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Please help me understand bipolar mania.
November 20, 2011 12:49 PM   Subscribe

Can you help me to better understand bipolar mania/hypomania and the thought-processes of the manic mind?

I recently posted an Ask regarding my mother and her most recent manic episode. In hindsight, it was ill-advised to have posted as soon after the events as I did, and as a result the post reads very scatter-brained, and I realize I didn't ask the right questions. I will attempt to not repeat too much of that previous question here.

My mother's mania almost-exactly replicates Narcissistic Personality Disorder as well as an increased sex drive and all the wonderfulness that comes with it. As a result of this (and her natural victim-mentality, I'm sure), my sisters and I were often exposed to a revolving-door of abusive, controlling and just plain Bad Men, most of whom were addicts and therefore enabling my mother's addictions.

As I mostly struggle with bipolar-depression and cannot remember a truly manic period (brief hypomania, but no full-blown) as an adult, I'm so far removed that I can't answer these questions myself, in spite of my symptoms being very similar to my mother's. I really want to *understand* the manic state and the thought processes which come with it.

Does the manic mind rationalize? I'm not asking if the rationalization is sound, only if there is one. Or does the manic mind not take the time to do so and in reality is acting without thinking at all?

Is such narcissism typical of mania? I find this in the example of my mother "prioritizing" her sex life over her children, and accusing her children of "ruining her life" any time a man leaves her.

What, if anything, can be said to the person to "break through" the manic mind?

Does the manic mind resent the people who try to help them and/or stand in the way of dangerous/damaging manic behavior? Does this resentment typically continue after the person re-stabilizes?

Is there any other insight you can offer me to help me understand what's going on in my mother's head?
posted by MuChao to Health & Fitness (14 answers total) 9 users marked this as a favorite
 
You might read An Unquiet Mind. It's quite old but considered a classic, and the descriptions of mania are very accurate, IMHO.
posted by DarlingBri at 12:54 PM on November 20, 2011 [1 favorite]


Oh, also Madness, which is specifically about BPD from a first person perspective.
posted by DarlingBri at 12:57 PM on November 20, 2011


Get hold of Stephen Fry's Secret Life of the Manic Depressive. It's available on DVD in some parts of the world and available by, um, other means elsewhere.
posted by caek at 12:57 PM on November 20, 2011 [1 favorite]


An Unquiet Mind. The author, Jamison, both has the illness and wrote the textbook on it. Literally.
posted by ROU_Xenophobe at 1:08 PM on November 20, 2011


My amazing friend angi's mother keeps getting ideas about helping the homeless and writing a novel, nevermind that she's homeless herself... angi always has to pull her back, stop her.... and it doesn't always work... sometimes mom sleeps the streets... that is bi-polar mania...and if someone could fix this it would be anji- but she can't. full stop. its mania.
posted by misspony at 1:18 PM on November 20, 2011


there's a website called bphope.com ... It's a magazine aimed at those with bipolar, and many of the columnists have the illness and write from personal experience. (I used to be an editor there but am no longer affiliated in any way).
posted by Buffaload at 1:30 PM on November 20, 2011


Does the manic mind rationalize? -- Yes, sort of. Even in mania you will see people using deductive and inductive reasoning, but it doesn't really make sense outside of their own random context. "I saw a bird flying, and I'm pretty sure I can fly too now" is reasoning of a sort, after all.

Is such narcissism typical of mania? -- Mania is all about a loosened grip on reality. "I can do anything" is typical of mania, as is "Of course I'm right, it's weird that you're wondering" and "Why won't you let me have any fun?" Many people who are manic, especially in the early stages, are also quite personable and charismatic - many people who are manic get really freaking pissed off if they're kept from doing whatever random thing they want to do right now. I will point out that personality disorders require a whole bunch of specific criteria that pretty much mean your mom can't have NPD if it only shows up when she's manic. To me the various personality disorders all have a lot in common with various stages of bipolar disorder - many people act like they have AvPD or DPD when depressed, and it can be tricky to differentiate between bipolar disorder and the DSM list for borderline personality.

What, if anything, can be said to the person to "break through" the manic mind? -- Heh. Well. Um. You could try "Have you told your doctor how you're feeling right now?" Or maybe "I'm not sure that makes sense, and I'm getting a little worried about you." Honestly, if someone's manic, really manic, then they're not making good decisions anymore, and that includes their responses to people trying to help them. That's why it's so important to focus on psychoeducation when they're asymptomatic, so they can stop themselves or ask for help before they reach that point.

Does the manic mind resent the people who try to help them and/or stand in the way of dangerous/damaging manic behavior? Does this resentment typically continue after the person re-stabilizes? -- In my limited experience a bipolar person in remission generally gets that people were trying to help them, though they may very well disagree with the methods used, or be embarrassed about how it happened, or not want to deal with being bipolar, or kind of hate their life right now, any one of those things very easily leading to expressions of resentment. As far as how they think when they're manic, anything goes. They're manic. People have been known to get murderously violent when manic, though it's rare. People have been known to threaten or attempt suicide when manic, and it's way less rare.

Is there any other insight you can offer me to help me understand what's going on in my mother's head? -- Consider the possibility that more than one thing is going on with your mother. I'm not just bipolar, I have ADHD, avoidant personality disorder, and OCD. I also have 30+ years of social conditioning and experiences, varying relationships with a great number of people, occupational stressors, etc. You've already mentioned that she's dealing with comorbid alcoholism, that she has a long history of abusive relationships with men, that she lets herself be controlled and manipulated by others. You don't need to try and make everything she does fit into a grand unified theory of mania.

I'd like to suggest that, if you're having a lot of trouble getting your mom to accept treatment or live in accordance with the recommendations of her doctors, you read I am Not Sick, I Don't Need Help!
posted by Fee Phi Faux Phumb I Smell t'Socks o' a Puppetman! at 1:47 PM on November 20, 2011 [2 favorites]


From my recent and upsetting experience with being close to someone bipolar who is undermedicated or unmedicated depending on the day, I have noticed rationalizations and narcissism to the nth degree. I believe these are part and parcel of this disease.

People have tried to intervene and ask the person to get help, but the person ruthlessly cut them off afterwards.

Part of the disease seems to include resistance to getting help. I'm sorry for what you're going through. This person was a close friend, not a relative, and it was still very painful to see them self-destruct.
posted by xenophile at 2:51 PM on November 20, 2011


Have you tried a support group for family members of the mentally ill? You could learn a lot from their meetings. To find a support group, visit the National Assoc. for the Mentally Ill web site and locate the office nearest you.
posted by exphysicist345 at 5:06 PM on November 20, 2011


I can only speak from my experience:

Does the manic mind rationalize? I'm not asking if the rationalization is sound, only if there is one. Or does the manic mind not take the time to do so and in reality is acting without thinking at all?

Yes, I rationalise when I'm manic. Possibly more than when I'm not manic.

Is such narcissism typical of mania? I find this in the example of my mother "prioritizing" her sex life over her children, and accusing her children of "ruining her life" any time a man leaves her.

I find this a bit of an odd question. I'm bipolar. I don't have narcisstisic personality disorder. When I'm manic, I can think that I'm the most intelligent / insightful / powerful person ever. I can believe that I have superpowers. I can also become very paranoid. None of this means I have narcissistic personality disorder. It's just a nasty symptom of a manic episode.

What, if anything, can be said to the person to "break through" the manic mind?

Nothing. When I'm manic, I truly believe that my decisions are rational. Arguing with me and telling me that I'm not making rational decisions will not help.

Does the manic mind resent the people who try to help them and/or stand in the way of dangerous/damaging manic behavior? Does this resentment typically continue after the person re-stabilizes?

I think it's normal for people generally to resent people who try to stop others doing things that they want to do. Being manic may mean that I'm wanting to do more things that others may want to stop me doing. But at the time, I'll have the same reaction as when I'm not manic. Afterwards, if people are supportive and treat me with respect, then no, I don't tend to resent them, I tend to be appreciative of their concern.

It sounds like your mother has a few other issues apart from her bipolar disorder. And I agree with posts above that suggest you find a support group for people close to those with bipolar disorder. You can't fix her. But you can support in learning how to manage her bipolar - if she is willing and able to do that.
posted by finding.perdita at 8:06 PM on November 20, 2011


I think An Unquiet Mind will answer all of your questions.

I have not have full blown manic episodes , just strong hypomanic ones. And it's been about 6 years since I had one. Still, I'll try to answer in brief from my own perspective.

Does the manic mind rationalize..Or does the manic mind not take the time to do so and in reality is acting without thinking at all?
It definitely rationalizes, but if you're asking what the (hypo)manic mind is thinking (underneath the crazy thoughts) it's 1) I am an invincible genius who can do ANYTHING and there are IMPORTANT REASONS why I must do these unbelievable things, and 2) let's keep this awesome feeling going no matter what by feeding it more awesome experiences (sex, drugs, alcohol, money-spending, risk-taking...)

What, if anything, can be said to the person to "break through" the manic mind?
Nothing. If the person is genuinely having delusions, definitely nothing. But even shy of delusions, the pull of those two motives I described above are absolutely irresistible. An outsider can't stop it. The ill person her/herself can't stop it. The mind just won't stop doing what it's doing. It's doing what it's doing so intently and intensely that it won't even let the body sleep. Medical intervention is needed in order to 'break through'. As you'll get tired of reading when you start looking into this, people with bipolar disorder almost never see doctors when they are manic; they seek help when they crash and become depressed.

I can't answer about resentment. People loved my hypomania, no one knew what it was, and no one intervened. Without it I'm fairly boring. But I do think resentment is quite possible. Once the person is medicated they lose their awesome mania. I sure resent that. But then, when the person is stable, they see how destructive they were and they come to accept the medication trade-off. Or, they don't and they go off their meds...
posted by kitcat at 8:29 PM on November 20, 2011 [1 favorite]


I just wanted to pop in and say that perhaps your Mom has NPD in addition to bipolar. The mood issue and the self-centeredness are related but not the same. So even when her mood is stable, she may just be a self-centered person -- which is also very difficult to deal with as her daughter.
posted by 3491again at 12:49 AM on November 21, 2011


Also -- if your mother doesn't know that she is bipolar, she just views what is going on as her life, much as you do. She doesn't see it as the "manic mind". She sees it as *her* mind. So she may not question what is going on, and it's hard for you to "break through" to her, because there's nothing to break through to. This is just how she is. These are NOT symptoms (to her). They are her life.

Imagine if someone said that how you perceive the world and how you feel is really just an example of "MuChao mind" and that everything you have done is somehow wrong, a disease, based on inaccurate perceptions of the world. She doesn't think you are trying to "help" her. She thinks you are criticizing her. And in a way, she's right.

While it's important to understand her, I don't think that she will necessarily appreciate the attempt. Her mental paradigm is so different from yours that what you think of as help and understanding may not come across that way.

It's great that you're seeing this so objectively and trying to help her, but it may be of more benefit to you than her.
posted by 3491again at 12:55 AM on November 21, 2011


Thank you everyone for your responses. I will be checking out An Unquiet Mind as well as the Secret Life of a Manic Depressive. I know that even armed with this information, I will likely not be able to help my mother, but the better understanding will help me and my sisters to deal with her more empathically when she's in these states.

My mother was diagnosed Bipolar, and has been on Lithium and antidepressants for 20+ years. She's been seeing the same psychiatrist for at least the last 10 or so years, and I only recently found out that she has not been seeing a therapist. She says she'll be seeing one starting in January. It would not surprise me to learn that there's more going on with my mother than Bipolar, likely PTSD. To clarify, I never said she had NPD, only that her manic states resemble NPD.

I have been discussing this a bit with my therapist, and he has given me a list of support groups in the area. I will be checking one or two of these groups out soon. I'm also looking for similar groups near my sisters (both younger than me and living with my mother), though the older one is resistant to the idea, and the younger will probably need to wait a few months until she has her driver's license. Yes, I also accept that I cannot make my sisters get help, but I try to be there for them as much as I can and give gentle pushes in the right directions.
posted by MuChao at 10:16 AM on November 22, 2011


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