Type 1 bipolar with an unusual history here.

My dad was bipolar and committed suicide while I was a teenager. I had a 6 months long mixed episode ~15 years ago that got me diagnosed. High energy, racing thoughts, little to no sleep, mood going from euphoria to more painful thoughts, always very high in intensity, borderline delusional.

After months of denial I accepted the diagnosis and I ended up with lithium then lamotrigine because of side effects of the former, but neither were effective. I still had to take olanzapine to quell nascent manic bouts a few times a year. I was pretty traumatized by the fallout of my first episode (I destroyed or damaged quite a few relationships), making me want to never go back there if at all possible.

Luckily for me the racing thoughts and high energy always came before the mood and ego distortions, which gave me the opportunity to act. I soon realized that the earliest I took olanzapine the lower the dose I had to take to shut off the episode. 1.25mg or at worse 2.5mg were enough to stop it in its tracks most of the time (taking another 1.25mg dose after an hour if the first wasn't sufficient). Sometimes I had to re-iterate on the next day, and that was it.

I discovered this paper [1] a few years down the line, which describes how both the speed and the content of thoughts influence the mood level. This made me want to try and control the pace of my thoughts willfully.

My first naive attempts failed (I had to fall back on drugs), but then I tried to use mental imagery under self-hypnosis (which I had learned independently, mania is very conducive to hypnosis), with success. I had realized that I had a hard time thinking fast while walking slowly, and thus I projected myself lingering in a derelict and deserted landscape, where everyone I loved was dead.

This let me cut the mania in its track, but let me sad for two days. Also, even in my mind, walking slowly was hard to maintain for long periods of time. So I tweaked the scenario, to a more pleasant and peaceful walk in the sea on a nice end of the summer day, with water above the knee. The imagined physical resistance of the water helped me keep the pace down, and the experience let me in a nice, agreeable mood. Practicing the scenario between manic episodes also helped getting there more easily.

Seven years ago, after a few years of not needing olanzapine, I tried stopping the lamotrigine as well, since it was not fully effective. The frequency and intensity of the episodes didn't worsen, and it even gradually went down to ~1 per year without any ill consequences. I've now reached a point where I don't even need the full self-hypnosis decorum to brake, sheer will is sometimes enough.

So this is how I got to mostly manage my condition and get rid of drugs. While unusual, this isn't unheard of [2]. Lewis Mehl-Medrona's approach with narrative analysis and imagery approach among native americans remains very marginal though (that paper has been cited once in 13 years, I discovered it this month).

I say "mostly manage", because there are still a few problems.

- Because of its long half-life, pseudoephedrine taken several days in a row is stronger than my own might, and self-hypnosis barely helps (sinusitis, fuck yeah).

- This summer, experiencing an epiphany while being in love pushed me over the edge into a slow but otherwise manic-like euphoric state, with a relentless, obsessive train of thoughts (not unlike a walking bass in an old jazz), and distorted thoughts patterns reminiscent of my initial episode. Without the usual warning sign (racing thoughts and high energy) it took me ~36 hours to realize something was amiss and come back down (I had watched a slow, contemplative movie without realizing it had a plot. This left me puzzled and I read about it on the Web the next day, discovering with dread that had just been out of my mind). I had ruined another relationship in the mean time. Conclusion: avoid thinking too hard while being in love (in that state, one's ability to think is badly impaired anyways).

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1. http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.405...

2. https://www.researchgate.net/publication/45389079_Narrative_...