I've been living with bipolar disorder for 11 years. It started with hypomania; I've had many ups and downs, including depression and heavy mania-hypomania cycles. You know that I was on lithium for a long time (8 years, I go into the details in this post). During that time I had a stabilization period that leaned more toward depression. Of course, every now and then when something good happened in my life I'd become hypomanic too, but I could never control it — I couldn't even tell that I wasn't stable.
While I was struggling to even understand what I was going through because of the damage I took after lithium toxicity, it was simply not possible for me to observe my psychological state or draw any conclusions about it. Until lithium was discontinued, I kept experiencing PTSD symptoms and anger outbursts. After lithium, when I switched to Depakine (for a while there was quetiapine as well), I felt more stable and noticed my anger outbursts decreasing.
With the effect of ataxia and the process of my cerebellum rebuilding itself, I noticed over time that as I physically came back to myself, my consciousness also began to clear, and I could understand my emotions, thoughts and beliefs better. It was as if there had been a curtain in my mind and it was slowly lifting. What I understand better these days is that the cerebellum also plays a valuable role in our cognitive and emotional processes. I'll write about that separately.
The reason I mention all this is that I realized that as my awareness increased along with rehabilitation, I also learned to recognize and manage my bipolar mood shifts better. Of course I can't attribute this progress solely to my cerebellum; my medication treatment and my rehabilitation are important parts of the process too.
Note: This post describes my personal experiences with bipolar disorder, hypomania and neurorehabilitation. It does not constitute medical advice. In managing mood shifts, psychiatric follow-up, appropriate treatment and a personalized early warning plan are important.
The Uncontrolled Period: Post-Hospital Trauma
After I left the hospital, because my damaged cerebellum put me through physical difficulties for a long time, my dominant emotion was anger. My mood was constantly high temper, full of rage, throwing whatever came to hand (literally — everything flew anyway because my hand was shaking). I have no idea about moments I could call stable or normal, because I don't remember them. You know how our childhood memories are faded? Everything is faded like that. I didn't know who I was, what I was going through, or why.
The Rehabilitation Process: The Curtain Parts
I never stopped receiving intensive physiotherapy after being discharged. I was so obsessed with recovering; I didn't know I loved life and living this much. Anyway. Over time, after my rehabilitation pace increased (starting neurorehabilitation) and I pushed hard on cerebellar exercises, I went through a physical and mental breakthrough. As I healed, my consciousness and my emotions developed too. I started to feel more emotions. Excitement, love, affection, compassion, sorrow, pleasure... They had come back. Each time, I drowned in the discovery of my emotions as if I'd discovered a new continent.
In the beginning I felt everything very intensely. I'd suddenly become very sad, very excited, and it wouldn't pass for hours. I know what it's like for my heart to pound from excitement enough to have a panic attack. I liken the cerebellum to a thermostat; just like its role in regulating the intensity and timing of movements, it also has regulatory functions in emotional processes. And I had to bring all these emotions back into balance.
Over time I learned to control my emotions better, because I also started to manage my thoughts better. I learned to get past my old thought patterns. For example, when someone criticized me, in the past I'd be extremely upset, dwell on it, cry. Now I accept the criticism, weigh it, and evaluate in my mind whether it's fair. I don't tear myself apart. This is a very small example; there are many more thought patterns like this that I've noticed I've changed.
Can our thoughts spasm too?
At first I didn't really question how I was suddenly able to free myself from such rigid thought patterns. Thinking about it now, I draw an interesting parallel with ataxia. In ataxia, muscles can sometimes contract excessively and involuntarily and go into spasm. Once they've contracted, it can take me a long time to get them to relax. Aren't our thoughts sometimes like that too? We get stuck on an event or a thought, we think the same thing over and over, we struggle to develop a different perspective. It's as if our thoughts go into spasm and become rigid from constantly contracting.
Rumination reminds me a little of this. The mind repeating the same thought pattern over and over, being unable to move on to a new appraisal, and the thought taking up more and more mental space. Maybe sometimes, instead of forcing ourselves to solve that thought, we need to loosen it a bit, redirect our attention elsewhere, offer the mind a new stimulus. Just like what we do when we try to relax a muscle in spasm.
Sometimes I even wonder how obsessive thoughts might be related to repetitive patterns in neural activity. Could thoughts also be experiencing a kind of firing spasm? Of course this isn't a scientifically defined mechanism, just an analogy I make based on my own neurological experience. But I think the relationship between rumination, cognitive flexibility and the dynamics of neural networks is worth researching.
Increased Awareness and Mood Swing Control
With my cerebellar rehabilitation, my awareness increased considerably. When I say "right now I feel like spending money," I immediately ask myself "Why?" Do I really need something, or is it just for fun? If I can't pull my hand away from shopping apps, I put the items in the cart. Then I say, "Let me go for a walk or lift some weights, let's see if I still want them." Afterwards I look and see that I've generally filled the cart with pointless things. "How ridiculous!" I say, and empty the cart.
When I'm hypomanic, it's usually the urge to spend money, excess energy and productivity. I can manage the urge to spend by moving, distracting myself and giving myself time to think. What really wears me out is discharging the increased energy. I've only recently started being able to control this. Until a month ago, when I was very energetic I could exercise nonstop and then do housework on top of it, and also get into a bunch of hobbies. I'd stay on my feet for hours and keep going even when all my muscles hurt. Did it help me? Yes, because this energy made me much better physically. But it isn't sustainable, and if I don't take precautions I can have an episode despite being on medication.
When I notice I'm starting to organize way too many cabinets (that's how my energy surge begins), I either push myself to go outside or dive into a hobby I enjoy. Usually that's video games. It takes my mind off things so well that I say, "Why should I waste hours organizing cabinets and stress myself out?"
I've always been meticulous and tidy, but now I've learned to prioritize my own enjoyment. Except for mopping the floors — I'm still obsessive about that. The cats come into the house with dirty paws and I go crazy. :D For example, my clothes closet isn't that tidy either. In the past I wouldn't have been able to sleep.
I still use this energy to my advantage sometimes. Sometimes it feels like ataxia is coming on, so I eat beforehand (energy is a must), then I start cleaning everything in sight. I observe that the more I move, the more my ataxia decreases. Of course there's a fine line; when I get too tired, the ataxia comes too. So now I try to notice my fatigue and stop. If my eyes are tired, I immediately wash my face and drink water.
Productivity: The Most Tempting Side of Hypomania
Now on to productivity... I think this can feel like one of the gifts bipolar disorder offers us. Might as well produce something, right? Since when my mood is low I only focus on the negative and just do things on autopilot, I appreciate the value of it when my mood is high. I want to read and write more, I have the energy to develop apps. We've already released one product: Yetir Budget Tracker ^-^ I'm also developing 13 more apps. Not at the same time, of course — all spread out over time.
New ideas about my current projects and new post topics come to me. Since I've always loved reading and writing, my productivity in those areas goes through the roof. I also start inventing new food or drink recipes. That's a nice thing for my stomach, of course. Sometimes I take on decorating the house; I try to make something out of small things, decorate my surroundings, shape them into something my nervous system will enjoy. I think these are valuable things.
Still, I know that rising productivity doesn't always mean it's healthy. What matters is not depleting myself while using my energy, and not chasing every idea at once. Spreading the ideas that come to me out over time makes this easier for me.
By the way, I used to write poetry when I was hypomanic. I'm thinking of writing again.
How Do I Manage My Rising Mood?
This is how hypomania goes for me. Lately I've generally been high, but because the irritability and anger that normally come with hypomania aren't there, I feel softer and better. I don't want to disrupt this, because I'm making very good progress and depression sets me back. So I prefer to notice and control my rising mood during the day. Of course, the absence of irritability and anger doesn't by itself mean I'm stable. I know I need to track the early signs so that my rising mood doesn't go any further. I don't neglect taking my medication regularly.
Since I don't have insomnia problems, I think control is easier for me. Because my brain gets very tired during the day, at night it puts itself into full repair mode. I sleep comfortably for 8–9 hours. I don't have much advice for this, but I think the magnesium I take before bed helps.
My General Suggestions for Mood Control
Cutting out sugar: Also consuming high-sugar fruits like dates in a controlled way.
Keeping vitamin levels at optimum levels.
Going to bed and getting up at the same hours.
Moving a lot: Using movement to avoid getting constantly stuck in thoughts, but without depleting yourself.
Getting out in the sun.
Exercising: Weights, aerobics.
Living mindfully: While eating, drinking coffee, etc., focusing only on what you're doing and enjoying it.
Doing body awareness and somatic work: This is another topic I'll cover in a different context.
Staying away from negative people.
*If you're very sad, exercise, work your muscles. For me, a feeling of well-being lasting hours can develop after exercise. If you're very energetic and can't sit still, you can try moving without exceeding your physical limits and then relaxing with a hot shower. These worked for me. Of course, especially in hypomania, balancing the pace and resting instead of over-exercising is important too.
Maybe everyone says these things. I used to say "Easier said than done!" too. But once a person steps out of their comfort zone and takes action, once they start using their motivation and reward system to their advantage, they see how much some things can change. What matters is being able to take the first step. The rest comes with time.
We don't have to be doomed to bipolar disorder, forced to submit to every demand our brain makes without question. Of course bipolar disorder isn't an illness that can be controlled by willpower alone; medication and psychiatric follow-up are very important. But we can learn to recognize our thoughts, our behaviors and the shifts in our mood better.
Thanks to neuroplasticity, our brain is an organ that can change and learn. The more we teach it new things, observe ourselves and repeat healthy habits, the more we can see the returns.
For me, learning to use hypomania to my advantage doesn't mean learning to stay hypomanic. It means learning my own limits while getting to know my energy, my thoughts and my behaviors better. Because sometimes real control isn't in being able to do more; it's in being able to stop while you still have the strength to go on.
Scientific Sources and Further Reading
Schmahmann, J. D., Guell, X., Stoodley, C. J., & Halko, M. A. (2019). The Theory and Neuroscience of Cerebellar Cognition. Annual Review of Neuroscience, 42, 337–364. Discusses the cerebellum's contribution to cognitive and emotional regulation beyond motor functions, and the dysmetria of thought approach.
Argyropoulos, G. P. D., et al. (2020). The Cerebellar Cognitive Affective/Schmahmann Syndrome: A Task Force Paper. The Cerebellum, 19, 102–125. Examines the effects of cerebellar damage on executive functions, cognitive processes, language and emotions.
NICE. Bipolar Disorder: Assessment and Management (CG185). Includes clinical recommendations on early warning signs, personalized crisis plans, psychological interventions and mood monitoring in bipolar disorder.
International Society for Bipolar Disorders Nutrition and Exercise Task Force (2026). Sedentary Behavior and Physical Activity in Individuals With Bipolar Disorder. Bipolar Disorders. Evaluates the potential benefits of physical activity in bipolar disorder, the current scientific evidence, and the points to watch out for regarding exercise intensity.
CANMAT & ISBD (2023). Guidelines for the Treatment of Bipolar Disorder: Summary and Update of Evidence. Discusses supportive approaches such as psychoeducation, cognitive behavioral therapy and social rhythm regulation alongside medication treatment.
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