Tag Archives: Psychosis

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.

 

 

 

 

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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.

 

 

Psychosis

Psychosis is a special word isn’t it?  It certainly conjures up scary images of insanity. Like bipolar disorder, psychosis exists on a spectrum.  I am either a little psychotic or a lot of psychotic.  Either way, it is a definitive state that is disconnected from time and space; meaning, I have been disconnected from reality.  I have experienced psychosis in two episodes–one last summer and another just last month.  My clinical diagnosis is Bipolar Disorder Not Otherwise Specified (NOS) with Psychotic Features. (Read my first post titled, “Rattlesnake, Dreamer, Child and King”)

Being told I had psychotic features, sent me quickly into denial.  I mean, basically telling me I had Bipolar Disorder for rest of my life was hard enough to handle, but to tell me I had psychotic features was another twist. Of my mind.  The word itself “Psychotic” sounds well… like the center of all things insane.  Bipolar Disorder is a mood disorder and psychosis is another realm of the mind.  “Psychotic” each syllable sounds surgical and succinct.  Like a drill.  I have spent many nights researching the word Psychosis.   Psychotic means having psychosis.  Medline plus defines it as

“Psychosis occurs when a person loses contact with reality. The person may:

  • Have false beliefs about what is taking place, or who one is (delusions).
  • See or hear things that are not there (hallucinations).”1

What I learned is that psychosis occurs from a chemical imbalance in the brain and not from an internal disposition.  Studies have shown cause and effect with an imbalance of dopamine and serotonin.  That’s why anti-psychotics are used for it. They balance the dopamine and serotonin.  Medication treatment is the only way to not experience psychosis.  No herbal remedies, sleep, yoga or meditation can prevent psychosis from occurring.  However, my psychosis is triggered from mania–I have to be in mania for psychosis to occur.  I have not experienced it in the reverse order.  All the stars have to be completely fucked up and misaligned.

So what does psychosis feel like?  I can assure you that when I experienced it,  I knew to be terrified by the disconnect from time and space.  Terror becomes the basis for my irrational behavior.  It swallows me up whole.  Psychosis is an intruder.  It is an invader that enters and quickly removes the ropes that keep me firmly tied to time and space–reality.   I cannot tell when it starts happening because the ropes are released all at once.  All this while I’m in the throes of mania.

At the time, I am not able to say, “okay, I need to chill cause I’ve disconnected from time and space” and then go lie down or stay quiet.  However, as I lose grasp, I will scream at you “What is real?” or “Is this real?” or ask if what you are doing “Is it real?” The first psychotic episode this past summer, I thought I was back in Iraq and thought it was 2008; but really, I was laying on my carpet in the middle of my living room and crying.  These behaviors are my cry for help and indicators that the ropes have unraveled.  I am in great distress as it happens.

I have not experienced auditory or visual hallucinations or maybe I did and that is why I believed I was in Iraq.  I am not quiet sure because I cannot remember.  My manic response to the delusions in psychosis is paranoia.  The two start working together to assault my understanding of my “self.”  My being.  My identity.  The worst part is that they play off each other like dominoes slamming down next to each other.  I think I know I have lost a grip with reality and that explains why I am terrified.  I must feel like there is nothing to hold on to but not for certain because I cannot remember.  I cannot stop it and probably feel like I’ve fallen into worse than an abyss–an unknown.

Each episode ended because my good friend was there to somehow help me out of it. In a psychotic mania, I can be dark, abusive, delusional and irrational.  I have not been physically violent and have not felt an inclination for it.

The second time, he was a godsend at at our expense, but his presence and words also perpetuated it too.  Anyone’s presence and help would perpetuate it.  It gets tricky to help me.  During this episode, he gently took my hand, and my psychosis ended in the snap of a finger.  Like the ropes instantly tied me back to reality again.   I have come out of each episode not understanding what I’ve just said or done. Out of sorts. Confused.  Tired.  Later on, I had flashbacks of what happened during the psychosis, and that is how I start to remember these episodes and a little of how I felt–through flashbacks.

The first time I think I was in psychosis for less than an hour, but the second time I was in psychosis for one hour.  After each episode, as I sifted through the insanity of what I said or felt, there can be no doubt that I felt terrified.  Mania with psychotic feature is an assault of the mind on the “self.” On my beautiful, hypomanic, joyful self.

 

1  https://www.nlm.nih.gov/medlineplus/ency/article/001553.htm

The Poop Story and Other Tales of Love

During my last manic episode,  I was in another city for a business training event. A 5-day long business training event.  My mania had started on a Thursday evening, I left for the business trip on Sunday morning out of LAX.  Why did I go?  Wasn’t I in mania?  Yes, I was but not a complete breakdown.  I had experienced the complete breakdown with loss of time and space-known as psychosis-on Friday morning and emotionally hurt someone very dear.  I recklessly tossed my meds out the window a few months earlier which is how I ended up in this situation.

During the weekend, I was in what is called acute mania.  Not like the one you think of from TV where the person is frantic, screaming or doing full paint body art on the walls with their bodies or being hospitalized.  However, my moods and energy were quickly over days becoming more manic.  I was gradually being swallowed hole.  Ultimately, I would have ended up in the hospital had it not been for The Poop Story and Other Tales of Love.

During the weekend before my trip, I was home where I live on my own.  The following day after my psychotic episode, I puttered around my home and kept busy.  I laid in bed for 4 hours and tried to read, but I couldn’t because I couldn’t focus on the words or thoughts of the authors.  I tried magazines but focus eluded me.  It feels like the words and pictures stop right at my eyes but are denied entry by my mind.  For some reason, in acute mania, the mind only wants to consider things from within.  I ended up laying in bed, staring at the ceiling and the walls.  It’s a nice feeling by the way.  It’s not like I’m laying there getting pummeled by thoughts.  My thoughts can be intrusive but not consistently.   They become worrisome when the negative ones start to have their way.  The rest of the day just passed, but I didn’t go to sleep or eat. 24 hours.

I finally made the trip to Utah to attend my business training event while I was in acute mania. I felt agitated, helpless, hyper and exhausted from a mental marathon but still maintained my grip on time and space.  The rest of the day just passed, but I didn’t go to sleep and only drank coffee, water and 400 calories of snacks.  48 hours.

I attended my first day and appeared presentable.  However, during an initial professional discussion with my new group, I spoke with confidence, but what I said did not make sense.  It happened to the first man I spoke to.  I saw the perplexed look on his face so I stopped talking.  Then I tried again to the man next to him, but I spoke in an expansive manner.  A few sentences of gibberish pushed out of my lips.  He too looked perplexed.  I stopped and realized that I was using the lexicon, but my expansiveness was making my reasoning loosely related to what we were discussing; thus, making me unintelligible.  I was able to casually laugh, and said I was kidding.  They relaxed, and I sat there feeling like I was being defeated.  This disorder. This thing.

I went to my hotel room and laid in bed and stared at the ceiling and walls.  As evening fell, I started crying and became incredibly agitated and felt lost.  I was slowly losing my grip on time and space which meant I was becoming psychotic.  I could tell because of my agitation and also my intrusive thoughts were increasingly involving  thoughts of persecution and paranoia.  I hadn’t slept and ate 800 calories in 60 hours.  So I called my best friend and cried for her to help me.  She recommended I take a Benadryl to knock me out, but I wouldn’t drive to the store to buy it.  Because, who knows what I would do if I drove off in a car at this moment in the night.  It was 10 degrees fahrenheit outside.  So I stayed safely in place.  I was still able to make safe judgement calls.  It truly is a battle within the mind.  One mood allowing me to remain planted firmly holding on to safety, and the manic mood tugging, pulling, pushing for the other to fall over and make way.

My best friend and I knew that I hadn’t slept for 60 hours, and we both knew without speaking what that meant.  That I had to sleep.  If I didn’t……..That mania would take total control and then what would happen to me?  So she told me to get in bed because she was going to talk me through the night to put me to sleep.  She said she would talk to me for however long it would take–hours, days, years–until I fell asleep.  What ever it took.  So I turned out the lights and got in bed.  I laid my head down and covered up.  In the dark, I heard her say.  “okay…..where should I start?……Would you like to hear a poop story?”  I smiled and we laughed.

She and I have been best friends over 30 years, and we have this thing where we share stories of our and others’ poop.  I don’t know when we started it, but it was because she use to talk about her poop to make me uncomfortable when I was much younger.  As time passed over the years, I joined her in her game. Our poop stories.

Through the night, she told me our tales of young and old. Our tales of bright and dark. Our tales of come and go.  Our tales of love.

I fell asleep.

Rattlesnake, Dreamer, Child, and King

BIPOLAR DISORDER

I suffered my third bipolar – mixed state episode in seven months this past week, and it was and still is painful. Mixed states are nasty and disgusting things to myself and those around me.  Those around me are usually the people I love the most.  I lash out when I feel uncertainty to my “self” and that means at those closest to me because well… they have a close proximity to me. They are there during the most intimate settings where my “self” is exposed.  Not if, when I go into mixed state condition, it will manifest itself in full force through me. My loved one’s presence and their reasoning with me perpetuate my mixed state. They reason with me because I look reasonable, but I’m not.  I’m paranoid, irrational, and delusional which are psychotic characteristics with mania.  I’ve been told it’s like being around a rattlesnake.

Bipolar presents in various ways.  The common understanding is that a bipolar person’s mood will swing from an elevated state to depression or vice versa and are separate from each other.  The least discussed and misunderstood state is known as a mixed state and considered the rattlesnake of the bipolar clan.

In mixed state, I become vicious and can verbally strike anyone near me that presents an uncertainty to my “self” if I am triggered by lack of routine, lack of sleep, alcohol, too many months in high level hypomania; and again, uncertainty to “self.”  Medical literature defines mixed state as elevated state and depression occurring at the same time.  The fact that it is close to simultaneous is hard to wrap your head around, but it is true.

The risk associated in this state is primarily to relationships.  You teach people to walk on egg shells around you. You are at risk of hurting yourself emotionally, spiritually, and physically. You are at risk of hurting others emotionally with words that do irreparable damage to your relationships.  The guilt and shame of the aftermath are overwhelming and cause you to experience a kind of shock.  It is never the same.  A more detrimental risk associated is the high risk for suicide.  When a person experiences mixed state, they are having intrusive dysphoric, maybe suicidal thoughts and now have the energy to take action.

My normal state is neutral to positive, full of appreciation for family and friends.  I’m funny.  I’ve been an overachiever most of my life and try to be a kind and loving person. However, I exist primarily in a hypomanic state which means I am hypomanic more than normal state.  It use to give me what is known as the hypomanic edge.  My hypomania without depression does not have intrusive thoughts.

HYPOMANIA

Low grade hypomania without depression is the dreamer of the clan.  I view life in merriment and wonder.  People and objects are effervescent and bright making everything more interesting.  I describe this as, “shiny.”  It makes life so wonderful.  There is very little self doubt involved, and when done right, it is an absolute positive freedom of the mind.  I am sexual. Racing thoughts do not occur during low grade.  The risk involved is similar to most who are enjoying life.  I consider risk but more outgoing than people without bipolar disorder; therefore, more exposed to doing risky things such as surfing or climbing. I’m “on.”

As hypomania increases it becomes middle grade hypomania without depression which is the child of the clan.  I become self-centered and try to empathize and be a good listener but because of my self-centeredness these qualities start to wane.  Good judgement starts to escape me. I become naive and gullible to the feelings and intentions of the adult world. I believe what I am told.  I just do.  My justification for my behavior and perceptions of disregarding adult ways is by believing the adult world is un-enchanted.  I happily skip around them full of mirth.  I am playful, flirtatious and more sexual. My ability to read social cues starts to loosen.  Racing thoughts rarely occur.  The risk to self increases because I am more outgoing and safety judgements are reduced. It is primarily about having fun, pushing it, and feeling exhilarated.  I find all things fully fascinating.   Ideas and problem solving skills seem to become enhanced.  When I’m hovering in this mood, I call those with bipolar disorder – primarily hypomanics,  “the cool kids.”

For me, high grade hypomania without depression is the philosopher King without a Kingdom of the clan. Now, I become interested in the un-enchanted adult world and want to change it through my wonderful ideas, philosophies and fearlessness.  During this phase, I lose filter, and say what I think people need to hear to help them.  Is she a helper, a lover, a parent, a friend, a controller, a sage, a leader, a caregiver? I am all these things. Still very self-centered and impatient because after all – I am the King.  My patience and filter decrease, and my opinions and actions are abrupt.  Flight of ideas occurs with the need to tell everyone my thoughts and pressurized speech picks up the pace.  My ability to read social cues diminishes greatly. I experience expansiveness and lose more control of my behavior, my emotions, my reactions.  My sexuality goes into overdrive.  The risk to “self” increases as I become grandiose and uncaring about safety. My senses change and things like food lose flavor.  My visual field seems larger and sharper.  I described it to a friend as “it feels like my eyes are open real big.”  My capability for complex understanding ideas and problem solving at work increases and I can work at a faster pace.  I call high grade hypomania without depression being “Amped.”

Hypomanic existence is all well and good because at its best, I’m fun and exciting to be with, and at its worst, I am grandiose and hard to follow.  Still, I am well intentioned. My perception of the world is skewed by positivity and grandiosity not negativity.

High grade hypomania is not to be confused with mania.  The line between high grade hypomania and full mania is very wide.  However, if depression sets in at this stage or is spurring it to occur then the line between the two becomes very thin and can vanish.

MIXED STATE

When the depression starts the hypomania stays and the two mix.  Depression mixed with hypomania attaches intrusive, almost constant doubts and dysphoric thoughts to my hypomanic energy which amplifies the depression.  The depression does not force me into isolation;  worse, I have the energy to interact with people.  It is here that the trouble begins for me and everyone who comes into contact with me.

The combined moods cause a mixed state which begins with irritability.  If lucky, just stays as such.  If in the wrong situation, depression can spur hypomania into full mania that can last one hour and enter acute mania for up to a week.  I’ve received medical intervention by my doctor before I experienced full mania.  Mania causes a disconnect from time and space until medication brings you out of the episode.

My risk to self greatly increases as the depression mixed with hypomania spurs it into mania; where, I experience paranoia and mild delusions of persecution and become unpredictable with my actions.  At this point, risk to self is significant because I am terrified and can make a sudden decision and/or movement out of defense of my “self” by using harsh language.  I have not been physical against anyone or myself.  I believe that I am hopeless and worthless and can scream it loudly in order to gain your sympathy, compassion and love. My mind turns on the “self.”  I stop sleeping and eating. For me, mania is a fully agitated, paranoid mixed state.  It is the image of the frenetic and paranoid person.

Low grade mixed state can be fraught with intrusive criticism of self and others and complaining. Mid grade mixed state can be fraught with alcohol, drug use, and sexual escapades.  High grade mixed state can involve a confrontational attitude, quick tempered arguing, paranoia and always the nasty verbal lash out to someone.  It can escalate to even worse-mania- with verbal abuse of loved one where irreparable damage to the self and relationship occurs.  My behavior is not always identifiable in such clear delineation and sequentially as provided, but it does normally happen this way–it is the rule for me at this point in my life.  The exception to the rule are the grey areas between low, medium and high that bring out many unpredictable behaviors.  When I start touching mania, the paranoia and delusions spur new types of thoughts and acting out.

All of my life, I could keep my hypomania in check with proper sleep, diet and exercise.  However, my depression has become greater and more frequent and mixing with hypomania because bipolar disorder is a progressive disorder.  Now, I require medication to prevent depression which stops mixed state and prevents me from going into mania and being hospitalized.

Depression hits in waves and then a Tsunami if I’m not carefully monitoring triggers.   Last week was the Tsunami, and it emotionally and spiritually pummeled me and the man I love.  He left me.  So here I am, Saturday afternoon on the beach making sense of it all. My bipolar episode occurred because I refused my medication. It was the worst decision because I hurt him.

CONCLUSION

Due to increased depressive mood states that caused mixed state,  I sought help from the mental health community and was clinically diagnosed in September 2015.  Now, I’m back on a medication treatment plan  in order to live a healthy and good life for myself and others.  My goal in life is to be lovable, and I know deep down inside I will be.  I’m going to live the life I deserve. All of it and with passion.