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> My belief is that everyone has minor bouts of mania and depression, and bipolar people just experience it more extreme

if you read about the symptoms of bipolar disorder you will see that it is a bit more complex than this.

http://www.nimh.nih.gov/health/topics/bipolar-disorder/index...

Take a look at the list of manic / depressive episode symptoms. Every single one of those applies to me in a very extreme way - i have been hospitalized once and believe i am going to be again soon as i feel very similar currently as i did in the past.

Edit:

oh also forgot to mention - i appear to be the kind of bipolar which comes with a touch of psychosis... its definitely more complex than the minor ups and downs of a normal person.

second edit: yes you sound bipolar and should probably get it under control because its pretty much wrecking my life now and had i not ignored the signs / knew what to look for earlier in life i would be in better shape right now.

Sleep. Sleep sleep sleep sleep sleep is the key. I cannot stress that enough. Sleep and schedule. Wake up at the same time every day, no. matter. what. Don't stay out late just cause it's the weekend, don't go out partying just cause your friends are. Don't pull an all-nighter just to get an A on a test or meet a deadline. Once your sleep gets out of whack, a manic bout is not far behind, and that's 6+ months of your life turned into chaos. If you find yourself staying up all night, unable to sleep, that should be a huge warning sign.

I speak from experience. Lots of it.

Amen, and well said. I'm a psychiatrist and I worry the most about sleep, full stop. In a disease (or set of diseases, or whatever) that can make people feel so out of control, sleep is one of the best ways to take back control.

yes! i agree. i have lots of sleep issues. now i go to sleep early in the evening (nearly right after the sun goes down) and i wake up between 3 and 5am.

my biggest problem right now is work: i have had issues holding a job throughout my life. there was a 6 year stint that i was able to keep 2 jobs, but beyond that i usually quit due to what amounts to nothing in the end. have been trying to get a fully remote position as seclusion seems to help.

Radiolab had a very compelling depiction of the manic phase of bipolar disorder:

https://www.podtrac.com/pts/redirect.mp3/audio.wnyc.org/radi... (starting at 3 minutes 30 seconds)

The defining factor between Bipolar I and Bipolar II is that you have been essentially never been hospitalized(and never had a completely documented manic episode). Ignoring psychosis the defining characteristic of a mental illness is often abnormal behavior which is slightly subjective. It is essentially the scale of the issue(mania typically) when it becomes a mental illness.

I'm not sure what you're saying. i was hospitalized last year during the election while thinking that the gov. was after me, reporting a coworker as a terrorist (def not a terrorist) etc. i could go on.

actually i will go on:

reported the nicest guy to HR (he's fine) was on the verge of suicide, then thought "people" were after me and just completely flipped shit. family member kindly allowed me to stay at their home and then took me to the hospital the following day where i checked myself in.

Psychosis is not required to have a diagnosis of bipolar and frankly I do not personally believe that it should be included in bipolar(it should be a separate diagnosis). IMO and many other psychologists opinions is that bipolar by the general public is often viewed as a mood disorder(not the psychosis part).

The genetics would argue otherwise. Here's an interesting recent illustration: https://www.ncbi.nlm.nih.gov/pubmed/29167880

No. That article proves my point exactly. Bipolar by definition currently may or may not include psychosis(there is no way for the medical provider to distinguish between the 2.) If you did not include psychosis(as the DSM does now), most people with bipolar diagnosis would actually have Schizophrenia because that is the next closest mental illness(which is why there are genetic similarities.) Bundling an angry disorder with hallucinations should not be done and was an afterthought. Actually psychologists agree with me. "psychotic features – is included almost as an afterthought. It is not one of the defining features of a manic episode. Rather, it is something that may be present.[1]"

[1]: http://behaviorismandmentalhealth.com/2009/09/06/bipolar-dis...

regardless, i had some sort of psychotic attack which lasted for several days along with a list of other symptoms which are fully documented, observed and on record. i have hardly been able to hold a job since that event and am stumbling through life.

Let me suggest you start a food diary as a useful tool. I have been successful in mitigating certain somatopsychic symptoms largely using diet.

I probably should. just started looking through the list again:

many people have bipolar disorder along with another illness such as:

anxiety disorder substance abuse eating disorder delusions runs in family Feel very “up,” “high,” or elated Have a lot of energy Have increased activity levels Feel “jumpy” or “wired” Have trouble sleeping Become more active than usual Talk really fast about a lot of different things Be agitated irritable or “touchy” Feel like their thoughts are going very fast Think they can do a lot of things at once Do risky things like spend a lot of money or have reckless sex Feel very sad, down, empty, or hopeless Have very little energy Have decreased activity levels Have trouble sleeping, they may sleep too little or too much Feel like they can’t enjoy anything Feel worried and empty Have trouble concentrating Forget things a lot Eat too much or too little Feel tired or “slowed down” Think about death or suicide

literally everything... and i've been denying it until like 2 days ago and am heading to the dr on monday after being talked out of killing myself for the 5th time by my wife ¯\_(ツ)_/¯

I'm not going to post a link to it on HN, but I have a discontinued food blog with some information potentially relevant to you.

The tldr: I am often suddenly suicidal. I have essentially a salt wasting condition. There is a salt and lithium connection and I have found it really helpful at times to eat a meat and potatoes meal to mediate the salt-lithium connection when I am under stress and expecting to soon fall off the deep end suddenly.

i am supposed to be taking lithium but have refused medication for a few reasons.

mainly everything i have been prescribed has screwed me up further -- lithium specifically felt absolutely amazing to be on, i felt "content" and started feeling more balanced and creative etc... however i was sleeping until noon and felt a weird fog and felt like i couldn't program well (which is pretty much the only thing i do).

edit: the above fogginess may have been from the seroquel actually i can't remember.

I tried other medications but has other weird effects (i'm not good with drugs).

secondly, the suicidal thoughts weren't fading and I was very focused on the drugs as a means to my end (they were hidden from me by my wife because of this and she would give me my dosage when it was time).

i have to use a number of techniques to keep me grounded and most of the time I'm fine (i meditate, read, listen to specific types of music, exercise, etc) however there are triggers in my life which i have no control over and i lose control (ex wife making my life a nightmare via legal system, lack of funds etc).

to be honest i'm sort of fucked. i'm an aging dev with mental health issues, little to no support from family, can't really do meds because it fucks up my ability to work. sucks

FWIW, I went 30 years without being diagnosed as or medicated for Bipolar 2. Life was hell, physically tortuous even, and socially and financially devastating. Wrecked my life good. I was around 43, when I found out.

I completely understand getting set off. I don't know how many thousands of hours I've lost to excessive anger and irritation. The bitch of it is that there's usually a good reason to be angry, just not _that_ angry.

With the proper meds, life isn't perfect, but I have the kind of peace of which I dreamt for decades...and without being zombified. I can actually hold down a job.

Friends, roommates, and noise generated by other people, still a big no. I live alone up in the hills and wfh. I like it that way.

As for meds, should you try any again,

Forget lithium. The best mood stabilizer I know is Lamotragine. If you are in the US, fill your prescription through canadadrugs.com. It's too expensive in the US.

As for anti-depressants, the Serotonin-based drugs never worked for me, but I take Viibryd now, which isn't Serotonin-based.

As for ensuring that you sleep (I was an insomniac for much of 20 years), Trazadone is an old, cheap, and non-addictive sleeping pill. It has nothing to do with ephedrine or melatonin, and won't mess you up at all.

> around 43

late 30s here.

> there's usually a good reason to be angry, just not _that_ angry

i experience extreme anxiety more than rage

> Friends, roommates, and noise generated by other people

i am similar. thankfully my wife is a very quiet person.

> Viibryd

was on it for over a year -- didn't end well (weaned myself off after running out of insurance)

I feel for you. I understand your concerns about the medications. Some of the treatments I have taken have basically prevented me from functioning normally. It is hard at times, because I haven't been able to find a solution. I think best hope is an improved ability to cope with the symptoms as they become more recognizable

yeah i'm not really sure what the solution with this one is. without insurance or support i'm basically out of options. I was going to live in my car last year but a family member let me stay at their home for 3 months (happened to get a job just as they were on the verge of kicking me out). wife is looking for work but won't make enough to cover rent let alone everything else. we have a couple more months to figure it out so i'm sure something will pan out.

I'm talking about a much gentler approach than taking drugs.

Best.

I used to experience this as well, and I always considered myself cyclothymic[0] (not diagnosed).

I feel much more even nowadays and I attribute it to a cumulative effect from plant medicine ceremonies over the last 3 years (five combination ayahuasca/san pedro, one 5-MeO-DMT), discovering an anchoring purpose for my life, and reducing my marijuana consumption (haven't smoked/edibled since New Years, longest in ~17 years).

I feel a general resistance to dwelling on depressiveness personally, or any groups that center around dwelling on any negative perception of self. In my experience I've found that it becomes self-reinforcing... if you're lonely and you feel less lonely thanks to your kinship within a group based on shared depression, then your desire to be less depressed becomes subversive to your membership of an in-group. Depression can become an immutable identity trait and not a state of mind that can be overcome with the right treatment.

This part of the interview resonated with me:

> Pourasghar: For one, if you’ve experienced extreme hopelessness at some point and came out of it stronger, I think it prepares you for the rest of your life in a positive way. It gives you a deep-rooted confidence. You learn that whatever comes your way you can always prevail, and I think that leads to allowing for more risk in your decisions. It helps me put any fears into perspective.

> Also, I think my experiences have opened me up to more vulnerability. Unfortunately, we are usually taught that vulnerability means weakness, especially as men. From my experience, I’ve found that opening up to people builds trust. When we bring our whole self to the people around us, we create stronger, more authentic relationships. In general, I’ve learned that it’s possible to turn pain into something positive.

I don't think I would ever use such a service myself though.

[0] https://en.wikipedia.org/wiki/Cyclothymia

I am not a psychiatrist, but it does sound like you have bipolar symptoms, especially if you have the hypo-maniac episodes.

Bipolar is sometimes misdiagnosed as major depressive disorder, because the mania doesn't seem like a problem. Who doesn't want to feel more productive and on top of the world? I know I've failed to recognize a manic episode, and wow did I end up paying the price when the pendulum swung the other way.

> because the mania doesn't seem like a problem.

To be clear, the feeling of being on top of the world and superhuman is hypomania, and not full blown mania (hypo indicating "less than" mania), which from my experience, is far and away worse than the depressive episodes. Don't get me wrong, depression is bad and you can literally end up dead from it. Not going to minimize that.

But the mania I've experienced? Watch out. Buying things you don't need, quitting jobs you need desperately, ending relationships on a whim, engaging in random sex, random drug use, not sleeping ever.

And if that weren't enough then there's the paranoia and delusions. The government is out to get me kind of stuff. The "I'm the second coming of God" kind of delusions. The CIA installed microchips in my cats and they're using them to spy on me kind of paranoia. That plus the sensitivity to light and sounds. I had to take the batteries out of my smoke detectors because the tiny LED felt like a spot light at night, watching me like the Eye of Sauron.

And if I haven't burned every bridge I've ever made, earned the scorn of everyone whose ever loved me, and spent every cent I've ever earned, I can consider myself lucky for not ending up in jail or an institution. The hospital is a whole different level of fun when you're susceptible to the idea that there's a conspiracy against you.

So yeah, while depression is bad and hypo-mania is fun sometimes, full blown mania isn't something I would wish on my worst enemy. It's the devil incarnate as far as I'm concerned.

Point taken regarding the difference between hypomania and mania symptoms. But not everyone, including those with BP2, experience the extremes of mania.

From my own experience I failed to recognize a hypomanic episode until it was far too late because I felt great and didn't realize something was wrong.

It ended with one of the most severe manic/mixed episodes I've ever experienced. It was one of those experiences you hear can happen to BP patients, but you don't believe can happen to you until it does.

When I finally snapped out of it, I was pretty damn shaken up about what had happened, and probably for the first time I came to terms with how dangerous this disorder can be.

So I agree, I wouldn't wish that experience on anyone

> To be clear, the feeling of being on top of the world and superhuman is hypomania, and not full blown mania (hypo indicating "less than" mania)

Which, unrelatedly, always confused me. "Hypo" in medicine usually means "a dangerous lack of something"--hypoxia, hypothyroid--not "too much of something, but not way too much." The first time I heard "hypomania," I assumed it meant depression! It seems like "semi-manic" or something along those lines would have been clearer.

Hypo just means low. Hypoglycemia is low blood sugar. Hyperglycemia is high blood sugar aka diabetes. Hypomania would be low mania. It's kind of like saying a little bit of mania.

This is accurate regarding the worst case. I’ve also had full psychotic manic episodes I would not trade for the world, although they were challenging.

Thank you for this comment. It's enlightening.

> My psychiatrists have flirted with a bipolar diagnosis but ultimately they think it’s standard anxiety / depression.

I hear that very often, especially from the people diagnosed around 30-15 years ago. I can't get the feeling that this is just an easy excuse to cover inability to find a real cause. I have no study to back it up, just my experience, but I've yet to see a person who has an anxiety just like that. It is an effect, not a cause. You can't treat an effect an just happily ignore the real reason. I am biased by the people I around me, sure, but I would say, very often the cause is being different (even if only slightly) and difficulties to find yourself in the society.

(edit typo)

Is it ok if you could detail your "mechanisms" that you use?

Just trying to grok against my own which has worked for me for the past decade or so but am struggling with its effectiveness recently.

As I know it goes away in a week or so, I don't get worried or overthink it, as I know it will pass. During mania I don't buy expensive things, start big projects, make life decisions, or do anything that may be tainted by my over optimism.

When I'm feeling low, just try to exercise, eat healthy, think positive, follow all my routines.

Basically I try to keep a rational mindset that I keep separate from my current state, and try to analyze the situation as a neutral third party would. This is a useful technique regardless but especially effective when I feel off.

Thanks for your response! It sounds somewhat similar to the mechanism I use albeit mine has a bit of a weird twist to it .

It sounds strange but my goto method is visualising my negative sate in my head as an "alter ego" of me but more messed up (think hobo + zombie-ish) and trying to either talk rationally to this person. Sometimes I get a good discussion out of it or sometimes it results in a fist fight. Either way, the outcome for me is I get closure out of it.

I did say it was strange. :)

I'll just say it, from someone who is similarly in your boat:

if you're even questioning it, there's probably something there

think about someone who is questioning their sexuality. there has to be some reason they're doing it.

i agree that there are probably varying degrees, like everything, but comeon...you're obviously very aware of the stigma. bipolar people who are highly functioning exist, and your doctors' metric is probably quality of life. if you can hold it together, it's not really life-affecting. it's just the way you are.

you could probably say you are bipolar-ish but have developed systems on your own for dealing with it.

> My belief is that everyone has minor bouts of mania and depression

I've experienced situational depression, but never mania. Belief disproven. ;-)