Navigating Manic Psychosis
superbowl.substack.com/p/navigating-manic-psy...
superbowl.substack.comPosted Nov 6, 2023, 5:47 AM UTC
4118
superbowl.substack.comI posted this previously on this subreddit, but I have unipolar mania and have had a bunch of manic episodes. In a similar way, I chronicled my symptoms here.
I can definitely attest that the comedown is rapid and nearly instant. It's wild to drop so abruptly from a manic state like that and I can't imagine it lasting for two years — my longest was 21 days and it was agonizing.
11
Thank you so much for sharing this article. When it was initially posted here, I sent it to my brother in law who had just recently been diagnosed with manic depressive, and it helped them contextualize their own manic periods and see that they had been experiencing mania for a long time. It really was invaluable and I can't thank you enough!
6
I can definitely attest that the comedown is rapid and nearly instant. It's wild to drop so abruptly from a manic state like that and I can't imagine it lasting for two years — my longest was 21 days and it was agonizing.
Do you mean the 21-day manic episode was agonizing or the comedown was agonizing?
5
Episode was agonizing, the comedown was a relief.
3
“The relationship between probability and utility estimates isn’t straightforward, but as an example, one widely-cited study found that people buying a car tend to underestimate its price, while people selling a car tend to overestimate. The effect varies heavily, and even inverts, across people and scenarios.”
This is a feature, not a bug. Part of the utility of consciousness is the public relations function. It helps us hold socially-convenient beliefs.
Of course I consciously believe that my car is more valuable than it is. I’ll get a better price that way.
8
This is a feature, not a bug. Part of the utility of consciousness is the public relations function. It helps us hold socially-convenient beliefs.
Hah, in an early draft I called it a "feature-bug"!
5
I don't agree, it's still a bug.
It can be a useful heuristic to go with your gut and not spend too much time on thinking about the price sometimes.
But ideally you still want to know the right price that people are willing to buy your car for. Then decide how much your time/effort/annoyance is worth and either just sell it relatively cheap and quickly, or advertise better and deal with people coming to see your car regularly until someone pays you more.
2
No, the ideal solution is to be in two minds about it.
You want to outwardly/consciously optimistic, and internally/unconsciously realistic.
6
The nature of the brain makes that difficult.
Now if we were talking about a business, the labor could be divided between a salesman who's optimistic, and an accountant who's realistic.
2
I don't see two minds about it. You want to know how much you can get and how to get more (and if it's worth the input to get more).
What you're saying would be just roleplaying as work to get more money, except not conscious (which often leads to more stress and way more input than it's worth). If you find it fun to haggle, it can still be worth doing even if it's not bringing the money. But still, knowing the "true value" and making a good decision whether to put the work is better.
1
I’m referring to a modularity of mind style of explanation: https://en.m.wikipedia.org/wiki/Modularity_of_mind
1
The Subgenius religion refers to this holy procedure as "pulling the wool over your own eyes". It's intended to enhance salesmanship, one of the church's primary virtues.
1
Good or bad, I'm always thankful when someone is willing to share personal experiences like this. Intimately describing these altered states in any regard hopefully can help paint a more clear picture.
6
Thank you for posting this. I've been struggling with manic depression for decades (mostly hypomanias, with a few manic periods), and your model resonated with me: "Deeply relaxed priors: ideas that would normally seem preposterous suddenly seem plausible...idea doesn’t take root due to the evidence in its favor, but due to the size of the feeling it generates...intense feelings make the idea seem not just more worthy of consideration, but more plausible"
Regardless of my state, I try to consistently make logical probabilistic decisions but my decision making changes wildly in hypomanic states.When I am in a hypomanic state, I feel biologically different. I have an extreme amount of persistent energy, like my mitochondria doubled. I have far more energy than anyone around me. So not only will random ideas "take root" but I have a justifiable adjusted prior (I am now a .1% high energy person) making some outlandish ideas more plausible. It suddenly becomes plausible that I'm one of the main heroic characters and the "good energy of the universe" is depending on me, and there are forces out to stop me.
From the outside my behavior looks and is textbook manic (grandiosity, paranoia, narcissism, et cetera), but internally, with the energy change and relaxed priors, I would still be operating logically. I still even run expected value calculations in my head (the probabilities are likely extremely amplified by orders of magnitude).
P.S. I'm out of that state at the moment and I want to offer caution about your list of mental techniques for controlling it. In my experience and from many years of reading papers and books on manic depression/bipolar, it seems like if your brain has gone to that place it will most likely go there again and no neocortical tricks are strong enough—more serious interventions are needed. I'm currently experimenting with the ketogenic treatment, but lithium seems to be the most effective established option.
4
Yeah, the attempts to think critically are still there, they just go off the rails along with everything else. When I was in a stimulant induced manic state, I suddenly had a realization that there are government spying devices in the walls. I immediately thought to myself, "This is the most textbook example of paranoid delusions imaginable. What is more likely, that I'm experiencing delusions due to taking stimulants and not sleeping for 4 days, or the cartoonish scenario of government hiding in the walls?"
And the answer I came to was that because it's such a textbook example, it would be a perfect choice for the government to use, as any secrecy mishaps could be blamed on people being delusional. I then explained this to my partner, starting with the fact that I haven't slept for 4 days, so of course you'd expect me to be rambling incoherently. That's precisely why this spying situation is so cruel and insidious. Because of the stimulant taking coincidence all I say will sound crazy, and that's how they win.
5
I'm a layperson and maybe a non-layperson wouldn't be very impressed with this,
but I thought that this article was quite good.
1
Thank you for posting this now. I will try not to read into it :)
1
These seem like traits that can apply to heathy people with big egos tough, like CEOs or politicians.
1
Very well written, this article achieved a difficult thing for me: increasing the ability to feel empathy towards those who experience mania or psychosis, towards whom I usually feel nothing but fear.