The Devastating Conundrum of the Manic Cycle

Bi-polar Affective Disorder

…continued from yesterday.

3:15 pm, March 17-St. Helena Hospital Center for Behavioral Health

Happy St. Paddy’s Day! I’m not wearing green but up in this club we can’t touch each other, so I doubt I’ll get pinched today. I’m wearing my baggy grey slacks and a Newark (NJ) pink Tee shirt.

Sidney needs to learn when to shut up his fat butt…I can hear him all the way over here in room 108A moaning and yelling most of the day. He drives me bonkers, that old fart. For more than one reason. He’s always telling me I’m too loud and that I never clean up aftermyself. Whatever. Earplugs in..where are they…?

Can’t find..oh. In my pocket—yay. I don’t like the noise…eternal and muffled…that they make in my head. Oh well. Better than listening to Sid.

Besides that, I’m pretty happy today. Tio just bought me some wax pastels in 24 colors, and yesterday a sketchbook (one of those big ones with 30 pages) so today I’m gonna be drawing and experimenting with those. Finally some real art supplies! We just go out of an interesting process group with a PhD psych intern named Michelle. it was enlightening for sure. Kellie told me to take deep breaths and it helped because I was talking/thinking a million miles a minute. I hope I didn’t dominate the conversation too much.

They have groups all day. Pretty much every hour or so. Sometimes they’re consecutive. I’m not sure I feel about that. At least they’re usually interesting. I think “movement group” is going on so I’m gonna go. Later…☺ I must come up with a name for you, Diary. Writing “Dear Diary” at the beginning of every entry would be too cliché. Maybe I’ll ask around.

I’m in a psych ward in Vallejo, CA. I’ll talk about how I got here next time.


We quickly discovered that all of Sarah’s strange Facebook posts and You Tube videos only hinted at her risky behavior during her manic cycle. When her aunt started looking through the content on Sarah’s phone, she wrote us an impassioned letter about what she had found.

Evidently, Sarah had made ‘friends’ with a strange assortment of people (mostly males) from all over the world. She had received videos from a young man in Iraq showing him and his friends torturing someone. She had sent selfies that a rational person wouldn’t send. She had strange conversations on social media apps like WhatsApp.

The findings shocked us at first because Sarah had always dressed more conservatively than anyone else in the family. But one of the markers of bi-polar affective disorder includes risky, exciting behavior (often of a sexual nature). In other words, a person’s normal filter or moral compass gets lost in the manic high.

Pedro and I felt we had to bring this behavior to her attention and try to help her understand that her behavior had NOT been normal and not a true representation of who she is. Pedro spoke with the caseworker and asked whether or not we should have the conversation with Sarah while she remained at the center, or wait until her discharge. The caseworker advised to go ahead and have the hard conversations over the phone while Sarah had a 24-hour support system around her.

After six days in the hospital, Sarah’s speech remained rapid, but her mood swings had slowed down. In retrospect, I don’t know exactly why we felt we needed to bring up this aspect of her behavior—maybe because based on her conversations with her aunt in the emergency room and the contents on her phone and our subsequent conversations, we didn’t think she actually knew what she had done in New York. And if she did understand what she had done, she didn’t understand that her behavior had NOT been normal. And if she didn’t understand than we knew that she would carry through with her threats and go off her medication as soon as the hospital discharged her.

As I read An Unquiet Mind: A Memoir of Moods and Madness, I saw clue after clue that tied all of Sarah’s behavior together over the last two years. The depression. The lack of self-confidence (despite her previous track record of success and excelling in school and sports). The weight gains and losses. The strange clothing purchases that she made whilst in Argentina. The time her good friend told her that she talked too much. The uncharacteristic pursuit of a young man. The multiple changes of plans and careers. The extreme depression upon returning to the United States that the standard depression medications didn’t touch. The suicidal thoughts and ideation. The long drive to Reno (which included multiple stops to shop). The incessant plan changes and utter rage and isolation from those who loved her and knew her best. The plans to travel to London with no money and no debit card. Her inability to see that her chosen course of action could only end in heartache.

The conversation did not go well. Sarah seemed shocked by our view of what happened. She didn’t understand that we could view her behavior in such an unsavory light.

Only now, as we write this series together, do I realize the strange conundrum of mania. A manic person might not be able to reason, but they have sensitive feelings. I fear we hurt her badly.


What Do You Want From Me?

Do you ever think
that maybe you were wrong?
To lock me up like this
A bird without a song…

I was living life
the best I could but now
you’ve kept me from wanting
to like this. How?

How could you stoop so low
send me to hell
stand back and expect
me to kiss your ass and tell..

then bow down to a fake god
one hidden from my sight
you call me a whore
then read the Bible every night.


Because I had been voraciously reading the book by Dr. Jamison, I knew on an intellectual level that the inability to see one’s behavior as aberrant or out of character is normal for a person on a manic high. On an emotional level, it would take me much longer to come to terms with this devestating conundrum. The fact remains: Bi-polar affective disorder, like any other disease, manifests itself differently in each person.

People in a #manic cycle might not appear to have logic--but they still have feelings! Click To Tweet

…to be continued.

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