How Transitions Impact Our Mental Health

Reflections on hypomania, self-care, and the limitations of the diagnostic process.

Happy Monday! This article is free for everyone! Subscribe to Relationship 101 below!

Saturday morning, I sat in the middle seat on a flight from Frankfurt to Amsterdam, an unexpected layover to start a much-awaited two-week return to The Netherlands, courtesy of Julia’s parents. (For those of you who are new to Relationship 101, Julia and I lived in Utrecht from 2022-24.)

From my Sunday kayak through Utrecht Central

I hadn’t slept the night before. While a cross-ocean flight that leaves Boston at 6:30 pm and gets into Europe the next day seems exotic, seven hours of flying time is hardly enough to get any functional sleep, especially when the disappointingly bland in-flight meal got served three hours into the flight.

It didn’t help that there were two bewildered toddlers on my row, who loudly protested the air pressure fucking with their tiny little ears despite the airline’s best efforts to help their overwhelmed parents by providing bassinets.

Julia sat behind me on this flight; our original flight, a direct flight from Boston to Amsterdam, was cancelled, but the stellar team at Lufthansa arranged Julia and I to stay seated as closely as possible. We’re totally a Wordle family; while we typically end our day with Wordle and Connections, Julia suggested that we started our favorite word game in the ten minute intermission between boarding and takeoff.

My brain is an ear worm factory; for the next minute after extracting “ghost” in three tries, I beebopped along to Santa Monica by Everclear. (“I am still living with your…ghost.” Now it’s in your head too.)

I faced forward, and the small, young woman sitting next to me asked, “Are you on the flight to Amsterdam?”

“Well of course I’m on the flight to Amsterdam. We’re all on the flight to Amsterdam,” I thought to myself.

But rather than responding sarcastically, it occurred to me. My 5’10 frame was bouncing all over the 18 inch width of the Lufthansa middle seat, albeit to a classic 90s banger.

She was attempting to get me to stop moving.

In fact, I had not stopped moving for most of the last five hours.

Worse, I had not stopped moving for most of the last five days.

My efforts to sleep on the flight from Boston to Frankfurt were interrupted not only by antsy toddlers, but moreso my lower body, which jerked every 15-20 seconds after I got comfortable and attempted to dose for the last two hours of the flight.

I’m fairly certain I had a different earworm and coinciding micro dance party while standing in line after a twenty minute walk from the landing gate to the customs gate at the Frankfurt airport. I had a similar experience of restless leg symptom while waiting for the connector flight, something that I tended to by playing a video game on my computer.

I should note here that I’m prone to hypomania.

The DSM-V defines hypomania as:

“A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day.”

In this case, the “persistently increased activity over four consecutive days” was generated by the extraordinarily busy client week that precedes a vacation combined with visiting fourteen apartments. I have a lot of energy, but this was extra even for me.

When I’ve had episodes of hypomania over my life, I typically experience the same three symptoms:

1. Inflated self-esteem.

2. Flight of ideas or subjective experience that thoughts are racing (usually the latter for me).

3. Increase in goal-directed activity.

The Cleveland Clinic references another symptom that I commonly experience: Being obsessed with and completely absorbed in an activity you’re focus on. I can zero in with the best of them.

Fortunately, my experiences with hypomania are typically, to use DSM language, “not severe enough to cause marked impairment in social or occupational functioning”. Although I do want to acknowledge a six month period a few years ago where the hypomanic tendencies morphed into something bipolar-II adjacent, with more sustainable mania and, regretfully, some persistent explosive outbursts.

The DSM-V notes: “The disturbance in mood and the change in functioning are observable by others.” Hypomania is definitely noticeable, and not just by the unfortunate woman who sat next to my jittery self on the plane Saturday morning.

And one of the hard things about hypomania is that it’s often praised in high-performance societies like ours. I can think of dozens of times where I’ve been told some version of “I don’t know how you do all the things you do.” These comments only fuel my inflated self-esteem.

I also want to be a bit cautious, because diagnosing commonly gets inappropriately intermingled with identity.

Statements like “I’m bipolar,” or “I’m ADHD” can become reductionistic and essentialist, typecasting our behavioral patterns rather than identifying how a myriad of variations, influenced by numerous contextual factors, can inform our tendencies.

For instance, I’m much more prone to hypomania in chaotic, unstable seasons of life.

One of the reasons that I’ve only been able to send out one post in the last two weeks is because during the month of June, I’m visiting two cities and looking for apartments and in The Netherlands on vacation.

I’ve learned that writing for 1-2 hours in the morning is a meditative routine that enables me to channel my high energy. When I lived in Utrecht, I went to the third floor of the library every morning to write. When I lived in Providence, a rotation of local coffee shops served as the setting for my morning writing.

Last week, during my extraordinarily busy client week with fourteen apartment viewings, I went to a coffee shop on Sunday. I skipped my writing routine for six straight days, scheduling additional clients and a few extra hours of sleep instead.

It certainly helped me survive the week. After all, when you’re an entrepreneur without a company providing vacation or other occupational benefits, you have to make financial and temporal sacrifices in order to pay the bills. Seeing a bunch of clients last week enabled me to take two of the next three weeks off.

However, my body did not respond well. And while I’ve done a lot of work over the last two years to ensure that I have healthy self-care routines and different emotional responses and fewer outbursts of anger when things interrupt the faster pace I set for myself, the shakes and jitters that my row-mate picked up on Saturday’s flight disclosed that I could be handling this particular transition much better.

---

Julia and I study the impact of transitions on relationships. In fact, a large portion of relational therapy focuses on how a couple makes one of the following five transitions:

1. Temporal and spatial transitions. What does a person need in order to effectively shift from activity to activity over the course of a few minutes? From awake to asleep? From an anxious state to a non-anxious state? For what it’s worth, Julia and I are in the midst of a larger spatial transition.

2. Role transitions. How can a person switch between the many different roles they play in their individual lives and relationships? As sex therapists, we’re especially focused on how a couple transitions from parent or administrative partner to sexual person.

3. Relational developmental transitions. Healthy relationships require the shift between five common stages of relational development. While conflict most often occurs between the bonding stage, where the goal of the relationship is to find commonalities, and the differentiation stage, where the goal of the relationship is to acknowledge, accept, and celebrate differences, transitions into the practicing, rapprochement, and synergy stages can create their own challenges.

4. Family developmental transitions. What adjustments do two or more people need to make when they add a new family member, such as an infant? How does a family treat each member of the family different when that infant becomes a preschooler, and that preschooler turns into an elementary school student, hurtling toward pubescence and adolescence?

5. Epistemological transitions. These are the shifts that happen when a person, couple, and/or family begins to see and engage the world in radically different ways, changing their religion, political ideologies, and communities along the way.

Epistemological transitions are the specialties for me and Julia. We specifically study this from the perspective of couples where one or both people are leaving Evangelical, Mormon, and Pentecostal communities.

But regardless of the macro-transition that you’re experiencing, it’s imperative that you find routines and practices that enable security and familiarity.

Because transitions are when the negative, caustic parts of mental health conditions are most likely to rear their ugly heads.

As a note, the context for the bipolar-II adjacent experiences that I had in 2022 was our international move. We spent the six weeks of our time in The Netherlands rotating between Airbnbs before landing in Utrecht; in the midst of our houselessness, we both had some significant stressors and trauma responses. And rather than pausing and recuperating, we buried ourselves into our client work, podcast, and other financially motivated ventures. The symbiotic relationship between my hypomanic tendencies and Julia’s PTSD symptomology intensified.

The Utrecht library saved me and our relationship. The kind owner at Ddadi, my favorite coffee shop a few blocks away, saved me and our relationship. (For that matter, the cycle gym around the corner from our apartment saved Julia and our relationship.)

Every morning, from the late spring of 2023 to when we left in the summer of 2024, I went to the library or to Ddadi to write, explore, and center myself. My hypomanic tendencies remained just that: tendencies. They seldom evolved or contributed to relational, occupational, or social issues, a trend that continued throughout our year in Providence.

And as I spend the next two weeks in Utrecht, revisiting the winding streets that I walked and canals that I kayaked for the two most formative years of my life, and as Julia and I make decisions about where we will be moving to, writing at these familiar spaces, the library and my favorite coffee shop, will be essential for ensuring that my hypomanic tendencies remain just that: tendencies.

---

Julia and I offer free 30 minute consultations with couples who are interested in pursuing relationship and sex therapy/coaching. (60 minute consultations for paying members of Relationship 101!)

We specialize in working with who participated in an Evangelical, Mormon, or Pentecostal community, and are looking to discover or rediscover the role that sexuality might play in your life and relationship.

Let’s heal together!