I’m Hypomanic and I Don’t WANT to Sleep!

Staying up till all hours
When you're hypomanic, you might happily stay up till all hours. Anthony Harvis / Getty Images

This was posted on our Facebook page and got quite a bit of feedback from the bipolar community. Here’s how it began:

Apparently my being awake for 39 hours at a time, and enjoying it, does not meet with my psychiatrist's approval. She has ordered me to take my night-time meds at the same time every night. Do you do this? I don't WANT to. Hypomania is so rare for me!

The responses were wide-ranging:

David: Mine said the same thing. But I love my precious hypomania. I get so much done. Oh, well. I generally take my meds about the same time, usually around supper because my pills need food in my stomach to work right.

Ruthann: I had a really bad experience the last time I took my meds at a different time. I felt really panicked, had cold sweats and felt really sick. My doc said it was from talking my meds so late. It was awful. I will never do it again.

Patrick: Oh, man, this happens to me all the time I'm a rapid, rapid cycler, and yes, I do enjoy this until I crash into depression. I can get a lot of things done when I am on the upside.

Jason: Just because they made it through medical school doesn't mean they are always right. But they do have a point.

Martine: You should! I do it, because hypomania never ends well.

Jamie: I sorta love/hate hypomania. I love it because I have so many ideas and I get things done, and everything is doable, and I don't have to worry if I have the energy to something.

Everything is easier, cleaning is easier, taking a shower is easier, everything is fun and funny. But then I'm also easier to anger, I start arguments, and I get bitchy and start yelling at everyone. Then my anxiety kicks in and I'm paranoid that everyone is avoiding me and mad at me and they all hate me and are going to leave me.

That's why I DON'T like hypomania.

Joanna: Hypomania is so nice when you promise to take your meds soon after this.

Pat: I love hypomania, agree with everything everyone has said about it. I wish that was my "normal" – I bet every one of us does. But as someone said, it never ends well.

Vikki: I have taken my bedtime meds at the same time for over 8 years now, and then I have the same get up time. I have some hypomanic symptoms some days, but I don't lose sleep with them.

Dottie: Good lord, I can't even get out of bed most of the time.

Kelly: I take all my meds roughly at the same time. Your body gets use to the regimen. I agree with so many others that while hypomania is great for multitasking, it is very hard on your body, mind and stressed soul. I'd give yourself a reasonable time and a window of an hour plus or minus. That should help – best of luck!

Margaret: Can't be a good girl every day ...

CiCi: Hypomania? Being up for 39 hours and enjoying it sounds like full-on mania to me. Well, I guess as long as you're not engaging in any reckless behavior.

Note: Actually, what distinguishes mania from hypomania is the severity – in mania the episode must require hospitalization, include psychotic features, and/or disrupt daily life to a severe degree. None of these factors were present. The situation could, of course, been a precursor of mania, though.

Lynn: Hypomania is not necessarily always a good thing. I've been hypomanic for a couple weeks, and like most of us, I love it. Staying up all night rambling around the house feels great. I have to be careful about it, though, and make myself take my night meds and sleepers and lie down so I don't flip on over too far.

Elizabeth Ann: I think a lot of us have been hypomanic lately in our own ways – maybe it has something to do with the sun. I do not feel as depressed as usual, and I take my nighttime meds when I go to bed.

Rhonda: It feels good but it can get one into trouble. Sleep is very important.

Carol: Yes, I take my night meds at 10pm every night. I still have hypomanias, so don't be so reluctant to follow your Doc’s orders.

Anne: Sweetheart, if you are awake and wired after even 24 hours there's a problem! That is mania! And it can spiral out of control very fast and you end up in the hospital. I learned the hard way. I don't ever want to spend 3 weeks in the hospital and put my family through hell ever again! Once was more than enough! I take my pills on time every day. And I'm so grateful they keep me stable. If you won't do it for yourself, do it for the people that love you.

Note: Fortunately, the mood didn’t get out of control before it steadied down again.

Norma: I miss hypomania! But yes, it is best to follow the doctor’s orders. The more regularly I take my meds, the more normal I feel. And coming down is a bummer!

Phillip: When I am manic I go from​ the time my feet hit the floor until I drop at night with an hour’s cat nap. I would say this is self-destructive mentally, emotionally and physically. I will stay manic for months at a time and when I crash it is like falling in a dark pit and stay in this depression. I become lethargic, I slip in isolation, and I have mood swings. I do not like taking meds; however, I have two prescribed meds and vitamins that keep me balanced and grounded. Nevertheless, it takes a lot of work on my part to stay grounded. I journal daily everything I do and my thoughts so I can inventory my behavior.

Note: Keeping a mood journal is something all of us should do!

Michelle: I go through what I call phases of this. I very often will stay awake functioning normally, staying busy, accomplishing a lot for several days/nights at a time and have been doing this for several months now. No new meds or stopped any; I assume its nerves and/or stress level. I don't like meds, prescription or not, so I just deal with it. However, about once every four to six weeks I'll go to sleep for 12+ hours and often be lazy, not steady sleep, for as much as 2 days and nights. I thought this was just another “Michelle thing” – I guess not!

Terri: Hypomania is incredibly frightening for our family. Watching a loved one self-destruct and not be able to understand they are is painful to say the least. For them, please take those meds and get some sleep!

Helen: I’ve not been hypo for a few years. Wish I was! Then I could sort my messy flat out. I am stuck feeling useless and lazy.

While “we all love hypomania” isn’t true, many people with bipolar disorder welcome and relish it when it happens. Refusing to take medications when you don’t want to sleep is just one example of the poor judgment that can come along with hypomania.

In this case, the incidents of being awake for 24-hours plus tapered off after about a week. I can’t say the patient is exactly compliant, but at least meds are being taken within 15-18 hours of getting up instead of “not till I’m tired anyway.” There has been no crash so far.

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