Mental and Emotional Issues

Edward T. Welch

Bipolar Disorder: Mood Swings, Mania, and Manic Depression

What You Need to Know

We all have mood swings. Sometimes on rainy days we may feel gloomy, and on bright cloudless mornings we often wake up with energy and a smile on our face. But if you are struggling with mania, your moods are much more intense—they’re highly exaggerated and unrestrained.

For example, start with feeling great and energetic, explode the roof off of it, and you get the sleeplessness and racing thoughts of mania. Take optimism and self-confidence, make it boundless, and suddenly you are overestimating your luck at the blackjack table, playing a hunch in the stock market, or starting a business on a whim. You are so certain of success (although others have their doubts) that you use your retirement money and max out your credit cards. Because when you’re feeling buoyant and up, you don’t take into account your faults or weaknesses. You believe you can do no wrong. And if something goes wrong, those less enlightened are at fault.

Acting like this is called mania, manic-depression or bipolar disorder.

The cycles in and out of mania are unique to each person. For some, the highs are only noticeable to family members and never become extreme. For others, mania is apparent to everyone and results in legal problems or enforced hospitalization.

How long will it last? When will it return? You might notice daily fluctuations with “normal” feelings being elusive. Or your mania might be on a biannual, yearly or multi-year cycle with long periods of normalcy in between. Unpredictability is the only thing you can count on.

What you might feel

If your mood swings were predictable you could prepare yourself for them. But they aren’t. They can, without warning, travel from low to high and back again. If you have the high, the low is almost inevitable. It’s as if the body can’t sustain the energetic highs, and its plea for rest overshoots its goal and careens toward depression.

Focus, for now, on the mania. Here is some of what you might feel during your high periods:

Restless
Full of energy
Talkative, garrulous
A sense of being creative and having many important thoughts, plans
Happy, up, funny, exhilarated
High self-esteem, no self-doubt
Confused and out-of-control, especially when mania won’t stop

Subtract “restless” and “confused and out-of-control” from this list and mania doesn’t seem half bad. It’s a welcome change from the down times. And who couldn’t use more energy? This is mania’s subtle allure.

Mania is not easy on those who love you.

Mania, however, is not a welcome change to your family and friends. Here’s what others might see in you when you are manic:

Impaired judgment
Unwillingness to listen to advice
Reckless, impulsive, risky behavior, especially with money or sex
Inappropriate joking
Nonsensical, incoherent speech
Irritability
Non-stop energy that keeps others awake because they are wondering what impulsive decision you might make while everyone sleeps
Resolute self-centeredness

You are on an adventure; they are living a nightmare. They are never quite sure who will show up from day to day. Will you be the happy, creative, energetic person? Or will you be the angry, irritable person … the person who won’t get out of bed and sees misery everywhere … the person who looks like a caged animal and is preparing his escape to who knows where? It’s exhausting for them.

Your family and friends welcome the normal times, if they come, but even those periods are tainted with fear because they are still haunted by memories of your last episode. It’s possible that medication has looped off the extremes of your mania and others are grateful for this. But medication does not promise an end to the cycle.

Researchers once thought that mania and relationships just didn’t mix, and there wasn’t much you could do about it. But that was before Scripture was brought to bear on this experience. Mania, although it’s very challenging, will not stand in your way of knowing God, loving Him, and loving other people.

Mania doesn’t listen well.

When you feel great, you usually don’t seek help. You don’t solicit the advice of others. You feel self-confident, and on the cusp of important discoveries and major contributions. If anything, you believe that others should be seeking your advice. This grandiosity is what makes mania so dangerous.

The more intense your feelings about something, the more loyal you are to the interpretations that rise from those feelings. When you are depressed, you may believe that you are an utter failure and unloved regardless of the evidence or protests from those who love you. When you are manic, you believe that your insights are particularly discerning, and you are especially loyal to your perspective regardless of who might be appealing to you to listen.

Imagine your friends and family coming to you and saying that your sweater, which you are certain is a tasteful shade of blue, is actually a day-glow pink relic of the 1960s. Can you imagine the humility it would demand for you adopt their interpretation? When you are absolutely certain of the truth and reality of something—and there is never a doubt during mania—it is very difficult to consider a competing perspective. It’s very hard to listen.

Scripture speaks

The problem is, who’s to say that another person’s perspective is accurate? Maybe the sweater really was a muted blue. Who has the authority to interpret reality? At this point mania sends us directly to Scripture.

Scripture is ancient, while mania is modern. Scripture deals in the spiritual, mania the physical. But if you are familiar with the Bible, you realize that it teaches us how to see everything, mania included. As 2 Timothy 3:16 (ESV) tells us, the Scriptures are God’s communication to us: “All Scripture is breathed out by God and profitable for teaching, for reproof, for correction, and for training in righteousness.” It gives us wisdom to guide us in all situations. Whatever life brings—wealth, poverty, a medical disability, a psychiatric diagnosis—the Bible’s wisdom is always rich and relevant to us.

With regard to mania, the Bible tells us that mania can’t make you sin. It can’t make you do things that Scripture prohibits (such as adultery), and it can’t keep you from things that Scripture prescribes (love). Mania can create a world of temptations. It can try to persuade you to trust your intuitive judgements rather than be suspicious of them. It can tempt you to believe that the best thing to do is to empty all your accounts and play the lottery with a number you are certain will win. And it can make wise judgement less natural for you because certain decisions feel so right. But it can’t make you do anything that Scripture calls morally wrong.

This simple teaching of Scripture is more hopeful and radical than it first appears. The popular understanding of mania is that it is a medical phenomenon. It’s the result of unbalanced brain chemicals, and the treatment is to restore proper brain function with appropriate medication. The Bible doesn’t argue with this theory—most likely there is a physiological contribution to mania. But the Bible does go deeper than psychiatric interpretations.

Physical and spiritual

Psychiatric theories tend to see human beings as merely physical. Scripture portrays us as both physical and spiritual. Physically, we consist of brain, bone, muscles, and an amazing array of biochemicals. Spiritually, we are like God. We can know Him and imitate Him. We know the difference between right and wrong, and we are responsible for our moral decisions. Brain problems cannot erase these essential spiritual features of human nature.

What brain problems can do is cause our mind to race, leave us sleepless yet energetic, and make our thinking chaotic. But notice that these are not explicitly moral problems. They are neither commanded nor condemned in Scripture.

Brain problems cannot force us to ignore advice, live autonomously and impulsively, or move outside God-ordained sexual boundaries. They cannot cause us to follow our own desires at the expense of loving God and neighbor. These are either commanded or prohibited in Scripture.

When God’s Word commands us to do something—loving other people—it speaks to everyone who hears. If those with chemical imbalances were exempt, we would all be exempt because none of us has a perfectly functioning brain. Scripture examines mania, and, without ignoring the uniqueness of it, reminds us that our similarities outweigh our differences. That is, we are all human beings who live before God in imperfect bodies. We all need God’s grace to live as His children, and we can all receive that grace.

Why all this concern about distinguishing moral problems from physical ones? The most important reason is that it helps you see that mania can’t keep you from the most important task of human life: becoming more and more like your Heavenly Father by way of the Spirit that works in you. A second reason is that it protects you. Mania tends to be reckless. Broken relationships and foolish decisions are the norm. You can avoid these consequences as you grow in godly wisdom.

What You Need to Do

Once you understand that your mania is not causing you to sin, you can ask God to teach you how to respond to the temptations that mania brings into your life. The apostle Paul tells us that, “No temptation has overtaken you that is not common to man. God is faithful, and He will not let you be tempted beyond your ability, but with the temptation He will also provide the way of escape, that you may be able to endure it” (1 Corinthians 10:13, ESV). In other words, nothing can keep you from living the way God intended you to live. Even during mania you can find a “way of escape.”

1. Distinguish between physical and spiritual problems.

When you look at your own manic episodes you should be able to notice the difference between physiologically-based brain excitation and spiritually-based decisions. While you are manic everything is a blur. Although you might not feel like you are doing anything wrong, often our wrongness is not premeditated and self-conscious.

When we sin, we simply do what we feel like doing. We do what we want to do, and we don’t do what God wants. Since we are sinners, sin feels very natural. Conviction of sin demands supernatural intervention, but it’s also a gift that God gives to those who ask. Make this your prayer: “Search me, O God, and know my heart! Try me and know my thoughts! And see if there be any grievous way in me, and lead me in the way everlasting!” (Psalm 139:23, 24)

Here are some questions that can help you focus on matters of the heart:

Did you consider others as more important than yourself? (Philippians 2:3)
Were you quick to listen, slow to speak, and slow to become angry? (James 1:19)
Did you seek counsel from other people for your decisions? (Proverbs 12:15)
Did you seek God in what you did? (Proverbs 3:5,6)

Anything come to mind? If so, you should feel quite ordinary because these questions, honestly answered, can reveal sin in everyone.

When we think about sin we usually think about condemnation. And it is true that sin is against God, and it is serious. But let God’s Word guide you in the way you think about this. The Bible teaches that conviction of sin means that God loves you and is graciously interrupting your turning from Him (John 16:8). It means you have the privilege of knowing the freedom and depths of God’s forgiveness through Jesus Christ.

Also, as soon as you describe your behavior as sin, you are saying that those same behaviors can change, because when you repent of your sins, God not only forgives you, He gives you the power to change and learn to live a whole new life. (Romans 6:1-14). So don’t be discouraged.

The treatment for sin is confession. Start by confessing your sins to God. The Bible tells us that, “If we confess our sins, he is faithful and just to forgive us our sins and to cleanse us from all unrighteousness.” (1 John 1:9). Dare to believe that because of Jesus’ death and resurrection you can actually be forgiven for every wrong you have done, and then take the next step of faith and confess your sins to those who were affected by them.

2. Ask others to help.

As you go to others to confess your sins, approach them with a humble attitude that is willing to listen. Tell them you are beginning to see that you do selfish and hurtful things when you are manic, and ask for their forgiveness for particular things you remember. Then ask them what they saw and felt. What was your mania like for them?

You can’t promise them that you will never experience another manic episode, but you can, at least, tell them that your goal is to learn to love others in all circumstances, including mania. There are some things that you might not be able to change, but you are able to change those things that are most important.

3. Help others understand.

Mania can be very confusing. When you look back on it, you’re afraid you said and did many embarrassing things. If you ended up in a psychiatric ward, your embarrassment is coupled with shame. You’d prefer to avoid any discussion of it. Those who love you are also confused by it, and they also might want to avoid raising the issue. It’s in this context that you need to put words on what happened.

While you take responsibility for your moral choices, you also should describe the other changes you experienced: the racing and fragmented thoughts, the energy that made it hard for you to stop and relax. This will help you and your relationships. For yourself, the more you understand mania, the better you can manage it and even grow through it. For others, the more they understand the more helpful and patient they will be.

Your challenge is to find everyday words for experiences that are very difficult to put into words. If the words aren’t coming, get help. There are resources in every bookstore and on thousands of internet sites. Each story will be unique, and you won’t find many stories that bring a radically biblical perspective to mania, but in those stories you will find words for yourself.

When you speak with family and friends, think of yourself as a visitor to a culture that knows nothing about your own. Think how challenging it would be to describe cars and faucets to people who have never seen them. This is what you are up against. It isn’t easy, but if you care about these people, you will want to share something of your world with them, and you will work hard to find analogies and metaphors they understand. Here’s one you might find useful:

“It is like a tachometer on a car. There is a middle zone for rpm’s when the car runs well. I feel like I am either below that zone or way above it. When I am going from one extreme to the other I briefly notice, ‘Oh, this is what normal feels like.’ Then I zoom right by it.”

4. Be a wisdom expert.

The spiritual problems exposed by mania—impulsiveness, unwillingness to seek or hear counsel, the tendency to go down a path that has painful consequences—are covered in the wisdom literature of Scripture. Your goal is to become an expert in this literature. Proverbs in the Old Testament and James in the New Testament should be among your best friends. You need to know them intimately.

Wisdom teaches us how to live in the way God created us to live. It redefines what is truly natural to the human condition. As we would expect, it begins with God. Consider the words or Proverbs 1:7: “The fear of the Lord is the beginning of knowledge.” Or Proverbs 2:6: “For the Lord gives wisdom; from his mouth come knowledge and understanding.”

5. Fear the Lord.

If you experience manic cycles, you naturally want to bring the extremes into more normal limits, and medication is the only way you know to do that. But you can’t forget the obvious: life is about living for God in the ever-expanding Kingdom of Heaven, where Jesus Christ is King. To put it more personally, life is about knowing your Father so you can love Him and act like Him. Don’t let mania sidetrack you from your most important task. Since, in light of your manic cycles, you need wisdom now more than ever, the knowledge and fear of the Lord are essential.

What does fearing God look like? It looks like a life of humble submission to God. It means recognizing your constant dependence on Him, and your need for His guidance in everything. To grow in this, allow the Bible to stir up in you a desire for the fear of the Lord. Pray for it. Ask others to teach you about the true God who is to be honored and reverenced.

6. Seek counsel.

The humility that comes from the fear of the Lord teaches us that we are creatures who need the counsel of others. Consider these verses:

“When there is no guidance a people falls, but in abundance of counselors there is safety.” Proverbs 11:14

“The way of a fool is right in his own eyes, but a wise man listens to advice.” Proverbs 12:15

“Listen to advice and accept instruction, that you may gain wisdom in the future.” Proverbs 19:20

God has created us to live interdependently. When you are manic, another person’s advice can feel like someone throwing cold water on a wonderful and powerful fire. This means you must start in this course of wisdom now.

Do you know two or three wise people who will give you honest and helpful counsel? Ask them for help, and expect that there will be times when you will be able to offer them counsel and advice too. Get in the habit of following your advisors’ counsel whenever at least two agree. This will become a profound protection for you in your life, whether you ever experience mania again or not.

7. Listen.

You might have noticed that you talk more when you are moving into a manic phase. If a wise person notices that he is doing most of the talking, he will switch to listening mode. When you read Proverbs and James, notice how often you find exhortations to listen. Your goal is to become an expert listener. If you’re listening to God, you will listen to others. If you listen to others, you are probably growing in listening to God.

8. Walk humbly with the Lord.

Wisdom can be summarized as a lifestyle of walking humbly with our God. We walk with Him because we know He desires us to come close, and we know we must walk with Him to grow in wisdom. We walk humbly because that is the natural way to walk through life when we understand we’re creatures who need the counsel of God and others. And we walk humbly because we’re also sinners who need the blood of Jesus to wash us so we can experience the ongoing forgiveness of the Father and continue in relationship with Him.

Should you try medication?

The majority of people who experience more extreme mania consult with a psychiatrist or qualified physician about psychiatric medication. There are new medications that appear regularly. Most of them are a form of Lithium or medications that have also been used to control seizures.

Should you try medication? Typically you have nothing to lose and something to gain. At worst, you will have unwanted side effects, or the medication will be ineffective. At best, you will be less prone to the mood cycles or the more intense highs. Since you might actually enjoy mania, at least when it is not extreme, you might be reluctant to try medication. But talk to wise counselors and family about this. You might decide to try medication as a way to love others.

What you can expect

Mania is one kind of trial that we encounter in life. Like most trials, there is no guarantee that you will be thoroughly free of it. Medication might help contain your moods; growth in godliness certainly will. Others who experience mania have found that growth in godly wisdom can sometimes limit the manic episodes and always limits the damage done during them. But there is no sure way to erase the possibility of future episodes.

In the midst of uncertainty be assured of this: When we seek God in our trials, He uses it to mature us and make us look more like Jesus. You will be different as you grow in the fear of the Lord. Your mania will be different. Other people will see the progress in you. And the maturing of your faith in Jesus Christ will have benefit for eternity.

Frequently-Asked Questions

Who would be a wise counselor for me?

It is hard to find people who are both spiritually mature and alert to the unique challenges of mania. You might be able to find this combination in your pastor and friends, but some people are intimidated by mania and prefer to have an “expert” involved—the expert is typically a person who has helped others with mania.

If you can’t immediately find a wise group of counselors, remember that wisdom is rooted in the fear of the Lord. So look for someone who has a growing knowledge of Jesus Christ and a track record of spiritual faithfulness. Investigate mania together with such a person.

My family is terrified that I will be manic again. How can I help them?

This is a good question—and asking it means you care about your family’s fears. Continue to bless them by listening to their fears. Encourage them to speak openly with you. With their help try to distinguish between behavior that is from a manic brain and behavior that is spiritual, based in your heart and your knowledge of God.

Let them know your plan. How are you getting help? What have you learned from your previous manic episodes? Share that with them. And don’t let shame or embarrassment prevent you from asking for help. Let your pastor know what is happening and invite him to help your family.