I would like to share my experience of ‘dysphoric’ or ‘unpleasant’ elation, as it can be vital to the treatment of bipolar disorder to know whether depression or dysphoric elation is the presenting problem. This can be very difficult at times to identify. I hope that in sharing my experiences in dysphoric elation, it may be helpful to those who identify with it.
When I’m having quite a high dysphoric elation I can appear very withdrawn, slowed down, with little to say. When I do speak, I have difficulty communicating the words I want to use. They do not come to me, or I use the wrong words altogether. When this happens I feel pressure in my head and an inability to think straight. It feels as though I have limited brain power. I find this very frustrating, which often leaves it easier to say nothing at all.
In this state, anger, hostility and aggression are very near at hand and I can even be aggressive with close friends without meaning to and suffer great remorse as a result. This anger, hostility and aggression is a response to the frustration I have inside of being unable to express myself properly, and the feelings of pressure inside my head as though I might explode. At times like these, I feel as if I am ‘going off my head’ altogether and find this very frightening. For me, anger and aggression are synonymous with dysphoric elation, closely followed by tears and terrible distress. Whereas in my experience of depression, I have no emotion or agitation to express at all.
Fear is another huge problem in the unpleasant elation. I fear people and can become suspicious of those close to me. It can leaving me feeling very vulnerable. I fear being on my own because of the frightening thoughts that go on in my head. When I feel like this, I want to be with people, or even one person, I need the distraction. Everything I do feels stressful.
The other main problem is total lack of concentration. I have difficulty taking in what someone is saying to me. I have an inability to read. I feel unable to listen to music or watch television.
Sleep disturbance is another feature. I experience great difficulty getting off to sleep and when I eventually do, I constantly wake up during the night.
Coupled with all these elative symptoms, are depressive symptoms, which can fog the issue. I sometimes experience anxiety and feelings of unreality, depersonalisation and panic attacks. It can extend to feelings of guilt and isolation, pessimism about the future, worries about money. I don’t have the energy to keep my home in order and can foster feelings of hopelessness and helplessness.
One ‘rule of thumb’ that I have learned in my education in bipolar disorder is treat the elation first, before attending to any depressive symptoms. When I approach it this way, I can came out of the ‘hell’ of dysphoric elation. For this I am grateful.
– Elaine Blake Knox