Dysphoric Mania---what's up with THAT??

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Specializes in LTC, assisted living, med-surg, psych.

Here's a question for folks who have been cursed/blessed with the lovely "gift" of bipolar disorder: Have you ever had a "mixed" episode, where you felt both hypo/manic AND depressed at the same time?

This is what psychiatrists must've been thinking of when they gave this illness its original term "manic depression": I could literally be laughing one minute and screaming the next. I still can't sit still or concentrate on anything longer than a bird can stay on one twig. I've been nervous, jumpy, agitated, and without an appetite. I've also been cleaning everything in sight and weeping uncontrollably while I scrub the gunk out of the tiny gap between the wall and floor with an old toothbrush. I don't do housework. And I actually was wide awake at 0130 this morning exfoliating, of all things. :sarcastic: It's like bipolar on crack!!

After almost two weeks of this rather exhausting battle, I finally gave up trying to fix it on my own a few days ago and called my doctor, who urgently advised me to double my antipsychotic medication and then proceeded to give me 20 minutes of free therapy over the phone. Funny, I'd thought the hysterics and feelings of desperation were symptoms of depression, but I had signs of mania too, so he called it something I'd never heard of before: "dysphoric mania".

Now, I recognize this phenomenon because I had a couple of episodes like it at different crisis points in my life, long before I was diagnosed. But now my dx is changing because what I've been experiencing was actually full-blown mania instead of hypomania, which seems weird to me because I haven't lost touch with reality and I thought BP 1 always involved psychosis. Oh, HECK no---this is much too real. I'm used to the euphoric kind of hypo/mania where I feel like I'm over the moon; this puts a much nastier spin on things and I am NOT happy. I've been writing a lot---it's the only thing I can keep my mind on for five seconds---but otherwise this whole thing STINKS and I am protesting it through channels :madface:

So does anyone else have these distressing episodes? How do you figure out if you're manic or depressed or both? When do you call your mental health provider? And what on earth do you DO with yourself during that dreadful period between realizing you're in trouble and getting relief from your med changes? Any words of wisdom would be appreciated!

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Specializes in Psych, Hosp, and LTC.

Myself no but one of my dearest friends suffered the same. Hers evolved into the dysphoric mania as she neared menopause and her hormones started to fluctuate. She eventually found a new regimen that offered some better control. My heart and prayers to you. I wouldn't wish this on anyone.

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Specializes in LTC, assisted living, med-surg, psych.

Thank you.. I wish I could blame this development on hormones, but I went through menopause years ago and if I have a single hormone left, I'm unaware of it. LOL

Things are calming down now; today I felt more 'normal' than I have in many weeks. This morning when I woke up, my first thought was "Oh, hey, this is what I'm supposed to feel like. Yay ME!" Sanity is returning....... :yeah:

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((hugs))

If you are aware of the fact that something is not "right" I would always call your mental health provider for guidance. As nurses, we tend to like to diagnose ourselves, over critically think, and think we can do these things on our own too long. Akin to non-medical people googling symptoms....:cyclops:

You have had a tremendous amount of changes in such a short period of time. Enough to make anyone go to the edge of sanity. I am glad you are better today. xo

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menapause is not nec the "end" of hormones....they continue to decrease over time....perhaps yours are "out of whack" so to speak. good luck.

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Dysphoric manic for me sucks......Its like a TON of energy that I just cant get out...just want to scream to let it out but know it wont help....I pace am very easily frustrated, very easily ticked off, yell. I broke my laptop harddrive once because my laptop wasnt putting words on the screan as fast as I was typing....still not sure if my laptop was being sluggish at that moment or my mind was just going too fast...but slammed the top down hard....when calmed down and opened it it didnt work any more. Its not like mixed.....no depression...just irritable aggitated and mind going too fast

For me the thing that sucks is my mixed episodes are never like its euphoric mania and depression stired together. Mine are bad dysphoric mania with depression. Am agitated and have too much eneregy that i want to DO something with....and im depressed and hate myself and constant negative self talk rotating through my head so all that agitation is directed at myself. Very potentially dangerous time.

Fortunately I am stable on meds.....never would have made it through nursing school if i wasnt

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Specializes in LTC, assisted living, med-surg, psych.
((hugs))

As nurses, we tend to like to diagnose ourselves, over critically think, and think we can do these things on our own too long. Akin to non-medical people googling symptoms....:cyclops:

Arghhh! You nailed it on this one. I'm terrible about this! I wait to call until I absolutely cannot stand myself one more minute....it's a game of "how much can I take before I blow a gasket?" :rolleyes:

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Think of it this way Viva--If one of your patients had nagging chest pain, and decided to wait it out to see if it would go away, got a little worse, but hey, it is a pulled muscle. Lets put a little ice pack on it, it will certainly go away....and then comes to the ED with crushing chest pain and in the midst of having a massive MI....

Please always call when it is just nagging.....let your profeessional rule stuff out. It may be a muscle strain....or it may be the MI...

Easier said than done. But, if it nags, it is an issue, not a character defect xo

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Specializes in Pediatrics, Emergency, Trauma.

Hey Viva!!!

It truly feels as though like I'm jumping out of my skin.

I've had times that I felt happy energetic, yet angrily depressed...they are less than before.

The initial solution was to roll around in bed like a toddler with a temper tantrum-the episodes usually occurred at night while I was in bed, watching TV (nothing controversial or violent) and the feeling would occur...I couldn't describe it!

What helped me was writing (like you are doing :) ) which really got to the root of the many feelings that I had about my life, and living with PTSD...VERY frustrating to have established pretty healthy coping mechanisms shattered, then learning to do it allll over again. Still working at it, staying positive! :)

My therapist started using a biofeedback app on iPhone to get my thoughts straight...and it works so far. It alerts me on checking in with my mood and uses breathing exercises and guided imagery. It helps.

I also love yoga, which helped me during nursing school (both times) with test anxiety. I'm contemplating going to a high cardio class to find a place for that manic energy to be free and unleashed in a healthy way...until then, the Heart GPS (the name of the app) is working...in fact, I need to check in now, lol.

Keep writing, keep busy and healthy! ((HUGS))

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Specializes in LTC, assisted living, med-surg, psych.

Oh, wow, you guys describe this stuff PERFECTLY! Yes, yes, it's all that and then some........I can almost feel the nerves snapping, like the strings on a violin, and I want to screeeeeeeeeeeeeeeeeeeeeeeeeeam until I lose my voice entirely.

I'm somewhat better today than yesterday, although I was up till almost 3 AM again thinking thoughts best left un-"thunk". The stress in my life continues unabated, and I still have to fight off the waterworks a bit; however, I can feel my grasp on things growing a little stronger each day, and that gives me hope.

I do appreciate your comments.....like most nurses, I'm nowhere near as good a patient as I am a nurse, and having grown up in one of those social-climbing families, I learned early to keep a stiff upper lip and never ask for help, lest I embarrass my progenitors. However, they are long gone and one of the legacies they left me was this illness, though my mother's case was never diagnosed. It's hard to undo a lifetime of conditioning, even though my psych gives me crap over NOT calling him when I'm in trouble and my family sometimes threatens to call him for me. But I'm learning, and you guys are helping me more than you know. :yes:

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And, if not for yourself, then for those you created.....for, as you see it "runs in families".

Oh, wow, you guys describe this stuff PERFECTLY! Yes, yes, it's all that and then some........I can almost feel the nerves snapping, like the strings on a violin, and I want to screeeeeeeeeeeeeeeeeeeeeeeeeeam until I lose my voice entirely.

I'm somewhat better today than yesterday, although I was up till almost 3 AM again thinking thoughts best left un-"thunk". The stress in my life continues unabated, and I still have to fight off the waterworks a bit; however, I can feel my grasp on things growing a little stronger each day, and that gives me hope.

I do appreciate your comments.....like most nurses, I'm nowhere near as good a patient as I am a nurse, and having grown up in one of those social-climbing families, I learned early to keep a stiff upper lip and never ask for help, lest I embarrass my progenitors. However, they are long gone and one of the legacies they left me was this illness, though my mother's case was never diagnosed. It's hard to undo a lifetime of conditioning, even though my psych gives me crap over NOT calling him when I'm in trouble and my family sometimes threatens to call him for me. But I'm learning, and you guys are helping me more than you know. :yes:

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Specializes in LTC, assisted living, med-surg, psych.

True that........I have one son who's diagnosed with PTSD and depression, not BP, but shows every sign in the book and then some. Even HE knows he's bipolar. The VA psychiatrist just doesn't seem to want to deal with that end of things, yet she won't prescribe an antidepressant for him---gee, if he's only depressed, why ever wouldn't she want him on an AD?? Now he and his wife, who happens to have PTSD, anxiety, depression, AND borderline personality disorder, are having a baby.......Lord knows what that little one may have to suffer through!

My younger boy may or may not have the disorder either, but I've definitely seen him go through what his partner calls "bipolar shopping" and nasty, irritable, depressed moods as well. Only the girls seem to have made it through relatively unscathed, but my oldest daughter was a cutter during her teen years and the younger one is just remote......so remote that she is literally half way around the world, working as a civilian contractor, far from not only me but her husband and 2 1/2-year-old son. So she's got some issues too.

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