Hey, so I am dealing with a mental health situation that, for once, I have no relevant past experience with. I could really use insight from people who have manic episodes or people who are close to people with manic episodes about just... like... literally any advice for Best Practices that you have. Spoiler: backstory My girlfriend, who has formal diagnoses for depression & anxiety, and probable diagnoses for BPD, autism &/or ADHD (she was in the process to get evaluation but, well, this happened), also recently got a sleep study done & was prescribed a new medication to help with her hypersomnia. Unfortunately, she went into a manic spiral instead. Discontinuing medication on Friday hasn't made a difference so far, and now she's at the hospital, last I heard being evaluated for inpatient. I'm functionally long distance due to COVID, so I have been trying to field this all through video calls and chatting. This hasn't been the best medium for making myself understood when I had concerns last week, or with understanding anything she's trying to tell me. Her live in boyfriend is in various waiting rooms at the hospital, basically feeling awful and hopeless, and I don't know what to do. TL;DR my LDR girlfriend is in the hospital for a medication induced manic episode. Of course I'm going to try to ask her these questions once she can communicate, but I'd appreciate input on the following: How do I be helpful as a long distance girlfriend once she's out? How seriously am I supposed to take anything she said while manic? In the future, if I'm concerned someone is having a full manic episode, how can I effectively communicate concern or that their perception seems to be slipping? I'm sorry if I'm saying anything hurtful or problematic, I'm much less well educated about mania than I am depression or trauma issues. (edit for typos)
I've got some limited experience with mania triggered by extreme stress, but mine definitely tilted very extremely towards manic paranoia. Mania kind of a state beyond nuance, and if you're already someone whose emotional regulation works with a tilted scale where you feel all feelings extremely, it can actually be really relieving. 'S a lot of emotions that kind of sit between two extremes and mania flips the table and throws them in one of the corners, like... the big thing for me was my friends at the time not being able to keep up with my social needs turning into "I wish they'd just told me they didn't have the energy for me anymore" as a kind of terminal condition, the end of the friendship. Undoubtedly, your girlfriend had a few of those come out, and I'm not advising you throw them out, but apply the "these things were said beyond nuance" to them. She probably had some real source of stress that hadn't yet breached the crest where she could get the Big Feelings about it (or alternatively, she could have had Big Feelings about them that she was processing poorly, IDK how good at communicating her feelings she is, usually). You shouldn't take any one "here's what you did" accusation from her personally, I doubt she managed to exactly verbalise her problem at the time, but it's a good idea to return to those things at some point to talk them through to see what tension she's been carrying around. I also had it happen that after my mania had passed, a lot of my relationship withered away b/c I was no longer putting all my anxiety-heightened-state-energy into maintaining them. Lots of ideas just fell through because nobody wanted to check back or was excited about them, and the "you don't have to feel bad if you don't have the energy" thing that is good advice for depression really kind of sucked b/c it made me feel like I couldn't do anything outside of getting into a hypomanic flow state again. Just because your girlfriend might have for now burned out her reserves, it's not the same as the kind of chronic lack of energy. If she's very Do Stuff Take Lead(tm) she is usually, it might be a good idea to plan stuff that she can involve herself in without needing to be the one directing the action, but still having something she can be involved in, could be good for when she's just not up for after action feelings talking. Mania can feel really good, but it's a kind of fitful oh-god-I'm-gonna-die-if-I-don't-do-this good and afterwards it's like you've run a marathon and accomplished nothing, so I guess my advice boils down to "establish that you can accomplish things, both communication goals and practical/entertainment goals outside of it."
Hey, I just wanted to come back to this and say thank you for your really thoughtful response. My situation is pretty different in a couple of respects, but it's still super helpful to know that some of this is normal, and that some of the things your recommending my girlfriend seems to be getting good support for from the people around them They got out of the hospital on Monday. They haven't been accusatory on a personal level, but they were, pre-hospital, getting increasingly distressingly accusatory of systemic injustice in, say, Healthcare, voter suppression, etc, in the "I am embarking on a Crusade where my armor and weapons are my Feelings" and it was a little overwhelming. Apparently their big stress point that emerged in all this was much, much stronger feelings about gender than they'd been acknowledging (thus the shift in pronouns between these posts), and a lot of their energy rn seems to be on accessing transition care. It seems like the people living with/interacting with them in meat space are supporting them a lot with hanging onto their big ideas but gently setting them aside to focus on essentials - they've been sharing lots of pictures of whiteboards covered in notes, for example. I still have a TON of stress about the whole situation, but at this point it's past crisis and is now about the really sucky faux-LDR situation we're in and some pre-existing relationship issues that are whoa exaggerated by the mania, so I'm not sure if there is any mania related advice that can help. I really appreciate you sharing your experiences though!
