Preparations Leading to Mania

In the last post I made I mentioned I had signed up for the MS program at a local university. Since then I have torpedoed the progress I have made and went mega manic.

Mania, for me, is so crazy. I become impulsive, irritable, euphoric, sexual, and I seem to move at a million miles a minute. I know this about myself. I am certain I have written about it before. This time I spent way too much money “school shopping,” I yelled at one of the only people who is always on my side, I made rash decisions, and I self-injured. Bad decisions, I know. Right now, I am still manic but I am trying to manage my symptoms.

I have been working a lot with DBT or dialectical behavioral therapy. According to PsychCentral, DBT was developed in the 1980’s by Marsha Linehan for use primarily with patients with borderline personality disorder, who have a tendency to experience extreme mood changes. The therapy form focuses on making patients aware of their emotions and helping them to manage their reactions to these emotions.

The DBT book we are using is the Dialectical Behavioral Therapy Skills Handbook used in Fulton State Hospital in 2004. This book advises using 3 techniques during painful events or emotions. I have adapted them for use when I am especially manic. Remember, take what works and leave the rest.

1. Distract yourself! The handbook uses the acronym ACCEPTS to help you remember.
1. A - Activities: Use activities to distract yourself. I like to play games and read. Basically, keep busy.
2. C - Contributing: Get your mind off yourself by contributing to those around you, whether that is volunteer work or just helping out your mom with the dishes.
3. C - Comparisons: Basically, it could be worse. I don’t really like this one, but if it works for you, focus on how there is always something that could be more wrong.
4. E - Emotions: Do something to make you feel differently. I read. Getting involved in someone else’s life helps to take the focus off of my own.
5. P - Pushing Away: Meditate or find another way of blocking out those emotions until you are ready to deal with them.
6. T - Thoughts: Use distracting thoughts. Try not to think about that pink elephant in the room. SEE! You are thinking about it! And maybe not your problem.
7. S - Senses: Focus on what you are experiencing in that moment, the smell of the room, the sound of traffic, the feel of your clothes, whatever works for you.

2. Self-Soothe your 5 senses
1. Vision: Notice what you see and find pleasant things to look at.
2. Hearing: Pay attention to what you can hear around you. This is one I use frequently. I can listen to the repetitive sounds of traffic or the fan blowing or music.
3. Smell: Be aware of the memories that smells can bring. Surround yourself with scents that trigger positive emotions. I like lavender, sandlewood, and baby powder.
4. Taste: Carefully savor what you eat, noticing all of the flavors.
5. Touch: Find comfort in what you can feel.  I react especially well to cold. Figure out what feeling you like and carry something with you that allows you to feel that.

3. Finally, you can IMPROVE the moment.
1. I - Imagery: Imagine a serene scene. Visualize your happy place and go there. A woman once taught me to visualize myself washing a load of dishes when I was feeling overwhelmed. I still use that technique.
2. M - Meaning: Find or create purpose or value in your pain. This is when you start looking for those silver linings.
3. P - Prayer/Peace: Open up to the peace that is available to you. For some that means praying to a greater being, for others it is simply meditating on peace.
4. R - Relaxation: Use muscle relaxation techniques by tensing and relaxing each muscle group in turn. Lay flat and pretend you are a sandbag with a leak. Slowly relax each part of your body in turn as the sand runs out through the hole.
5. O - One Thing: Just focus on one thing, anything. Focus entirely on that thing. Right now i am feeling each key I type, I am listening to the clickety-clack, and I am watching each letter form a word.
6. V - Vacation: Get in bed and pull the covers over your head. You are on a 20 minute vacation. Play beach sounds with your eyes closed. You are on an island with no worries.
7. E - Encourage yourself. Repeat “I can!” Accomplish little tasks to build your confidence.

Not all of these will work for everyone, but one of them might work for you. I know I have a few of mine,  by which I made little notes (they look like this).

I know when mania hits my life can go crazy, but by reaching out to my support system and using my skills, I know I can get through without too much damage. Suicidal ideation has a constant presence in my life, especially when I am manic, so I am sure to keep the emergency numbers on hand. The National Suicide Lifeline at 1 (800) 273-TALK (8255) or the Kern County Mental Health Hotline at 1 (800) 991-5272.

Take care of you.

-Nikki