or with his/her social surroundings. For example the Swedish journalist Ola Wong recently shared his story on national radio about going hypomanic and then full on manic during the Swedish "refugee crisis" in 2015. It was quite interesting to hear him describe how he just felt that his social surroundings of journalists and opinion makers had gone mad when they refused to acknowledge there were potential problems associated with accepting 160k refugees in a single year (relative to population that's like if the US accepted 5.2 million refugees in one year). After "banging his head against the social wall" for a few months he became more and more agitated and restless, and finally needed hospitalisation. Just weeks after his hospitalisation the debate climate turned around 180 degrees to agree with Wong. That probably helped his recovery. He seems to have had no psychiatric trouble before then, or after. Now, was the problem entirely with Mr Wong? :P
    - jac241 6y ago
      Yeah for sure. Just wanted to lay out for other passerby's in the thread that there's nothing forcing people to take medication that they don't think is beneficial for them, or for people who've never seen someone in a frank manic episode that we're unnecessarily medicating all of the next DaVinci's or Einsteins. Great and thought provoking example. I think you could argue there could be some genetic susceptibility to having a manic episode when placed under stressors like that, meaning potentially there's a relative with bipolar disorder or pretty severe major depressive disorder. I don't think most people would fall into a manic episode when placed in situations like that, but it is impossible to know. In my time rotating in the psych emergency department I saw someone with a similar presentation to Ola. No psychiatric history, stressful event happened, didn't sleep for a few days, came in in frank psychosis, treated with Seroquel, left the next day totally fine. Diagnosis given was brief reactive psychosis. Maybe the same happened for Ola Wong.
__s 6y ago
My sister's bipolar. Many people (including her) enjoy her manic behavior. It can go a bit too far at times, but there's a learning process on how to calibrate it. You work with what you have
erokar 6y ago
Mania is debilitating, that's one of its diagnostic criteria. The milder hypomania can be both productive and pleasant for some though. It can be useful to think of bipolar mood and behaviour along two axes: depressed vs. elated mood and low vs. high energy levels. Sometimes people with bipolar can be both depressed and energetic, a so called mixed state. Some manic episodes will be energetic and accompanied by an elevated mood of optimism, joy and even ecstasy. I agree that full blown mania needs to be treated.
- biddit 6y ago
  >The milder hypomania can be both productive and pleasant for some though. > I agree that full blown mania needs to be treated. Curious - is it your view that hypomanic symptoms don't need to be treated then? If so, why? Edit: formatting
  - wayoutthere 6y ago
    So as someone who is normally hypomanic but had a reaction to antidepressants that put me fully manic for a while, I don't think hypomania really needs to be treated with anything other than talk therapy. If I'm aware of it, I can manage the downsides pretty well through emotional regulation techniques like breathing / meditation and exercise. Hypomania can be overall positive if you learn to control it. Mania on the other hand is basically like, you can't control the shit that comes out of your mouth. You act on every fucking thing that pops into your head, even when you recognize that it's hurting the people around you. You just can't stop yourself; its compulsive and incredibly distressing. People are uncomfortable around you and you can tell. Your judgment is impaired and you don't understand the grey area between right and wrong. You have like 15 thoughts flying through your head and you can't keep any of them straight for more than a few seconds at a time. It really, really sucks.
    - biddit 6y ago
      > I don't think hypomania really needs to be treated with anything other than talk therapy I generally agree with this to my experience, with the caveat that their depressive swings are managed well - via medication or other means.
biddit 6y ago
> Its not fun for anybody except for the manic. I'm not sure what you're basing this statement on, but it's actually anything but "fun" for the person experiencing the manic phase.

Erlich_Bachman 6y ago

In other words, the experience of mania is not so much like the experience of MDMA or cocaine, it is more like methamphetamine.

suzzer99 6y ago
MDMA has its benefits in moderation. But cocaine will eventually steal your soul.
- Erlich_Bachman 6y ago
  Yes, probably. I was not referring so much to "benefits", or lack thereof, but to the subjective experience of the kind of high it gives.

bjornsing 6y ago

> It is a disorder, and it benefits from treatment. Its not fun for anybody except for the manic. So whom does the “treatment” benefit? ;P No, real mania is dangerous and the patient surely benefits from treatment. But there is a rather wide gray zone where I sometimes get a feeling it’s not the patient that benefits from the “treatment”, but rather his or her social surroundings. Not entirely unproblematic from an ethical perspective... depending on the reasonableness of those in the social surroundings of course.

jac241 6y ago
The patients benefit from the treatment significantly since a lot of time people who are manic are living recklessly, spending all their money, gambling, being hypersexual, trying drugs, getting into fights, committing crimes, tearing up their relationships, and the list goes on. The percent of people with bipolar disorder who die by suicide is 10-15%. Patients who are hypomanic by definition aren't having marked impairments in social or occupational functioning and won't need to be hospitalized. There's nothing forcing someone who isn't currently on a psychiatric hold to take medication, so if they're taking it it's likely because they believe they're benefitting from it.
- bjornsing 6y ago
  Well as I've said real mania should surely be treated (regardless of cause). But there is an interesting gray zone where I think it's more difficult to say if the problem lays with the patient, or with his/her social surroundings. For example the Swedish journalist Ola Wong recently shared his story on national radio about going hypomanic and then full on manic during the Swedish "refugee crisis" in 2015. It was quite interesting to hear him describe how he just felt that his social surroundings of journalists and opinion makers had gone mad when they refused to acknowledge there were potential problems associated with accepting 160k refugees in a single year (relative to population that's like if the US accepted 5.2 million refugees in one year). After "banging his head against the social wall" for a few months he became more and more agitated and restless, and finally needed hospitalisation. Just weeks after his hospitalisation the debate climate turned around 180 degrees to agree with Wong. That probably helped his recovery. He seems to have had no psychiatric trouble before then, or after. Now, was the problem entirely with Mr Wong? :P
  - jac241 6y ago
    Yeah for sure. Just wanted to lay out for other passerby's in the thread that there's nothing forcing people to take medication that they don't think is beneficial for them, or for people who've never seen someone in a frank manic episode that we're unnecessarily medicating all of the next DaVinci's or Einsteins. Great and thought provoking example. I think you could argue there could be some genetic susceptibility to having a manic episode when placed under stressors like that, meaning potentially there's a relative with bipolar disorder or pretty severe major depressive disorder. I don't think most people would fall into a manic episode when placed in situations like that, but it is impossible to know. In my time rotating in the psych emergency department I saw someone with a similar presentation to Ola. No psychiatric history, stressful event happened, didn't sleep for a few days, came in in frank psychosis, treated with Seroquel, left the next day totally fine. Diagnosis given was brief reactive psychosis. Maybe the same happened for Ola Wong.

__s 6y ago

My sister's bipolar. Many people (including her) enjoy her manic behavior. It can go a bit too far at times, but there's a learning process on how to calibrate it. You work with what you have

erokar 6y ago

Mania is debilitating, that's one of its diagnostic criteria. The milder hypomania can be both productive and pleasant for some though. It can be useful to think of bipolar mood and behaviour along two axes: depressed vs. elated mood and low vs. high energy levels. Sometimes people with bipolar can be both depressed and energetic, a so called mixed state. Some manic episodes will be energetic and accompanied by an elevated mood of optimism, joy and even ecstasy. I agree that full blown mania needs to be treated.

biddit 6y ago
>The milder hypomania can be both productive and pleasant for some though. > I agree that full blown mania needs to be treated. Curious - is it your view that hypomanic symptoms don't need to be treated then? If so, why? Edit: formatting
- wayoutthere 6y ago
  So as someone who is normally hypomanic but had a reaction to antidepressants that put me fully manic for a while, I don't think hypomania really needs to be treated with anything other than talk therapy. If I'm aware of it, I can manage the downsides pretty well through emotional regulation techniques like breathing / meditation and exercise. Hypomania can be overall positive if you learn to control it. Mania on the other hand is basically like, you can't control the shit that comes out of your mouth. You act on every fucking thing that pops into your head, even when you recognize that it's hurting the people around you. You just can't stop yourself; its compulsive and incredibly distressing. People are uncomfortable around you and you can tell. Your judgment is impaired and you don't understand the grey area between right and wrong. You have like 15 thoughts flying through your head and you can't keep any of them straight for more than a few seconds at a time. It really, really sucks.
  - biddit 6y ago
    > I don't think hypomania really needs to be treated with anything other than talk therapy I generally agree with this to my experience, with the caveat that their depressive swings are managed well - via medication or other means.

biddit 6y ago

> Its not fun for anybody except for the manic. I'm not sure what you're basing this statement on, but it's actually anything but "fun" for the person experiencing the manic phase.