Not a Nuisance, a Nuance: Learning My Prodromes
Spot the warning signs before you end up chasing men on Tinder.
My ex-husband was driving me to the cardiologist the other day. (Yes, ex-husband. I’ll save that for another post.) We had barely moved a block when he glanced over and said, “You’ve been driving slower lately. That’s good. Good for you.”
He looked genuinely proud. I didn’t get it.
“Why are you happy that I’m driving slow?”
“Well… you drive a bit fast when you’re…extremely happy.”
Then came a long pause, the kind that says everything without saying anything.
“Oh,” I said. “You mean when I’m hypomanic. Cool.”
He wasn’t wrong. A few weeks ago, I was. I’m not anymore. But he noticed the frequency of my foot on the gas pedal before I noticed my mood. It’s not like I didn’t know-know, but I was trying to play it off a simply being excited about work related stuff (which, obviously triggered the hypomania in the first place).
So, what are prodromes?
In Spanish we call them pródromos. In English, they’re prodromes: the early warning signs that show up before a full episode. Think of them as the birght light that happens even before thunder strikes, which may or may not predict the storm. Prodromes aren’t the episode itself, but they tell you one is on its way.
It’s kind of beautiful to have someone who knows your prodromes almost better than you do. It’s also kind of a nuisance. (Nobody likes being out-diagnosed from the passenger seat.) But these are the nuances of living with bipolar disorder that many of us never learn to identify.
Some of my prodromes are obvious. A few weeks back I was sleeping less, eating less, and my thoughts were starting to race. My brain was pitching ideas like a startup founder on espresso:
Let’s write another book. Let’s get a second job. Let’s get a part-time job on top of that.
Blah, blah, blah.
But I know myself pretty well by now. I treat racing thoughts like racing cars. I sit down in the crowd, all thea way up in the bleachers, and see them drive by. I’ve learned to just wave and think, “That’s a nice shade of blue”. To avoid immersing myself deeper in the episode, I put myself to sleep, literally. I spray myself with melatonin. I eat, even though I don’t want to. And I do not act on a single one of those brilliant ideas. If I do, I’d have bought myself a one-way ticket to a full-blown manic episode.
Then there are the quiet prodomes, the ones that don’t look like symptoms at all:
- Driving really fast.
- Pacing back and forth in the morning.
- Forgetting I turned on the coffee maker and letting the coffee burn because I’m too far ahead that I am not paying true attention to what I am doing.
One at a time, they look like a busy woman. Together, they’re red flags waving in my face.
This got me thinking about the women in our mutual support group, women on the bipolar spectrum here in the Dominican Republic. Everyone’s flags look different.
For one of them, it’s overworking. She fills her calendar until there isn’t a free square left, gets busier and busier, wears herself out completely, and ends up in her psychiatrist’s office begging for help to calm the heck down.
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For another, left unsupervised, she downloads dating apps. Within 24 hours she’s driving two hours to meet a completely random guy she met on Tinder.
We all have little red flags we tend to ignore. And those little flags are often the biggest signs that a hypomanic episode is coming.
Why I love CBT
This is exactly why I love cognitive behavioral therapy. It teaches your mind to tell your brain: We are not acting on every magnificent idea you have right now.
They’re called episodes for a reason. They’re temporary. We can think and struggle and wrestle with them all we want, but if we don’t act on them, we’re much more likely to come out the other side unharmed. So will the people around us.
Depression asks for the opposite. Here’s something I told my psychiatrist the other day, and I’ll admit it might sound harsh: it frustrates me when people entering a depressive episode don’t take action right away.
I know that can sound minimizing. But I’ve been there, and I know how hard it is to crawl out. It took me ten years (yes, a decade) to figure this out. The way back up is doing the things that get your brain making the good stuff on its own: endorphins, serotonin. In therapy-speak, this is called behavioral activation.
What makes you happy? Do it, even if you don’t want to. Especially if you don’t want to. One day you’ll wake up, your brain will have caught up, and you’ll feel better.
Put the body to work and the mind will follow. I promise.
With hypomanic and manic episodes, it’s the other way around. Stop. Cold turkey. Want to text your boss at 11 PM about how the meeting went completely off the rails and now you’re anxious about it? Don’t. Just don’t. Stop.
It’s simple, really. But we humans love to complicate everything.
I know it isn’t easy. It takes time and therapy, and not everyone has access to that. But learning to identify and manage your prodromes is what will define your well-being with this condition.
Will I stop having racing thoughts? No.
Do I know how to deal with them better? Yes.
Will I stop having feelings of grandeur, hypervigilance, or nights when I’m just not sleepy? No.
Do I know how to work around them, stick to my regular programming, and keep la loca at bay? Yes.
Here’s what happens when I don’t:
I’m not sleepy, so I say, “Screw it, I’ll go to bed at 2 AM.” I fall asleep late and wake up really early for work. I’m instantly irritable, and I spend the whole day fighting people off. Fighting people off makes me feel guilty and sad. Guess who’s in an even worse mood by the end of the day? Me.
Guess who can’t stop the racing thoughts about feeling guilty for not stopping the racing thoughts in the first place? Me.
Guess who can’t sleep again? Me.
See?
In the end, I think it all comes down to wanting to feel better and not wanting to hurt the people around us. That is the greatest motivator there is. Learning to be vigilant of prodomes will give you higher odds at stopping the cycle and reengaging with euthimia quicker. Albeit, again, it takes practice (remember, 10 years in my case). But it is not impossible.
And when it comes to prodromes, and to what pulls you back, every person is different. Heck, cooking lasagna makes me feel like the most special person in the universe. When I told this to a fellow bipolar, they just stared at me: “…Eugh, cooking?”
Yes. Cooking.
You are the best person, and the only person, you’ll spend the rest of your life with. So get to know yourself. I am certain you are super, duper fun and intelligent– and the bipolar community needs you well and healthy to tell us your story!
What are your prodromes? I’d love to hear which red flags (and which cooking recipes) you’ve found.
