Movin’ on up… and it sucks

I was diagnosed with Bipolar II five years ago last month.  Two days ago, that diagnosis changed to Bipolar I.

For those who don’t know, here’s the difference between the two.  People with Bipolar II have major depression plus hypomania, a milder form of mania that can involve elevated mood, irritability, and behavior that is unusual for the individual but not outside the realm of “sane” behavior and not overly disruptive to their lives.  Until recently, this was me.  When hypomanic, I would spend more money than I should, flirt inappropriately, talk a lot and quickly, and do a lot more goal-directed activity.  It felt great.  It was a fun break from being severely depressed most of the time, and I usually knew when it was coming, as it would surface at certain times of year and then pass on its own after a couple of weeks.  I’d been experiencing these moods since I was a teenager, and no one had ever suggested they were an illness, assuming instead that I was just a very labile teenager.  Some people are very bothered by their hypomania because they get very irritable and have an unpleasant sensation of racing thoughts.  This was rarely the case for me, so I resisted and resented treatment for it.

Full-blown mania is another, though related, beast.  People who are manic exhibit bizarre behavior and thoughts that are clearly outside the norm and are not healthy or safe.  (I wish I could remember where I read this, but I remember someone saying, “People who are hypomanic buy five pairs of shoes.  People who are manic buy 50.”)  It can still feel amazing and in fact I believe it may be the most purely pleasurable experience possible to have; one that people who have never experienced can never understand.  However, one hallmark of full-blown mania is that it puts oneself or others at risk.  Another is psychotic features like hallucinations and delusions.  If either of these occurs, the diagnosis changes from hypomania to mania, and anyone who experiences one full-blown manic episode is considered Bipolar I, and in many cases, the person has to be hospitalized.

Two weeks ago, I started to feel manic.  I knew the markers because I’ve been dealing with this for a long time, and learning about it is how I cope.  I was a little surprised because my hypomanic episodes have always been almost exclusively in the early fall when the light and weather start to change, but I didn’t think much of it, and expected it to be a welcome relief.  For the first few days, it was.  I was energetic, talkative, imaginative.  I played enthusiastically with my son, filled page after page of my notebook with many ideas, talked a lot, and only slept a few hours a night, all of which was basically fine and no danger to anyone.  Then shit got weird, and wonderful, and terrible.

My son had just gone to his father’s (we have joint physical custody) and I was alone in my apartment when I heard the most beautiful sound I had ever heard.  I was paralyzed with bliss.  It was similar to a very large windchime, but indescribably more intense and captivating.  As I froze everything to listen to it, I realized that it was not a tone but a voice.  Unlike any voice I’d ever heard.  It made me ache and wonder inside.  And suddenly everything became clear.

This was the voice of the consciousness of the stars, and without knowing it, I had been waiting and preparing to hear it all my life.  Everything I’d done, everything that had happened to me, was orchestrated for the sole purpose of testing and readying me to receive this consciousness.  It was what I can only call a deeply religious experience, which is something I’ve never had, and is drastically out of character for me, being otherwise intensely skeptical, irreverent and critical.  But it didn’t feel like an anomaly.  It felt like the only real, sensible thing that had ever happened.

My mission, the voice communicated to me, was to prove myself worthy of being chosen as the next in a line of great scientific minds that reached back to the beginning of humankind and included people like Democritus, Isaac Newton, and, my immediate predecessor, my hero Carl Sagan.  Deep inside, it said, I had access to all of their knowledge and memories, but to access those, I must first show that I was ready to receive them.  I had to do this by bringing others closer to an understanding of science and the universe.

So.  How to do that?  Why, social media, of course!  That’s where everyone gets their information these days, and lo and behold, the Facebook homepage was sitting right in front of me, waiting for my divine insights!  So I typed.  And typed, and typed, and typed, and hit enter a lot.  I harassed public figures on inappropriate forums because I didn’t believe they were upholding the legacy of Sagan, and repeatedly exhorted others to do the same, getting myself kicked out of several of my favorite groups.  I wrote stream of consciousness poetry directly into the status box, believing that it would be sacrilege to filter or edit the insights I was given.  I raved on science pages about my visions of the future of space exploration.

In addition to the bell-like, serene voice of the stars, I realized that I was being bombarded with other, more subtle messages, which I had just been missing until now because I wasn’t ready.  Certain wordings in science articles were clues to me about meaning and purpose and what I should be doing.

The whole time, I interspersed this unstoppable flood of ideas with sprinting around my apartment and halls, laughing maniacally and waving my arms around.  When I went outside to take a “walk”, one of my neighbors noticed my bizarre behavior and stopped to ask if I was drunk.  Taking great umbrage, I assured him that I was both safe and wonderful with enough force, insistence and annoyance that he eventually gave me a cigarette and his phone number, told me to call if I was in trouble, and left me alone, at which point I went back inside and resumed typing faster than ever.  (I am deeply grateful to my neighbor for not calling the police on me.  It’s probably for the best that he attributed my insanity to substance abuse, which oddly has less stigma than being mentally ill, it seems.)

And then, by the end of Monday night, it was over.  All at once.  The most wonderful experience of my life evaporated instantaneously like water on Mars and I was left alone like an empty husk with no soul, no purpose and no joy.  I was devastated.  I pleaded the stars to take me back, to forgive me for failing them.  Then it dawned on me, as my mood fell, that everything I had just experienced was nothing but a byproduct of my fucked up brain.  I began to cry, and cry, and cry.  I cried for hours while I read back over all of my rantings and began to understand the damage I had done to my public image and friendships– which are few for me, and therefore very valuable.  I had never hated myself so much or wanted more to disappear.

I could only think of two ways to escape from this harsh re-entry to reality and exit out the other side into despair.  One was to kill myself.  There were easily accessible ways to do it, and I wasn’t afraid.  But I am a mother before and above anything else, and I decided long ago that nothing, no matter how miserable, will make me leave my son motherless.  I know too much about how much this devastates a child.  So I took the second route, drinking myself into oblivion.  I drank and slept for two days, then went through a long and excruciating alcohol withdrawal, and continued on into a horrifyingly black depression, made more monstrous by its juxtaposition with the most terrible beauty I had ever known.  Paranoia took over, and I paced and wrung my hands, convinced that the police were going to beat down my door, restrain me, commit me, and sedate me.  I begged my friend to tell me that he wouldn’t let them take me.  I resisted telling anyone exactly what I had just been through, believing they would use the excuse to commit me.  When I thought about my mania, I didn’t know whether I was more fearful that it would return and further wreck my life, or that it would never return and I would never know that penetrating, reasonless ecstasy again.

As the withdrawal eased up and my friend and parents became gradually aware of what had taken place and reasoned with me about it, I began to really take in the fact that I was experiencing severe, rapid mood swings that were psychotic in nature– delusions of grandeur and reference; auditory hallucinations; paranoia– and that I needed more and better treatment.  Luckily, I had an appointment with my psychiatrist, who is one of the kindest, most competent people I know, coming up very soon.  Though terrified of what she would say, I went in, with my best friend as moral support, and told her honestly what had occurred.

My trust in her was rewarded.  While she did exhort me to go to the hospital if I ever became psychotic again (though I’m still not sure how I’m supposed to recognize that while it’s happening) she did not try to commit me there and then.  She instead supplemented my usual regimen of mood stabilizers, antidepressants, anxiolytics and sleeping pills with a low dose of an antipsychotic medication.It was none too soon, because the next day, I began again to show signs of mania.  I began jumping, running and skipping around the apartment whistling and laughing.  My thoughts and voice raced and shouted and interrupted each other.

I was again torn between my passionate desire to commune again with the stars, and my humiliation and having been witnessed in such a state; my fear of being committed.  Fortunately, I was still just rational enough to say to my friend, “I think I need to take my Zyprexa.”  I did, and after a while, it began to calm me, leaving me confusingly drained, sad, still hyper, and relieved.  And that’s where I remain today.

While I was at my psychiatry appointment, just before leaving I said tentatively, already knowing the answer but needing to hear it out loud, “I know my diagnosis has always been Bipolar II.  So…?”

“This is Bipolar I,” she said quickly and definitively.  My heart sank, even though I’d seen it coming– I’ve read the DSM criteria; I knew that only full-blown mania explained my experience.

“That’s what I was afraid of,”  I muttered.  When she asked why, I admitted, “I’ve always been comforted knowing I was just a little crazy.  There’s so much more stigma attached to Bipolar I.”

And there is.  Bipolar is a fad right now, it seems, perhaps the next Adult ADD or primary postprandial hypoglycemia, and a lot of people are of the attitude that “Oh, we’re all a little bipolar, I have mood swings too.”  Well, now it was clear that I wasn’t “a little bipolar,”  I was a lot bipolar.  I was the type of person who would have probably been locked in an asylum and drugged forty years ago.  Even though it had been brief, I had gone mad.  I had broken with reality, and it would probably happen again.

I worry about my ability to comply with taking my antipsychotic.  An acquaintance of mine who romances psychedelic drugs told me recently, “When you’ve tripped once, everything changes.  When you’ve tripped a lot, everything changes again.”  Well, once you have heard the voice of the stars, once you have communed with the universe and felt the wholehearted, incontrovertible truth that you are the most important person in the world, set apart since before your conception, there’s a place, a pre-psychosis, to which you can never go back.  I still don’t know what that will mean for the years ahead.  I only know that, more than the fear, more even than the shame, I feel heartwrenching melacholia and loss that until now, I could have never understood.

You asked for it, you got it

I’ve received a few messages (okay, meaning two) requesting that I post more stories of my relatable experiences with intrusive thoughts, so with some reservation I’ve decided to share what happened to me last night.

I was exhausted from a new medication dosage and ended up sleeping from about 6 to 8 p.m.  As is usual for me, this sleep was filled with violent, disturbing nightmares, and also as usual, I woke up shaking, drenched in sweat, feeling like there was a crushing weight on my chest.  Then for some reason I started thinking about ways people die, and why people are more afraid of some causes of death than others.

Specifically, I wondered why people are more terrified of dying in flames than of dehydration, which is a much more protracted experience.

And all was well with those thoughts until I remembered a movie from a few years back called Ladder 49, in which Joaquin Phoenix gets trapped in a burning building and calls off the rescue operations because he doesn’t want his fellow firefighters to die in the futile attempt.  I wondered if I would have the courage to do the same.

And there went the thoughts.  Suddenly, in a matter of seconds, I became utterly convinced that my apartment was about to catch fire and burn me alive.  I knew beyond a doubt that I had to get out of there, but at the same time, I knew that I had to be there to save my beloved cat and my family photos and my laptop.  I lay in bed feeling paralyzed, not knowing what to do, for over an hour.

Perhaps this was substantiated by an electric fire in a neighboring apartment building, where my mother lived, a year and a half ago.  Perhaps it was spurred by my childhood obsessive fear of spontaneous combustion.  I don’t really know, I just know that it felt as real as anything around me, all of which, including my own self, felt less and less real.

Even as convinced as I was, there was still a cold, logical part of me that knew I was being irrational, and this only made it more painful because I felt so ashamed and frustrated at not being able to control my thoughts.  Luckily, after enough time had passed, that part of me induced me to seek help.  I texted Person of Interest and we were able to video chat for a couple of hours, until I felt distracted; he even managed to make me smile, which is a special superpower he possesses.  He helped me to put my thoughts in perspective and remember how to deal with them.  As I sometimes do, I was able to envision locking the thoughts in a safe deep in my mind and building brick walls around them until I felt slightly less controlled by them.

Of course, my inner narrator, of whom I’ve spoken in a recent post, made all of this much more difficult.  She was talking to me, describing the whole thing at every turn, murmuring things like, “The apartment is about to burn down.  She knows she should get out but she’s too stupid and cowardly.  She’s going to burn alive because she’s so stupid and lazy.” How do you cope if the extra person inside you, who knows your every thought, predicts your imminent demise with such clarity and conviction?

But at the same time, I think she, the Narrator, helped to create the resourcefulness that allowed me to keep a little perspective and seek help.  I’ve grown so used to her over the past 25 or so years, so used to recognizing her as unreal, that I’ve developed an intensely skeptical attitude toward pretty much everything.  Show me the evidence or GTFO, and there was no empirical evidence to support my claim of immediate danger.  I’ve always cultivated this side of myself because it’s served me well– certainly not in relating to a community, but definitely in creating a separate area of my mind that analyzes and criticizes itself at all times, inducing a scientific, doubtful frame of mind.  Were it not for the unexpected power of this part of me, I don’t know what I would have done.

Still, despite all that, I kept getting up to check that the stove was off– rattle each knob five times, then say “Goodbye, Mr. Stove” and soon do it all again– as well as unplugging all the lights and electronics, despite my terror of the dark, because frankly being attacked by an intruder or supernatural being seemed less horrible than being burned alive at random.  I was in agony, much more so than any physical pain I’ve ever experienced.  I have a special ability to consciously control my own heart rate, but only when I can focus intensely, and so even that wasn’t helpful with such distracting litanies occupying my brain. 

I hyperventilated and had cringeworthy heart palpitations and, again, felt like an anvil was on my chest and pressing my shoulders into the bed.  Every muscle in my body was tensed to the extreme.  It felt like every neuron in my brain was firing and frying; I didn’t know what was real; I couldn’t control myself; the cognitive strain seemed to induce an indescribable migraine in which everything I saw swam about randomly, my ears rang deafeningly, and a specific spot in my head endured a sharp, focused pain.  The narrator whispered, “She’s going crazy.  She’s broken.  Her mind is broken.  She thinks these things are real.  She’s lost it.”

After I talked to Person of Interest (who is fantastic at making me feel better, but talking to someone else I trusted would also have worked well) I laid back down and thought I would go to sleep, when I suddenly remembered that after using mascara (which I very rarely do) a few days ago, some of my eyelashes– maybe half a dozen– had fallen off when I washed my face.  I panicked and worried that there was some disease on the mascara that was going to make all of my eyelashes fall out while I slept.  I kept having to check my eyelashes by touch at one minute intervals, and after every three checks, I had to go turn on the bathroom light and scrutinize them in the mirror to make sure they were okay.  I vaguely remembered reading the story of a girl who suddenly lost all her hair at age 11, and was mortified to imagine walking around with no eyelashes, as much an object of ridicule as I already am. 

Fortunately, in this case, I was able to reattribute my thoughts and distract myself with 5 episodes of 30 Rock, because the skeptic in me knew how absurd the fear was.

I like to think I’ve gained some control over the way I react to panic attacks and intrusive thoughts, but the fact is that the sensations of the thoughts, the physical symptoms, are still ever-present and seemingly intolerable.  Over the past few months, in which I’ve had to work myself down from panic attacks multiple times per week (sometimes multiple times per day) I’ve even learned to consciously control my heart rate (I know, pretty awesome, right?) but it only works when I can focus exclusively on it.  My narrator has both made matters worse, and helped me develop rock-solid defense mechanisms.

Frankly, it’s fucking confusing.  I’m used to understanding and adjusting to the mood-based tricks my brain plays on me, and addressing irrational anxiety.  But over the last six to eight months, and particularly a difficult time I went through several weeks ago (not to say it was wrong or intolerable; any other factor could equally have triggered the same result) I’ve begun to break.  Like a piece of aluminum sheeting that’s been bent back and forth so much that it’s not quite severed yet, but the stress has begun to show clearly on it; it’s grown thin and weak. 

That’s how I am.  I am a camel’s back waiting for a straw.  I am a storm waiting for a butterfly to flap its wings.  I don’t know what’s happening.  I have cocooned inside my own mind, and the thoughts there seem more real, more concrete, than anything outside myself.  And yet I have protected this small part of me from the deluge.  Who can explain it?  Not I.  To break, I was fragile to begin with, but why?  Why did I have to quit university?  Why am I unable to work?  Why am I who– no, what— I am?  The question frightens me.  I have to walk away from it now, before it scares me more.

I hope this story, as painful as it is to share, is helpful to one or more people out there.  Cheers.

ETA:  It’s been brought to my attention that this post is slightly incoherent and somewhat redundant.  I do apologize for the problem, but I haven’t the capacity to rewrite it in a better manner right now.  I hope it will still be helpful.

Edited for grammar and coherence 9/10 –mhc