Category Archives: bipolar

When The Sandman Leaves

One of the strongest indicators of being in hypomania and feeling it grow stronger is the sudden inability to sleep.  Routine sleep is critical for those with bipolar disorder, and I make every effort to keep a regular schedule.  I take my medication at 8pm and it kicks in around 10pm.  Once, I lie down, it takes about 30 minutes to sleep.  However, when hypomania appears the sandman leaves.  When the sandman leaves, I stay awake until the sun rises.  Since I am in hypomania and not mania, I do not spend my evening painting or writing; rather, I just lie in the dark.  Thoughts of the day run through my mind and other hours I just lie in bed with a quiet mind.  I keep my eyes close, but sometimes I open them and look at my hands in the dark.  Stare off in the veil of darkness that cocoons my room safe and warm.  I do not know how I lie in bed for hours til dawn.  I just do.  I suspect I do go into a light sleep, but in the morning, I wake exhausted for a few hours.  The exhaustion passes and I become alert again.

I did not sleep last night and suspect tonight I will stay awake.  I feel very alert right now.  This is the other indicator.  I am not dragging at all, but I do make it a practice to lie in the dark to allow my body to rest.  When the morning comes, I have to go to work.  When I go to work, but do not sleep, I can function at work, but I can not exercise afterwards because it seems to daunting.  Tomorrow, I had planned to play against a tennis wall, but I do not think I will have the energy.  I come home and try to stay calm and peaceful since I know I am in hypomania.  Back in the day, I would have gone out and drank alcohol.  Nowadays, I am more disciplined in my self care.  Human interaction can become intense, and I am able to maintain a calm distance and protect myself until the hypomania wanes.  It crashes into me in waves even on my low dose medication treatment.

Tonight, was different.  I ended up pleasantly talking on the phone with my boyfriend until we started discussing politics and the recent debate.  It became very uncomfortable and intense.  We disagreed on the presidential nominees and voiced our opinions strongly.  I kept saying “let us agree to disagree,” but he would not let it go.  I felt negatively judged and really bad for how I was thinking.  It was horrible.  I came crashing down left in shock.  My eyes felt like the size of giant saucers making the lights brighter.  My mouth went dry and I lost my appetite.  I was in a kind of shock.  Hypervigilant and uneasy was how I was left.  This is what happens when you lose sight of how your mood is affecting you.  I knew I had not been sleeping and should have immediately and politely hung up or changed the divert with some levity.  These are lessons learned.  I had not been sleeping and new I was vulnerable.  It is during these times that I really have to not say much or engage in charged topics.  During these phases, I have to stay vigilant but not hypervigilant which causes mayhem too.  It is a delicate balance, but I do know when I do not sleep, I have to lie low.

After I hung up, I cried and then sat staring at the TV.  Just feeling so bad about a conversation that went so wrong.  I could not eat nor drink.  I just sat there.  Now, I cannot sleep.  My blogging is a nice escape.  I am not concerned with destabilizing because of my med, but I am in distress. For the rest of the evening, I will listen to my favorite comedian Bill Burr podcast and hope my words for this blog will flow.  I have many thoughts running over and over in my mind about what we said about people who do not even matter.  The shock.  Tonight, I will not lie in the dark.  I will allow my shock and hypomania to engulf me and stay busy, but I will not drink alcohol.

 

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The Reality of A Bad Decision

I have been on my med for six months and have managed to attain stability through many trial and error.  Since I am not heavily dosed, a recent hypomanic episode can be felt simmering under my surface and does not float away with the steam.  Although the shower no longer screams, and the freezer no longer plans warfare against me,  I can still feel the other physical effects.  Over a week ago, I stopped sleeping regularly for three days in a row but managed to rest and sleep a few hours each night.  I became intimate with the dark.  My appetite is reduced to Ramen and beer.  Things become shiny and then fade.  My periphery waves hello and then fades goodbye.

My med keeps me anchored so I do not float away.  I flicker.  I flicker.  I flicker ever brighter and dim with the sunset.  It is times like these that my med seems like something I can live without because the hypomanic feeling of invincibility taunts me.  I take the pill from my pillbox and stare at it wondering out loud if I still really need it.  Of course, I need it and continue to take it.  It is times like these that the reality of a bad decision is at the forefront of my mind.

Reveille

The alarm clock sounds off like reveille across a field.  It calls for me to wake up and start my day.  Through groggy eyes, I look for my alarm and shut if off.  A sigh escapes my lips and my head returns gently to my pillow.  It sinks into the comfort and warmth.  I am awake and become aware of my warm body under the warm sheets  I stretch like a cat and roll onto my side.  I look at my clock in frustration as if its the clock’s fault that I have to wake up.  Why can I not wake up perky and bouncy like I use to, but the answer is always there — my med.  Fortunately, my med does not effect my libido in the morning. Through the sleepy leepies I still want to play.  To feel.

 

The Wicked

How did I end up self admitting into a psychiatric institution for the first time?  I can still clearly see myself signing my rights away.  I remember the ilegible scrawl that scratched from the pen, which represented my signature, as I signed the official documents. I remember how at that moment in the emergency room, I felt surprised and oddly interested that for someone with beautiful penmanship, my messy signature was unrecognizable.  I was losing control of my mind and my body, and I was slowly losing the will to combat this insipid side effect called Akathisia.

To give some background, I had unknowingly lived with untreated bipolar for quite a number of years.  I barely sought medical treatment in September 2015 because the mania was swallowing me up one day at a time.  I was medically diagnosed and entered the realm of antipsychotic medication and therapy.  When I was prescribed 80mg of Geodon — 40mg in day and 40mg at night, I refused the prescription because I wanted to start at the lowest dose possible before moving on.  It is the way I think.  I wanted to titrate up and watch all the changes.  I wanted control.  So I refused the day med and only took 40mg at night.  I continued on 40mg at night for two and a half months.  This dosing only at night caused my side effect.  Apparently, some doctors believe Geodon should be taken two times a day; otherwise, one dose is spiking your brain.

Taking Geodon one time at night caused a side effect called Akathisia which caused me to end up in a psychiatric institution.  The horror of it all still lingers.  A memory that has yet to fade.  I watched myself lose a grip on reality over a three day period.  It was not like experiencing psychosis.  It was different because it did not hit me like a ton of bricks like psychosis where you cross a line and cannot see where you came from.  When I experienced Akathisia I could see my mind crossing a sanity versus insanity line that I could not control and then return back to me.  Each time was more powerful, and the restlessness, that it is known for, occurs in waves.  It rolls through your body.  You cannot stop the urge to move, to fidget, to walk, walk faster and then to run.  You cannot settle your mind.  You just want to move faster than your mind is capable of doing.  The mind and body are disconnected.

At the time, I did not know what was happening to me and this occurred over a three day period.  I survived three days of Akathisia and two minor episodes before this.  When I experienced it before, I called it “The Hurt” and I wrote about it in my blog in a short story titled, “The Hurt.”  The episodes that occurred on the first two days started two hours after I took Geodon and lasted one hour.  I dealt with it by putting myself to sleep with Benadryl. I did not know it was Akathisia until the third day of my episodes when it started at 8:00 in the morning during work.  I googled my symptoms and came to the conclusion that this was what I was feeling in addition to the wretched anxiety that presented mortality to me in ways that I never thought of before.  In ways only those who are terminal or in the gallows probably feel.  The anxiety was smothering me a little at a time and left me gasping for air.  For mercy.  It lasted a few minute but then returned for longer and longer periods.  It dragged me through a dark, chasm of helplessness.  I wanted to jump out of my skin and run full speed down the street away from it.  I realized that I could possibly end up running down the street – screaming.  I was convinced this would be my outcome if I did not get help.  These three days were no longer ‘The Hurt.’  They had become ‘The Wicked.’

Akathisia causes a distressful restlessness of the mind and body.  In the third day, as it progressively got worse, it made me walk circles around my office, around my building and then outside the building.  I got up and walked every 30 minutes for 15 minutes for eight hours on the third day.  I was worried that the security guards would notice me and this caused me to change my pattern of walking so that I was not so obviously and oddly walking the building.

So you see, I could still think things through.  I even read my crises plan that I had in my phone.  My doctor asked me to photograph the crises plan we wrote together, and it was in my iphone.  The photo was a list of things to do in crises and one item read “go to the emergency room if in psychosis.”  Although I was not in psychosis, the words “emergency room” jumped out at me.  I just knew then… I just knew this was my safe haven.

After work,  my boyfriend was driving me home and as calmly and as rationally as I could through the waves of Akathisia rolling through my body, I told him that I was not well.  At the same time,  I was willing myself not to jump out of the moving car.  Like in a major way.  He said we would go home, and he would take care of me.  I came to the conclusion in front of him that this episode was bigger then the both of us.  We were entering unchartered territory – the emergency room for a mental health crises.  When the ER Psych doctor asked me why I was admitting myself, I told him because I knew that when I started running out the door screaming, they would stop me.  With that, my first formal admission to a psychiatric institution was complete.

 

*I stayed in a psychiatric ward for six days while adjusting my medication.  My final treatment plan was Geodon 20mg day and 20mg night.  In order to stop the acute Akathisia, I was given Cogentin 1 mg which worked.  I titrated off Cogentin after one month and the Akathisia stopped.  I am still take Geodon.

 

 

 

 

Psychiatric Institution

Here are funny things I heard while in a Psychiatric Institution adjusting my meds with 32 other detox and/or adult psychiatric:

  1.  “How do you lose a cane up in this bitch?” – One patient wondering out loud how the old man misplaced his cane in the milieu.
  2. “Hello babycakes” – what some of the detox patients called me.
  3. “I’m not staying here. I’m going to escape” said my roommate as she tapered off the bottom of her pants while the other roommate was helping her escape by shoving personal items down her pants.
  4. “I shaved my head because my boyfriend broke up with me. I was in mania” me:”that makes sense”; her: “the problem is it makes sense to us in here but not to people out there.”
  5. okitee dokitee – a form of okay
  6. “come here baby. I’ll talk to you and your teddy bear”
  7. “Come here baby. Let me wipe off that little bit of soap off your face”

Irritable Depression and Mixed State

This is a very important discovery for me because the part of bipolar disorder I detest is the irritable depression that occurs with mixed state.  It is the rattlesnake part of my disorder.  The more I learn about it, the better I can manage and reduce it.  For instance, I started taking Vitamin D3 and Magnesium supplements because deficiency in these minerals is linked to depression.  I have been diagnosed as vitamin D deficient in the past.  Hypomania is fine but not irritable depression. It causes me to snap at loved ones which leads to a horrible guilt.  It is a nasty cycle.  I hope this article helps those who havent figured out that depression does not only present as a sadness but can present as anger as well.  Click on the link below for more information.

Irritable Depression

CBD Can Effectively Treat Bipolar Disorder

How CBD’s Can Effectively Treat Bipolar Disorder Symptoms and Manic Episodes

My Periphery

As I walk through the gentle sway of trees, the greenest movement of the leaves tug at my sleeve. Each tree passing into my periphery and keeping its clarity in a space others call the background.

Vibrant, singing colors if you please from each blade of grass that I have become. From the front, they are a great sea of plants and then into the periphery they wander bursting asunder into a space that many dismiss as a less distinct place of vagueness.

The hypomanic path is one of distinction with colors and intensity existing to the front and the sides. Hugs of tone and value fill my entire field of view.  I feel like I am walking through a snowglobe of poppy fields. Flowers dance and plants wave hello to this captive audience.  Into my periphery they go but do not fade away into the space others call the background.