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April 5, 2012 10:52 AM   Subscribe

How to deal with the shame that comes after hypomanic behaviour?


After doing some reading this week, and thinking about my mental state and behaviour over the past 5 years, I am pretty sure that when I see my doctor this week I will be diagnosed with either Bipolar II or cyclothymia.

My personality is naturally shy, and I feel I am at my best when playing the piano, reading/writing, or having a one-on-one conversation. I am on facebook but I am normally shy about posting and having my name splattered all over the place.

But when I am in a phase of hypomania, it's like all the comments I never made and messages I never wrote will come out of me. When the hypomania is over and the shyness returns, I feel so ashamed that I went and made my private thoughts public.

Recently I wrote to a friend that I hadn't spoken to in several months, (my own fault), and said all sorts of nice things about their personality and how awesome they are. I've done this on several occasions with different people. And many times I have done it, the person never replies.

During these phases of hypomania, I also feel extreme awe of certain people, and sometimes feel the need to tell them that I think they are awesome. It nearly always yields a weirded-out result.

I've done the opposite too;sending off an email to an administrator at my school that I dislike and trying to argue about the way things are run; sending vaguely "fuck you" messages to people who annoy me.

Generally: I become far too frank and open about my emotions, which, themselves, are elevated to begin with.

It feels as though I am not myself during those times---I always envision my true self to be a quiet listener and observer. But there is something very gratifying about speaking up once in a while, and I think this urge to make my beliefs known becomes uncontrollable when the hypomania sets in.

So how can I deal with the shame of my uncharacteristic extroversion? And what should I write to the friends who I have expressed awe to? Should I just never write to them again?

Also. Please don't suggest medication. I am skeptical of the medical model as it is and intend to do what I can to help myself without the use of pharmaceuticals.
posted by costanza to Human Relations (19 answers total) 13 users marked this as a favorite
Without disputing your feelings about medication, would you consider counseling to figure out how to deal with your feelings of shame about your behavior? No decent counselor is going to judge you or try to force you to take medication you don't want (unless it becomes a safety issue for you or others around you), but they can help you find ways of coping with your own feelings, both during the manic phases and after they're over.
posted by decathecting at 11:02 AM on April 5, 2012

I don't have any suggestions at the moment for the shame, but here is something that might help if you have Gmail.
posted by lakersfan1222 at 11:02 AM on April 5, 2012 [1 favorite]

You say you're uninterested in medication, but would you be willing to consider therapy? Because my usual answer to questions about shame you usually involve a professional, disinterested third party that can help you re-evaluate the situations that you feel shame about. For instance, I would point out that sending people "you rock" emails isn't very shameful behavior. You may not like it because you feel out of control, and you may have vaguely weirded out a friend here or there, but the amount of Harm you've inflicted is probably not proportional to your shame.

Which gets to the larger picture of what to do about the hypomania - again, therapy could help. I resisted it for years, but found that people who have had years of training in these issues really helped me.
posted by ldthomps at 11:08 AM on April 5, 2012

Response by poster: Yes, if I am diagnosed I will see a therapist.
posted by costanza at 11:10 AM on April 5, 2012

Response by poster: I think it has to do with transgressing my own boundaries. How do I deal with the awkwardness?
posted by costanza at 11:11 AM on April 5, 2012

Sometimes, when I've 'shared too much' I feel pangs of regret later than I've learnt to recognize as a symptom of feeling exposed and vulnerable.
posted by infini at 11:13 AM on April 5, 2012 [5 favorites]

I tend to lash out a lot when I'm depressed (different trigger, same behavior), and my friends and family remind me of this: Outlying behavior from someone you love is often a source of concern, but (especially if you know why it happens), it's very rarely something to feel ashamed over.
posted by xingcat at 11:15 AM on April 5, 2012

I have been in your position. It has created a lot of feelings of shame which lasted for a few years.

With that being said, I know how awkward it is after having done this. You deal with the awkwardness by no longer communicating with these people depending on how close you actually are (don't send messages to them/don't write to them again). Wait for them to communicate with you next. If they don't, learn from this and move on. But, please don't feel ashamed of yourself despite how hard it is to feel otherwise.

With time, you will realize that they are not thinking about what you did because they have so much going on in their own lives. It will take a while to reach that point, but it will come.
posted by livinglearning at 11:18 AM on April 5, 2012 [1 favorite]

Maybe you've got the cause and effect backwards here. Maybe you're right that hypomania is enticing you to say things you later feel ashamed of.

But maybe the problem is that you mostly feel ashamed of yourself all the time (which is why you're shy about sharing your thoughts with the world) and then once in a while you don't feel so ashamed and all of the things you've held back come gushing out at once. And you feel wonderful, even hypomanic, because it's sooo good to be rid of those awful feelings about yourself. But it doesn't last and soon you're back to your usual shame-filled self-image, and your view of all those things you said changes accordingly.

I've sent the overly effusive private messages without getting a response, too, and that silence just lets my worst fears run wild-- I convince myself they didn't reply because I totally made them uncomfortable. (And sometimes that's been true, sadly!) But a few times I've gotten a wonderful reply, which feels really good.

I would try to forgive yourself for making mistakes, because you're not sharing often enough to be good at it yet. I also think that you should work on commenting and writing *more* often, not less, so that you get practice, so that you feel less shy about it, and so that you share in little bits and pieces rather than holding it in until the urge is overwhelming and it comes out all at once.
posted by Dixon Ticonderoga at 11:31 AM on April 5, 2012 [12 favorites]

You absolutely don't need to be diagnosed with anything in order to seek therapy. If you are having negative feelings that make you unhappy, that alone is sufficient reason to talk to someone who has expertise in helping you to deal with those feelings.
posted by decathecting at 11:36 AM on April 5, 2012 [2 favorites]

Hi, I've got bi-polar II, and this is how I've answered my version of your question:

When I have any kind of episode, I remind myself that I'm sick. That doesn't mean that I'm not responsible for responding to the problem, but it does mean that the problem isn't me, it's my illness.

I wouldn't feel ashamed if I got the flu and my nausea kept me from going to work (or maybe in your case, I threw up in a company bathroom). That's just what happens sometimes with the flu.

I don't feel ashamed when my bi-polar acts up and I have to change my schedule as a result (which usually looks like some combination of stepping back my commitments for a while, and changing the composition of the people I spend time with to some degree).

In both cases I acknowledge what's happening and try to find a response that is appropriate and will put me in the best position to deal with the illness and mitigate the symptoms.

Now, as to the people that you've already written to:

Some of them you're just going to have to not respond to. They have probably already forgotten about it. Maybe they've had manic periods of their own before. Maybe they think you were high, or were just sleep-deprived. Either way, they've already filed it under "No Big Whoop" and completely moved on.

With some social outcomes of mental illness, the "cure" is worse than the "disease" (so to speak). So just keep keepin' on like what you did is not a big deal. It most likely isn't. If you're already not in the habit of talking to them, great. Just keep, you know, not talking to them. Problem basically solved. They are not thinking about that weird message you sent. I promise. So just put it out of your thoughts. If they ask or have asked, then you can tell them whatever you want about your illness (provided you end up being diagnosed with one). By doing so they have asked to be put into the second group of people, described below.

For some other people (people you care about, people you talk to a lot, people that you need to actively like you, etc), you may want to let them in on what's been going on with you and why you've been acting the way you've been acting. You can be pretty straightforward about it. It doesn't need to be a big emotional production. You have a disease. It isn't contagious or deadly. You have these symptoms sometimes. Sorry for any inconvenience (in the case of a "fuck you" letter that you can't ignore). Thanks for understanding. Boom! Done.

I find these conversations are better in person, and brought up when apropos. Email (especially group emails) and out-of-left-field announcements can be drama-generators. Remember, you've got the flu. You are not losing your religion/coming out as pansexual/joining the Communists. You are just sick. People get sick all the time, and they deal with it.

I hope that helps, and good luck with finding a way to treat your illness!

Oh, and resist the voice inside you (if you have one) that tells you that you have to put out all these imaginary fires with the people you interacted with. You don't. Those fires don't exist. Take time to think with your brain, not your heart. You'll figure it out.
posted by Poppa Bear at 11:47 AM on April 5, 2012 [10 favorites]

I have similar tendencies to tell people what I think (good or bad) in a way that I wouldn't normally when I'm hypomanic (I haven't had a fullblown manic episode in over 10 years now, but still go into hypomania from time to time). The biggest problem is that hypomania is something that I often only recognise in hindsight...

My approach is 3-fold.

1. Ride it out. Good stuff - I let it go. It's actually nice (if a bit odd) to hear positive feedback. Negative comments - if someone is upset by the way I've approached giving negative feedback then I apologise. Not necessarily for the comments (usually I don't say anything I don't believe, I just say things in a confrontational and unhelpful way).

2. Self-discipline - I'm aware that I get hypomanic sometimes, and try to second guess myself and recognise that I often write emails that in hindsight I would want to reword - or not send. (And even when I'm not hypomanic, I try and recognise when I'm stressed / upset about something) So I try to save everything with any remotely emotional content as a draft and review it the next day. That helps - and is getting easier the more I do this. lakersfan1222's suggestion wouldn't work for me - being hypomanic doesn't impair my ability to do maths!

3. I try to voice my opinions more often when I'm not hypomanic. That gives me an opportunity to get things off my chest (good or bad) when I'm feeling more normal, which reduces the pressure to do this when I'm hypomanic.

Good luck!
posted by finding.perdita at 11:59 AM on April 5, 2012 [1 favorite]

Best answer: For starters, jumping to conclusions about a mood disorder diagnosis might not be the best approach here. I don't think it's uncommon for a certain type of highly analytical person with unipolar depression (and their clinicians too, sometimes) to assume that they must be bipolar or cyclothymic just because they experience a bit of mood reactivity from time to time. In some cases, being a self-monitoring person who's straining at the seams is less about hypomania than it is about just wanting to feel okay with expressing yourself in an authentic manner for once.

You say that you "envision [your] true self to be a quiet listener and observer," which perhaps isn't all that accurate. In fact, it's quite possible that you work hard to uphold that image of yourself without consistently embracing your more outspoken side. That approach will cause problems, mood disorder or not.

I bet that this pattern of behaviour may mostly go away once you learn ways to share more of yourself with the world on a regular basis, which therapy can absolutely help with.
posted by thisjax at 12:11 PM on April 5, 2012 [3 favorites]

Best answer: Maybe it's not your openness that's causing you the grief, it's your morbid self-consciousness that's the problem. You were honest and expressive-- so what? Why be ashamed of having feelings and expressing them?

Being a little overexcited and loopy isn't the worst sin in the world. If extroverts can do it 24 hours a day, why can't we? Go ahead-- tell people they're awesome. Tell them to fuck off. Don't be so terrified of being yourself and stop obsessing about what people's imaginary opinion of you is. Nine times out of ten, people are so wrapped up in their own concerns they don't care much about you one way or the other--and if uptight people are judging you, who cares anyway?

Make new friends and don't beat yourself up about what you can't change. Endlessly rehashing old embarrassments ad nauseam doesn't help a thing. Never forget that being willing to risk hurt and rejection by opening up brings more good things than you can imagine...keep your head up and keep moving forward. Good luck!
posted by doreur at 12:13 PM on April 5, 2012 [8 favorites]

Time. Time shrinks shame. The longer you go without a hypomanic episode, the more time you have to let all of the shame of previous acts float away.

You probably will need to let go of the relationships you damaged in this time. It's hard in the present. Again though, after years have passed, the wounds will sting less and the shame will shrink.

This is why I am skeptical of your refusal of medication. The purpose of the medication is to buy you time - time free of hypomanic episodes. Time to heal your wounds without creating new ones. Feel free to explore therapy and behavioural changes first, but I would keep an open mind about pharmaceutical options. This is coming from somebody who has been on mood stabilizers for over six years now. I am eternally grateful for the time they have bought me.
posted by crazycanuck at 12:15 PM on April 5, 2012 [5 favorites]

You might want to take a look at Kay Jamison's book "An Unquiet Mind." She's a therapist who also has bipolar and she writes very compassionately about what it's like to live in that world and her very mixed thoughts about medicine, even though she's a psychiatrist herself.
posted by jasper411 at 12:21 PM on April 5, 2012 [3 favorites]

I think you should wait and see what diagnosis you get. Hopefully the physician who diagnoses you will give you a reading list and point you towards some support groups, and if they don't proffer this, ask for it.

Whatever your diagnosis, you will absolutely not be the first person to have screwed up in whatever way, and you can learn from others of your tribe about how they dealt with it.
posted by tel3path at 1:15 PM on April 5, 2012

For things like this (especially if you are resistant to taking medication) Cognitive Behavioral Therapy helps you to take stock of your emotions, and be aware of how you are responding to the world around you.

Over time you'll learn to identify when you are having a hypomanic response to something rather than a "normal" response to something.

Definitely agreeing on "An Unquiet Mind". When I was first diagnosed BPII it really helped me to understand how my mood worked into the concept of what Bipolar Disorder is.

I understand that you are reluctant to take meds, and I'm not trying to encourage you to look at that route unless you feel comfortable about it, but I have to disagree with something that crazycanuck said anyhow:

True Bipolar Disorder (which needs to be differentiated from periodic depression) is a physiological brain disorder. You can use tools like CBT to help mitigate your highs and lows, but the kindling theory states essentially that every cycle you have makes your chances of having another cycle even higher.

As such, the main thing I have to disagree with crazycanuck on is:
In true bipolar disorder - medication is not to buy you time while you "recover", It is a maintenance thing. You never "get over" being diabetic, and similarly, you never "get over" being bipolar, and the belief that you are going into remission leads the majority of bipolars into a false lull of security which then comes back to slap them in the face. (yes, I speak from experience, having been in "remission" for 5 years, only to be hit full steam with a mixed-mania episode that almost destroyed parts of my career)

Rant over, but to recap - look into CBT, it can help you deal with these swings by making you more conscious of how your emotions "work".
posted by aloiv2 at 1:50 PM on April 5, 2012

aloiv2 - I actually agree with what you are saying on meds, I perhaps misstated my position.

By using meds to put yourself into remission, this gives you time between hypomanic episodes. Unmedicated - you might cycle every 3, 6, 9 months - who knows. When medicated that time can stretch to years.
posted by crazycanuck at 4:15 PM on April 5, 2012

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