I keep a daily log of my state on a continuum from very manic to very depressed. I find this enormously helpful for watching my rhythms, noticing patterns, communicating with my therapist and psychiatrist, etc. Any format will do, but I created a spreadsheet in my Google docs with these column headers: date – md rating – hours of sleep – comments.
- psychotic mania – lose touch with reality, develop paranoid or grandiose delusions, Needs hospitalization, peer respite care or some form of residential treatment.
- full-blown mania (not psychotic, which i have never had), way out of control: buying way too much, whirling dervish time, pulling all nighters. I have only visited this state a few times – almost always in response to a new anti-depressant, and not for the last several years.
- very expanded – genuinely hypomanic
- significantly expanded: starting to ramp higher, getting genuinely ungrounded. Maybe excited, very happy. Can be very creative (lots of writing), but hard to stop. Not getting enough sleep (which came first?).
- slightly expanded (hypomanic): even my friends would not call it this, but i can spot it (and i know that it’s dangerous, as it’s going to trigger a more powerful crash). A little speedy, not really centered. Can be very creative and productive.
- peaceful: I used to call this state “in balance”, but have realized that another way to be in balance is to have some up elements and some down elements coexisting. You could also call this state content. It sometimes includes happy, though not always – and happy most consistently is found on the manic end of the continuum. This, for me, is the most ideal state. At this point in my healing, I don’t inhabit this state for long periods of time – mostly for an hour or two, except for maybe one or two days when i am sliding from high to low or climbing from low to high. It’s more a transitional state than one where I get to live. I aim for that.
6 CHS: another kind of balance. A blend between up and down. We may be depressed (maybe an 8), but with something positive going on that complicates things – good stuff that doesn’t usually go with being down. Or we may be up, but – rather than run ahead of our more grounded, down side – we find within ourselves the strength to allow ourselves to feel or deal with something hard while we are still up. See the Page on Complex Healing States.
- slightly depressed: garden variety human depression.
- definite physical contraction: i can see the biochemical core of the state, my brain is in pain. This physical contraction is not every time accompanied by an emotional mood component, but usually includes significant discouragement and negative self-talk (Zen teacher Cheri Huber calls this “self-hate”).
- very contracted: pain in my brain radiates out into the rest of my body when i attempt to function at all. Movement itself becomes so painful that i wince against the pain, may lean against the wall for support, get very still or immobile to get under the radar of the pain – flee into sleep just as much as possible. Usually accompanied by serious discouragement, and lots of self-hate. .
- completely unable to function
- suicidally depressed – needs hospitalization
The affective component of depression – sadness, discouragement, negative self-talk, despair – which many people think is depression, including clinical depression, for me operates somewhat independently from what for me is the core of the disease: brain pain. Typically the physical pain shows up first. Sometimes the affective side follows a couple of days later, but i have gone through a 2, 4. or even 7 day cycle of brain pain with absolutely no negative affect.
And the deeper cognitive side of depression – actually believing the negative self-talk about myself and my life – is still one more relatively independent dimension. As I have – over many years (about 15 years now that depression has really taken hold of me) – gotten used to the rhythms of depression, I have developed more and more ability to stand separate from the nasty talk in my brain, to observe it, without necessarily believing it. I know, now – and can sometimes remember – that these kinds of thoughts are just part of the physical disease. Sometimes they kidnap my mind completely and i absolutely believe them, but i do now have a growing capacity to not take them seriously.
I have gotten very clear that mania is either not a friend to me – or, when not too out of hand and fueling a creative period, still a potentially dangerous friend. And i am seeing more clearly the anxiety that underlies some of my speediness – the mostly accurate fear that if i lose my momentum i will sink into depression . So i have gotten pretty good at spotting my hypomania – my energy getting too expanded – even when friends whom i have specifically asked to keep me honest about it do not.
But, if a particular post in this blog sounds more hypomanic – or even genuinely manic -than i am rating it, feel free to send me a comment ;).
I’ve also created a spreadsheet where I’m charting these numbers, to get a quick eyeball reading on my ups and downs. Here’s a link to that spreadsheet. If you can’t get it to open (Google drive can be quirky) email me and I’ll send you the link directly.