Marks Psychiatry

Sometimes it’s difficult for bipolar patients to tell when they are in a depressed mode or if they have simply lost their manic high.  For many, mania can be a very destructive phase, but for some, mania or hypomania (milder form of mania) can feel very good and be a very productive time.  Sometimes this loss of the elation can make patients not want to take their mood stabilizer.  Some will say they experience the non-manic period as being flat or as if they are living a generic version of themselves.  They may then conclude they are “depressed” when in fact, they may not be depressed, they are just experiencing the middle ground.

Some patients may swing between cycles so often that they may not know how to recognize the middle ground.  This is why it is important for patients with bipolar disorder to stay in regular contact with their health care provider so they can have someone keeping an eye out for their mood states.  It’s not always as easy to recognize the beginning of a manic state as it is to recognize depression.  A person who is hypomanic may appear happy, upbeat and busy.  On the surface, that doesn’t seem so bad.  But it is usually the people close to them that recognize the more destructive behaviors such as functioning on little sleep, making impulsive decisions, etc.   So, although the hypomanic state may seem desireable and some even try to prolong the state (by avoiding medication), mania can spiral out of control.  Therefore it is important to keep a careful watch and welcome periods of non-mania and middle ground.

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