Since I last wrote

I couldn't handle that so I brought it down to 450mg, which seems to work better. I still sleep very heavily and although I apparently speak and react to things while asleep in the night, I have no memory of it all.

I have found it easier to control my loud behaviour at work, sometimes I am about to launch into something and I just think ‘no, that won't achieve anything’. Sometimes colleagues remind me of things I said before – often just the 'worst' thing to say in a given situation. It feels like I have had a case of 'social tourette's syndrome' – but at least they can see the funny side and I am not so bad now.

Recently I read this write up of a conference session given by Richard Bentall, and it struck a chord with me:

"It seems that the self-esteem of bipolar patients tends to fluctuate between extremely positive and negative evaluations of the self; and, importantly, these changes may be linked to the way in which bipolar patients respond to their depressed mood.  (...)

(…) students who score highly on measures of hypomania not only showed greater fluctuations in their self-esteem but also showed a greater tendency to use the type of response styles that are commonly used in reaction to depressed mood. These response strategies include ruminating about feelings, trying to work through and solve problems, using distraction strategies, and, in the more exotic cases, indulging in risk-taking activities. But Bentall doesn’t merely believe that this is a correlational relationship. He argues that these response styles may be driving the fluctuations in self-esteem. Bipolar patients may adopt dysfunctional strategies to regulate these shifts in self-esteem."

I'd be interested to hear if any other people with a bipolar illness recognise these extremes of thinking and self-evaluation. I wonder if it's not the mood imbalances that are the main 'problem' as such, but your response to them. I know of some people, including my brother, who have displayed similar fluctuations in behaviour as me e.g. grandiosity, risk taking, irritability and impatience, but have never felt the extremes of mood that I have. And because of that they have never felt they were 'ill' or been diagnosed as mentally unwell.

The good thing about that is that as you get more experienced dealing with mood fluctuations, you can perhaps counter these extremes more effectively with some more focused and balanced thinking. I wonder how easy that is?