For the past two weeks I’ve been having the most substantial and intense episode I’ve had since October 2014 (that’s 20 months ago and my last hospitalization).
While I’ve had symptoms of bipolar disorder and anxiety since then pretty consistently I’ve generally found ways to cope with living with negative thoughts and urges without falling into the trap of believing them or acting on them (or, at least, not for very long). Sometimes the rapidity in which my mood swings happen help bring even just a few moments of clarity to me when I find myself slipping into a dangerous place, but when long, somewhat seamless episodes happen for me (and they do, almost always requiring hospitalization) I can easily sidestep from coping with my negative thoughts and urges to believing or acting on them -typically without even realizing I’m doing it.
I’ve written a little the last two or three months about how my depression has been getting worse and I told my boyfriend several times I was concerned that it’s persistance was signaling a long episode for me that might require hospitalization. Imagine my surprise to find that something (though I don’t know what) switched my increasing depression into a mixed episode two weeks ago.
Actually I didn’t exactly notice right away, and that’s where the downfall really started. I was having so much energy and euphoria suddenly thrown in with my depressive symptoms that I felt great at times, leading me to believe I was getting better. It wasn’t until the dreaded agitation and hostility that are usually a trademark of mixed episodes for me showed up in a big way that I felt relieved to see my psychiatrist last week.
That is how one of the most misunderstood aspects of bipolar disorder was dropped in my lap. Yep, I am definitely sick -to the point of wanting to destroy every element in my life. Even though my symptoms are treatment resistant and I am able to take very few medications in the long term I have an antipsychotic (risperidone) I typically take when psychosis or mania show up. The trouble is (and one of the reasons I don’t take it continuously) is that it is notorious for wiping out the mania and psychosis and leaving me with the remainder of the mixed episode, a sedated and faint-worthy depression. I don’t like to take it, who would like disparaging and laying on the couch all day crying and watching Charlotte’s Web?
At the same time, even though wanting to destroy my life doesn’t feel helpful and offending all of my friends isn’t a plus either, that euphoria and energy feels like such a liberation from the straight-up depression I felt before that and I find myself actively not wanting to feel “better”. At least, not when “feeling better” means having to feel worse first. After all, I have found zero treatment options to help with my depression, so having any episode switch into depression can be the potential for weeks, if not months of ongoing depression.
I am fully aware that this “logic” isn’t helpful to me or my life in the grand scheme of things, and I think that is why it is hard for people who haven’t experienced this kind of situation to understand that there is even a question of what someone like me in a position like this one should do. I know that when I feel well I like to believe that I will choose the best option for myself every time, even when I am sick. Unfortunately it doesn’t always turn out that way.
Ultimately I’ve been taking the rispiridone, but the first few times it was too low a dosage to achieve anything helpful. I tried it at a higher dosage and found myself resisting how emotionally pulverized I felt the next day.
I am really lucky that my boyfriend is so intelligent and empathetic. He kindly explained why I need to be taking this medicine anyway, which showed some extreme patience given the fact that my mixed hostility and agitation have often given way to labeling him the ultimate villain in my life, producing constant and obsessive thoughts about how I need to get away from him as quickly as possible (another reoccuring theme for me, the same issue that inspired my hospitalization in 2014).
Somehow I have become Dumbledore and while rational I have told Harry to make me drink whatever foul liquid is in that crystal podium even if I resist until we can get that damn horcrux in our efforts of defeating Voldemort. Now that I’ve drank half I’m kicking and screaming but he’s doing his best to make me drink it anyway.
Even though I dislike the situation, I have to say I find my boyfriend’s efforts quite admirable, and in those brief slivers of moments where I remember that he is kind and sweet I’m doing everything I can to remind myself that I asked him to do this for me in the first place.
Mixed episodes like this one are the worst sort of episodes I come up against. Combining the hopelessness and futility and lack of self worth of depression with the energy, euphoria, and rage of mania offers a dangerous situation where I constantly feel compelled to do whatever I want without any fear of the consequences (because they’re pointless, remember? And with mania I don’t feel anxiety or fear.). Meanwhile it doesn’t feel like I’m really doing any harm (because I feel great!) as I shuffle around and stomp on everyone else’s lego castles.
So far the rispiridone hasn’t made any dent in my symptoms (or perhaps it has and they just keep coming back with a vengeance). I pouted and told my boyfriend I didn’t want to go to the hospital (because I really don’t) but he wisely told me that the hospital “is just another kind of treatment that I might need right now, nothing more.” While I hope to make it through the week as a free woman, the instant I make a beeline to more lego-castles with the intention to stomp I’m going to have to check myself in. After all, if I don’t the cool kids might kick me out of their lego club, even if that only matters to the version of me who is stable.