I’ve been trying to retrace my steps and become aware of what in the past may have been a ‘trigger’ for the onset of my hypomanic episodes. I figure if I can remember key events that happened before my mood shifted, I may be able to find something in these events that stands out as a ‘trigger’. My objective is not to hide and fear parts of my life, but to gain greater control over the shifts that occur in my mind. I also don’t want to delude myself into believing that I have complete control over my mood because I know that shifts do occur occasionally without a ‘trigger’ or a condition that is out of my control.

My hypomanic states usually begin in the Spring and continue through the Summer. A unique feature of Spring/Summer compared to Fall/Winter is longer days and more light. I spend more time in the sunlight, which I believe increases my energy level and begins the onset of hypomania.

In the Spring I begin to feel more energetic and social. This boost in energy without restrictions enables me to end up in many social situations that I wouldn’t have thought twice about in the Fall/Winter (usually depressed phases). I start going to BBQs, patios, cottages and parties.

Inevitably the first thing to get disrupted are my sleeping patterns. I start going to bed later, but continue to wake at the same time for work. Another feature that is introduced is alcohol consumption. I go from drinking nothing in the Fall/Winter to drinking everyday and being buzzed/drunk at least twice a week, sometimes more. Hence, I’ve also been diagnosed as a seasonal alcoholic by my psychiatrist. As this pattern of behavior continues, my hypomanic mood increases in intensity, followed by my reckless behavior and attitude.

The question now is a chicken and egg question. Does my hypomanic mood in the Spring/Summer increase this pattern of behavior or does this pattern of behavior increase my hypomanic mood?

I really think it’s a bit of both. They feed off each other. I think initially it’s my hypomanic mood that occurs, but it is then fed by the associated behaviors that go along with it (excessive socializing, drinking, smoking, risky behavior, etc.) or in other words, self medication. The better I feel, the hungrier I get for the associated behaviors and this leads into a perpetual cycle that always ends in a social, family or financial disaster.

As far as I can remember, I haven’t had a Spring/Summer yet where this pattern didn’t occur. I was only diagnosed with Bipolar II about 4 months ago so I have never tried to manage or understand my behavior from a diagnostic perspective until now. I’ve been aware of the patterns of lows and highs, but I’ve never tried to understand what is actually happening. I thought this behavior was just me, my personality.

I have recently read about two German terms called zeitgebers and zeitstorers and their relationship to Bipolar Disorder. A zeitgeber is a environmental cue that entrains our circadian cycles (e.g. light/dark cycles, seasonal patterns, etc.). A zeitstorer is an external demand put on you that throws off your established circadian cycles (e.g. rotating night shift, stress, lack of sleep, etc.). I know from many articles that I’ve read that there is a strong relationship between disruption of circadian cycles and the onset of episodes. Below are a few articles related to this topic.

1. Body Clock Disruption Brings on Manic Behavior
2. Clock Molecule’s Sensitivity To Lithium Sheds Light On Bipolar Disorder
3. Circadian Rhythms Factor in Rapid- Cycling Bipolar Disorder
4. Circadian Rhythm Linked to Bipolar Disorder

How can this evidence about disruption to circadian cycles help me understand and plan my life in an attempt to avoid or decrease the intensity of my episodes?

Well, it gives me a great starting point. I now have a condition that I can measure events against. Is there a possibility that this event will disrupt my circadian cycle? If so, can I still participate in the event, but in a controlled manner (e.g. leaving early, not drinking, etc.)? If disruptions to my circadian rhythm increase the intensity of my hypomania, then I should try my hardest to not disrupt my circadian rhythm by not drinking, smoking, staying up late, etc. In other words, I should always manage my activities with my condition in mind.

The next Spring/Summer of 2008 should be a very interesting time for me. It will be the first time that I’ve ever tried to manage my participation in events with knowledge of my condition. I don’t know where my head will be, but I hope I’ll be able to control my behavior. I know how difficult it is to separate myself from my mood, and to make decisions that are in my best interests as opposed to decisions based on the feeling flowing through my veins at any given moment.

I was visiting my mother yesterday, and during my visit she mentioned that she found a very interesting letter that I wrote about 7 or 8 years ago during one of my ‘periods’. What makes the letter so interesting is that at the time I wrote the letter I had no idea that I was bipolar. I was only diagnosed about 4 months ago. I had suffered a few bouts of depression up until that point in my life, but bipolar disorder was definitely not on my radar. Reading this letter now 7 or 8 years later is quite a strange but interesting experience.

The first line of the letter begins…

“I’ll begin by trying to express to you a very strange sensation that frequently sneaks up on me without any warnings. In the past, I’ve tried to desperately explain this shadow that lurks in my awareness…”

“It (the sensation) caused my patterns of thoughts to mutate. It planted dynamite in the comfortable blanket of beliefs that I once wrapped around myself and left me hungry for answers in an attempt to dissolve this new-found discontentment that plagued my senses, my logic. I had become unsure of who I was; I had become unsure of my experience, my existence.”

The letter continues to describe my lack of consistent identity and the coping mechanisms that I used to compensate for this in social situations, and looking back now it makes so much sense as to why I felt this way. My sense of identity would drastically change with my mood, so when I would try to find my consistent grounded identity I would only find inconsistency, instability and what at the time I believed I was - ‘nothingness’.

“I realized my identity was a vacant stage where I would present different shows for the eyes and ears that would look and listen. I was a man with many identities, with some more beautiful than others. When I could connect the character with the audience’s expectations things were fine, but this apparent game that I was playing with people began to lose its appeal. I became quite lonely and confused not knowing who or what I was, and the more I contemplated on this search for identity, the more I became aware of the nothingness of my existence.”

The letter then continues to describe what I believed was my understanding of the “sensation.” I guess I believed that my subjective experience gave me a deeper understanding of a world I thought no one understood or cared about. I thought my condition was unique and that I was in touch with something that nobody else could be in touch with. I guess this can almost be described as semi-delusional grandiose thinking.

“Realizing and digesting this understanding of my subjective experience is what created this feeling which I conventionally refer to as the “hollow empty feeling.” The feeling of being caught in a world which no one seems to understand or care about. Maybe this alienation that plagues my life is due to the unavailability of people to share such experiences with, I’m really not sure, but I am sure that it exists because I can feel it.”

The letter continues with more descriptions about how I felt around people and how little their social interactions stimulated me.

“Night after night, I float through the atmosphere of my life like a phantom observing everything, but saying very little. I watch and listen to the people who surround my perceptual field, and the context in which they socialize doesn’t stimulate me anymore. My senses can feel them, and they all appear to be plastic, fake.”

It’s amazing looking back and seeing my old self with a new and better understanding of those experiences. Although I still feel many of the same sensations in my life, they are understood differently. Knowing that there is a biological cause makes a huge difference in my attempts to understand the sensations that visit me. It wasn’t long ago that rational “normal” people would burn women at the stake because they believed their personality/behaviors were those of a witch. I really don’t feel so bad for misinterpreting the symptoms of my future diagnosis. It took almost 8 years to be diagnosed from the date that this original letter was written, but I guess it’s better now than never.