Category Archives: Mental Health

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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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

sillIfied

We walk together in an uplifting mood cause of our closeness. He discusses his day at work in a more serious tone of adults. Me on the other hand, feel the giddiness bottled up inside.  Like a child, I want to skip and sing outloud, but  do not in this professional setting. I keep a lid on it and do good by staying quiet.  I imitate his mood. I answer, “uh huh” and say, “interesting” at the right moments. It seems to get brighter outside, and I put on my sunglasses. I become cozy again with my giddiness.  Silly thoughts with strings that go to funny places play through out my mind. His words go on in my background  until he  says something playful about my sunglasses. He pulls my silly string…

I become sillified by his certain single statement sidewinding to my sternum.  His words hit dead center and release me. My giddiness bursts into the open.  It shoots up into the air and burst into fireworks.  Glints of falling sparkles come down and settle on my crown.

My exhale heaves out a hearty laugh.  Finally, my surroundings are in sync with me, and we are one.  I get to be silly and silly I become. Playfully,  we make each other smile.   The pace of my words pick up speed , and I say whatever I please.   They are my silliest of thoughts and dreams.

When we are together, and you look at me, know that I am wishing for you to sillify me.

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.

How to Be on Antipsychotics.

This young lady, who calls herself “the misadventures of me” wrote the funniest post on Antipsychotics.  It’s my favorite.  Enjoy her good writing.

Recently I was told I may have bipolar disorder and was promptly put on, you guessed it, antipsychotics. Now something about the name makes antipsychotics sound really scary, or rather, the person …

Source: How to Be on Antipsychotics.

A Not So Tough Pill to Swallow

Treatment for Bipolar Disorder is based on a menu of medications.  They Are a diverse group from Lithium, antieliptics, antianxiety to antipsychotics.  Depending on where you lie in the spectrum of your disorder, the med menu will change.  You may be challenged with having to take a polypharmacy and manage the side effects of many pills or be on monotherapy and contend with much fewer side effects.   I am one of the lucky ones because monotherapy has been successful for me.

My treatment was determined by the bipolar symptoms I told my psychiatrist.  This is very difficult because, in my first visit, I could not remember all the key things to tell my doctor.  I did display some pressurized speech so that was a clue that I was in acute mania…again.  But this was my first visit so it was not definitive.  Maybe I was a chatty person.  The doctor did not know.  Determining your mental illness is similar to a treasure hunt. The psychiatrist discusses  your behaviors, looking for bipolar indicators, and determining where you exist in the spectrum.  Do I exist in the spectrum? Or does the spectrum exist as a sliver in me?  We only had one hour to figure this out because one thing was for certain-I was in an episode of some sort.  I sat in the doctor’s office laughing, hyperactive, and certainly mentally ill.  There, I said it…mentally ill.  My initial diagnosis was Bipolar Disorder II but later on it changed to Bipolar Disorder I.

Did I behave a certain way because I was tired, stressed, anxious or because I was in a bipolar episode?  Some behaviors are evident such as manic and depressed behavior, but they have to be witnessed by a medical team in an inpatient setting to be certain; otherwise, they are considered subjective.  In the beginning, my mental health picture had not formed.  So you start with the moving target, and if you do not get it right, you start a “chance” of a med.  The next time, you now have to explain to your doctor why you behaved a certain way but on a psychiatric med.  Layers start to form from the side effects.

Once you are prescribed your med, the waiting game of seeing which side effect will occur begins. Do you need another med to counter a side effect? You have to wait and see if the new med stops mania or if it pushes you into mania.  Bipolar Disorder is push and pull of your mind. You can stabilize, but now you have to be on the look out for break through episodes of mania indicating the med did not work. All this while you are living your daily life, interacting with loved ones, and trying to keep your career from imploding. Exploding. Side winding.  The name of the game is to hang on while snowboarding an avalanche.  Hang on. With your eyes open.  Hang on.

Treatment is not a sure bet in the beginning which caused me great unease.  Some people in our community are treatment resistant which means the menu of meds does not treat the disorder.  Mentally, I was not prepared for the reality of psychiatric meds because of the uncertainty but more importantly, I had this idea that meds were my last resort.  What if they did not work?  I still had a long life ahead of me.  Initially,  I thought I would need them in my twilight years.  Just in case,  you know?  Because now, I am strong, young, and could handle this through pure willpower, but I was oh so wrong.  I since learned that this thinking is backwards.  In order to not be the crazy later on, I have to be on a med plan now.

The uncertainty of it all was disconcerting. I wanted to hold on to something that was a sure thing because I could no longer hang on to my foundation since it was crumbling.  Cracks a mile long were forming.  Mentally,  I was hanging on a cliff and could feel my fingers slipping.  Just hang on.  I wanted certainty.   For instance, I know I can take an aspirin for a headache, and the headache goes away. There is a definite cause effect that can be experienced.  When I realized that my med was not a sure bet, I became scared and opted out the first time.  I was not ready to contend with the “possibilities” of “might” getting well or more worrisome that my med would not work. I stopped Lithium cold, and two months later succumbed to another manic episode.  This one was fast and furious.  I remember each one sort of. There was the one in Salinas, which was a drug and alcohol fueled binge; the second one was a flashback of Iraq and my first psychotic episode; and the third one I call Utah, which was my second psychotic episode. I am a rapid cycler and like clock work, I experienced my third episode in nine months.

During Utah, I called my doctor and well..I was in Utah and refused to voluntarily admit myself to an Emergency Room so my treatment could not start until I returned home.  I have a short story on Utah called, “The Poop Story and Other Tales of Love.”  The good thing about Utah was that I displayed very distinct bipolar behaviors such as psychosis that gave us the ammunition to pick a more precise med. Initially, I was on Lithium, and although this is known as the gold standard, it was not for me.  I felt…like…the sound you make when you place your tongue on the roof of your mouth and click it.  That sound.  For me, that sound was how Lithium felt on my mind.  After I made the click sound with my tongue my doctor asked, “You mean you feel blunted?” Her training and experience was good because that was the word for it. Blunted.  For me, blunted is the sound of your tongue clicking off the roof of your mouth.  After this episode, my diagnosis changed from Bipolar Disorder II to Bipolar Disorder I with Psychotic Features.

I was prescribed an antipsychotic that has worked well for me. Up until today,  I have been in denial and embarrassed that I have to take an antipsychotic.  It is the word is it not?  A med that clearly states that I can become psychotic.  This is a tough pill to swallow.  However, the antipsychotic is helping me by allowing me to be mentally free.  It keeps me somewhat in hypomania which is where I want to be.  I am more of my creative self then mania ever allowed me to be.  My med also helps me manage my daily stressors, which I am not so good at anymore.  Stressors mentally fatigue me in ways I never could imagine.  I am on a new path in my journey. It use to be that I was a “mental mountain.” Now, I need help.  Even though I am managing my disorder, my core being is changing.  It has to change I think.  Not so much outwardly that people might notice right away. Certainly, your thoughts change; therefore, be and then become happens.  You become a new normal.

The good thing about meds is, when you get the right kind and dose, the effect isolates the mood disorder. This enables you to see the paths to managing a stable daily life.  You can separate from the disorder.  It helps you discern trigger effects on your mood and behavior.  Enables you to develop stress release actions and form crisis plans.  Also, they reduce the cycles of bipolar episodes and protect my beautiful, sweet brain, which I love so much.  Meds can be effective.  It is what I call my good, hard work.  My goal is to swallow this pill and stay of healthy mind, peaceful, and loving of heart.  For this, it is not such a tough pill to swallow.

 

 

There is no “I” in “Loneliness”

A discussion I had a few weeks ago with my psychiatrist came to the forefront of my mind.  This was not an intrusive thought or episodic depression breaking through.  Not dysphoria. I can tell the difference now that I am on medication treatment.  It is something that I am  working through, which is about the emotion of feeling “lonely.”  I realized I have never experienced it.  Even if I ever did, it is not an emotion I can remember.  When did it secretly depart? This realization lingered in my mind.

After the first week on my new med, I experienced the emotion of “loneliness.”  I was in my apartment relaxing as usual.  My life is somewhat effortless.  I have it made.  On one particular evening as I worked on a short story, a new feeling pulled at me in a disconcerting manner.  I did not like it and was unfamiliar with it.  My apartment was cozy, and I had my things around me.  I had my freedom.  My friends and family were all fine and available; however, this feeling of something I knew not what trailed after me.  It was subtle.  It barely showed its face and whispered its name–loneliness.  It was hollow.

At my next therapy session, I discussed this with my psychiatrist.  Our session was moving along as usual in her white clinical office with the bright lights of a surgical room.  Perhaps the lights helped her search for the darkest corners within me.  She asked me how loneliness felt, and I replied that it was unpleasant.  It tugs at things.

My psychiatrist said that I would experience a lot of new emotions and moods on my med. My med would clear a path for them like a pathfinder. That it would take time to learn how to manage them.  Manage is the clinical word for feeling an emotion in a more balanced way.  Being the curator of my emotions, I was dismayed that I had not noticed that loneliness had been missing from my collection.  What I was uncertain of was whether it was stranger to never have felt loneliness or to never have realized it. Perhaps both are equally puzzling.

Surely, I watched it play out on TV, read about it in books, and provided a shoulder for my friends to cry on after their most heartbreaking breakups where they expressed the depths of their loneliness. All those times, I thought I was relating to them, but really, I had not been at all.  I had been understanding their loneliness by knowing the definition but not because I was drawing from experience.  In order to relate to my world, I substituted the feeling of “longing” because I knew how that felt. However, longing means a yearning desire which is completely different from loneliness.  All my life, I had existed in a way where there was no “I” in”loneliness.”

As a person who exists in hypomania, the feeling of loneliness is nonexistent.  At least not in my spectrum. Some people would wonder, “What had gone wrong?” or maybe even “What had gone so right?”  Because loneliness is such a negative emotion, who would care to feel it? However, loneliness can cause people to form and hold on to attachments to others.  The consequences of not feeling it are much greater than I am able to understand at this time.  Again, I am working through it. I am fortunate to have a good friend to discuss this with because I trust him implicitly.  It is good to have a strong person’s view on these new emotions of mine.  His responses in words and facial expressions are my carpenter’s level.

It would seem that hypomania would be a wonderful place to exist in because it is a devil may care feeling.  The world is conquerable, but a more important statement that effects practical efforts of daily life, is that everything and I mean everything is possible. This sets me apart from most people.  Therefore, my feeling of loneliness is one of the three definitions that pertains to place and defined by Google as, “(of a place) unfrequented and remote.”