Pete arrives for his session, becalmed. He usually vacillates between intense productivity as a salesman and inertia that is correlated with his gaining weight, sleeping much of the day, and not calling customers. The lows generally last 1-4 weeks and are usually triggered and ended by externals. Loss of a key account or discovering a new one sets off the next emotional phase. His lulls, unfortunately, sometimes cancel the high periods; his income and career are not where he would like them.
He has a history that suggests great stubbornness and a highly competitive nature. His brothers and mother have similar natures.
He needs a quest, a mission. He's good with kids, he also tends to adopt stray puppies when dating. I suggest a big brother role. He's hesitant. I suggest perhaps something more outrageous, something meaningful to him. He wants his own distributorship that would let him hire one of his brothers. Unfortunately, a big project with delayed outcomes and no solution for today. However, he has a consulting tie to a firm in Baltimore that could be expanded. He also has a lead to help a local guy market microbrew ale. A match with his adaptations; he does know his beer! However, he balked again, that he has to "have all his ducks in a row" before such a thing.
I outlined my own Obsession Management Scheme (OMS). I, too, get blah in winter and when things don't go my way. After a half century of being victim to season and circumstance I've learned a few tricks:
a. Schedule something new ... a hobby, an art project, a class, a home renovation job for the winter evenings
b. Seek obsessions that are legal and affordable. Two years ago I impulsively committed (with some instigating from my son) to "bandit" the 100th Boston Marathon on the day before the official race. (Pretty outrageous for a desk jockey. That project kept me up for over a year. I also tied it into my father's death and "proving" that the Brody's were still around and counting for something.)
c. Line up fresh obsessions to pursue when your current love wilts. I now do a marathon every 6 months, alternating Boston in April with the October Marine Corps event in Washington. Both events have inspiring settings and traditions. (The Boston event has a magnificent history. I'm also proud of the Marines; I want to shuffle through their course in such a manner they will be proud of me.)
I ended with giving him permission to forget arranging things, take some chances, and buy a banana split. All of us grew up hoping that mom might consent to such a luxury. We no longer have to ask mom to get a banana split. I reminded him that he's in charge of such things and can now DO ANYTHING HE WANTS so long as it's legal and affordable! (1)
A big, crooked grin split his lower face, his jaw cocked to his right. "Damn you, doctor, you can see the wheels turning, can't you?" "Yes. I expect to see your name in the paper."
He was still smiling and humming when he left.(2, 3)
1) My son is grown; Pete has no significant family commitments. We are both in phases where we can afford to take risks. People with family responsibility can use these tactics but in a more financially conservative manner and perhaps involve doing something outrageous for/with their children or spouse as well as themselves.
2) Thornton Wilder ("The Matchmaker," later "Hello Dolly") sends two clerks from Yonkers to New York to have an adventure. The younger is uncertain that he would recognize an adventure. The older promises to yell, "Pudding" when one occurs. You can talk and juggle insight with manic personalities in low periods; their grabbing a cup of pudding may have greater effects. Some wins, some power often beats despondency. Of course, you need to mix in Brian Goodwin, " ... finding a place to be yourself."
3) The generalized tactics of monitoring obsessions, backing off the expensive (social or financial) ones, and spotting new quests to take the place of fading ones should be helpful for depressed clients with subclinical degrees of mania in their recent history. Determination, mild feuding, higher activity level, past overinvestment in projects, slightly less need for sleep, mild hypersexuality, and a family history of domineering people may be clues to recognizing such personalities. I have seen apathetic, hopeless people become slightly hypomanic when they had some personal wins. Negotiation and assertion training are traditional (for the past 20 years!) and effective ways to get a bit of power at work or in marriage. There's even an appealing radio ad that discounts formal "resume" entries for making career assessments. Instead, the lady wants to know the unique things that really excite you so that you can vitalize your life and career without abandoning responsibilities.