Are you part of a book club? Make Beyond the Label your next book selection and invite Dr. Chris, ND as a guest author! This is what one of Dr. Chris’s friends did and there were some wonderful and enlightening questions that come out of the book club meeting that she attended. It was very exciting for the book club members to meet the author. If you are local, reach out to Dr. Chris – she’d be happy to come speak to your group.
Below is the first instalment of the series of questions from the book club. What would you like to ask? Contact Dr. Chris, ND and bring her to your next group meeting or book club!
1. Do you remember escalating into a manic state? What is it like for you?
I do remember the feeling of escalating into a manic state. People ask me about it because there is a fascination about it, and I also believe there is a fear of it. Especially because the news talks about the dangerous things that a few people with mental illness have done, it casts a shadow of stigma on anyone experiencing an altered state, be it depression, panic, mania, or psychosis. But did you know that people with acute mental health issues are more likely to be victims of a violent crime, than to be perpetrators?
Remembering the feeling of escalation into a manic state is something that is important for me to remember because I can now recognize my “relapse signature” of what that looks and feels like. This means I can catch myself in the future, should it ever escalate again.
It started with feeling like a mixing pot of a lot of energy, a lot of enthusiasm and motivation, and needing less sleep. I would also lose my inhibitions in this state and be more outspoken and flirtatious. The lack of confidence that I would typically feel in a depressive phase was replaced with a super charged level of confidence as I escalated into mania. My strength and speed also increased and I felt like I could break Olympic track records. At first, this combination actually feels pretty good: I finally had the energy and confidence to start lots of new projects, and I also had the time because I wasn’t sleeping. I felt like others were too slow and I was ten steps ahead of them with my thoughts. However, when I escalated into delusional thinking, it became a bit scary. During my first manic episode, this was very frightening as I didn’t know what was happening to me. It was an extremely surreal experience. I remember asking for reassurance from my loved ones that they loved me and to keep me safe. That part is very interesting to me because I wonder if the manic state uncovered and gave voice to the long-held core beliefs I had that I wasn’t good enough, not loveable enough. In my delusional state, I believed people around me to be hiding some secret, and that somehow meant that I wasn’t loved, that I was alone, and that fed my delusional fears more.
I encourage anyone who experiences hypomania, mania, or episodes of delusions, hallucinations, psychosis or altered reality to get clear on what it feels like, and what was happening when you last escalated. You can help keep yourself safe by knowing your relapse signature, because you can notify someone early, and let them know what is happening. It removes a lot of the fear and indecision for you and for someone caring for you. This will lower the risk to you when in an altered state.
Knowing what I know now of my manic state, I constantly work to remain balanced in my life by managing the following key aspects that I discuss in my book “Beyond the Label: 10 Steps to Improve your Mental Health with Naturopathic Medicine”:
- Sleep
- Stress
- Thoughts & beliefs
- Emotions/fear
So much of my self-work has been developing a deep sense of self-love that soothes this part of my worried heart. Knowing that I have worth and value makes me a healthier person in the long run, so for that, I’m grateful.
2. Are you aware of what brought on your manic episodes?
I have had six manic episodes since 1987 – with the last one occurring in 2008. While every episode was unique, the common thread between all of them has been an imbalance in one or more of the following areas: sleep, stress, fear, thoughts, emotions and beliefs. In my first episode, the triggers for me were a combination of: 1) high stress, on an existential level, 2) lack of sleep, and 3) antidepressant medication.
At the time of my first manic episode, I was feeling hugely weighed down by the pressure of University; not just the workload, but the existential-level stress of “what am I doing with my life?/what is the purpose of life?”. I had extremely high expectations of myself, was an over-achiever with perfectionist tendencies – a dangerous combination. I wrote about this stress in my book: “When we had to choose our majors, I was feeling overwhelmed, indecisive and unsure… At the time, I couldn’t identity what I was feeling. Words seemed to escape me, and that feeling of general anxiety just kept getting stronger and stronger, to the point where I felt completely paralyzed. In fact, there was a day when I stood outside in the pouring rain without an umbrella, for what seemed like several hours, because I couldn’t muster up the strength to make my legs move in any direction. I don’t know what step to take and instead remained paralyzed on the sidewalk as students moved briskly onward, passing me by. I felt like every decision I made carried so much weight. I was being crushed under the pressure of making the perfect decision” – chapter 2
This stress developed into depression, which led me to start an antidepressant medication. Unbeknownst to me, this medication would play a role in stimulating me towards hypomanic behaviours like decreasing sleep and increasing activity which escalated into a delusional manic episode within a week (after being on the medication for 3 months).
You see, for some people with an underlying susceptibility for bipolar disorder, antidepressant medication can stimulate them to go to the other side of the spectrum from depression and have a manic episode. This isn’t the case for everyone, but it is the reason why practitioners should always screen for bipolar tendencies in anyone they give an antidepressant to.
I tell this story for several reasons. Mostly, it serves to break the stigma around mental health issues. It is not someone’s fault when this happens. I also tell it to help people know there is a way out; there is help that can stabilize you and make sense of what happens in mental health issues. One important point is that I do not tell this story to scare people, or to persuade anyone to avoid seeking help, be it from a conventional MD, or from an integrative ND. Medications do not flip everyone into mania, but they are strong biochemical agents that stimulate the body. It is important to know that sometimes a combination of a stimulating antidepressant plus lack of sleep, plus lots of stress (and the stress hormone cortisol!) can combine to create a perfect storm in some people.
We can use the gift of hindsight to learn how to prevent future episodes. Because I know what triggered my first episode, I now control the types of medications I take, if and when I need them, support myself during this process with natural medicines that stabilize and calm me, and manage my tendency for depression, and finally, I protect my sleep like it’s the most important thing I can do, because it is!
