When ‘Feeling Amazing’ May Indicate Bipolar Disorder

Reader’s Question

About seven months ago I experienced something of a mental breakdown that lasted only a week. However, before I went out of control I felt extremely good. I felt as if I was famous and really smart. I thought everything had a symbol behind it and there was a new meaning behind everything.

After months of psychiatry and a low dose of Zyprexa to keep it from happening again, my psychiatrist explained that I just have severe anxiety and panic, so he prescribed Zoloft.

Now, I’m starting to feel like I did just before my breakdown. I feel amazing, but almost like I have super-power, and can do anything. What’s going on?

Psychologist’s Reply

It’s not clear what symptoms you had during the week-long period you characterized as the actual break down. The other experiences you describe, however, sound like what one might experience during a hypomanic episode characteristic of bipolar disorder. Once referred to as ‘manic depression,’ bipolar disorder includes alternating periods of depression and either mania or hypomania.

Full-blown mania inolves hyperactivity and little or no need for sleep. It can involve becoming psychotic, or not experiencing the world in the same ways as nearly everyone else. So, in the midst of mania, the individual may hear voices or have other sensory experiences not shared by others. The person frequently also has delusions, or false beliefs, and these often involve a sense of grandeur (inflated self-importance). As a result, the person is liable to make poor choices and end up in trouble of one sort or another.

Hypomania is simply a lower level or degree of mania, but often involves very similar experiences. So, instead of being extremely hyperactive, the person may feel very energetic and motivated. Instead of experiencing hallucinations, the individual may be plagued more by delusions regarding his or her own abilities or the meanings behind his or her own experiences. Because hypomania may feel positive (especially compared to periods during which the person experienced depression), people are less likely to seek help or treatment during hypomanic phases, compared to fully manic periods.

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For some people with bipolar disorder, antidepressant medications and stimulant drugs seem to facilitate or trigger a manic or hypomanic episode. Indeed, this is how some people come to be recognized as having bipolar disorder, rather than depression alone — treatment of the depression stimulates a switch to the other extreme.

It may be relevant to know whether you have a history of depression. Also, because bipolar disorder tends to have a genetic component, it could be significant if there are other members of your extended family with similar experiences or symptoms. Regardless, however, it is worth asking your health care provider about the possibility that you may have bipolar disorder. The disorder is manageable but requires different medications than those used for depression or anxiety.