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This reads out exactly how a manic or hypomanic person would experience things and rationalize past events and feelings. The idea that it has to be something complex and in a sense grandiose compared to "just being burned out" is often a very telling sign.

Perhaps it's Twitter forcing the format a little, but I could see myself thinking like this during a hypomanic episode. I'm diagnosed with bipolar disorder (type 2, rapid cycling). I could see a lot of people with undiagnosed behavioral disorders being thrown into a complete mess of a situation with any resemblance of a functional system being thrown out of the door when Covid-19 hit.

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This sounds exactly like a psychotic break to me. I had a massive one and it started with a pop in my mind followed by half a year of similar symptoms. In the end, I was diagnosed Bipolar type—1.

Some people often ask, the story is here: https://kayode.co/blog/4106/living-with-psychosis/

I experienced something like this in my early twenties. It was very scary. I was fully incapacitated for two weeks where I couldn't do anything or make decisions, even play games, and I couldn't touch code for months.

I pushed myself too hard with too little sleep and that was combined with pressure from family.

There was a feeling in my mind of something snapping and it was like throwing a switch. One minute I was tired but still myself, the next I was incapacitated, delusional, paranoid, unable to sleep or relax or focus.

Have you recovered entirely by now? How long did the symptoms last for to get back to normal, did you take other measures to recover or just giving some time and less stress did it for you?

I took lexapro (anti depression drug, ssri class drug). It took about 1 month to be mostly functional again and about six months to be back to normal.

I took all the pressure off, stopped coding but continued university. I still finished the semester with excellent grades - but it was business school.

Never experienced anything like that ever again. I work hard, usually 7 days a week, but I'm careful not to push past my limits and I keep stress down, exercise, sleep well, and try to eat healthyish.

Thanks for sharing the details. Glad you made it through pretty fast, sounds like a valuable experience to know your limits.

That physiological (it seems phy to my lay self) snap at the onset is really interesting.

Is the understanding that it is a TIA/mini stroke?

I don't think so, but I remember the moment it happened. That day I was feeling more stretched and tired than I've ever been. It was the last day of university before spring break. Then my parents started pressuring me over my recently declared non belief in Christianity, and I felt like something in my "spirit", just broke or snapped in that moment. It was clearly defined instant in time where I was completely changed afterwards. I don't remember if it was like a physical pop, but I knew as soon as I felt it that something in my brain had just dramatically changed for the worse.

The words on that webpage were in no way what I was expecting when I clicked on that link.

Do you still experience yourself as a wolf with paws and wind in your fur?

No, but I have developed a different issue with disassociation.

If I’m outside under bright sunlight in an open area, I can sometimes see trees starting to become pixelated. I slowly find myself thinking in a character in a video game. This is somewhat dangerous. Actions in a video game generally has few meaningful little consequences. In the real world, death has a annoying tendency to be rather permanent.

This will sound very stupid or like a joke, but I'm not joking: Maybe if you play (almost) exclusively games with permadeath, where the consequences of dying are bigger, could at least hard-wire some kind of survival instinct in your head in case you get lost in this surreal feeling? In the worst case scenario you played some good games.

I don't think it's stupid or a joke. It's actually a pretty interesting suggestion that may work pretty well under different circumstances. Unfortunately, I haven't been able to focus on video games for a long time. What little energy left after work goes into the continuous maintenance that is life (showering, eating, cleaning). Sometimes I have enough focus left to sacrifice one of those to write stories.

I wonder, what could other people have done differently, so that you'd found help sooner?

What signs could they have reacted to, and then done what, I wonder, in case I meet someone with similar undiagnosed bipolar some day?

Nice sketches -- I wonder, you sketch the avatar (the wolf / wild dog) yourself? Seems like fun.

> T his reads out exactly how a manic or hypomanic person would experience things and rationalize past events and feelings. The idea that it has to be something complex and in a sense grandiose compared to "just being burned out" is often a very telling sign.

Bingo. FND is another name for “conversion disorder.”

I’m not going to say this doesn’t sound manic or hypomanic, but “just being burned out” is not an actual explanation.

Being burned out like he’s describing is a physical phenomenon, like many neuropsychological problems. It’d be nice if we advanced the state of our knowledge about these things beyond “just being burned out.” I’m skeptical as well about “burned the glucose out of my brain” being a good physical explanation, but there’s a physical thing going on.

We often treat burnout as an idea thing. (And this somewhat makes sense as ideas are incredibly powerful.) Having more insight into the physical (ie chemical and/or mechanical) mechanism of burnout would be interesting and probably very helpful.

It wasn't supposed to read like that, but I can see how you'd read it like that. It was definitively not meant as a put down to those that suffer from being burned out, whatever the cause might be.

I think that would just be a misdiagnosis. Seizures don’t typically accompany manic episodes and not being able to come up with words that are used in everyday situations is also an oddity.

Seizures during a manic or hypomanic episode is very common, it's often what lands undiagnosed people in hospital to begin with. Lamotrigine and Lithium was primarily used to treat epilepsy, now they're also used to treat mood disorders like bipolar disorder and schizophrenia as well.

The problem is often that there are compounding issues. There's nothing that stops you from having TIA at the same time. People often describe being overworked and stressed as burning the candle from both ends. Hypomania can more aptly be described as setting the entire thing on fire.

My post wasn't meant as some form of medical diagnosis, more of an observation from someone that lives with this. The feeling of numbness and having some sort of brain fog is how a lot of people with mood disorders like ADHD and bipolar disorder would describe things.

Do you have any sort of citation for this? I’m not trying to be snarky, I’d really like to read more.

My understanding of the med lit is that bipolar and epilepsy aren’t particularly associated, and pure BD in particular is a rarity - when epileptic patients were assessed for BD symptoms, they were mostly only found in the confusional states pre- and post-seizure, which isn’t BD at all.

At least in my hospital, the most common way we get BD patients hospitalized is either during a severe depressive episode, or when their mania results in violence or law-breaking. We do sometimes have patients land on our floor whose first presentation was seizure, but that’s after they’re assessed by neuro and found that it was pseudoseizure (factitious seizure).

I don't really have anything like that. People diagnosed with bipolar disorder in Norway are given the opportunity to attend a six months intensive and in-depth group therapy where the primary focus is to learn about the disorder by psychiatrists that specialize in bipolar disorder. I've always taken what they said at face value. At least a couple in the group was first admitted after having had a seizure during a manic episode.

I think you're right in that we don't think they are directly associated. I was more trying to explain that people might experience something that looks like a seizure without having epilepsy. And that medication (previously, mostly) used to treat epilepsy seemingly have great effect on people that suffer from bipolar disorder, which would lead us to believe that there are some neurological similarities.

And you're right, the most common way to end up in the hospital is from having a manic episode with all that it usually entails. I shouldn't have written it was often the reason, just one of many reasons people might end up in the hospital from mood disorders.

Maybe serotonin syndrome? That causes seizure like stuff and mania.

Serotonin syndrome is due to an excess of serotonin almost exclusively due to serotonin agonists. Seizure is pretty rare - it produces stuff that looks like seizure (myoclonus, tremor, delirium), but actual seizure is only seen in SS so severe that it’s usually fatal.

Unrelated but have you seen our friend TedPetrou recently? He seems to have gone quiet.

May be more common than you think (or perhaps you are a doctor with more recent info than I have, in which case I would love to read about it.)

https://www.health.harvard.edu/newsletter_article/Epilepsy_a...

> Psychiatric symptoms may also resemble epilepsy, and in that case they are sometimes called psychogenic seizures or nonepileptic seizures. Conversion disorder (formerly called hysterical conversion disorder) can produce symptoms that look uncannily like generalized seizures but actually occur in connection with a need for attention or relief from stress that the patient is not aware of.

I don’t think OP is claiming he experienced seizures, rather he’s using the “thrown out back” metaphor to explain what he felt when he attempted to work — that is, a re-triggering of the initial symptoms.

I don't see it close to resembling any kind of manic episode, and the professionals didn't either.

Sounds like somebody worked too much, started having seizures, and burnt out.

I'm not particularly fond of diagnosing people, I think it's part of reducing "bipolar", either through projection or through normality, which it's not, it's miserable.

But I am particularly fond of having companies be responsible for the health of employees, regardless of what it is, or what they need.

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