Tag Archives: mixed state

Redefining My Urges

Trigger Warning: topic includes some discussion on self-harm, suicidal, and homicidal urges.

Lately I’ve been trying to do a better job of understanding the urges I feel and how they fit with my symptoms. Living with treatment resistant bipolar disorder has meant that even though I find myself having the sorts of urges everyone else seems to (though as human beings we all seem quite reluctant to talk about urges) I also experience urges brought on by my illness. On top of that, my ability to respond to these urges can be quite compromised based on what my symptoms are doing as well… but let’s back up for a second.

Urges are impulses. Strong desires. They are those feelings inside of us that scream out to “just do it” in certain situations. Sometimes my urges come only in the form of a feeling like gravity taking over and I act on them without thinking, sometimes they’re accompanied with thoughts that can encourage or discourage following an urge.

To break it down, here’s an example of a relatively healthy urge I have. A simple craving.

Urge: make eggs.
Thought: I do like to eat eggs.
Action: made eggs.

You can substitute chocolate in for eggs, chocolate is good. Or you could substitute tea, in which case the urge and actions become blurrier for me because I have dietary restrictions. In that situation having a chai tea latte, for example, becomes something I shouldn’t do. I will get sick if I have dairy, so the urge has a negative consequence –it becomes unhealthy.

Urge: drink a chai tea!
Thought: holy yum batman, but this will make me sick (Reminder: I can’t have milk or caffeine).
Action: urge denied, drank juice.

Even though drinking a chai tea is unhealthy for me, there are times when I am run down or worn out where the negative consequences of drinking one sort of fade out. In that kind of situation I find my thoughts work against me.

Urge: for pumpkin spice’s sake, drink a chai tea!
Thought: It is fall, I do like chai, and even if I get disgustingly bloaty and gassy and can’t leave my house for two days I don’t have any plans anyway.
Action: 20 minutes of sweet, sweet chai tea action, 48 hours of intestinal horror.

Finally, there are those situations where thinking doesn’t even come into play (I swear, I have a point here). If someone put the chai tea in my hand and told me to drink it, the impulse becomes much easier to carry out.

Urge: drink this chai tea in your hand!
Action: yes, thanks.

Alright, so this seems perfectly reasonable to understand when I am thinking about something mundane but delicious, like breakfast… but these same scenarios are true for most types of urges I encounter. As human beings, we come up against a lot of kinds of urges, but the ones I want to look at more specifically are the negative urges, the ones that we know will have (or are likely to have) negative consequences. Things like lying, cheating, stealing, violence, sexual attraction to inappropriate parties, overeating, overuse of drugs or alcohol, self-harm, and suicide (to name just a few).

Most of the things I’ve listed are not things people talk openly about despite how commonly we find ourselves feeling urges to do negative things. I’m sure there are people who excel at shooting down these urges, but I don’t think it is very clear cut. If my chai tea was now an act of violence (let’s say slapping someone in the face who had done something inappropriate), even a totally rational person might not deny the urge after several drinks.

Urge: that bitch just threw a drink in your face! Slap her!
Thought: I’m the bigger person here… she looks ridiculous, I can let it lie.
Action: deny urge, stand around dripping.

(But after several drinks, or a bad day, or after something particularly offensive like groping your partner…)

Urge: oh no she didn’t, slap her!
Action: slapping.

I’d say that, more than anything else, is why I don’t drink anymore. My mind, for whatever reason, seems fully capable of jumping from urge to action without being intoxicated.

Anyway, last example. Living with treatment resistant bipolar disorder has often meant living with suicidal urges on a regular basis, and this is one aspect of my illness that I think people understand least. You see, these urges are something I can typically rationalize away.

Urge: you should kill yourself.
Thought: I might not feel good right now but I’ll bounce back. Plus that sounds like a lot of work. Plus what about my dog? Plus I think people might get upset.
Action: still alive, despite lack of chai tea lattes.

But, as I mentioned with my chai example above, if I find myself in a position where extreme stress or a particularly long depressive episode has eroded my ability to think clearly, the urge becomes harder to contradict.

Urge: you really should kill yourself.
Thought: you’ve been pushing that nonstop for months, and I’m sure there is a reason I have resisted that urge in the past even if I can’t quite remember it now. I’d better call someone.
Action: call my therapist, she acts as a rational brain for me when mine isn’t working.

Then there are situations that I call “level 3” suicidality, and that is when hospitalization becomes required because the urge has consumed any ability to contradict with thought.

Urge: kill yourself.
Action: jaywalk, check into the ER.

I know it isn’t a pretty topic, I’m sure that is why it goes unmentioned most of the time. Just the fact that I spent so many years not knowing where the urges I felt were coming from or that they did not mean immediate suicide, or violence, or self-harm, that I still had a choice as to whether I would act on them or not, was exceptionally confusing and wildly detrimental to my sense of self-worth. On top of that, not knowing what kind of situations (alcohol, mania/mixed episodes, high stress) led me to jump from an urge to an action without thinking made it really hard for me to stop acting on the urges I felt.

Being unable to separate the urges I felt from the totality of who I thought I was meant years of trying to punish myself for urges I could not control in an effort to curb them because I assumed that “getting better” meant not having those horrible feelings anymore. Besides, urges that provide harmful consequences are not generally seen as normal in our communities despite how often people experience them because the topic is typically taboo. Needless to say, when I was sixteen and experiencing psychosis with homicidal urges I immediately assumed I was a terrible person who probably didn’t deserve to live, given the fact that I wanted so desperately to hurt other people. Even though I worked hard to deny those urges I still felt wildly ashamed for having those urges in the first place.

I still catch myself sometimes, telling myself that the urges I feel to self-harm or commit suicide mean I am something less that others, that it doesn’t matter how many worms on the sidewalk I frantically save from being walked on because overall I’m a terrible person.

But that simply isn’t true. (And I’m sure the worms do appreciate it in their own way.)

I can’t judge myself based on the urges I feel because doing so is like judging an entire library because one book doesn’t seem to get shelved properly on a regular basis. To discredit the entire system and collection because of one book seems absurd, especially once I’ve learned that there are many creative solutions for where to keep that book in the catalog.

As I’ve gotten older I’ve started to understand that everyone feels urges and that urges are outside of our control. We might not all feel the same ones, but I’m sure we’ve all felt an urge now and again we have felt ashamed of. Being able to take a step back from that shame has meant feeling better about myself and even though I don’t expect those urges to go away anymore, I just try to focus on the way I view the urge and how I choose to act when it comes up.

…and if I slip up and drink a chai tea now and again, I’m only human.

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Swapping Big Moves for Little Moves

Let’s face it, living with bipolar disorder has had a huge influence on the way I make decisions. It hasn’t been all bad, I admit the impulsivity I tend to feel has left a trail of both exciting fun memories in my wake as well as some cringe-worthy ones, but I’ve spent a lot of time considering impulsivity and the ways it has both helped and harmed me.

Instead, today I want to specifically discuss making big moves.

For a long time I believed that I only made impulsive big, life altering decisions when I found myself experiencing hypomania and mania. This was evident when I dropped out of college, for example, at age 19. The idea of living aimlessly in the Colorado sprawl seemed like a wonderful idea, and it was great… for a while.

Likewise mixed episodes have lent themselves to impulsive big moves as well. Spur of the moment breakups would be an example, running away from home. Usually these kinds of big decisions have been fueled by the need to escape something (rather than make a positive change in my life) and the results have tended to be regrettable when I returned to rationality.

Recently I’ve been thinking a lot more about how that overwhelming impulsive urge influences depression, because for most of my life I would say I didn’t think it did. I mean, is sitting down and watching a full season of Ru Paul’s Drag Race because I’m too tired and depressed to do anything else a big impulsive move? Yeah… I didn’t think so.

Lately I’ve been seeing it a bit different. Maybe it is the nature of the depression I face, maybe it is a little mixed and coming with a small paper cup full of mania to act as a dipping sauce. Whatever the reason I’ve been able to hone in on this feeling, this urge to make a big move, and somewhere inside of me there is this spark that says,

If you make a big, sudden change in your life this depression with disappear.

To be fair, I’ve been doing this all along. In my younger years I found myself in some kind of Job-Hopping Phenomenon loop that I tried my best to grasp but couldn’t understand.

I would start a new job, be doing fine, and then start sinking into deep depression. The answer always seemed to involve quitting and starting a new job, where my hypomania would take over and I would feel great for a while until… you guessed it… wash, rinse, repeat.

For the most part I always chalked this job-switching thing to be coming from a place of reason though, not emotion. I told myself, “well, maybe this isn’t the right job for me,” and I’d launch myself out into the world feeling a sense of purpose every time I tried to find a new one. It kind of acted as a really inefficient, W2 swamping sort of band aid.

I didn’t connect the dots between these actions and that general bipolar big move urge until this month. I’ve been declining into depression for almost two months now, swiftly and severely enough for my psychiatrist to be on red alert (more on that next time). Honestly I think what I am experiencing may be a depression-heavy mixed episode because I’ve found myself in several swirling pools of psychosis where I seem to find myself in another place.

While I’m there everything is turned on its head, the only consistent element is that I feel overwhelmingly compelled to make a big move!

Sometimes the urge is to run away and start a new life, or get a job, or demolish my relationships with people… but every time the haze wears off I’ve been thankful to find I haven’t done any of those things.

With my manic and mixed episodes I feel like I have had the opportunity to practice not making those big moves I find myself gravitating toward. I’ve tried to remind myself of how horribly wrong they tend to go sometimes, and how what I am experiencing at the time is typically in the minority of how I feel otherwise.

The last few years my treatment resistant symptoms have left me experiencing severe depression without much alleviation, so much so that the only thing I could do was binge watch Ru Paul’s Drag Race. I feel like that might be what is causing me to hesitate when I fall into those whirlpools that try to bully me into mixing things up, because now I know that even when I do nothing at all I can make it out the other side.

In the grand scheme of things, I often picture bipolar disorder as a set of scales. I used to chuck whatever blocks I could find at them knowing that if one landed, they would flip my emotional state into the opposite direction and I could slide from depression into mania almost immediately. This crude method was effective short-term, but didn’t set up any kind of system for long-term stability.

The last few years I have been learning to scale down those moves when the urges hit. Instead of running away, maybe I’ll take a shower. Instead of getting a job, I assign myself to take out the garbage every Monday and see if I can consistently do it. Instead of destroying my relationships I turn on the Xbox and funnel my aggression into some kind of PvP deathmatch.

Instead of chucking those big blocks at the scales it is more like I am adding single grains of rice. While there is a kind of tension that comes from refusing the big move beast the satisfaction of an impulsive remix, I’m finally understanding that I can come closer to making those scales balanced by making little moves than I ever did with the big ones.

 

Providing an Outlet

Even since childhood I have often equated pain (emotional or otherwise) to be like electricity. Failing to provide an outlet for that force once it has entered my system generally results in short circuiting; an explosion of force down an unintended pathway as it tries to escape.

This morning I leaned in to kiss my partner goodbye as he left for work and stubbed my toe. You know the feeling you get when you know something gruesome has occurred to part of your body (in this case: a toenail) without looking -you can just feel it? Well, as pain started shooting through my foot I knew I wasn’t ready to look down and look at the damage quite yet. Even so, my first impression was to scream out in pain… but with my boyfriend standing less than 12 inches from my face (and it being 7 am in a crowded apartment building) I decided to hold it in.

Big mistake.

That energy that should have been released out my mouth shot down my throat to the next available thing; my arm. I immediately punched the wall (twice, apparently the first time wasn’t quite enough to allow all of that energy to escape) and winced as he left, attempting to walk off the pain in my foot.

While my big toenail is split (right in time for sandal weather, drats!) it wasn’t until my hand started to swell up from punching the wall that I realized that maybe I should have just screamed. Denying myself a natural outlet for letting that energy out certainly backfired, and my attempt to help my boyfriend and neighbors by keeping my seemingly inevitable screaming at bay ultimately hurt me in the end.

In my experience, the turmoil experienced in mental health isn’t much different. Providing myself with an outlet while depressed usually means verbalizing or writing through what is bothering me, while my manic outlets tend to be more physical; cleaning/exercising/and creative based projects. It took me many years to realize that, like punching the wall because of my big toe, failing to give myself an outlet for that energy trapped inside has often led me to explosive behavior, and outlets that have been seriously more damaging than what might have occurred if I had just followed my natural instinct.

I’ve done several training workshops about how to mitigate suicidality in crisis situations for other people, and I was shocked when each technique boiled down one core idea; confront the person about feeling suicidal, and then talk about why they feel that way with them.

Certainly I was expecting black hawk helicopters and swat teams and maybe a little magic to be involved, but ultimately providing an outlet for the person to express those feelings verbally in a nonjudgmental atmosphere proved that allowing some of that energy to escape was usually enough to disarm the threat of imminent suicide and get the person to some kind of treatment.

I would say that usually in my most dire moments I find myself at a loss for how to get that energy out. The fog associated with depression or mania might make it seem impossible, or unnecessary, and I might feel trapped in the moment, unsure of where to focus that energy without hurting myself or other people.

And obviously… I’m not perfect at it. After 15 years of considering this idea I still find myself punching walls occasionally or throwing my phone or rushing to my therapist feeling like a ticking time bomb because I’ve become certain that any words or actions on my part will destroy whoever I’m around (not true, as it turns out, but it still feels that way sometimes).

One thing I’ve done to help myself along though is to make a list for each of my intense mood states of good, useful, positive, harmless outlets that can help me get whatever energy I’m feeling out in a safe and satisfying way. Any time I think of something new, I add it, and that way when I am in the throes of a depressive fog, or so revved up on manic sunshine, or so irritable and agitated I don’t want to leave my room I have a little something to jog my memory.

Otherwise I might wind up punching the wall all the time and I’d never get my deposit back.

Revenge

Over the weekend I went to see The Revenant, and though I am not typically interested in dramas or anything relatively violent I am interested in stories about mountain men and stories about revenge.

I’ve been thinking a lot about revenge and why it is so interesting and even consuming, at times, to me. True that in a heightened state of emotion revenge can seem that much more gratifying, but most of these stories about revenge (or my experiences with revenge) well… they never quite end well.

The thing that interests me the most about revenge is how my own mental health has been able to completely warp this concept in different situations. For example, I started having my first full-on panic attacks in elementary school in P.E. when our teacher had us running around the track. He told us that we were not allowed to stop for any reason, not even to get a drink of water. When I asked him if I could stop to tie my shoe (which had become untied) he said no. I was supposed to keep running.

Now, this might seem totally mundane in terms of “personal threats”, but I have always been a somewhat awkward being who is able to trip on a line in the road. Having my shoe untied was a serious invitation to biff it on the track, and I was both pissed off and terrified. However, my fear quickly turned into something else as I found myself desperately wanting to trip on that shoelace, fall, and get hurt enough for some kind of punishment to befall my P.E. teacher.

It didn’t happen, but there have been many situations where my apparent inability to do anything about a perceived injustice has left me believing that the best form of revenge would be to take that revenge out on myself and subsequently whoever I meant to get revenge on would be forced to watch me withering away… potentially causing them inexplicable amounts of pain. At times I have thought that my younger self may have wandered into believing herself some kind of witch-doctor, capable of performing voo-doo. Of course, that almost never, ever worked out the way I expected it to, and while I admit the idea of hurting oneself to exact revenge on someone else seems totally ludacris there have been times where the act of revenge seems to completely outweigh the act of living. Watching any number of “revenge” themed movies will typically suggest the same.

I fought this notion a lot via the church. The act of forgiveness being the total opposite of revenge, I figured that might help me shy away from a lot of the odd, convoluted notions I had about punishing others or using myself to do so. Unfortunately, I found myself living in the opposite extreme, constantly in a state where the people around me were taking advantage of me and I would be ushering out forgiveness in a never ending revolving door of pain.

As it turns out, forgiveness without any sort of boundaries can be just as detrimental as revenge.

The road since then has been awash with many different theories and attempts to live a healthy life. I would say I have made significant progress on that front, but as a profoundly emotional individual it still swells up, from time to time, and revenge becomes something shiny and wisp-like begging me to chase after it. Even if I can withstand chasing it, it isn’t hard for my imagination to take the bait and for days, weeks, or even months I become trapped, seeking this thing out -if even only in my mind.

I am hoping that one day I will have replaced that inexplicable pull with something as simple, but as important, as acceptance. While it is something that seems distant to me now, I hope that little by little, inch by inch, it will become a more central part of my life and my future.

One day I will be able to sit with my life as it is as opposed to being haunted by the notion of what it should be.

And an Epiphany in a Tree

I can say with some certainty that November and December have become my least favorite times of the year. For a long time I thought the stagnant months of February and March were worse (as they hold the record for the majority of my psychiatric hospitalizations) but it seems that every big blow-out started with a seed of intense stress in November and December.

Last week was really rough. Our dog Luna has been having seizures that our local vet has been having a hard time getting under control, and combined with the stresses and pressures of the holidays I started to crack very quickly. It started with really intense insomnia, and waking up psychotic around 4 or 5 am each morning for three days in a row. By the third day I had put on boots and a coat and walked to the grocery store outside in the dark in an attempt to outrun the vibrating energy in my body as I was filled with unprompted rage, and then the walk back tipped the scales in the other direction. Uncontrollable crying.

The swings were intense, on the brink of hospitalization-worthy. After having the ten-minutes-of-rage, ten-minutes-of-despair, ten-minutes of clarity, (wash, rinse, repeat) for a couple hours Corey and I decided it would be best to start the day with my emergency antipsychotic (Risperidone). 15 hours of sleep later I was a little more evened out, but it was a very serious sign to relax and take things more slowly. The last thing I wanted was to spend the holidays (and the new Star Wars premier) in the hospital.

One of the biggest difficulties I have at this time of year is that all of the progress my various family members have made regarding understanding my illness seems to evaporate (I am chalking it up to holiday stress, I don’t think they mean to do it) and things seem to reset to a time where I had little to no control over what I was doing or where I was spending my time.

It is often very hard for me to communicate my needs when it comes to managing bipolar disorder, but the problem always seems to grow exponentially around the holidays. It can feel really frustrating (to say the least) when my actions attempting to keep myself safe and sane start being ignored or demeaned when my needs start being categorized as selfish wants or irrelevant to the success of a holiday gathering.

I come from a long line of people who are much more quick to accommodate others than accommodate ourselves, and I think my Grandma said it best to me when she told me recently, “I always put my family’s needs before my own.” While this is something I have admired about us (lending itself to being giving and compassionate) one of the most difficult aspects of my life up to this point has been watching the people I love not taking care of themselves and feeling helpless to do anything about it.

At times it seems like my desire to take better care of myself is seen as an insult to my family when it has nothing to do with any of them. That is why I have had a whole series of Christmases where I made plans, and then always disrupted them at the last minute to do whatever whichever family member wants. These are people that really matter to me, and the shame and guilt I end of up feeling about not letting them control me is usually enough for me to give in. I don’t want to disappoint them, and I find myself traveling back to being a teenager or a kid who would rather just forgo helping myself and hide that I ever needed anything at all to keep from feeling vulnerable and like a disappointment.

Obviously that is a big part of what got me into this mess in the first place. Not taking care of myself when I really needed it has made my bipolar symptoms much bigger and stronger over time, and now that I am finally at that point where I am (making a good attempt at) managing my symptoms with a lot of help from my friends, things seem to be improving -albeit slowly.

Yesterday after a significant struggle through some knee deep inner turmoil I had a lightbulb go off. After the episode of this last week and all of the family conversations I had it was clear that taking care of myself has finally outweighed pleasing my family.

Like I said, I love them and I want them to be happy, but this doesn’t have to do with me being selfish, or my own happiness, or trying to punish them for not accommodating me, or just not wanting to be around them. This is about my health. My sanity.  My brain is a pretty integral part of my daily living, so it’d be better if I gave it a hand here, you know?

Putting my family first doesn’t keep me from having bipolar episodes. It doesn’t help me cope with stress. It doesn’t let me live the life that I want to live because I am not living through them, I am living through me. It took me many years to learn that I could not take care of them when they were failing to take care of themselves, but taking care of me is the one thing I can do.

My needs are important and they can’t be ignored any longer. I am thirty years old now, and it is crystal clear that nobody is going to take care of me but me. That means I need to step up and do it all the way, not just a little bit here and there.

This doesn’t mean I am becoming a hermit, it simply means that what I want is going to have to agree with what is appropriate for my health before I do it, and the execution will involve a firm “no” (gasp!!) from time to time.

I’ve spent ten years trying to execute this plan and failed every time before now, but I am finally able to see that the old way… well it isn’t working. While I recognize that this is always easier said than done I can feel that guilt and shame window closing. I am tired of being ruled by my emotions, because emotions can be manipulated. I want my life to be about the things that are important to me, and while my family is important I am finally recognizing just how important my health is to me too.

Finding Psychosis in Unlikely Places

Lately things have been up, up, up! A rather profound and relatively welcome change from my typical morose malaise dragging down even the most cheerful of moments. Things seemed to be going perfectly well when I hit a bit of a speed bump last week and started noticing my slightly-elevated hypomania (and general stability) being peppered with hysteria riddled buckshot.

Right now in the DBT (Dialectical Behavioral Therapy) group I am in we are learning about a skill called check the facts which involves taking time out to look at the big picture and discern if my reaction to events (or if my interpretation) might be colored by unwise reasoning (like jumping to conclusions).

I felt like I had a pretty good grasp on the skill and practiced it multiple times before that speed bump I was talking about last week. In these periods of agitation and intense depression-laced moments (lasting a couple hours at a time) I could no longer find “the facts”. It seemed like my ability to step back was totally negated, adding fear and panic to my already disoriented state.

I have always had a hard time identifying psychosis when it is happening, or at least identifying it before it has altered my psyche in a profound way. Typically the only way I have been able to pinpoint it in the past was after the fact, faced with a trail of breadcrumbs leading in several opposing directions at once.

Granted, I have experienced a few situations where the psychosis I was experiencing was something that seemed pretty easy to point out at the time. The overwhelming need I had to live with gypsies and time I thought I had become a werewolf are definitely two examples, but both occurred many years ago. Since then things have changed, and the psychosis I experience now is almost exclusively tied to fear, not euphoria or grandeur.

The fears are almost always something that could happen. Typically not things that are likely, but possible in the realm of actual life events. My boss trying to undermine me at work was a pretty infamous episode I had, but this time it was a little closer to home and my fear revolved around my boyfriend and an impending doom of our relationship.

In my mind, my boyfriend was trying to push me away to the point where I would become fed up with him and break up. Though this is not even remotely based in reality I was certain it was happening (but only for 1-2 hours 3-4 times a day) and I became terrified to speak to him. Unfortunately not speaking to him only fed into the awkward feeling I was having, making the whole thing seem more real.

For me, psychosis is typically like a real asshole lawyer. It builds a case based on tiny clues that are generally considered meaningless in our everyday lives, and when there are big pieces missing to corroborate the story, it makes them up. I’ll often find myself with memories of saying or hearing things that never actually happened, despite feeling very much like they have.

Trying to reason with someone who isn’t playing by the rules (psychosis) became relatively meaningless in my experience this last week. I felt overwhelmed by mass confusion because trying to check the facts led to so many contradictory facts that I didn’t know who or what to believe.

And that’s when my boyfriend found me.

I tried to explain why I was upset (without knowing at that point that I was even experiencing psychosis). It didn’t seem like him to be vindictive or evil, after all our relationship had always been like a slow, lazy river as opposed to the Niagara Falls of my last relationship. I blamed him for a long list of things that apparently never happened, and when trying to express my confusion I suddenly started laughing. Yep. That’s when I figured it out, the contradictory breadcrumbs were coming from many different directions and were made of several individually delicious but totally different and clashing baked goods.

[insert emergency antipsychotic here]

Things have been fine since, and while these sorts of episodes always lead me to feeling rather embarrassed and apologetic I was very lucky that I had some help in pinpointing this situation early. Being able to celebrate my birthday over the weekend without any added psychosis was huge.

Corey reminded me that this sort of thing tends to crop up for me when I am starting to get stressed. It was a good reminder to pay attention this holiday season and do my best to remain relaxed. I never want to come off as being a “Scrooge” but finding a way to celebrate the holidays without totally losing control of myself can be a big challenge. High-five to my man for being smart and compassionate!

On a final note, I am in the market for a new psychiatrist. This last one has made some comments that were more harmful than helpful, so this week I hope to switch to the next doctor on deck. Stay tuned!

“Mixed” Messages – A Firefly in a Swarm of Bees

My bipolar symptoms the last week or so have largely been mixed. Mixed episodes have often been the ones landing critical blows on my relationship, and having one over the first weekend in three that I’ve been able to spend with my boyfriend was… well, I think the word frustrating works on both ends.

While I’ve had mixed episodes that blended pieces of mania and depression into a clear goal (annihilation of myself and everyone around me), more often my mixed episodes are an odd, muddled mixture of many distinct (and sometimes opposite) feelings occurring at the same time. As it was over the weekend, I was able to feel excitement, anger, profound sadness, desire, disappointment, and completely calm (as a very rough example) all at once.

Internally it feels like walking into a party and having a conversation with several guests at once, I am reacting to each simultaneously.

You can imagine how much of a problem this poses when trying to have a conversation with someone externally on top of that. Even just having a conversations about sandwiches, this touches the “completely calm” internal feeling I am having (so I feel like I am calm whilst having the conversation) but all of my other reactions (excitement, anger, profound sadness, desire, and disappointment) are showing through randomly through my facial expressions, my body language, and the inflection of my voice.

All of the intense emotions I am feeling in a mixed episode are spinning on a roulette wheel, presenting themselves continuously without any rhyme or reason. Naturally, this confuses the crap out of people.

Imagine I told you, “oh yes, a sandwich for lunch sounds great,” and even though that is what I meant verbatim, I am crossing my arms, stomping on the floor, or throwing my hands in the air when I said it. Or maybe I am crying uncontrollably but singing and dancing.

Or maybe I can’t decide, because I both love and hate sandwiches at that very moment?

Corey (my boyfriend) has known for a long time that I have a really hard time with making decisions when I am having episodes, but it wasn’t until I explained this scenario of mixed messages to him this weekend that he began to realize that my indecision doesn’t come from disinterest (at least not during a mixed episode) but from way too many interests vying for the decision to be made on their behalf.

Sometimes making a decision while being bombarded by all of these emotions simultaneously is like trying to catch a firefly while being stung by a swarm of bees. It is even more perilous knowing that reaching out and grabbing the wrong insect might mean exposing a volatile emotion or putting myself or others in a situation where conflict arises, damaging myself or my relationships.

“That must be really confusing,” Corey replied. “Especially not being able to always distinguish what you want.”

Sometimes “what I want” is the option that is the least harmful to myself and those around me, but honestly it can be hard to tell which insect buzzing around me is going to be friendly or harmful. Other times I try to draw from cues from people around me. Being able to ask someone else what to have for lunch helps me forgo getting stung by that swarm of bees as all of them are vying for my attention.

Ultimately, in a mixed episode it isn’t uncommon for me to want everything and nothing. To love everyone and despise them. To want to laugh and cry and scream all at the same time. It feels like being pulled in every direction at once, but also like implosion is desperately imminent. Sometimes it takes all of my effort just to hold it in, and other times… I can’t.

It has been very confusing trying to understand all of this (and I have experienced it firsthand for many years now), but tying to convey it to someone who doesn’t experience it can be even more confusing. I do think, though, that taking the time to try to explain my motivations to Corey regarding my mixed episodes helped both of us understand better… and in the long run I am hoping better understanding will set us both toward better coping.