Comfort, Support, and Rapid-Cycling.
The joys and trials of caring for a spouse with mental health diagnoses.
The "Talking a family member through hypomania and rapid-cycling while both of us are working vibes were strong a few days ago. Our day started slowly, dragging my husband out of bed to get dressed for work. As I drove to drop him off at his office, he began alternating between exhausted, anxious, excited, and silent.
You might ask, What is hypomania? “Hypomania is a condition in which you display a revved-up energy or activity level, mood or behavior. The new "energized you" is recognized by others as beyond your usual self. Hypomania is a less severe form of mania, and both are commonly part of bipolar disorder.” (Cleveland Clinic). Mania, in general, is something those who are bipolar mourn when they begin taking medication, to the point of gambling by taking and not taking medications. Hypomania is the step just before psychosis, where patients have experienced hallucinations and delusions and generally lose touch with reality (NHS).
You also might ask, What is rapid cycling? “People who live with bipolar experience the “highs” that come with mania or hypomania; they also experience “lows” that come with depression. When Rapid Cycling occurs, it means that four or more manic, hypomanic, or depressive episodes have taken place within a twelve-month period. Changes in mood here can happen quickly and occur over a few days or even over a few hours. If there are four mood changes within a month, it is called ultra-rapid cycling. While the phrase “rapid cycling” may make it seem that there is a regular cycle to these shifts in mood, most cycles do not follow a pattern.'“ (DBSA) For Bipolar II people, their cycle can rotate entirely within days, weeks, or even a month, meaning their rapid cycling can be minutes, hours, and days. Mania and depression are difficult to live with, but when a person starts quickly rotating through varying emotions, it’s one of the scariest things I’ve witnessed.
Truly, Thursday was a terrifying day. Alternating between the verge of passing out due to sheer exhaustion, crying because the medication wasn’t working, and speed walking outside while repeating, “I’m going to be fine, I’m going to be fine, I’m going to be fine,” all I wanted to do was be there with him. To soothe and comfort his wild mind.
The most important thing a family member can do at that moment, contact their psychiatrist immediately to schedule an emergency appointment. Our psychiatrist is terrific, and we were able to schedule an appointment to begin taking Husband off his medication.
Days are filled with patience, gentle reminders to take medications, quiet coaxing to start the day, scheduling endless doctor appointments, and praying he might finally start to keep a routine. I shared some of this on my Instagram stories the day this occurred, but at the core, I was frustrated with those who didn’t understand.
Mental health is more than “self-care.” More than journaling and meditation. More than only depression and anxiety. It’s psychosis, it’s mood disorders, it’s psychiatric hospitals, it’s medication after medication, it’s not drinking alcohol or eating grapefruit due to potential reactions. Too many are written off as a burden because of their diagnosis. I never want to be the person to write off my husband’s diagnosis, my sister’s diagnosis, or my own diagnosis. The minutes after sharing a diagnosis are foundational for the relationship.
As we were in the process of receiving a bipolar diagnosis, we shared everything with two close friends. My husband’s close friend told him he needed to believe more, try harder, and pray more. Perhaps there was sin in his life that was hiding. He distanced himself when Husband started taking medications to treat his bipolar diagnosis. My close friend, while hesitant, continued to encourage us with prayer and patience. She celebrated with us when we received the official diagnosis and continued praying at the start of the first medication.
Two paths taken. Two relationships displayed. As the patient, he lost a dear friend. As a caregiver, I always had someone to lean on and lament with, a companion to encourage me. The diagnosis is lonely. I have shed countless tears for those who have debilitating mental health concerns and have no one to lean on for help. I hear from homeless residents in my county who have schizophrenia; they share their psychosis ramblings with me — because I care, I listen.
My Thursday and the last several days are spent checking in with my husband, gauging where he is mentally and emotionally, seeing ways I might be able to help, and keeping our home in check. For myself? Several close friends are patient and always check in with me.
I am no expert in the mental health field, but I encourage you to sit with those struggling. There is much to learn about encouragement and lament; mainly, you can do both just by sitting and listening to those who need help.