That Bipolar Thing

Lately, bipolar disorder is reminding me that it has, in fact, got a place in the chemistry of my mind.  I work very carefully to manage the disorder.  I take my meds correctly (with a few exceptions that we all seem to have), I keep appointments with my psychiatrist and therapist, and I am diligent about monitoring my symptoms.  Lately, however, I’ve been riding through a chaotic storm of bipolar swings.

It started with irritability and restlessness that I didn’t put together as precursors.  Last weekend, things started getting particularly interesting.  The world stopped moving at the right pace; it was far too slow.  Things started magnifying to the point that the entire world and everything in my life was a trigger.  I just wanted to cover my head and pretend that nothing other than soft, plain dark colours existed.  Evil voices kept telling me of horrible things I had done or would do, none of which were true.  Things continued to decline from there, and by Thursday, I wanted to dissect the veins in my forearm to get out the shiny things in my blood that I knew would protect me.

Throughout this, I missed work which means financial problems abound.  It’s left me feeling selfish, lazy, and more than a touch mad.  Things are still big and mean and scary, in that the slightest thought of negativity gets magnified to the point that it seems a personal crisis.  I’m not willing to spend a cent, simply because I feel undeserving of anything because of missing work.  I don’t have the energy, really, to do anything anyway.  I feel like staring in to space for the next few decades just to avoid anything that might send my mind back down the path of horrible scenarios and hallucinations.

Things have fallen apart, due completely to bipolar disorder this time.  I feel incapable of do anything productive, as I feel like a complete waste of space and oxygen.  My mind, when it does become lucid, takes so much time to process information.  I fluctuate quickly between the depths of despair and the terror of psychosis.  *Everything* is a trigger these days.  Ironically, I have no idea of what actually triggered the bipolar symptoms, but I don’t remember purchasing a ticket for this particular ride.

Stop Arguing with the Voices

Although the title of this post can be made hysterical by implications, I’m actually referring to voices *not* related to multiplicity.  I’m referring to those haunting disembodied voices that tend to frequent my psychotic periods.  They have been most problematic lately, and my therapist suggested a seemingly simple technique that has actually worked:  stop arguing.

No, really.  Think about the physiological concept of arguing.  When you argue, your temper tends to flare.  This leads to racing pulse, shallow breathing, dilated eyes, increased muscle tension, et c.  In other words, it brings about the fight-or-flight response.  This directs your entire focus to the voice(es), which become more and more real.  You begin to argue with the voices, as any good opponent in a strange debate would do, thereby justifying their position in your life at that time.  Your focus is on those disembodied voices by then.  You’re listening for them acutely and readying your defence.  You’re in a state of panic, on edge and waiting for the next comment that will need refuting.

So what happens if you simply do not argue?  In my recent experience, the voices stop, even if only for a moment.  My disembodied voices tend to bring up horrific images and assert that I *will* have to see or do the things they are explaining.  This reads directly in to my trauma background, of course, but it is a symptom unto itself, as well.  After a somewhat heated therapy session yesterday, I came away with the idea of thanking the psychotic voice for bringing my attention to a concern and then reality testing.  A somewhat innocuous example:

External Person:  Wow, the weather has been terrible lately!

Disembodied Voice:  See?  The weather is becoming more violent.  You’re gonna see that violence.  The whole world is becoming violent, and you’re gonna see all the death and destruction.

Me (silently):  Thank you for drawing my attention to this connection that I’m making.  I can cope with the violent weather.  If I see violence in the world, I might feel bad about it for a while, but I won’t be responsible, and I’ll get past whatever I see.

Voice: Bollocks.  She got me again.

Ok, I’m only imagining the last line.  I do hope, however, that the voice leaves with a little indignation.  What’s a psychotic argument without a little whimsy?

Descending in to Madness

Things are bad.  Very bad indeed.  I’m having miserable luck which would almost be tolerable if I were not also having mood issues and psychosis.  The food problems returned a few weeks ago, and they’ve hung about to some extent.  They’re better, in that I’m not doing the binge/purge thing on a daily basis, but they’re still in place.  I have a feeling they might be in place for a while.  This feels like it did when I was first diagnosed at aged 19.  I know, logically, that this is very damaging to mind and body, but I can’t quite fend off the behaviour.  Which probably led to the next bit.

The weekend before last, I started getting extremely paranoid.  This is never a good sign.  By that Saturday night, I was incredibly stressed.  By that Sunday, I was suicidal.  Staying alive was quite honestly a fight.  I was awake most of that night debating whether to stay alive and fighting with a very strong urge to swallow every pill in my side table.  The thought was ‘what if my only hope is just to hope it doesn’t get worse.  The SRA component means it never will get better.’  I still feel like that, but I’m trying to ignore it.  My mind flirts with suicide, but I don’t feel a critical danger.  Last week I set the plan and wrote the letters.  This week, I’m just overwhelmed and aware that I could very easily slip back in to that suicidal mindset.

This weekend, the psychosis started.  It started whilst I was driving, and I thought I might have an accident.  A dead woman with solid white eyes and wet, stringy black hair leaned between my best friend and I.  Eventually, her eyes turned dark, and worms started crawling out of her mouth.  I told this to my best friend and said I hoped she didn’t stay once he left.  Next I knew, the hallucination gave me a sardonic smile and nodded her head yes.  On my one hour drive home, I could hear the voice of the dead woman sitting in the car behind me.  Only when I phoned a dear friend did the voice stop.  I don’t typically hold phone conversations whilst driving, but that night it was a choice between trying to drive whilst minding an hallucination or talking with a friend to drown out the voice and (partially) the image.

I went home briefly, but the hallucinations continued.  Once again, the man who calls the dead people stood in my room and told me he would bring them if I didn’t give a blood sacrifice.  Once again, I cut my arm until the blood flowed down it.  Finally, I managed to escape and walked the half block or so to my friend’s house and stayed with her, watching carefully for the man and dead people because I knew they’d be angry with me for hiding.  The psychosis has passed.  The depression is still set firmly, interrupted only by hypo-manic symptoms and hypervigilance.  I have therapy on Thursday and am slightly afraid she’ll put me in a crisis unit until things calm.  The repercussions of that, given my SRA background, could be severe.   I just want to get help, though.  I’m at my final tether now.

Add to that ‘normal’ problems.  A cutback at work that will, once put in to effect, cause me to make less than I need to even pay my bills.  A crap review makes me think they might fire me soon anyway.  And, to be completely honest, I’ve missed a fair bit of work lately because the depression left me too tired to even get out of bed early in the week.  Financially, I have no idea what I’m going to do.  The Americans refer to ‘bleeding a turnip’ as the term for trying to get money from a person who has none to give.  I’m in that position right now.

So this is me: overwhelmed by even the smallest problem, on the verge of suicidal, depressed, psychotic, and hypo-manic all at once.  No idea of the path from here.

Reminders

I have the choice of being constantly active and happy or introspectively passive and sad.  Or I can go mad by ricocheting in between. ~ Sylvia Plath

 

Every now and then my wonky brain reminds me that, in spite of the myriad of other possibilities, I do have bipolar disorder.  This would be one of those times.  I feel like I’ve been sliding on a helter skelter since Saturday night.  Saturday was the top of the spiral.  My best friend and I had an *amazing* day.  Over the course of that day, I felt the somewhat manic pace of my brain bumbling about but decided it was probably just excitement.  By the end of the evening, however, my thoughts were coming so rapidly that I had to focus on small things like drawing just to be able to think at all.

Sunday started similarly.  About midday, however, the crash began.  It was one of those bumpy descents that threatened to even out, only to fall lower the next round.  By Sunday night, I was so depressed that texting my best friend seemed to take too much energy.  And I don’t miss a minute of texting him.  Not to be outdone, however, Monday brought back the helter skelter. In the bipolar vernacular, there is a debated pattern called ultradian cycling.  This is when a person cycles between euphoric highs and deep depressions over a 24-hour period.  Mental health professionals debate the existence of this pattern.  They would not debate it if they bloody felt it.

Mind you, things have settled back in to a lovely depression today.  The type that makes the sun seem darker somehow and any chance of happiness is destroyed by whatever thought it happens to bring.  Couple that with thoughts that still won’t stop racing and a variety of psychotic symptoms, and you get a semi-functional unfocused me who takes well over an hour to write a simple blog post.  I suppose that’s still loads better than not functioning at all.  Optimism at its finest (and most sarcastic).

All Mixed Up

I was diagnosed with bipolar I disorder in late 2005.  At the time, I was out of my tiny little mind.  I was convinced that the groundskeeper at my best friend’s apartment building was working in cahoots with a four year old boy to lock me into a storage building and kill me.  All these years later, I can look back on that and almost laugh.  Almost.  At the time, I *did* think my life was in danger.  It’s scary to know that your mind can get that out of stride, so when it started happening this week, I got a bit panicked.

Friday was awful.  I was irritable, angry, and scared that my best friend was going to walk out of my life, something I was certain of.  Saturday was better.  Nothing around me could go fast enough, and my thoughts were coming at warp speed.  I had to work to keep the nervous laughter from spilling over and making me look like a fool.  I think I managed to keep things out of sight, though.

And then there was Sunday.  I slept maybe five minutes Saturday night, none at all on Sunday, and no more than a few minutes Monday.  All in all, I’d slept about a half hour between Saturday night and Tuesday morning.  Mind you I wasn’t the least bit tired.  Mania will do that.  They say some people enjoy being manic for that very reason, but I hate it.  It is frightening when your brain is moving at warp speed.  You can’t keep a thought long enough to process it, but you can’t stop the thoughts coming.  For me, the thoughts aren’t of beauty and happiness.  They’re typically about death and frequently bring images of decaying bodies.  Yay, me.  Actually, as I write this it occurs to me that I’d had hallucinations most of the week.  Definitely something to tell the shrink.

Yesterday (Tuesday) was awful.  I have an early class on Tuedays and made a relative fool of myself there.  My partner barely got a word in edgeways, as I couldn’t stop chattering, nor could I stop the peals of nervous laughter bubbling over.  On my 37-mile drive back, I felt like crying the entire time. Monday night I heard a helicopter and swore the people in it were coming for me. Deep depression following a way-too-high energy level, with a bit of psychosis mixed in. It sounds like a sort of psychiatric cocktail.

Today is a bit better, but I’m still feeling shakey.  I slept three hours last night, which is a *definite* improvement.  I’ve had no signs of psychosis today, either.  The depression is stronger, but to be honest, I’d rather deal with that than mania.  Mania scares me, especially when it’s accompanied by depression.  Depression alone is easier for me to deal with. Last night I was terrified. Fortunately, my best friend was there to text me a bit as I got ready for work and tried to calm down. Yet another tribute to what an amazing friend and person he is. The shrink is out until Thursday, and I actually couldn’t get anyone from the main clinic to phone back. Good thing this hasn’t been serious.

I am going to phone up tomorrow and see if I can get an appointment with the shrink soon. My next scheduled appointment isn’t until May, and I don’t want to put things off until then. It’s very unusual for me to phone the clinic in general, so they know things are more than a bit odd when I do. Right now I’m taking 200 mg. of Lamictal twice a day. There was talk of adding Depakote, as the atypical anti-psychotics and I do *not* get along. One caused a seizure; the other two caused dangerously low blood pressures and heart palpitations. I’d rather be crazy than dead.

DID vs. Psychosis

Psych meds are a tricky subject, especially when you’re dealing with the ‘rare but serious’ DID issue.  I just finished a month-long course of prednisone for a physical issue, and the side effects from that made me think about psych meds.  Prednisone causes bloating, sweats, joint pain, and this lovely thing they call moon face in which your face literally rounds off like a moon.  Fun.  Unfortunately, that particular med is what helps when the physical issues I have creep up.  Prednisone rant over– I’m past that now.

My official psych diagnosis is bipolar I disorder.  I presented with what the shrink termed severe paranoia and extreme mania.  Bipolar or schizophrenia seem to be the going socially-accepted diagnoses for people who actually have DID, and I truly doubt their comorbidity.  My mood swings, anxiety, paranoia, et c. certainly *look* like bipolar mania and depression sometimes, but they look like different people internally.  That’s it– tell the voices in my head they’re merely chemical imbalances.  *That* would be interesting.

Based on all of that, I cycled through various atypical anti-psychotics with horrible side effects before landing on Seroquel which only had minorly horrible side effects.  I’ll agree that the Seroquel was probably necessary until I got back into reality, but now I don’t see the point in taking it.  In fact, I’ve only taken it three times this year.  While the side effects certainly aren’t as bad for me as they were with the other anti-psychotics, Seroquel still causes my heart to race and *really* drops my blood pressure.  Yeah, I’ll take my chances on being crazy with a functioning heart.  I’ve discussed this with the shrink, but she insists that Seroquel is necessary as a maintenance drug along with Lamictal (which really does help) because of my level of paranoia.  I hear voices, you know.

So here’s my question– how do you distinguish between ‘normal’ DID stuff and actual psychosis?  Based on my SRA background, I don’t doubt in the least that some of my hallucinations come from outside the realm of DID.  Neither do I doubt that some of my fear really could be paranoia.  I’m willing to bet, though, that the largest majority of it comes from DID and just trauma in general.

I’m able to recognise the voices of my internal folk, and when I hear a new person, it’s reasonably easy to tell that this is part of me.  Still, sometimes I get those voices that are distinctively Not Me, and they aren’t typically suggesting I take time to do something pleasant.  It’s probably due in part to a handy SRA technique called complex poly-fragmentation that causes alters and/or fragments to be so separate from the overall system that they seem part of an entirely different person in a physical sense.  That’s really hard to explain.  But, on the other hand, it could just be psychosis at that point.  I truly don’t know.

Merely being out of my tiny little mind would certainly be easier to conceptualise, but where’s the fun in that?