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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by hyperfocus on October 27, 2011, at 10:53:55
Most of us have had it, however briefly. That surging in your chest where your body is telling you for the first time in years it's going to be ok. You have so much energy and motivation and feel that everything - showering, laundry, cleaning, cooking breakfast is worthwhile. All of your plans and dreams are back on track. You feel very social and talkative - the wall of anxiety and fear between you and the rest of the world is broken down. You feel the sun on your skin for what feels like the first time in years. Colors are sharper and brighter, food tastes right, you notice details in people and life and respond to them in a way you haven't since you were a child. The term I've seen used here is healthy euphoria. You feel that this is what remission feels like and if you could feel like this every day for the rest of your life it would be worth it.
And when it passes away, perhaps inevitably, it's like you spend the rest of the year chasing after it, trying to solve the puzzle of what combination of meds got you to there. Yearning for that feeling was in part responsible for my amitriptyline incident this month. But isn't that what life is supposed to feel like?
I remember somebody making a joke about house cleaning and saying that after a few weeks the dust and grime and disorganization really don't get any worse. That's how I feel too - I'm so behind with basically everything in life there's no reason anymore not to just spend the day vegetating. But yesterday and the day before I did some cleaning. I didn't feel particularly enthusiastic about doing it but (and this is the change from the status quo) I didn't feel like not doing it either. Most the of time doing some reading or (gasp) actual work is so beyond me. I don't have the energy and concentration for it and in any case it's hard and I'm so lazy and stupid and will never amount to anything so why should I do it. These past few weeks though it seems that sometimes the gap between doing something productive and do laying down on the couch staring mindlessly at the TV is getting narrower. I don't feel particularly thrilled about listening to an audiobook for half-an-hour or working a tiny bit on a project or writing this PB post, but I don't see any particular reason not to do it either. I didn't like being disturbed this morning by strangers coming to look at our fridge but the whole thing was not terribly frightening or fatiguing the way it would normally be either.
So is this the med response I should be looking for - simply well regulated motivation and concentration and decreased fear and neurotic thinking? Is that healthy euphoria I felt and long for unrealistic? I think to myself there's no immediate reason the serotonin/dopamine peaks of hypomania should be 'normal' for me right now. Yet when I was well and healthy wasn't this how I felt all the time and took for granted till I became ill? It's always what people ask about how normal feels - where exactly does personality end and morbidity begin. I was always very shy but not to the extent where I can't leave my mouse or make eye-contact with a stranger. On the other hand where does response to meds diverge from your true self? If in my hypomanic state I start talking to a girl on the bus, is that 'normal'?
ace (The Nardil Champion) reported that this healthy euphoria phase could be permanent. Last time I heard from him he was still going strong and apparently into full remission. But can this serotonin/dopamine enhanced state really be maintained by everyone? Is that what I should be aiming for?
Posted by Phillipa on October 27, 2011, at 12:10:37
In reply to Chasing hypomania: is it realistic?, posted by hyperfocus on October 27, 2011, at 10:53:55
I feel being content and accepting of life's responsibilities ups and downs and enjoying some great feelings is rather normal and kind of what I personally should aim for. I understand what you felt. When younger and didn't care nor take meds I just lived and felt content. Phillipa
Posted by floatingbridge on October 27, 2011, at 12:50:30
In reply to Chasing hypomania: is it realistic?, posted by hyperfocus on October 27, 2011, at 10:53:55
>So is this the med response I should be looking for - simply well regulated motivation and concentration and decrease fear and neurotic thinking?
This sounds like a good starting place on which to build a life. At least to me. It's difficult to live life in the absence of regulation and in the presence of unremitting fear.
>Is that healthy euphoria I felt and long for unrealistic? I think to myself there's no immediate reason the serotonin/dopamine peaks of hypomania should be 'normal' for me right now. Yet when I was well and healthy wasn't this how I felt all the time and took for granted till became ill?I'm not sure I have ever felt a healthy euphoria. Certainly not as a child. Even the idea of Santa coming would send me into fits of insomnia. I think because life was such misery as a child. I guess I question the word 'euphoria'. Do you place the advent of illness in childhood or teen years?
Anyways, I am looking for a peaceful neutrality. But that's me talking about my personality and what is tolerable for me.
I think we each need to ask this question for ourselves. What might be a correct state for the poster you named below might look good and may even get support in popular culture (no knocks to anyone implied) but we each have different set-points. I tried to combat my fears for many years by trying to maintain and inhabit a self that was too large, too happy and shiny. I admit I am very worn down by the years, but I do think the pleasure we (as a culture) sometimes ascribe to the childhood years is not sustainable. Nor should it be. Along with the child freshness is an innocence from a lack of experience. It was Blake who wrote that innocence comes after experience. I feel that is a state I want to strive for. But again, this is me talking about my own self. You may indeed have a large or robust personality and may be correct in seeking more for yourself. Maybe dancing on table tops and breaking plates like Zorba is really your speed. I am exaggerating here, maybe.
I once saw Iggy Pop on a small stage and almost fainted from the sheer force of his personality. If I deified his lust for life, I would always be falling (very) short.
I have been having on-going discussions with an educational therapist about brains. The way they work. It is fascinating. Anyways, in ways I do not understand, the child's brain does not work at all like the adult brain. So the freshness that is endearing in a child is not the same freshness adults can bring to a situation. As someone who missed out on much pleasure as a child, I have tendencies to mourn and try to recreate that child-experience. But really, it would only be an imitation for me. Now that I am older, I have less time to spend on imitation.
I'm not sure what I'm saying here HP. I guess we come to recovery on our own and need to find our own way. So I am just talking.
>ace (The Nardil Champion) reported that this healthy euphoria phase could be permanent. Last time I heard from him he was still going strong and apparently into full remission. But can this serotonin/dopamine enhanced state really be maintained by everyone? Is that what I should be aiming for?
Posted by hyperfocus on October 27, 2011, at 13:45:13
In reply to Re: Chasing hypomania: is it realistic? » hyperfocus, posted by Phillipa on October 27, 2011, at 12:10:37
> I feel being content and accepting of life's responsibilities ups and downs and enjoying some great feelings is rather normal and kind of what I personally should aim for. I understand what you felt. When younger and didn't care nor take meds I just lived and felt content. Phillipa
Yes that's how I used to feel too before age 12. When the ups came I could feel pride and pleasure in success or good fortune. When the downs came I just rode them out. I didn't feel then that life had any particular issue with me personally. We all had strengths and weaknesses. I didn't feel so afflicted and defective and looked down on by other people the way I do today.
Posted by SLS on October 27, 2011, at 13:57:10
In reply to Chasing hypomania: is it realistic?, posted by hyperfocus on October 27, 2011, at 10:53:55
What is the difference between a healthy euphoria and an unhealthy euphoria? Is there such a thing as a happy or elated euthymia (normothymia)? Must elation be the product of mania?
I am not sure that what you felt was euphoria. I think anyone would be elated to have their depression vanish and a kaleidoscopic world of experiential wealth open up anew. Was your reaction to this long-forgotten state of normal consciousness abnormal?
I have experienced euthymia, hypomania, and severe mania. Of these, euthymia felt the best. The euphoria of hypomania did not produce the crystal-clear thinking and sense of reward that euthymia brings me. Is there anything in particular that would lead you to believe that you experienced hypomania?
Whatever it was that you experienced, I hope you experience it again. It sounded healthy to me.
- Scott
Posted by floatingbridge on October 27, 2011, at 14:46:54
In reply to Re: Chasing hypomania: is it realistic? » Phillipa, posted by hyperfocus on October 27, 2011, at 13:45:13
Oh. This sounds good, HF. I'm sorry for my tangent. I really misunderstood.
Posted by creepy on October 27, 2011, at 17:14:41
In reply to Chasing hypomania: is it realistic?, posted by hyperfocus on October 27, 2011, at 10:53:55
It seems like a fine line between euthymia and hypomania. This is where your pdoc and therapist come in. You need someone that you see regularly to get a feel for when you go beyond euthymia.
I dont think hypomania is sustainable. If you push it too far you could even have a psychotic break. Too many unknowns, if it was me doing it.
Posted by Phillipa on October 27, 2011, at 20:58:09
In reply to Re: Chasing hypomania: is it realistic?, posted by creepy on October 27, 2011, at 17:14:41
Hyperfocus when did you last hear from Ace? I have to wonder if he did become a pdoc? Do you know? Phillipa
Posted by jono_in_adelaide on October 29, 2011, at 4:25:53
In reply to Chasing hypomania: is it realistic?, posted by hyperfocus on October 27, 2011, at 10:53:55
"I remember somebody making a joke about house cleaning and saying that after a few weeks the dust and grime and disorganization really don't get any worse. That's how I feel too - I'm so behind with basically everything in life there's no reason anymore not to just spend the day vegetating"
Thats exactly how I feel - when i had my breakdown i lost everything, career, house, self respect..... and I dont seem to have the strength to get it back......its a good thing they dont sell Nembutal any more...
Posted by Phillipa on October 29, 2011, at 19:24:30
In reply to Re: Chasing hypomania: is it realistic?, posted by jono_in_adelaide on October 29, 2011, at 4:25:53
Jono I'm truly sorry. I also lost my career. Stinks doesn't it? But wait don't you work now again? Phillipa
Posted by hyperfocus on October 30, 2011, at 15:42:39
In reply to Re: Chasing hypomania: is it realistic? » hyperfocus, posted by floatingbridge on October 27, 2011, at 12:50:30
> >So is this the med response I should be looking for - simply well regulated motivation and concentration and decrease fear and neurotic thinking?
>
> This sounds like a good starting place on which to build a life. At least to me. It's difficult to live life in the absence of regulation and in the presence of unremitting fear.Yes it is difficult. One major feature of the state I'm describing is vastly reduced fear and miles better emotional regulation. I don't feel like I've murdered children in my past, the dial on rejection sensitivity is turned way down and perceived reward for activities, social and private, turned way up. The smallest social miscue was not life-ruining and anything requiring more than ten minutes of concentration was not insurmountable. Honestly when I'm in this good state, no matter how short it is, I see the rest of the time as just not living.
>
> >Is that healthy euphoria I felt and long for unrealistic? I think to myself there's no immediate reason the serotonin/dopamine peaks of hypomania should be 'normal' for me right now. Yet when I was well and healthy wasn't this how I felt all the time and took for granted till became ill?
>
> I'm not sure I have ever felt a healthy euphoria. Certainly not as a child. Even the idea of Santa coming would send me into fits of insomnia. I think because life was such misery as a child. I guess I question the word 'euphoria'. Do you place the advent of illness in childhood or teen years?Euphoria might be too big of a word. I like your term better - innocence. Like Phillipa described it was ok to be just content with and to like living for what it was and accepting the ups and downs. We didn't have much money and it would grieve me a lot to see the other kids with their Nintendos and bikes and other things I didn't have. I was also scared to death of any adult outside my immediate family. But it was just part of life I accepted and was content with. I was no better or worse than any one else I (subconsciously) thought. It was only around age 12 that other people began communicating to me that I was different, that I was somehow inferior to them, that I was deserving of scorn and ridicule.
>
> Anyways, I am looking for a peaceful neutrality. But that's me talking about my personality and what is tolerable for me.
>Hypomania is probably the wrong term - what I crave for is also peaceful emotional neutrality. I'd just like to feel like how I did when I as much younger before I became ill. I just want to stop having to con and convince myself that reading or working or going out is worthwhile. I'd like to get a proper emotional response to the things in my life - not the exaggerated despair and crushing sadness and self-loathing I've had for so long.
> I think we each need to ask this question for ourselves. What might be a correct state for the poster you named below might look good and may even get support in popular culture (no knocks to anyone implied) but we each have different set-points. I tried to combat my fears for many years by trying to maintain and inhabit a self that was too large, too happy and shiny. I admit I am very worn down by the years, but I do think the pleasure we (as a culture) sometimes ascribe to the childhood years is not sustainable. Nor should it be. Along with the child freshness is an innocence from a lack of experience. It was Blake who wrote that innocence comes after experience. I feel that is a state I want to strive for. But again, this is me talking about my own self. You may indeed have a large or robust personality and may be correct in seeking more for yourself. Maybe dancing on table tops and breaking plates like Zorba is really your speed. I am exaggerating here, maybe.Whenever I see 14-and 15-year olds out in the mall having fun and holding hand I feel a lot of grief because I know that is something I've probably lost forever. I used to watch shows like The Wonder Years and My So called Life in my early twenties and wish I could have had a life like that. It's not that I want 4 girlfriends and a Ferrari and be CEO of a billion dollar company.
> the child's brain does not work at all like the adult brain. So the freshness that is endearing in a child is not the same freshness adults can bring to a situation. As someone who missed out on much pleasure as a child, I have tendencies to mourn and try to recreate that child-experience. But really, it would only be an imitation for me. Now that I am older, I have less time to spend on imitation.
>It's funny - I was reading the Wikipedia article on euphoria and it says that children can generate euphoria in themselves by playing. We don't really want to regress to this state - it's just the emotional neutrality and sense of hope and freedom that I think that we miss. I used to wake up every morning wondering what the day would bring. Really this is most of what I really want from my meds.
Posted by Phillipa on October 30, 2011, at 20:01:02
In reply to Re: Chasing hypomania: is it realistic? » floatingbridge, posted by hyperfocus on October 30, 2011, at 15:42:39
Exactly right on the money. To be content and happy with what is going on right this minute in our lives and to be able to plan for the next day and not wonder if will be able to do it. Phillipa
Posted by sigismund on October 30, 2011, at 20:29:41
In reply to Re: Chasing hypomania: is it realistic? » floatingbridge, posted by hyperfocus on October 30, 2011, at 15:42:39
>I was reading the Wikipedia article on euphoria and it says that children can generate euphoria in themselves by playing. We don't really want to regress to this state
I wouldn't mind it at all. To actually get pleasure out of play.
>- it's just the emotional neutrality and sense of hope and freedom that I think that we miss. I used to wake up every morning wondering what the day would bring. Really this is most of what I really want from my meds.
Children play naturally. There is no reason to stop but it often happens. Perhaps humour is a kind of play? Play can come into many things and the lack it it is a loss. I am just thinking out loud, but sex minus play is just regimented performance?
That sense of emotional neutrality you mention is valuable. It is what I notice with emotionally healthy children, and is also similar to the state I recall from productive psiloscybin experiences. In one of those I felt consciousness to be, in and of itself, really pleasurable, rather than being a calamity.
Posted by floatingbridge on October 30, 2011, at 22:39:07
In reply to Re: Chasing hypomania: is it realistic? » floatingbridge, posted by hyperfocus on October 30, 2011, at 15:42:39
HF, I felt like such a scold after I wrote my response.
I read the wiki on euphoria just now. It's interesting how the history of the word has changed. The original Greek had the sense of being actively involved in euphoria which goes along with children at play. I have seen it in my son though not really seen it as 'euphoric' because I base my usage in the modern connotation. I might revert.
Thank you.
Posted by hyperfocus on October 31, 2011, at 23:38:27
In reply to Re: Chasing hypomania: is it realistic? » hyperfocus, posted by SLS on October 27, 2011, at 13:57:10
> What is the difference between a healthy euphoria and an unhealthy euphoria? Is there such a thing as a happy or elated euthymia (normothymia)? Must elation be the product of mania?
I guess I was thinking the euphoria of cocaine or heroin or ecstasy that could be unhealthy and not sustainable and not tied to reality. But as sigi says elation could just be the product of a non-dysfunctional consciousness. My baseline state has been pretty low for such a long time that I see not feeling bad all the time as some sort of abnormality.>
> I am not sure that what you felt was euphoria. I think anyone would be elated to have their depression vanish and a kaleidoscopic world of experiential wealth open up anew. Was your reaction to this long-forgotten state of normal consciousness abnormal?
Euphoria is probably too strong a term. Euthymia is better. But yes I was feeling good about feeling good. The idea that I might finally escape from this 2-decades old prison was quite exhilarating.> I have experienced euthymia, hypomania, and severe mania. Of these, euthymia felt the best. The euphoria of hypomania did not produce the crystal-clear thinking and sense of reward that euthymia brings me. Is there anything in particular that would lead you to believe that you experienced hypomania?
It was just the perceived rapidity of getting there - there wasn't a gradual measurable improvement from baseline - and also the elusiveness of it. But it was probably just euthymia - psych meds tend not to follow a schedule. I keep hoping that one day the meds will unlock whatever needs to happen in my brain to sustain such a improvement.>
> Whatever it was that you experienced, I hope you experience it again. It sounded healthy to me.
Thanks Scott, I hope you do as well. Regressing from these euthymic states is crushing but it at least gives us hope. The fact that we know it's there is comforting on its own I guess.
Posted by Chairman_MAO on November 3, 2011, at 19:56:50
In reply to Re: Chasing hypomania: is it realistic? » hyperfocus, posted by SLS on October 27, 2011, at 13:57:10
I'm with SLS on this.
This is the end of the thread.
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