CRASH! Living in fear?

There are a few things that can strike fear into my heart. One of those is crashing.

There's the overtired crash, when you just need a second to let out how frustrating everything is and how tired you are and then eventually you're fine. I actually don't get too many of those crashes. Those are benign. They don't scare me.

Then, there's the depression Crash. Those scare the crap out of me.

Bipolar episodes are unavoidable. Even on medication, they will happen. They can be managed, to some point, through medication and therapy and self knowledge. They can be "headed off at the pass" or intervened before they make your life unmanageable. With practice you can learn where you're going. I can almost always detect a manic episode coming soon enough to know what to do. (Doing it is hard, as evidenced by my last entry.) In the first few days I have enough time to talk to a doctor, figure out medication, crack down on food and sleep and try and get my life moving at a more sedate pace. As long as I intervene in those first days I have a good chance of holding back from mania.

I have almost no defense against a depressive episode. For me, a lot of the time they come without warning. I can be fine one hour and then in hell the next. When I crash, I tend to crash hard. Every one of my big crashes has landed me in the hospital. I've described bipolar depression in previous entries. A lot of the time they crash suddenly like that.

Sometimes they slip in a little more covertly. Things will start feeling less important. Motivation starts to ebb. Anxiety increases, guilt increases. Anger works its way in there a little bit. I start staying inside, I stop communicating with people. And it slowly gets worse until I'm just as bad as if I'd crashed faster. And that way is worse because you almost don't realize how bad you're getting.

There are things I can do. I can make sure I don't drink, make sure I'm taking care of myself; food, sleep, hygiene. I can make an effort to get out, stay in contact with people. I can find someone to talk to.

But I've never been able to avert a depression from coming, not completely. I'm sure I've been able to make them less severe, but there's always that risk of the big Crash.

I'll admit that sometimes I live in fear of that Crash. I don't know when it could be coming. But I can't let bipolar disorder control me so much that I never take risks. I can't hold myself to a strict non-stimulating perfect controlled regimen. That goes against who I am. I take risks, I like working hard and pushing myself. I feel the need to do my best. And if that puts me at risk of crashing I can't let my fear dictate my life. I can't let bipolar disorder tell me who I am.

There is a quote that says:
"Life is not a journey to the grave with intentions of arriving safely in a pretty well-preserved body, but rather to skid in broadside, thoroughly used up, totally worn out and loudly proclaiming... WOW! What a ride!"

I don't need to use up my body too early, but I don't want to hold my life back just because I'm bipolar. I want my life to be a ride, an adventure, a place where I can explore and excel.

I will also admit that I'm bracing myself right now. I spent a week pushing myself recently without being careful. I'm waiting for the post-volunteering crash. I could be lucky. There could be only a slight dip. I'd love to tell myself that there will be nothing but everyone would have some sort of let-down when a great experience ends. The only problem with bipolar is that a let-down can lead to more.

So what am I doing? Trying to find things to keep me busy. I'm singing a lot. Playing the piano. Making sure I have an outlet. Staying in contact with support. Talking to people, talking to others with bipolar. Learning. Trying to grow.

I know I'll make it. You will too. Everything passes, everything changes.

wow, what a ride.

I can has mania?

Mania is addictive.

Well, actually there are different types of mania. Some manias present in the form of extreme irritability. Everything pisses you off. You're likely to fly off the handle at the smallest things. You are the extreme authority, you are right and everyone else is wrong. You don't know what to do with all of this angry energy.

But some hypomania and to a certain degree, mania, can be addictive.

Euphoric hypomanias are wonderful. Everything just feels fantastic. Food is better. Sex is better. Colours are brighter and even scents are more pleasant. Sometimes when I'm hypomanic I'm struck still by how perfect things seem to be.

When I'm hypomanic I have energy. I can run days with no sleep. I am compelled towards goals and am so productive. I will never quit. I can do anything. I have so much creativity and my ideas are coming so quickly that I feel brilliant.

In hypomania I have written some great songs. I've discovered artistic abilities that I would never have found otherwise. I've out-performed, out-lasted. It feels great.

Then you get into mania. The euphoric feelings deepen and you're king of the world. You are in control. Those are the good feelings. It's easy to see how addictive that can be. And once you're staying up all night, you don't want to return to sleeping 8 hours a night. 5 AM is just as addictive. Night time is magical, being the only one awake gives you the feeling that you own the world.

So it's hard to turn your back on all this. It's hard to let go of the superhuman and just be human.

There's just one problem, though.

It's virtually impossible to have good hypomania without any bad. Things tend to go a few ways.

First: Hypomania deepens into mania. Great feelings turn into overwhelming anger, fear, and you feel like you're out of control. Things are too fast, too sharp. Judgement is impaired, you become reckless. In the grips of mania I've turned to sex, incurred large amounts of debt. I've wandered the streets at 2 am, fleeing from some invisible enemy. I've done many things I regret. I drink too much, I spend too much, I put myself in danger. There is nothing funny about mania. So why is it so addictive? I think it's a slippery slope - I know in the past I've started feeling hypomanic and have purposely done things to heighten it, like messing around with my food and sleep and medication.

Second: Mania doesn't stay mania. Mania can turn into a mixed episode. Mixed episodes are defined as mania and depression occuring at the same time, but there are a lot of possible combinations there. When my mania turns mixed, I get really angry. I start wanting to hurt. I feel like crap and like there's no hope and like there's no point, but at the same time I still have incredible amounts of energy to carry out any destructive feelings I may have. I am overwhelmingly angry at myself. It's dangerous. Mixed episodes tend to include psychosis for me. That's when I end up in the hospital. The very first time it happened, I was scared to death, felt ready to hurt myself, felt like I was about to die, got on the subway and all of the sudden I could hear peoples' thoughts, and they were all thinking that I should be dead.

Third: What goes up must come down. Not always, but a lot of the time mania brings on depression. That's usually the case for me, and it happens like a switch. In the morning I feel like queen of the world and by the afternoon I want to die. I described depression a little in my last post. For me, it's just blank. What's the point of doing anything? Everything is just pointless and hopeless. I start to wonder why I'm living. I feel intense guilt. I'm anxious, panicky. I want to scream but really what's the point of that, either?

So that's the deal you make. Hypomania is awesome, but it comes with a price. And the hardest, hardest thing for me to accept is that this is beyond my control. My brain chemistry can throw me a curveball whenever the hell it feels like it. And I have to fight it.

Would I give up every second of hypomania if it meant that I could be stable all the time?

That's a hard question.

The answer is, I don't know. Would you give it up?

depression, and I hate my computer.

I hate my computer. I keep trying to run a game but it won't let me. So I e-mailed tech support. And they e-mailed me back an answer that has nothing to do with the question I asked. So now I hate tech support and my computer.

I just spent a week volunteering. Overall it was an amazing experience. My current pattern of not sleeping and lots of energy really benefited me there since there wasn't time to sleep and being able to go go go really helped.

Until I crashed.

I've ended up in the hospital thrice. The last two were back-to-back, the third one being just a residential program. I've learned a lot about bipolar and how it specifically affects me. I've built up defences I can use against it. I've learned how to try and intervene during an episode, to keep me out of the hospital. Out of the hospital is good. I've spent the last month just holding myself away from mania. It all went the other way, all at once one morning last week. I was great when I got up at the ungodly hour of 5. Two hours later I felt like something had punched me in the stomach. I felt deflated. Everything actually looked darker and flatter, with less detail. All the hope I had had about school, my new apartment, my music, my writing, it all disappeared. There was no hope. I felt like all the hope had gone out of the world. At its lowest point, I began to entertain the idea of being dead. Thinking about it is one thing. Planning or doing is another. I wasn't anywhere near that stage. But it was surreal, leading kids around and being cheerful and helpful, while really I just wanted to give up and lie down. Things lost meaning. There was no point. The feelings got so bad that I knew the only thing that was saving me was that I was volunteering and that people were counting on me. If I had been at home I don't know what could have happened.

I was worried. I knew things were getting bad but I didn't want to reveal my difficulties to my managers. I didn't want to be seen any differently or less able or god forbid, sick. At the same time I knew that the pressure of performing when it was all I could do to move would push me over the edge. My gut knew what to do, and for once I followed it.

I pulled my managers aside. I told them I was crashing - not tired-crash but mood-crash. They knew I was bipolar. (topic for another time, stigma - who do you tell?) So I told them I was crashing mood-wise and didn't want to take it easier but wanted to make sure I was still busy and doing my job so I didn't sit in the scary feelings. I knew my best chance of getting out of this was to try as hard as I could to hold onto myself. My real self. So I did - I wouldn't let myself stew in how crappy it was, even though it took pretty much all I had not to go there. And lucky for me, I was able to pull out of it this time. And once I let the managers know, they looked out for me. I still did the same job and gave the same quality of work but I knew they were checking on me to make sure I was ok. And I was ok. I still felt like a truck was sitting on me but I didn't feel so panicky and trapped, because I had let someone know. I didn't have to carry it all myself.

Yeah I know I'm pretty open here. I'm reasonably open in real life, too. But I don't make a habit of telling people when I'm doing poorly. It helped so much this time. Telling people saved me from a lot of hell that I was headed for. So maybe next time, I'll let someone know what's happening. I don't really talk in person much about bipolar. I'm hoping this blog might open up or ease the stigma of bipolar disorder for some people. And help me talk about it a little bit.

But just to talk a little more about bipolar depression is that it stinks. It's like life is gone. And I want to throw things, I get so frustrated that my body and brain are doing these things against my will. I know who I am. I'm musical and funny and caring and cheerful and passionate and helpful and determined to whatever it takes to do her best. Depression strips me of all that and leaves me just blank and anxious and hopeless. And the shift from one place to depressed happens so quickly. It's like a light flicking off.

I'm happy and productive and am enjoying myself.
then
I'm empty.

Depression makes you wonder who you are anymore. Mania makes you into someone else. And then somewhere in between when you're feeling sane, you get to carve out your niche of who you are. And you get to know that person very well.

I know who I am. Not everyone can say that with certainty. But I know who I am. Thanks to bipolar? Probably.

Bipolar still sucks though.

And I'm back around the circle to not sleeping. Do not pass go, do not collect $200. Maybe I can make muffins again.

university, moods and medication

Today I found out that I've been accepted to university to study psychology. Look out, world, Silla's a student now.

I'm going to talk about mood minding. Because once a bipolar person gets put on medication, that's not the end of the story.

One thing that is very useful is a mood chart. There are lots of them online, and they track things like your mood (give it a number), anxiety, irritability, sleep, medication, external influences and etcetera. You pick what you need to track most and track it. I have my own version, so I can track patterns.

Because medication doesn't mean you'll be fixed forever. Unfortunately, bipolar doesn't go away. Once bipolar is treated the moods aren't as extreme and you have periods of stability but sometimes breakthrough episodes happen. Sometimes meds don't work so well anymore and need to be adjusted. Sometimes life stressors can push you out of your safe mood zone. All three have happened to me recently. (All at once, ouch.) That's where mood charts come in handy. With one, you can track how things affect your mood, what makes it go up, down, anywhere. You can figure out what triggers you. You can see if there are any patterns. Sometimes your mood will cycle at certain times of the year. April is a month where my mood ramps up. January I'm prone to crashing. If I'm not careful to stay on top of my medication while going through a lot of stress I'll wind up manic. I know this thanks to charting and I can take steps to protect myself during this time.

Minding your mood takes work, but it's worth it if you can help avoid major mood episodes.

The other thing I can talk about is medication adherence. It is common for someone with bipolar disorder to go off their meds. For many reasons. It sucks having to take pills every day, the side effects range from uncomfortable to horrendous - weight gain and absent sex drive and slowed cognitive abilities are some of the worst. Also sometimes the medication is working and you're feeling fine so you think you don't have to take meds anymore. This happens with non-bipolar people as well, once you start feeling better you stop taking the medication even if the doctor ordered you to finish the bottle. And sometimes the medication flattens you out so much that it sucks and all you want is to find a little mania again. Hypomania is addictive - who wouldn't want to feel like they ruled the world?

I've gone off meds several times. Once I thought I was better and didn't need to take as much medication. I really should have discussed that with my psychiatrist first. Once in the first few months after I was diagnosed, I felt horrible. The medication made me stupid and tired all the time. I hated it. So I stopped taking it. Unfortunately, not too long after I stopped the medication, I was manic again. Once I was patient enough to stay on the medication I found that pretty much all of the side effects calmed down or went away. But I didn't learn, either. I'd gone off meds just before Christmas and then I crashed on New Years' Eve and wound up hospitalized. Now, ever since I've moved (super stress) I've been hypomanic. It is still hard for me to keep myself on the medication I should be taking. I like the hyperproductivity and the staying up all night and the super confidence. I admit that. But I've also learned that it's impossible to have your cake and eat it too. If I decide to mess with my medication to find some hypomania, it's going to escalate into mania, and then crash. What goes up must come down and oftentimes a high will bring on a low.

Medication sucks. You have to remember to take it, and it has side effects that you hate and you feel like it stigmatizes you and you want to be better, but when it comes down to it, if you want to lead the life you want you probably have to be stable. So it becomes a tradeoff.

I just got into university. It took a lot of work, and there is so much I want to learn and so much I want to do with my life. I could give in to the part of me that wants to go off my medication so I can be on fire again. Giving into that would put everything I've worked for at risk. In mania, people spend and lose fortunes, alienate their loved ones, throw dreams away on a whim.

When I'm on medication, even when I'm not in an episode, I still get fire. I get the same fire and pain and ups and downs that everyone gets. A world of mercurial moods and firey ups and dark dark downs and upheaval and drama is available to me. It's seductive, the power of it. But I'm not willing to throw my life away with the consequences of it. I remember the frightening power of mania, the heavy, suicidal depression, the dark and screaming mixed episodes. It's not as glamourous as my head tries to convince me it remembers.

Keeping myself on an even keel takes work. It sucks sometimes. But I can harness my moods and my powerful emotions and use them to create something wonderful. Me, just me, medicated and dedicated.

Is bipolar a curse, or a blessing? I don't know. All I know is it's a part of my life and if I take care of it, it won't kill me.

3 am muffins and mania

It is three o'clock in the morning and I am baking muffins. Have been for a while. Don't really know why.

So while I'm waiting for the next batch to finish, I will talk to you of mania, at least as I experience it.

Wikipedia says: Mania (from Greek μανία and that from μαίνομαι - mainomai, "to rage, to be furious". (Yes I quite like Wikipedia.) It goes on further to say: Symptoms of mania include rapid speech, racing thoughts, decreased need for sleep, hypersexuality, euphoria, impulsiveness, grandiosity, in some cases psychosis, and increased interest in goal-directed activities.

That's what Wikepedia says. Online definitions don't speak much of the human experience, however.

Increased interest in goal-directed activites. Hmm. Maybe that's why I'm baking tray after tray of muffins in the middle of the night. I've also been getting mad urges to go to Alaska.

But anyway.

I will describe one of my previous manic episodes.

It started out simply with me not sleeping. It crept up quickly and before I knew it I was running almost all night with no sleep and I wasn't even feeling it. I started to feel really, really good. Everything took on a sort of detail, it was like I was experiencing the world through a 50 inch hi-def flatscreen with super surround sound. I felt so in control. It was like I could see everything in my head and could organize it perfectly. I felt like I could control the world.

These feelings scared me at first. I could tell something had changed, I could tell that my world was speeding up, and I mentioned my concerns to my therapist. She thought I was fine. I did not share this view. I was just coming out of a depressive episode (will talk about that next time) and everyone thought it was great that I felt So Much Better.

Things escalated. Suddenly I could orchestrate the world, I could make everything work exactly as I thought it should. By the next week I went to the appointment with my therapist and didn't want to sit down. I wandered the office restlessly and talked a blue streak about everything that popped into my head. The weather. The news. My cat. Last night's television. How wonderful things were. My cat again.

This time she was concerned. I was perfectly fine.

She sent me to a psychiatrist for a one-time assessment. Being the good student that I was, I took notes on what things were like and brought them into my session with the psychiatrist. She wanted me to try Seroquel, an anti-psychotic/mood stabilizer that is good at getting people back to sleep. This is where my mind broke loose from reality a little. When I got the prescription for six little pills filled at the pharmacy I was convinced that she was only humouring me and had secretly told the pharmacy to give me a placebo. I decided not to take the medication. I didn't know what it would do to me and I didn't trust her anyway. Bad decision.

That was the more fun, early beginnings. My memory of what follows isn't exactly clear. Mania tends to give you fuzzy spots.

Pretty soon I went from feeling great to feeling terrified beyond reason. I wasn't sleeping because if I did, something bad would happen, some catastrophe would fall. One night I was so struck with creativity that I spent four hours composing pages of poetry, and then started two new short stories. The next night I spent too much money on paint and more paint and I decorated my apartment with detailed rabbits and random abstract finger paint. I started going for walks at 2 in the morning. Frantic walks that took an hour or more. I stopped going out during the day because the sky was so big and open that I was convinced that the sun would crush me. I pulled away from people. I was paranoid. When I went on my 2 am walks I could always hear people whispering behind me, and shadows flew past the edges of my vision. Probably the biggest personality change is that I started compulsively sex-seeking. I went to craigslist to look for sexual partners. I talked to several guys and made some plans. I was supposed to meet up with the first one after work on a Saturday.

Work was particularly hard that Saturday. I had spent the week hiding in isolation and slowly going crazy. When I had to come out on Saturday all of the sudden I didn't quite fit properly into the world any more. I had to whitewash over myself, to try and keep the illusion that my world hadn't just cracked apart before my eyes. I held it together for most of work.

Something shifted. All week I had been slowly moving from pure mania to a "mixed" state, which is when symptoms of mania and depression both occur. Mixed states are scary. They are dangerous. Gone was the superman feeling. All I was left with was paranoia, extreme amounts of energy, and the idea that maybe I should be dead. I canceled with the guy, and he was angry and stalked me via text message for awhile. That was the day I stepped on the subway and heard people thinking that I should be dead. Everything broke to pieces after that. I was worse off than I was before. But alas, that will wait until I decide to write about depression.

Which won't be right now because I have to go take out some muffins!

I can fly, and other fun delusions

This blog came about in a wonderful hypomanic moment of clarity. The stars aligned. Angels sang. And something said, "Get a blog, you must document this."

"This" means the fun land of bipolar disorder.

Wikipedia refers to bipolar disorder thusly: "Bipolar disorder, also known as manic depression, is a psychiatric diagnosis that describes a category of mood disorders defined by the presence of one or more episodes of abnormally elevated mood clinically referred to as mania or, if milder, hypomania. Individuals who experience manic episodes also commonly experience depressive episodes or symptoms, or mixed episodes in which features of both mania and depression are present at the same time." Wikepedia says a lot more about it as well, so it's worth checking out. My official diagnosis is Bipolar 1, with psychotic features. Maybe I'll talk more about 1 vs 2 later.

But what does this mean to me? Well, it means that things get pretty interesting.

It's currently 3:00 in the morning. I haven't slept more than a few hours a night for at least two weeks now. No I'm not tired. It's like the need to sleep has suddenly evaporated. Also I might be spending a little too much money. I just moved to a new city so I've had to buy things for the new place, but it's gone a bit too far. Maybe I didn't need all those shelving units that don't fit in my room and will never be used. Maybe I shouldn't have done that before my rent check came out.

But alas, no sleep and weird spending are hallmarks of mania. Or at least, hypo. I'm not quite sure where I fall. I'm also rather irritable and like to talk at the moment, so I'm a joy to be around.

But I digress. And I'll digress a lot. Because manics tend to be rather distractible. I just realized that since the ceiling above me slants in an A, the light fixture is much too high for little me to reach. When the light burns out, I'll have to call the landlord. And god, there are so many infomercials on at this time of night. Also, my cat is being annoying. There. See?

The feature of my own bipolar illness that I was going to talk about are delusions. See, I tend to get deluded when I'm either manic, or depressed. One of the early ones for me was that I could hear peoples' thoughts on the subway train.

Yes, delusions are scary to the person who doesn't experience them. They're scary to me, too. And I can almost hear people hissing and crossing themselves. Bipolars and Schizophrenics and other sufferers of mental illness are people. They are not contagious. They are not a sign of the apocolypse. They are usually intelligent and are really great people once you get to know them. I mean, geez, haven't you ever felt like you could tell what someone was thinking?

But I digress again. This was more than the passing thought that I could tell what they were thinking. I could hear what they were thinking. And they were thinking that I should be dead.

That was a scary one. It was what led me to my first hospitalization. I'll talk about that in some other post. Some delusions I can look back on and they're actually sort of funny. During the olympics last summer, I started watching them day and night. By the end of them I was totally convinced that I was the next gold medal olympian. I've never had any sort of athletic training. I kind of dance. That's it. But I was sure that I'd pick up an olympic sport in no time and not only that, I'd be gold medal-worthy in two years. I even paid for trampoline lessons that I never actually went to because by then I'd gone back down again.

See, that's another thing that happens with manics. WE ARE KINGS OF THE WORLD. When you're caught up in a euphoric mania, you can do no wrong. You're invincible. So of course I was a gold medal winner. They're not all about being superman, though.

When I was in the hospital I shut myself in my room alone for six whole days. I told the staff that I was radioactive, that I'd caused a rip in time and I'd broken from my predestined path, and that anyone who came in contact with me would have bad things happen to them.

Yeah, they got me out of that one by putting me on an antipsychotic. Which I still have to take today. (I see you thinking "Oh no, unclean." Shh.)

And then there was this one time in the hospital when I became obsessed with a particular painting of squares. I wasn't sleeping by this point so instead I was bugging the staff to let me into the room with the painting. This little woman/girl in pyjamas and sock feet standing in the darkened hallway, bargaining with a nurse. I needed to study the painting because there was a message hidden in it that only I could decode.

Sometimes I still wonder if there really was a message amongst all those squares. It makes you wonder, what separates strokes of genius from strokes of madness? There's another future topic of discussion.

I have a few other fun experiences like the time I believed that the FBI was after me because I was onto their secret cloning experiment and I hid in my closet for six hours until it got dark.

I wonder about delusions. From the outside they just look like you're going crazy, but once you get inside you see the indentations it leaves in your present and you think that maybe those strange illogical beliefs come from some real place. My old therapist once said that my psychosis was only an exaggeration of what I deep subconsciously thought or feared, it was taking those dark places and forcing them to the surface.

So am I this random psychic radioactive olympian painting-reader who is wanted by the FBI?

Maybe in some parallel universe I am.

Oh and I have a confession to make. I've never really believed I could fly. Yet. So I guess the title of my blog is somewhat misleading. Don't tell anyone.