I was diagnosed with bipolar disorder in 2023, probably type I. I’ve had several severe episodes since then, including around seven in 2024 alone.
One thing I still struggle with is how clear-headed I can feel during an episode. I can be completely convinced that my judgment is sound. Sometimes I even think I’m seeing things more clearly than usual.
During some episodes, I became very sensitive and irritable. I would keep going over what someone had said or done and become convinced they meant harm. Other people disagreeing with me rarely made me reconsider. I felt like I had noticed something they hadn’t.
This led to serious conflicts. Conversations that seem ordinary to me now felt full of hostility at the time. I became suspicious, made extreme decisions, and sometimes tried to control what other people were doing. In my head, I had reasons for all of it. I thought my reactions made sense.
What confuses me is that this doesn’t always stop when the obvious symptoms ease. Sometimes it takes another two or three months before I can look back and recognize that my thinking was still affected. I may have spent that whole time believing I had recovered.
I’ve also had severe depression. There were periods lasting several months when I could barely manage daily life. At my worst, I couldn’t bring myself to go outside. There was a month when I ate only one bag of bread. Getting up, showering, cooking, and eating were difficult, and sometimes I needed someone else’s help.
During another period, I cried at night for two or three months, couldn’t sleep properly, and was terrified that I was being watched. I’ve had auditory and visual hallucinations, including voices giving me commands. I’ve also talked to people who weren’t actually there.
In 2023, I lost my wallet. For about two months afterward, I walked around ten kilometers almost every day looking for it. I was convinced I could find it. At the time, I saw nothing unusual about continuing to search like that. Looking back, I can recognize how disconnected some of my thinking had become from reality.
My mania hasn’t always felt happy. A lot of it has involved irritability, anger, and sleep problems. There have been times when I couldn’t sleep for two nights in a row even after taking quetiapine. At other times, I became so talkative that I could barely stop, and my thoughts and speech sped up.
My tolerance for other people could drop sharply. Small things would set me off. My spending also changed: I don’t usually feel a strong need to buy things, but during certain periods I would suddenly spend 10,000–20,000 RMB(roughly US$1,500–3,000 at today’s exchange rate)
. The purchases seemed reasonable at the time. I only started questioning them after my state changed.
These things don’t all happen together, and each episode has been different.
Recently, my sleep has been especially confusing. Some nights I take my medication as usual but still can’t fall asleep until six or seven in the morning. Earlier this month, I had several nights of only three or four hours of sleep while still feeling mentally active.
Then I started sleeping much more. Sometimes I sleep eight hours at night and another two during my commute, and I’m still exhausted afterward. I can struggle to stay awake during the day, then lie down at night and find that my brain won’t settle. Sometimes my mind feels very active while my body is worn out.
I’ve also been agitated and irritable, with trouble concentrating and physical symptoms I don’t know how to explain. These include pressure in my head, intermittent stabbing pain at the back of my head, nausea, and numbness.
I’ve been getting intensely hungry too, sometimes just one or two hours after a normal meal. Occasionally I feel close to fainting, although my weight hasn’t noticeably changed. I don’t know how much of this is connected to my mood, disrupted sleep, medication, or something else physically.
I used to take quetiapine on its own. I started with a quarter of a 25 mg tablet, or 6.25 mg. Later, I took 200 mg, then 300 mg, and eventually 400 mg. I currently take 50 mg of quetiapine along with gabapentin.
I’ve felt more stable on this combination than I did on quetiapine alone. For a while, the difference felt very noticeable. I know gabapentin isn’t an established mood stabilizer for bipolar disorder, though, and I can’t tell how much of the improvement came from it. I can only describe what I noticed.
I’m reluctant to go back to higher doses of quetiapine because of how sedated I felt. I’m a university student, I spend a lot of time commuting, and sometimes I’m away from home all day. Becoming too drowsy to function before I get home makes that difficult. I also need to stay alert on public transport and in other public places.
My courses have strict attendance requirements, along with projects and assignments. When my sleep gets disrupted, I struggle to concentrate, recall things, and get work done. Sometimes I don’t feel particularly depressed, but thinking and handling everyday tasks still take much more effort than usual.
I’ve been through enough episodes to recognize some warning signs. Sometimes I notice the reduced sleep or changes in my behavior early. But there are also periods when I can still talk to people, attend classes, and deal with everyday things, so I assume I’m back to normal. Months later, I look back differently.
That’s the part I still find hard to judge. I can notice some of what’s happening now, including the disrupted sleep, agitation, and exhaustion. I’m much less certain about when I’ve actually recovered.