My recent manic episode

In my last post I described my journey trying different medications and finding a combination that finally lifted me out of depression. I mentioned after increasing the dose of venlafaxine I became manic, and that experience is exactly what I’m going to share with you now.

I take venlafaxine to lift my mood and quetiapine to help me sleep (because I don’t sleep well when depressed and venlafaxine is stimulating and makes me even more restless at night).

Shortly after increasing my dose of venlafaxine from 75mg to 150mg, which in itself made it difficult to sleep, I accidentally missed a dose of quetiapine. This, coupled with an extremely busy schedule which in it’s own can trigger episodes, led to less sleep, more missed meds and finally, a steep ascent into mania.

I’m not going to lie, once the ascent was in motion I got excited about my high mood and energy and stopped taking quetiapine altogether. I was sleeping less than three hours a night and I surrendered myself to the episode. After so long in depression it was impossible to resist the rainbows that were mania.

I took multi-tasking to a whole new level and worked around the clock on experiments for my PhD and various artistic projects. Although I’m strongly introverted and usually barely attend social events, I was suddenly scheduling several social meetings every day and randomly talking to a lot of different people. People couldn’t keep up with what I was saying and were amused by how much energy I had, bouncing around on my feet, drumming my hands, burbling nonsense excitedly and incoherently.

I lost any sense of inhibition and battered my body by twice jumping off a roof at a friend’s party, as well as jumping on a table and collapsing it, doing tight-rope gymnastics over a swimming pool (which I am definitely less than capable at) and dangerously running around for a long time on an unstable roof to a watertank, which nobody else would get on to rescue me because they feared it would collapse. None of this stopped me. Even my falls were barely registered – I was like a child who falls but is already onto the next task before the mother reaches her to see if she’s ok. People annoyed me when they tried to make me pause for a moment so they could clean away my blood.

The feeling was strange. My thoughts were like a raging river after a storm pouring through my brain at breakneck speed and saturating me with insight. Everything was clear to me and all tasks were effortless. I could feel in my eyes that I’d been awake for a long time but I didn’t feel tired at all. Just an expansiveness that wouldn’t allow me to sit still, and a desire to connect with everyone and everything.

Usually I experience mixed episodes or highly irritable hypomanias. This was one of the few pure euphoric episodes I’ve had. I enjoyed euphoria for two weeks before I started feeling irritable and suddenly feared crashing into another depression. I started taking the quetiapine again and avoiding stimulating activities and forced myself to bed even though it was a few nights before I was able to start sleeping a respectable amount and my mind began to slow to a normal pace.

When I saw my psychiatrist she was very upset and worried. She urged me to drop the dose of venlafaxine immediately and it took quite a while to convince her to let me wait before adding lithium back into the mix. It was only because I waited until I was mostly back to normal before seeing her that more drastic action wasn’t taken.

I was extremely lucky that I was able to reign myself in and avoid a crash into depression. My mood was unstable for a few weeks afterward but has leveled out to normal now.

Although mania was a beautiful experience at the time, it did lead to some problems with my friends. A lot of them were worried about my safety and some even refused to spend time with me again if I continued to be so reckless. They feared seeing me die right in front of them. Thankfully I have been able to repair these relationships since. I am glad to have understanding people in my life who were keen to maintain our friendship when they could see I was taking steps to help myself.

The irritability toward the end of the episode was inevitable because there was no way I could keep at that pace and function happily in a world that revolves at a pace that’s much slower. I’m happy to be back in my stable state.

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