What Nobody Tells You About Mania

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As I’ve said before there is more to mania than just feeling good. It’s a complicated symptom of bipolar. When someone asks me “What’s it like to be manic?” I have to really think about it. There’s so much to it, I can’t sum it up in a couple of sentences. It goes through many stages, with different symptoms appearing, disappearing and resurfacing again.

One of the major parts of mania for me is anger. I’m not talking about irritability, like you can have with depression. What I mean is real, intense anger. My partner and I have coined the phrase ‘KatieRage’TM to describe these moments. I turn into an entirely different person, I’m completely unrecognisable.

It’s like a constant itch I can’t scratch. I can’t seem to find any relief from the anger I’m feeling.

I have a scar on my right knuckle from when I punched the wall. I hit it so hard, I left a dent in the bedroom wall. You’d think something unbelievably dramatic had happened to make me do that wouldn’t you? In reality I’d found out I didn’t get the day off work, so I couldn’t go to a party. That’s it. I get stuck in a loop of anger. One little thing will trigger it and then, I can’t move on from it. It just keeps going around and around in my head, until I found an outlet for it.

Delusional thinking can be another aspect of mania. I’ll believe I’m the most important person in the room. Actually I’ll know I’m the smartest, most valuable person on the planet. Anyone that disagrees with me is wrong. Anyone that calls me out is an idiot. Even when the right answer is staring me in the face I won’t believe it. I have to be right, because nothing else would make sense.

The anger leaks through to my delusional thinking. Because I feel that I can do no wrong, when I see people doing something differently to me, or not listening to my opinions, it makes me extremely angry. I feel like there is a tremendous pressure in my head that can only be released by me screaming, shouting, ranting and raving.

Along with delusional thinking, people with mania may also see, hear or feel things that aren’t really there. I’ll hear voices that are sometimes comforting, but mostly they drive my manic behaviours. They push me to take risks and do things I wouldn’t normally do.

Overspending. Not “Whoops I lost track of how much I spent on Saturday night” I mean serious, crippling debt. Making the choice between the gas meter and food, sort of debt. Bailiffs at the door kind of debt.

It’s a compulsion I can’t control. I know I don’t have enough money to cover my spending, but I don’t think about the consequences. Mania makes me believe that everything will sort itself out, that it doesn’t matter.

As a young person with bipolar, I was free to collect as many credit and store cards as I wanted. At one point I had four credit cards and three store cards, all spent to their credit limit. I’m still paying them off years later. I got to the point when I would regularly go beyond my overdraft limit and had literally nothing to fall back on.

Mania varies for everyone that experiences it, but for each individual it’s a complex set of symptoms. Listen to people’s experiences of mania and ask how you can support them. Whether it’s keeping an eye on significant changes to their behaviour, or their spending, small gestures can make a positive impact.

 

 

“Why Are You Walking On Eggshells?” How I Began To Recognise Manic Anger

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I saw my parents today. They came over to my flat and I made them coffee. We had a catch up and giggled at my Mum attempting to play video games.

We moved on to how well I’ve been coping recently. They told me they were so happy to see me stable and well. Then they told me what they didn’t miss about me being ill. The mania and what it often leads to; anger. They don’t hold back my Mum and Dad. They tell me how it is. Although, it’s been a long road to get to this point.

My family and partner used to creep around me when I was manic. They didn’t want to say anything that would make me lose my temper and really, just about everything did.

I used to be fully aware that everyone around me was scared to call me out on my behaviour. The problem when I’m manic is that I’m delusional and believe that whatever I do and say is right and justified. No one can tell me otherwise. Knowing they were too worried to say anything to me riled me up even more. It made me feel like a freak, someone that needed fixing and I hated that idea.

I’ve learnt to recognise it. Here’s how:

One of the main ways I’ve done it is making sure my family and friends call me out on my behaviour. I don’t mean confront me, or make negative statements. They tell me my anger or behaviour isn’t normal for me (normal for me, because there’s no such thing as normal) and I should take a step back and think about how my actions are hurting others.

The problem with this is when I’m manic I can’t be reasoned with. Everyone is wrong. There’s nothing wrong with me. I can’t see through my behaviour. There’s no voice telling me to stop or behave. No usual voice of reason we all have that says,

“Should you really do/say that?”

I’ve learnt to rely on my partner and family to be that voice of reason.

When I’m in the midst of bipolar anger there’s no point telling me to calm down. Or to explain anything really, it just doesn’t get through to me. So I ask people to tell me when I’m more stable how out of control I was. Then I’m in the mindset to say I’m sorry and reflect.

They know I need help at those points. I won’t realise it, but my loved ones do. A support system is so important to have. They keep me grounded in reality when otherwise my world would unravel.

What It’s Like To Have A Mixed Episode Of Bipolar

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A couple of weeks ago I had what’s called a mixed episode of bipolar disorder. What this means is that I was experiencing mania (the highs) and depression in very short succession, to the point that I felt both at the same time. In this post I wanted to write an account of what it felt like at the time, to hopefully shed some light on this difficult to understand symptom of bipolar.

I’m sitting at a table outside a restaurant, waiting to be served. I’m with my husband who is attempting to start a conversation. The air is warm and the sun is out and canal boats are drifting along the canal next to where we’re sitting. It should be an idyllic setting, leaving me feeling happy and contented, but I’m not. My head is abuzz with uncontrollable thoughts. The world around me feels very surreal right now, like I’m seeing it through a kaleidoscope. The images keep flicking backwards and forwards, never staying still. I’m restless and on edge, my whole body feels on high alert. Everything and everyone is irritating me. The chair I’m sitting on is way too uncomfortable. My husband is talking and right now I can’t stand his voice. The laughter from the table behind us is grating on me and I feel like screaming until my throat is hoarse,

“SHUT THE FUCK UP!”

My head is full of pressure, it literally hurts from all the thoughts racing in my mind. It feels like my head is going to explode. I can feel my hands and body trembling. It feels like I’m on the edge of a cliff  with a safety net below. I know I need to jump and if I do they’ll be a release from the ceaseless, building pressure. I can’t make myself jump. It’s like my legs are stuck and I can’t move forward.

Now, suddenly, I have an overwhelming feeling of dread. It feels like all the energy has been drained from my body and I feel utterly useless and completely broken. The pressure in my head is still there, and my mind is still racing away. The thoughts are negative and intrusive, telling me I’m worthless,  pathetic and don’t deserve to live. Ten minutes later our food has arrived and I can’t stop talking. My head is full of thoughts, mostly gibberish that I can’t decipher. I’m laughing but I feel like crying at the same time. I don’t like this feeling. I feel like I’m losing grip on who I am and the world around me. i can’t concentrate because I’m trying so hard to grip hold of some type of stability.

I feel like I’m at a crossroads and which ever way I go something terrible is going to happen, but I don’t know what. I maybe at the crossroads but some other force beyond my power is going to choose the direction I turn. Will it be mania? Or depression? Its a terrifying feeling to have seemingly no control over your own mind.

This had been going on all weekend and now it was Monday and I was mentally exhausted. We went home and I cried on the sofa, not knowing what to do with myself, as my body and mind continued to hum along with a relentless energy.

The mixed episode broke, eventually, but not to my relief. I found myself severely depressed, a depression I’m still trying to ride out. I hope my story helps others going through these experiences and shows people what it’s really like when someone says they’re in a mixed episode. if you want to help someone, listen and above all be patient with them.

 

Is Stress A Trigger For Mental Illness?

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For me, the answer is yes. However, it’s not the cause of my mental illness but a trigger for an episode of bipolar mania or depression. It’s usually coupled with other triggers such as; a lack of sleep, drinking alcohol, or not taking medication.

I’ve been through many occasions where stress has had an impact on my mental illness. When the pressures of work have become too much, I find myself spiralling. The most likely repercussion is an episode of mania. The stress will disappear and I will become a whirlwind of energy and activity. Misdirected this energy can lead to reckless behaviour and I’ll find myself in dangerous situations. Mania also leads to obsession. Either with my work, with colleagues I dislike, or on projects in my personal life. I talk about one example in detail in the post Unhealthy Obsession

Often I don’t realise I’m stressed until I start showing signs of mania and then at that point I don’t care that stress has caused me to feel so euphoric. Of course with bipolar, being so hyperactive and full of relentless energy, I have to come down sooner or later. I talk about this feeling in the post The Mania Hangover . Then the stress I’m under really hits me, as I fall into a depressive state. There have been many times when for whatever reason I am already manic or depressed when a stressful situation pops into my life. Depending on the type of episode I’m experiencing, my reactions and ways of coping will differ dramatically.

Although stress can make us feel ill, a mental health condition has to already be there, whether it’s known to you or not, to trigger a mental illness. We all go through times of stress where we feel run down, lacking energy and generally feel overwhelmed by life. If you’re susceptible to depression or anxiety, the stresses of life can definitely trigger these. I find with bipolar disorder, which I continually live with, stress exacerbates the condition. I’ve learnt that I have to manage the stressors in my life and face up to the causes. Whether that be my job, a relationship, or money worries I need to assess the impact they are having to my stress levels, and ultimately my mental health.

Workplaces in particular need to work with individuals to create an environment that eases daily pressures. Society needs to be more compassionate and provide aid to those struggling for money and living in poverty. I grew up in a household where both my parents worked, yet we struggled financially. I know firsthand as a child and then as an adult how much stress is caused every month when bills are overdue and you have no way of paying them.

If you go through stressful situations but don’t have a mental illness that’s great! But don’t judge those that do. It doesn’t make the person weak or less resilient because stress triggers their mental illness. In times of extreme stress those with mental illnesses suffer; it’s unavoidable.

 

I Gave Up Alcohol For My Mental Health

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My last psychiatry appointment was a tough one – I was told with certainty that I should, no, needed to give up alcohol. My response was a hopeful one, surely half a bottle of wine on a Saturday night was alright? The answer was a definitive no, even that amount of alcohol was far too much. We agreed that I should go sober, and I agreed reticently. I left feeling dejected, grumpy and silently cursing my psychiatrist. Although I felt fed up, I had known before my appointment that this change needed to happen.

Why go sober? 

My psychiatrist explained that alcohol reduces the effectiveness of many medications. Alcohol is a depressant, and pretty much cancels out the work my mental health medication does. In other words, I might as well not bother taking my medication every time I drink. If I have three days in a row of drinking, then that’s three days without medication. For me that can cause the beginning of withdrawal symptoms, that feel like having the flu. Or, more seriously, it can cause a bipolar episode of severe depression or mania.

The mental and physical effects

After a heavy weekend, or a number of days in a row of a ‘few’ drinks in the evening to help me unwind and relax I start feeling the negative effects of alcohol. I’ve noticed a correlation between heavy drinking and heart palpitations, that often leads to a full blown panic attack. Panic attacks are a debilitating and exhausting experience, and I’ll feel drained for days afterwards. Another experience I’ve had after drinking is psychosis. Earlier this year I drank heavily over my birthday weekend and at the end of it began to hear voices. I wrote about the experience in this post, My Hearing Voices Journal Alcohol free, I wouldn’t have gone through these experiences, and would have stayed mentally well and stable.

How I did it

I literally just stopped! Seriously though, it’s been tough, especially on nights out and at family celebrations. I’ve been drinking since I was fourteen, so to just suddenly go completely sober was a massive challenge. I was open about it with everyone, and my partner, family and friends have all been extremely supportive. I reached out to the twitter community and was given heaps of advice and tips on non alcoholic drinks so I wouldn’t feel like I was missing out on nights out. Soda and lime cordial has been my saviour when I’m out at a bar, along with flavoured sparkling water when I’m having a night in. It’s taken a terrific amount of self determination and will power, but I knew it was something I had to do for my mental health.

How I’m feeling now

Two months later and I feel fantastic! I’m clear headed, have more energy and haven’t had any palpitations or panic attacks. I’ve been stable and haven’t experienced psychosis or any depressive or manic episodes. I feel physically healthier and I’ve lost weight. I know my medications are working as they should be now, and that’s given me the impetus to stay sober.

I may have left my psychiatric appointment with a feeling of dread and wondering how the hell I was going to go sober, but I’m so glad I stuck with my decision.

The Mania Hangover

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The Best Feeling Ever!

When I’m in the grips of mania, I love Bipolar. The euphoria I feel is like no other drug. The feeling is addictive and I never want it to end. The mania is unbelievably epic, like I’m living in a blockbuster movie and I’m the star. The whole universe revolves around me. Continually going through my head are thoughts that instil an enormous, gratifying confidence: ‘I’m the best at everything!’ ‘I can do anything, be anyone!’ ‘Nothing can touch me. I’m invincible!’ It’s a feeling like no other and yes, when it ends I do miss it. Because of course, like any good thing, it has to end. I talk more about mania in this post Mania is…

Here Comes The Hangover

What I hate about Bipolar, above anything else, is what I call my mania hangover. First of all, I realise I’ve spent far too much. Imagine having a big weekend when you’re suddenly buying everyone shots, but that weekend stretches on for months. Or that clothes and shoes binge you’re on when you spend an evening sat in your pyjamas on the internet, but imagine it lasting weeks. I’ve found myself in crippling debt more than once, the first time meaning I had to move back home with my parents. I felt terribly embarrassed and an absolute failure for having to go back to live with mum and dad. Luckily I had that option.

Next, the realisation of my actions set in. I start to see with clarity and I realise I’ve done things that I’ll regret for years to come. I cheated on my ex, whilst I was away traveling in Japan. When I was feeling stable again the memory rushed toward me and I felt dizzy and sick over what I had done. It was completely out of character, and I was remembering it through a haze, as if I had been drunk. I see how much stress I put family and friends through with my unpredictable, sometimes rageful emotions. I’ve made family and friends cry with vicious words that cut them to pieces. I’ve done so many embarrassing, ugly things I regret over the years I can’t fit them into one blog post.

From constantly being full of energy and unable to sleep, now I’ve become emotionally and physically exhausted. I’ve been running on empty for weeks and not even noticed. All I want to do is to become a hermit, hide from the world in bed and eat junk food.

Hello Depression

Then, inevitably depression sets in. I hate the depression, and it’s usually part of the whole mania hangover. The juxtaposition between the mania and depression is ridiculous. I’ve heard the description of ‘it’s like living on a rollercoaster’ but it’s too simplistic a description. Rollercoasters for me are fun, and the lows of acute depression are far from fairground ride fun and games. Depression, just like mania, takes complete hold of you, and won’t let go. I can no longer function like the average person. I stop going outside, I have to force myself to shower and brush my teeth. Everything is an unbelievable effort.

My Hangover Cures

Ultimately, I would not want to be manic in the first place! To do this I check The Warning Signs of a Manic Episode that I have identified over the years. Even though at times it can be a tempting prospect to go back to that feeling of constant elation, it’s not worth the adverse effects. Taking my medication is the surest way to stop this from happening. If I do find myself with a mania hangover, I take the time to look after myself. I’ll take some time away from work and socialising. I’ll keep an eye on my mood and check for the warning signs of depression.

So, What Is Bipolar Disorder?

 

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Bipolar disorder is characterised by extreme lows, and extreme highs. What I mean by this is extreme mood swings. Lows can lead to suicidal depression, and highs resulting in mania. Bipolar is extremely difficult to diagnose, as it affects people differently. Not everyone has extreme mania, which can result in reckless behaviour and delusions and hallucinations.

Depressive Symptoms 

If you’re depressed, it often manifests as being tired all the time, crying over little things or for no reason at all. You’ll find yourself losing interest in hobbies and activities you used to enjoy and not wanting to socialise or leave your home. Depression can leave you feeling worthless, hopeless and fill you with dread. The most serious aspect of depression is having suicidal thoughts, planning and possibly acting on them.

Manic/Hypomanic Symptoms

Hypomania begins with accelerated speech, where you talk very fast and people find it difficult to keep up with what you’re saying. You’ll not need to sleep or eat as much as you used to. Thoughts are uncontrollable and constant. With mania, your judgement may become impaired and you start to act impulsively. The most serious aspects of mania are characterised by a complete lack of control and putting yourself in dangerous situations, as well as delusional thinking (believing wild ideas about yourself or others) or hallucinations (seeing, hearing, feeling things that are not really there).

According to the charity Bipolar UK;

  • More than one million people in the UK have bipolar.
  • It can take on average 10.5 years to receive a correct diagnosis.
  • Individuals with Bipolar are misdiagnosed, on average, 3.5 times.

Below is a mood scale that explains the extremes of Bipolar. Most people will usually find themselves between 4 and 6 on this scale. With Bipolar, mood swings could leave you falling anywhere on the scale.

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My Experience

As  I’ve already mentioned, Bipolar unfortunately can take a long time to diagnose. I first became very ill when I was 14 and was misdiagnosed with depression. It took until i was 27 to finally have a definitive diagnosis of Bipolar. The problem I have found is many people misunderstand it and only ask for help or are given support when they are depressed. Bipolar in young people can sometimes be misdiagnosed as ADHD, because of the manic symptoms they are showing.

I was on antidepressants on and off for years. Initially I was given counselling as a teenager, and took antidepressants in my twenties. They didn’t help me, but made my mood what I would call hyper. I couldn’t stop talking, I did reckless things, drank too much, took drugs. I would feel amazing and full of confidence on anti depressants. I would often become very angry and upset people and get into arguments and fights.

Now I’m doing really well, I’m stable and I’ve found the right combination of medication that helps me manage Bipolar. It’s taken four years to find the right combination of drugs that help me stay relatively stable. I need to be very strict with myself and take them everyday and limit how much I drink, or they won’t work how they are supposed to. I’ve been told by my psychiatrist that it is a life long condition, and I need to learn how to manage it.

So where did your bipolar come from? 

To be honest i have no idea what the cause of it was. I came from a happy family, although we struggled with money and had arguments, nothing traumatic happened to me during my childhood. My Dad believes that my Grandmother had it, but she was never diagnosed that we know of, and we think I may of inherited it from her. As a child I was quite quiet and would bottle up my emotions, and then I became very depressed as a teenager. It wasn’t until I was about 16/17 when my behaviour changed and now I realise it was probably mania. It was like my whole personality changed overnight and I became very loud, talkative and hyperactive.

Advice on what to do next

I think it’s important to be careful before diagnosing someone with Bipolar. It is a severe and life long condition and the medication is serious stuff. Doctors I understand want to be careful before referring patients. To be diagnosed, you have to have a psychiatric assessment with a psychiatrist, but you first have to be referred by a GP or counsellor. Often it helps to take someone with you to an appointment. Sometimes a doctor needs to see supporting evidence from family or a partner before you are taken seriously.

My advice if you are worried that you or someone you know may have Bipolar is to keep a mood diary. Track how you are feeling everyday over a period of a few months and take it with you to see a doctor. I know that seems like a long time but it’s better than waiting years to be heard. It might also help to sit down and write a chronology of your problems from when they started up until the present day. Both of these can then be evidence to show a doctor, and will show if there is a pattern of depression and mania.

 

Physical illness when I’m mentally well – it’s not fair!

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It’s a regular occurrence, whenever I find myself mentally stable, I become physically ill. It seems so unfair. I have lived with this phenomenon for years. As my mind starts to heal, my body relaxes and I find I’m much more susceptible to becoming physically ill.

I have been stable for about four months. The first flare up was my back and I found myself in excruciating pain. I’ve been referred to a physiotherapist but I still wake up every morning in agony. It seems I’ve had this problem for a number of years, but my body has never fully relaxed. When I’m manic I’m full of energy and on the go. During depression I’m often extremely anxious. In both situations my body is tense, so my back pain hasn’t been so obvious. This week I’ve had a terrible cold. I haven’t had a full on cold like this for years, and it just so happens to coincide with me being stable. I don’t think this is a coincidence.

As a Bipolar sufferer, I have always suffered from what I call the comedown, or hangover from mania. Mania can be euphoric, but it is always exhausting. After an episode, I almost always become physically ill. I haven’t looked after myself properly for what can be months at a time; exercising till I nearly faint and hardly eating or sleeping. No wonder my body rebels when I finally relax.

I’m not sure what the answer is to this. My body is obviously reacting to how I have pushed it to extremes and how stress and anxiety has weakened my immune system. I’m hoping with longer bouts of stability, I find better physical health. I’m already finding that I’m eating more healthily and looking at finding a suitable exercise regimen.

What not to say to someone with Bipolar Part 2

Continuing on from the first part, which you can read here I’ve explored conversations I’ve had regarding bipolar. As I mentioned in part 1, many of the questions or statements are meant to help, but are things I have heard many, many times before. Sometimes they can be insulting, which is difficult to deal with. I have been taken aback by how little people understand the condition and what they feel is acceptable to ask. It’s like when a woman is visibly pregnant, and people will touch her tummy without asking. It’s invasive and so are some of the questions I’m asked. Statements are made without thinking. If people stopped and thought to themselves “would I be alright if someone asked me that?” they may change their mind before speaking.

You can’t have bipolar, you seem so nice!

I’m always confused by this one. Having Bipolar is not a character flaw. Just because I suffer with intense mood swings it does not make me a bad person. I’m not going to suddenly attack you or go on some rampage. Mental illness for the vast majority of us doesn’t work like that. I find people that suffer with mental illness have a huge amount of empathy for others, and are willing to support friends and family even when they themselves are struggling.

A healthy diet and exercise will make you feel so much better.

I know this suggestion is supposed to be helpful, but honestly I have heard it a ridiculous number of times. As someone that wasn’t diagnosed for over a decade of suffering, I have tried everything I can possibly think of and that includes a healthy diet and regular exercise. Although I agree it helps with general well being, it cannot alone alleviate symptoms.

But you don’t look Bipolar.

I’m not sure exactly what people imagine a Bipolar sufferer to look like? I suppose they feel I should be wearing all black when I’m depressed, with my head in my hands, rocking back and forth. When I’m manic, maybe they believe I should have a crazed look in my eyes and act like a clown all the time? People don’t always present as being manic or depressed. I don’t look much different during these times, I just look like me. I might look more tired than usual when i’m depressed, but on good days I can still dress up and wear makeup.

Do you really need to take all of that medication?

Yes, yes I do. Medication has saved my life and giving me stability that would never have been possible without it. I talk at length about this in the post Psychiatric Drugs Saved My Life

I’ve watched Homeland/Silver Linings Playbook and you don’t act anything like that. 

Bipolar disorder is not the same for everyone. There are different forms of Bipolar such as Bipolar I (characterised by extreme manic symptoms and severe depression), Bipolar II (with a milder form of mania called hypomania and severe depression). Rapid cycling (where you switch from mania and depression in quick succession). A mixed episode (where you could be dealing with both extremes at the same time) and cyclothymic (a chronic but milder form of Bipolar disorder). Film and television will always show the extremes of mental illness. I have become astute at hiding how I’m feeling, after years of trying to fit in. So I may not always appear to be ill, but in fact inside I’m struggling.

It’s a shame that I’ve had to post this, but the reality is that many people still do not understand bipolar disorder, and mental illnesses in general. I’m sure there will be a part 3 of this somewhere in the future, but I hope not for a long time.

 

 

 

 

Stability

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I’ve found myself in a a strange situation. It’s one I haven’t experienced for years. It’s called stability. My life has been full of desperate lows and extreme highs and not much in between. It’s been like this for over a decade. It’s true I have had periods of stability, but usually they only last up to a month. This time it’s different. This time I’ve experienced stability for nearly four months.

It feels strange and alien to me. I’m used to living an intense life, full of drama, fear, anger and emotional heights and depths. The euphoria I feel during a manic episode is unparalleled to any other I have experienced. I’ve experimented with drugs but nothing comes close to a full on bout of mania. I always say I don’t need to take hallucinagens because psychosis has that covered.

Back to life being surreal right now. I’m not used to this. I’m not used to feeling calm and organised, feeling happiness without worrying it will morph into something toxic. Or days when I wake up and I feel slightly on the down side, but being able to carry on without depression creeping up on me. I feel like I can accomplish things, without obsessing over a task and becoming completely absorbed by it. I’m wondering if this is normality, or if there is such a thing. Is this how healthy people live?

I’m lucky that I have finally found a combination of medication that works for me, and hasn’t given me extreme side effects. I’ve put on some weight, but now I feel stable, I’m less likely to drink and crave junk food. It’s something I could change if I wanted to.

I’m not always sure I like this feeling. Life feels quite bland and monotonous. It’s like my world is slightly overcast and grey, instead of full of darkness or bright sunlight. I don’t know how to act or to live like this. Sometimes I daydream about the fun side of mania and how if I stopped taking my medication I could get back to that. However, I then remember all the negatives that come along with it. The delusional thinking, the intense anger, obsessive and dangerous behaviour. There’s also that air of foreboding surrounding me that at any time I could become seriously ill again. If I push myself too much I’ll trigger an episode of mania or depression.

It’s a bit cliched to say but I’m taking each day as it comes. Life I know shouldn’t be full of extremes constantly and should be quieter. Sometimes yes, even boring. I’m grateful that I’m in this position and I’m trying not to take it for granted.