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[LONG] Dealing with Hypomanias

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  • Shlomi Fish
    Hi all! This is an essay I started writing, currently in email format, in which I am giving my experience of dealing with hypomanias, and to a lesser extent
    Message 1 of 1 , May 20 5:06 AM
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      Hi all!

      This is an essay I started writing, currently in email format, in which I am
      giving my experience of dealing with hypomanias, and to a lesser extent
      clinical depressions, clinical anxities, and unipolar and bipolar disorders
      in general.

      It's still very rough on the edges, so any commentary will be welcome
      (including corrections of errors). It's also incomplete, and I still need to
      convert it to DocBook/XML.

      If you're responding to the list, please trim the text.

      (Oh, and Chen, please allow Elizabeth to reply.).

      The permanent version is currently on:

      http://www.shlomifish.org/dealing-with-hypomania-email1.txt

      But here goes nothing.

      Regards,

      Shlomi Fish

      --------------------------------------------------------------------------


      First of all - a note:

      In a previous email someone complained that I should write my emails more
      carefully, cite sources, research the subject, etc. and not just write them
      offhand. In response, I'd like to note that xkcd explained very well
      what happens if you take it to extremes: http://xkcd.com/406/ .

      I have different levels of discipline for different levels of documentation
      (SMS, Email, IM, IRC, Blog posts, blog comments, essays on my sites, stories
      I'm writing, etc.). I haven't yet written a scientific paper, but this will
      require a whole new level of discipline. I don't expect any original post
      to a mailing list to be fully researched and 100% correct (from the many
      aspects of correctness), much less a reply.

      So you won't be able to cite what I write in a scientific paper, but I feel
      I have to pay this price if I want to actually write it faster and write more.
      (See http://www.paulgraham.com/hp.html for more about this.)

      It doesn't mean that I completely lack any discipline when writing an email.
      It's just that I'm taking it into proportion depending on the context.

      -----------------

      Now onwards. This email is kind-of a brain dump of mine for a topic I've
      wanted to write about for a long time. I plan to eventually convert it to
      DocBook/XML and research it some more.

      The topic in question are Hypomanias
      ( http://en.wikipedia.org/wiki/Hypomania ), which while containing the word
      "mania" are actually below mania, and the person is still in control to
      some extent, and, with some awareness, may realise he's in a bad condition
      and should improve.

      Hypomanias are a variation on Clinical Depressions (
      http://en.wikipedia.org/wiki/Clinical_depression ). The latter are not
      everyday
      "I am depressed." depressions, but rather a feeling that one is bad, being
      consumed with guilt, with a tendency of being less communicative and less able
      to perform your responsibilities.

      Now I probably have Mania-Depressia (
      http://en.wikipedia.org/wiki/Bipolar_disorder ) because I had a single
      "Grand Mania" and a few smaller manias, and have frequent Hypomanias, and have
      been clinically depressed or clinically anxious at the time. So I'm writing
      about this from experience.

      ------------------------------------------------

      Quoting from the Wikipedia (
      http://en.wikipedia.org/wiki/Clinical_depression ),
      the symptoms of depression are:

      {{{{{{{{{{{{{{{{{{{{{
      * Persistent sad, anxious or "empty" mood
      * Loss of appetite and/or weight loss or conversely overeating and weight gain
      * [[Insomnia]], early morning awakening, or oversleeping
      * Restlessness or irritability
      * [[Psychomotor agitation]] or [[psychomotor retardation]]
      * Feelings of worthlessness, inappropriate guilt, helplessness
      * Feelings of hopelessness, pessimism
      * Difficulty thinking, concentrating, remembering or making decisions
      * Thoughts of [[death]] or suicide or attempts at suicide
      * Loss of interest or pleasure in hobbies and activities that were once
      enjoyed
      * Withdrawal from social situations, family and friends
      * Decreased energy, fatigue, feeling "slowed down" or sluggish
      * Persistent physical symptoms that do not respond to treatment, such as
      [[headache]]s, [[digestion|digestive]] problems, and [[chronic pain]]
      * Decrease/Feeling in motor-speed (time seems to slow down)
      }}}}}}}}}}}}}}}}}}}}}

      These are mostly the external symptoms. While the exact thoughts differ from
      person to person, here is how I felt:

      * I felt I was bad and evil. That I was a bad person, having a bad influence
      on the world, that "God hated me".

      * I felt this was my true state, and that my happy, capable, intelligent and
      active state was due to "a pact with the devil" or something along these
      lines.

      * I found that the thoughts haunted me, that I couldn't really sleep, and
      was afraid of thinking.

      * I believed the entire world was bad and kept perceiving everything as bad.

      * I had trouble communicating with others, and was afraid to tell them how
      I felt.

      * I found it harder to do things that I found easy to do. For example,
      I spent hours on end solving a single math problem. I kept convincing myself
      that it should be easy which made me feel much worse.

      * I was consumed and overwhelmed with guilt. I felt guilty for many things
      that I perceived as wrong.

      --------

      In regards to hypomania, Wikipedia says
      (http://en.wikipedia.org/wiki/Hypomania) :

      {{{{{{{{{{{{{{
      * '''[[pressured speech]]; rapid talking'''
      * inflated [[self-esteem]] or grandiosity;
      * decreased need for sleep;
      * flight of ideas or the subjective experience that thoughts are racing;
      * easy distractibility and attention-deficit (superficially similar to
      [[attention deficit hyperactivity disorder]]);
      * increase in [[psychomotor agitation]]; and
      * steep involvement in pleasurable activities that may have a high potential
      for negative psycho-social or physical consequences.
      }}}}}}}}}}}}}}

      It's a pretty good description of me when I'm hypomanic.

      --------------------------------------------------

      Many people (mostly computer developers) I've talked with admitted to have
      been clinically depressed:

      * One of my best friends has admitted that she used to have many depressions.
      Whenever I met her in real life, or talked with her (on the phone, on IM,
      etc) she seemed very cheerful, fun loving, intelligent, and rational.

      She claimed that when she is depressed she tends not to communicate a lot
      and also cannot achieve too much at work, which she said only makes her
      feel worse. I can relate to both of these, as I recall that that was the case
      for me on both accounts when I was depressed.

      * I talked with a programmer, well into his 50's (and still active) who
      admitted to having got into depressions several times in the past. He again
      seemed normal (if somewhat eccentric to me).

      * One time on irc.oftc.net someone joined and spoke in l33t-speak, asking
      how he can be a "haxor". People thought he was a troll, but I ended up PMing
      him and it turned out he was depressed. I spent the afternoon trying to
      help him. Eventually, at evening, he claimed that he was feeling better and
      parted. (It is known that often depressed individuals feel better in the
      evening and at night.)

      * A fellow programmer I talked with admitted to having got into depressions
      in the past, and that she tried to function despite that.

      * A fellow Perl monger I talked with said that he sometimes exhibited some
      of the symptoms of hypomania. He seemed very hyperactive to me, so I wasn't
      really surprised, but it may also be plain excitement and not a medical
      condition.

      ----------------------

      Here is a list of some famous people who have had Mania-Depressia:

      http://www.mental-health-today.com/bp/famous_people.htm

      Bipolar disorder is relatively uncommon and many more people are
      Unipolar and only have depressions and anxieties. Depressions and anxieties
      are considered the "common cold" of mental illnesses, and are exhibited
      in a large amount of the populace.

      Someone told me that he read a study that said that roughly 50% of the
      authors in the English language today have Mania-Depressia. I haven't been
      able to find it online and would appreciate any references.

      ----------------------

      Dealing with Clinical Depressions:
      ---------------------------------

      There is a lot of mis-information and dis-information about depressions in
      the public. When I was depressed and hypomanic as a teenager I didn't know
      how to call these "conditions", or how to effectively deal with them. If,
      after reading the description on the Wikipedia, you feel that you have been
      depressed in the past, read on.

      The best advice I can give on dealing with clinical depressions (and possibly
      also as a preventitive measure or just to understand what people think) is
      to buy the excellent book "Feeling Good":

      http://www.amazon.com/Feeling-Good-Therapy-Revised-Updated/dp/0380810336

      It is a self-help guide for cognitive-behavioural therapy[CogBeh], that was
      originally written in English and was recommended to me by my therapist.
      Just reading it helped me understand the source of my hypomanias, and I found
      the exercises recommended there to be helpful as well.

      {{{{{{
      [CogBeh] - http://en.wikipedia.org/wiki/Cognitive_behavioral_therapy
      }}}}}}

      Note that if you are depressed, and even more if you're feeling suicidal,
      you need to consult a cognitive-behavioural therapist for a session, as
      soon as possible. I am not a mental health professional and am not qualified
      to give professional therapy, and this essay is not a substitute for it.

      A few things that should be realised:
      -------------------------------------

      1. Mentally Ill is not Eccentric
      --------------------------------

      When people say that someone is "crazy", "insane", "out of his mind" etc. they
      usually mean that he or she is eccentric or behaving irrationaly, not that
      they
      are mentally unsound. I know and have heard about many people who are
      eccentric
      or very eccentric and yet are perfectly sane, and lead perfectly happy lives.

      There's a difference between conformism or "being normal" and mental health.

      2. Not every bad mood is bad:
      -----------------------------

      Some bad moods are normal and are a healthy part of living and would not
      lead to depression. For example, if someone you cared about died, it's
      perfectly OK to feel sad. Rational fear is also normal and healthy. (but one
      should avoid irrational fear). My point is that one cannot or should not be
      happy all the time. Sometimes it is also OK to be a little "down".

      3. Drugs are not the most Effective Way to Treat Depressions
      ------------------------------------------------------------

      Depressions have a cause. According to "Feeling Good" it's usually a
      thought or a group of thoughts that is bothering someone, and caused someone
      to feel depressed. Psychoactive medication aims to deal with the symptom
      that is a chemical problem in the functioning of the brain. However, it
      does not deal with the actual cause that is the mental problem.

      So you still need cognitive-behavioural therapy and to read "Feeling Good".

      That put aside I should note that I am taking medication, prescribed
      to me by a Psychiatrist. It does not prevent me from becoming anxious, but
      it may make the anxieties less severe (I'm not entirely sure about that).

      Computer Developers and Anxieties:
      ----------------------------------

      Computer Developers are probably likely to become anxious more than people
      of most other professions. With the irrational working hours (see
      http://www.igda.org/articles/erobinson_crunch.php ), tight schedules,
      tactless or unfriendly co-workers, bad software management practices,
      bad code and lack of craftsmanship, irrational management that
      "demands-the-impossible", too few vacations, and other factors - it is
      probable that they will feel trapped, resentful, unhappy and as a likely
      result anxious or depressed.


      As a software manager, it is your job to keep your software developers happy.
      This means doing the exact opposite of the above-mentioned points. Refer to
      this essay which I started writing:

      http://www.shlomifish.org/philosophy/computers/software-management/perfect-workplace/

      (Work in progress)

      As opposed to common belief, treating your software developers with superb
      conditions, will make them much more productive, not less. So make sure
      you read my article above (and the links pointed to from it), and integrate
      its recommendations into your workplace.

      Naturally, this is more difficult to do if you're a grunt programmer. However,
      you can still refer your boss to what I wrote if you feel he's reasonable
      enough. If not, it may be a good idea to quit or even to relocate to somewhere
      with more job opportunities. Some jobs are worse than being unemployed.

      -------------

      Obviously, from reading "Feeling Good", it is evident that depressions,
      anxieties and hypomanias are not limited to programmers, and actually predate
      programming by a long time. Many retired people also find themselves the
      sudden victims of these mental ailments. However, I feel that due to bad
      state-of-the-art of software management in the world today, it is especially
      common there, than in most other jobs.

      Some Advice from my Experience:
      -------------------------------

      Like I said, I still haven't fully recovered from my Mania-Depressia and
      am still getting into hypomanias. However, here is some advice I can give
      from my experience:

      #. Do Cognitive Exercises:
      --------------------------

      This is probably the best advice one can give. Read "Feeling Good" and do the
      exercises given there. They are very helpful.

      #. Exercise:
      ------------

      Exercising and especially doing aerobic exercise is very useful for preventing
      or lessening anxieties.

      #. Diet:
      --------

      I don't consume alcoholic beverages, don't consume caffeine, have never
      smoked, and have never consumed any of the currently illegal drugs. While
      it does not prevent hypomanias, I find that it makes me less moody, more
      energetic throughout the day, and allows me to sleep better at nights. (I
      had also tried to refrain from eating sugary foods, but I didn't persist
      in it very well.)

      I also take multi-vitamin pills, and some people take many more individual
      minerals than I do, and while I'm not sure it helps with anxieties, it's
      very good for health and longevity.

      #. Relaxation:
      --------------

      I also find that relaxing or doing things you love to do is helpful for
      keeping a good self-esteem. It's especially important during anxieties.
      Listening to music, sitting, thinking and doing nothing, taking a time
      for leisure at the computer, are useful for relief from troubling thought.

      #. Write Down Your Thoughts:
      ----------------------------

      When I'm hypomanic, I'm getting lots of good ideas: for stories, for essays,
      random useful thoughts, etc. While a lot of them had seemed silly in the
      past, some of them proved to be very useful and rational.[ManiaStories]

      It would be a good idea to write the ideas down, or even work on realising
      the essays or articles, because it makes one less excited and calmer. It
      would be a good idea not to publicise them in public until you're well out of
      a hypomania, because they may prove to be immature or silly in the
      short-run.

      I personally may have sometimes been rejected from jobs because of my many
      things I've written online, and are easily accessible using a Google Search.
      I don't mind that because I feel that expressing and publicising my
      creativity is more important than making myself a better job candidate to
      some "attractive" jobs. And some employers seemed to be very impressed by
      some of what I wrote online, or at least did not mind that, and these seem
      like jobs I prefer.

      {{{{{{{{{{{{
      [ManiaStories] - I even ended up finding many really crazy stories I had
      during my "great mania" as fodder for the following stories:

      * http://www.shlomifish.org/humour/humanity/

      * http://www.shlomifish.org/humour/Star-Trek/We-the-Living-Dead/

      And naturally my hypomanias have been catalysts for most of my other
      stories.
      }}}}}}}}}}}}

      It is naturally a good idea to receive as much commentary as possible about
      one's articles or writings in private before publicising them for all the
      Internet to see.

      #. Be Honest:
      -------------

      It is a good idea to admit that you're "stressed" - anxious, etc. My therapist
      said that the word "hypomania" is intimidating because it contains the word
      "mania", so one should rephrase it in case the other party is not that
      knowledgable about Psychology. Sometimes you may find some of your
      friends or family (but not all) good candidates for consulting with your
      thoughts or feelings. I once spent an hour or so on an IRC conversation
      listening to a 19-years-old whom I knew, talking about her problems.
      I also consulted people on IRC or IM about my own issues and often found
      creative solutions or empathy.

      This is doubly correct for talking with my family members.

      #. Maintain a low online profile:
      ---------------------------------

      During a hypomania, it is a good idea to maintain a low online profile.
      Namely, don't post too much to mailing lists or other forums, don't chat on
      the IRC too much (and try to focus on technical problems or your psychological
      situation), and in general try to maintain a low-profile.

      However, I feel that real-life meetings with people and talking to
      them face to face is actually very good for one's well-being during a
      hypomania.

      So if you can get a friend or a few to meet with you in a café , or go to a
      club meeting, it will be a good idea.

      -----------------------------------------------------------------
      Shlomi Fish http://www.shlomifish.org/
      "The Human Hacking Field Guide" - http://xrl.us/bjn8q

      The bad thing about hardware is that it sometimes work and sometimes doesn't.
      The good thing about software is that it's consistent: it always does not
      work, and it always does not work in exactly the same way.
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