who seek treatment for maniaas in
hypomania, a less severe form of
maniaas in cyclothymic
disorderoften find themselves stuck in an
unconscious philosophical impossibility. But more about
this in a bit.
stabilizers, such as lithium and valproic acid, are common
for mania. Lithium, for example, though not used much today, is a natural
salt that helps to stabilize a persons mood, so that the peaks arent
so high and the valleys arent so low. Its a fairly simple chemical
though it can have some unpleasant side effects, such as a metallic taste
in the mouth. But the side effects of mood stabilizers usually dissipate
within a week or two. Some mood stabilizers also have a small
window of efficacy, such that too little does no good and too
much can be toxic; therefore, you will need to monitor its serum level regularly.
All of this should be fully and clearly explained by your prescribing
can be very dangerous. Without psychiatric medication, and under the influence
of a manic phase, a person can be tempted by powerful impulses to take risks
and engage in dangerouseven life-threateningbehaviors. Moreover,
illicit drugs, often used for self-medication, only increase the danger;
not only do they damage the brain and erode whatever self-restraint may be
alive there, but also they place the individual in dangerous social
One other effect
of a mood stabilizer will be its success: you will lose the high
of hypomanic expansive creativity. You wont be a zombie
like some persons who must take highly sedating antipsychotic medications;
you will just be ordinary. And this, in fact, brings us to that
impossibility I mentioned earlier.
Even though mania
has organic causes that involve brain chemistry, mania also has a psychological
cause. Its psychodynamic roots lie in a desire to avoid
of life and to escape into the pleasurable, uninhibited, and expansive aspects
of life. Any attempt to stabilize these expansive moods will feel like a
grave threat to the part of the
that uses flight into expansive fantasy as a defense against its inner emotional
And there is
the problem. That part of you that uses flight into expansive fantasy as
a defense against its inner emotional pain knows full well that
all human social constructions are empty illusions, and so it yearns for
something meaningful in life. Even treatment for mania will be seen
as boring, and so your manic defense will resist the very thing you need for
your own protection. But because the manic defense is just another vain illusion
like all the other illusions it seeks to escape, it is always bound to fail.
that I speak here about unconscious knowing,
not about what you think you feel or believe consciously.
Sadly, our entire
social structure has its unconscious basis in the need to hide
feelings of vulnerability and helplessness with feelings of power and
grandiosity. Just look at our political system, our law-enforcement system,
and our military system. Its all filled with overblown rhetoric and
Just look at
some of our most profound social problems today. Certain elements of certain
societies feel oppressed and disavowed. So, to make themselves feel powerful,
they lash out with terrorist acts. Those who
are terrorized by those acts feel momentarily helpless, and then they respond
in turn with grandiose acts of retaliation.
So, if our entire
culture has oriented itself around power and retaliation as a response to
fear and vulnerability, imagine how difficult it can
be for one individual to be healed from the
depression and grandiosity that result from this
unconscious cultural infection.
bipolar disorder, therefore, can be difficult unless you can disentangle
yourself from the unconscious thirst for grandiosity that surrounds you in
our culture. Everything can seem hopeless until you can accept the true
spiritual realization that meaning cannot
be found in a psychological defense; meaning can be found only through
a humble surrender to something greater than the
to the Healing: Religiosity
Once we begin
to talk about a humble surrender to something greater than the
self as is done also in 12-step programs
for treatment of addictionswe open up an awareness of
spirituality and religion.
This spiritual element can complicate the treatment of mania, however, because
religiosity is a common component to the manic defense of expansive
fantasy. Rather than face the pain of your childhood experiences of aloneness,
despair, darkness, and alienation, you can convince yourself that experiences of
aloneness, despair, darkness, and alienation are a grand spiritual
around you in the present. Hence, if you were to tell your
you wanted to use a spiritual understanding to help you in your recovery,
the psychiatrist would most likely panic and would want to increase your
So, how can you
tell if your spiritual aspirations are genuine or if they are merely defensive?
Well, the only way is to look for their fruits. If your spiritual aspirations
produce socially beneficial qualities in you such as love, joy, peace, patience,
kindness, generosity, faithfulness, gentleness, and self-control, then they
can be considered to be something more than a mere psychological defense.
In contrast, if you are overcome by qualities such as impatience,
distractibility, impulsiveness, demandingness, conflict, discord, and scorn
for others, then you are growing weeds, not fruit.
psychotherapy with someone who really knows his
job you will learn wisdom and humility as you encounter
them in the healing process. But until you reach that place of full emotional
commitment to looking beyond what you merely think so as to peer deep
into your unconscious motivation, you will always be trying to argue
with life (and with your psychotherapist) the same way adults argue with
a child. It will seem that life, in all its empty vanity, is treating you
just like a distracted parent treats a child: with expectations, not nurturing.
You will want desperately to rise above everything that seems foolish and
to poke holes in it with brilliant
But, as I said
above, because the manic defense is just another vain illusion like all the
other illusions it seeks to escape, it is always bound to fail.
Your own inner
pain must be understood through the psychotherapy, not hidden away with flashy
slight-of-hand. In essence, it will be necessary to learn to treat yourself
with the honest, gentle, and compassionate true
love that your parents never gave to you.
Needless to say,
at the outset this will seem quite distasteful, more so than the taste of
lithium even. And so a mood stabilizer may be your easiest solution.
Eventually it will force your body to submit to it; it will effectively do
to your body what you fear to do: surrender humbly
to something greater than yourself.
that psychiatric medications are not curativethey
work only for as long as you continue to take them. No one, really, should
ever be taking psychiatric medication without also being in psychotherapy.
Psychotherapy can lead you to the roots of your unconscious motivation where
you can find a more lasting healing than day-by-day containment. So, if only
you can get yourself stabilizedif only chemicallythen turn to
the deep psychological and spiritual issues and do the work to resolve
advertisingno sponsorjust the simple truth . . .
Disorder (menu) from the National Institute of Mental Health
Mood Disorders from THE MERCK MANUAL, Sec. 15,
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