I’ve been a little hypomanic again lately. It started, as it usually does, with a reduced need for sleep – even continuing to take my usual doses of lithium and quetiapine (Seroquel) I began to have difficulty drifting off, and started to find myself wide awake hours after the antispychotics have usually kicked in. When I did get to sleep, I found that I was waking frequently throughout the night, every night. My dreams become much more vivid and intense than usual, and the boundary between dreaming and reality somehow got blurred – I know I woke my partner several times last week calling out, or thrashing about, unsure what was dream and what was reality.
It’s not surprising to me that my dreams become larger than life, because hypomania makes me experience the world differently in a whole range of ways. For me, it is a state in which ordinary sensory experiences become transcendent. I bite into a bar of chocolate, and I am stopped dead in my tracks by the way the flavour seems to literally burst onto my tongue and fill my whole being with pleasure. It is almost an out of body experience. Music has a similar effect. Find the right song and - especially if it is delivered to my ears via headphones - I experience a phenomenal rush of bliss. I feel my pupils dilate, and I have to close my eyes and breathe in to deal with the intensity. I often listen to music on public transport, especially when on the London Underground (somewhere I necessarily spend a lot of time as I travel between appointments). I this state I can find myself over-receptive to every little movement and sound of the train, so that it feels as if I am travelling much faster than usual. Combined with music, travel by tube as it hurtles through the tunnels begins to feel like being on some kind of weird, cut-price theme park ride.
Another ordinary-turned-astonishing experience is running in the park. Despite the lack of sleep, a key feature of hypomania is that I don’t feel tired in the day – in fact I have plenty of energy, for writing, for cleaning, for exercise. The combination of pre-existing hypomania, endorphins which are naturally generated by running anyway, and up-tempo workout music, results in another wallop of brain-chemistry high. It makes me so euphoric that I feel like my head might have to burst in order to release the rush of ecstasy. I am surprised that nobody seems to be looking at me strangely. Never mind walking your dog, can’t they see how UNBELIEVABLE I feel?
On top of all that, like most hypomanic people, I feel great about myself. I don't just think I'm smart, I know I’m brilliant, and what is more I feel beautiful and sexy, too. Instead of worrying about the weight I've gained from months and months of taking lithium and quetiapine, I glory in my curves, somehow knowing how to pull together outfits that flatter my figure. If I can't find just what I want, I can go shopping, an activity where I will be amazed at how many absolutely perfect items seem to be queuing up to bring themselves to my attention. Everything will be a bargain, as well as an essential purchase, and all the shop assistants will be wonderful people who could not be more helpful.
At the time, hypomania feels like an entitlement. A wondrous, amazing, exciting experience, but one that feels like this is the way life should be lived. Intellectually I know that, far from being my birthright, hypomania is pathological. The impulsive, distractible, disinhibited part of it is risky. I often feel that I want to quit my job and start things I can’t follow through, some of which have a financial cost attached (I am so glad I pulled out of that six year part time degree in archaeology just in time). Part of the reason I can’t go back to my job yet is that it involves making important decisions based on detailed and confidential information, which affect the lives of vulnerable people. In that context, the grass-hopper brain and the poor decision-making of hypomania is a dangerous liability. And so I forced myself to tell my psychiatrist about it last Thursday. And of course I know there is only one logical response to acknowledging my hypomania and accepting that it is pathological, and that is to treat it. In fact, in the context of my overall goal of reducing my symptoms to a point where I can return to work and pick up the pieces of my life, treat we must.
I am only a few days into tackling my hypomania with a combination of increased antipsychotics and a deliberate avoidance of stimulating activities (shopping, socialising ), but I have already been hit with the conviction that my hypomania was in fact not a right but a gift, and a gift I took for granted. And suddenly I feel that in telling my psychiatrist about it, in agreeing to increase my medication, I have thoughtlessly given the gift away. I’m sleeping better at night now; the elation is dampened down to such a degree that I can only catch glimmers of it, and my main mood state is now probably one of slight irritation. And now I miss my hypomania badly. I miss it badly enough to briefly consider stopping my medication, although I’ve never done that in the past and I don’t intend to start now. It’s just that as I grieve for my hypomania, I can’t help feeling like taking pills to cure me of the most explosive joy I’ve ever felt in my life – a bliss that other people take drugs to achieve - is the craziest part about this illness.