Triumphs and tumbles

Ups and downs of bipolar disorder

I was a light bulb in a world full of moths. Carrie Fisher about her mania

This chapter is an overview of the experience of bipolar disorder. Seen through the eyes of those who have had the disorder for many years, these accounts capture the exhilaration, richness and seductive nature of the 'highs'. It also presents some of the varied techniques that individuals have perfected during their quest to best manage their mood swings.

The following account vividly depicts the seductive and irresistible trapeze swing into an elevated mood. The writer recounts her first episode of bipolar disorder, and her unwitting ascent into the vortex of a manic phase. She has since made excellent use of these experiences and has achieved ongoing stability.

Dancing with the Devil

I've always found the word 'high' to be a little misleading. Sure the bipolar 'dance' begins with self-assurance and delight with the world. However, I'm immediately paired with an uncomfortable restlessness that I can't shake. It's pure agitation. I can't relax. My eyes widen. I make simple errors in my daily tasks, I miss birthdays and struggle to organise myself. Pretty soon, I can't remember what day it is.

If I let the dance with the Devil continue, you really see some interesting moves.

Next comes the sensory overload. I see colours more vividly, have the urge to express myself in stories, and can lose myself in music for half the day. In fact, I'm not just listening to the music. In this state I have the sensation that I can somehow breathe it in. The music is all through me.

Then the romantic mood spills over into life. Everyone is fascinating to me, and I am to them. It's amazing how contagious this dance is. Only, things get out of hand. I dance too fast, with too many people, or with the wrong people. I get no sleep. I miss job interviews, or worse still, I show up for them. So now there will be consequences like embarrassment, ruined friendships and lost opportunities.

It becomes a devilishly expensive dance. I lose control over the purse strings. I need a new outfit; it must be black and sultry. I love it so much I don't take it off for days. And always, the music. I have been known to buy twenty CDs at a time whilst high. All bought randomly, for their cover or some weird connection to something else that I can't remember in the end. I love books too. And don't the booksellers love me. I choose books on colour or because they contain quotes I like or maybe they just smell good. I am unable to stop at just one or two. The only thing that distracts me in the bookshop are all the men. All these gorgeous men seem to be shopping with me. I am admiring eyes, necks, beautiful hands, and even their glasses or the way their hair is parted. I have truly become part-woman and part-werewolf. Finally, I am browsing for magazines, luscious magazines with beautiful people and things. Nothing with any connection to my life. Nothing that will help distract me when the bank statement arrives.

The rest of the dance speeds up and is not for the faint-hearted. In fact, I have only continued once. My first dance. My terrible first dance.

Mildly spiritual feelings emerge. I'm suddenly reading star signs and buying books on astrology. I feel a bit unusual and decide to buy a book on the matter. It's called, Are you getting enlightened or are you going out of your mind? I'm so out of my mind by then that I decide I am getting enlightened. Soon after I am having messianic delusions with a feminist twist (why wouldn't God come back as a woman?). These are intermingled with delusions of reference (everything in the newspaper is about me), romantic delusions (a married man is in love with me), and grandiose delusions (I'll be moving to New York to set up a management consulting company). I was having delusions about bombs going off, about people I love getting hurt and eventually persecutory delusions (people are out to get me).

By now I am completely disoriented and terrified. I can't dance. I can only run. And run I do. From two hospitals, one public, one private. I am on the missing persons list for a time. I sleep in parks, in 'new' friends' houses. I have two trips in the back of police cars, the final one to hospital, where I belong but do not know it.

Having danced 'all the way' with my first bipolar high has actually made it easier for me to intervene medically when I sense a high coming. I know how dangerous it can be. I know not to let the high run its course. These days I intervene as soon as I notice changes. I will enjoy one afternoon of mild mania by putting the music on and letting myself 'breathe it in'. I'll also let myself buy a couple of CDs, knowing I will probably give them away in a few weeks when my normal taste in music is back. As soon as I take medication, the wonderful effect of music is gone, but I am happy to give that up to stop the dance progressing.

My major warning sign is a change in my sleep pattern. If I start waking up earlier than normal with a feeling of wanting to start organising something, it's time to act. I might get up at 5 a.m. and sort through paperwork, or re-arrange my photos. My friends joke that I am welcome at their places to organise them when I have this energy. As things progress, I become more talkative, possibly even talking over people or dominating the conversation. I also notice the agitation and a big drop in my ability to concentrate very early on. I can be a bit more hotheaded at these times, and I have to remind myself not to get worked up over small things. These days, this is as far as my mania gets. I feel secure having learnt how to recognise symptoms and intervene early.

The other benefit of intervening early with mania is the effect on the depressions. I am someone who has had four cycles, each with a high and a low. It is true to say that the size of my depressions has basically matched the severity of the high I experienced. Each time, I have learnt how to intervene with the high quicker and each time my depression has been less severe.

Once an episode has started, I will reduce my social activities for a few weeks. I'll concentrate on gentle, calming activities like swimming or walking. I'll book a massage or two. I'll tell friends that I am a little bit high. That way they know I...