Tag Archives: psychosis

Total Eclipse of the Gut

For many years now I’ve been avoiding my gut instincts. Maybe avoiding is the wrong word, I’ve been wary of them and I haven’t been implementing them when they come up. I guess that is probably one definition of avoiding, but for whatever reason it feels important to me to add that part about feeling wary.

I’ve been thinking of my gut feelings as the product of an inner-office anonymous comments box and I’m the poor sap who has to sift through the comments that have been left there.

“This is a place to leave comments,” the box says, “ideas, and suggestions on how to make the office run more smoothly. They will be reviewed by management in the consciousness department.”

Of course, I haven’t been able to take the program very seriously when many of the comments have read things like:

Absolutely trust that guy who is inviting you inside his house and says there is free taco bell inside.

or

Can we please collect more roadkill? The IT department won’t even notice the smell.

or

Make Fridays “casual werewolf” day.

In the beginning I followed through with most of the suggestions in the box only to realize there are one or two A-holes in the office (damn you Psychosis! Mania! And don’t think I don’t see you sneaking around over there too Depression!) who keep leaving these bizarre notes they expect me to follow through on.

Without a filter to keep the odd comments from the important ones the results historically turned out poorly.

But that’s always the story, isn’t it? One or two bad apples ruining it for everyone. As the manager of the office inside my brain I’ve had to stop allowing comments from within myself simply to keep from doing some totally stupid and irrational things. The trouble is… all of the good, useful comments have also been discarded in the process.

In the meantime I’ve worked to try to improve the comments program. It has been temping every time someone has told me “just trust your gut” I feel like I ought to give it a second chance, despite constantly winding up in situations where I’ve taken away all of the pairs of scissors and staplers in the office during a busy week or deprived my employees of contact with the outside world for days until they go on strike and say, “you know, we really aren’t getting any work done at this rate.”

As someone who wants to manage this office well I’ve taken it upon myself to try to find answers. To research and test through trial and error what I could do to keep the team running. I’ve scoured the anonymous comments with handwriting analysis in hopes of being able to pull Psychosis’ notes from the rest (and the rest of those who love to throw a wrench into things) with no luck. I even hired on a new employee (Rationalization) to help manage the comments department but ultimately it didn’t seem to make much difference. Before long Rationalization seemed willing to justify why casual-werewolf-Fridays would be great and I had to halt the project over again.

While I was searching for a solution I wasn’t expecting things to get worse. One of my employees, Sexuality, began leaving notes in the comment box in an effort to make the break-room more LGBT friendly. I discarded all of those comments with the suspicion that they may have come from Psychosis playing a prank. Denying all of the comments meant denying the legitimate ones too, and before long Sexuality was upset and launching a full scale mutiny, bringing all of her closest co-workers on board. Depression wailed, Energy dropped dramatically and wouldn’t come out from under their desk, and Self-Worth made a very rude gesture at me during my 3 pm coffee break.

When Intimacy made a request to work harder on relationships in an effort to feel more connected I ignored it. I was certain it was Psychosis again, and even though I hadn’t seen them in weeks I thought for sure it was some game of misdirection. Pretty soon Anger snapped after a paper jam and ripped the feeder tray off the unit and Productivity simply stood up and said, “I can’t work in an environment like this, I’m going home.”

I watched chaos erupt from my cubicle and that’s when my phone rang.

“Yes, Department of Consciousness here,” I answered.

“This is HR,” a voice said. “It has come to our attention that you’ve denied a request to make the breakroom more LGBT friendly and I’m afraid Sexuality has come to us to file a complaint.”

Sexuality filed that comment?!?” I asked astounded, “Are you sure it wasn’t Psychosis?

“Sarah, Psychosis hasn’t been in in weeks, hasn’t even booted up to work remotely, there hasn’t been a need. I’m afraid the issue at hand is bordering on discrimination at this point so it needs to be addressed immediately. If you can’t take care of it, we’ll find someone who can.” The voice said.

“Of course!” my mind reeled, horror struck that I had ignored something so important. “Right away!”

“Good day.” The voice added.

“Wait!” I quickly cried upon realizing I’d never encountered anyone from HR, “Who is this?” But all I heard with a click followed by a dial tone.

 *

I’ve gone through years of therapy trying to figure out how to discern which piece of my internal dialogue to listen to, how to pinpoint the difference between when my gut says something to me and when it is mental illness pushing me in a specific direction.

Ultimately I reached the point where I felt the need to scrutinize everything that ran through my head before making any decisions. It didn’t keep me from having manic episodes, or depressive episodes, or psychotic episodes or doing wildly irrational things. All it did was create a backlog of personal issues that built up and began contributing to my anger and depression and paving strange avenues that I’d find myself trying to take to solve those issues when I was psychotic or manic. In some ways it seems as though Psychosis was trying to help me, attempting to take back doors to solve issues I wasn’t solving directly.

That is part of what has made everything so blurry. I was so worked up and emotional about some issues when I was psychotic (or depressed or manic) I couldn’t see how important the same issues were to me when I wasn’t. I simply didn’t feel the same level of intensity about them when I was feeling stable, even though they still mattered.

All this time I’ve considered psychosis to be like a bubble, like I could discard anything that happened within the bubble in which the episode took place and discount any aspect as being useful or informative (though usually a good story later). The psychosis bubbles that arose eclipsed my gut instincts entirely, or at least discounting anything within those bubbles often also meant discounting real and important instincts. Really, the more time I take to understand the issues I’ve been avoiding, the more it seems that my episodes have acted more like a magnet drawn intensely to those same issues rather than provoke or direct me toward new useless ones.

I’m sure all that is confusing, and it is to me too. Even so, this has been a huge revelation for me because it means the eclipse is ending. I’m realizing that there is value in every comment in that comment box, even the ones I considered to be a joke.

“You mean, you’re listening to yourself again?” My therapist asked last week.

*

I imagined myself in that office, smeared with printer toner and covered in paper cuts climbing on top of my desk and waving my arms.

“Alright! Alright!” I shouted at them. “I’ve been a terrible manager, I can see that now. Ignoring you isn’t helping us get things done and the box,” I kicked the comments box off my desk onto the carpet littered with remnants from the three hole punch and paper clips, “screw the box. The box isn’t working! From now on we’ll have an open door policy and if you need something you can come directly to me. Even you Psychosis,” I added as a fit of giggles came from over one of the speaker phones.

“I’m sorry I went behind your back,” Sexuality said to me as the last of the internal raging died down and we began cleaning up.

“I don’t blame you,” I replied, dumping the old comments box into the trash. “I guess I was so wrapped up in working on communicating to the outside world that I forgot the importance of communication here.”

*

“Um, yes,” I replied to my therapist, blinking for a moment. “I am listening, and I expect I have a hell of a lot to say.”

 

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Alternative Mental Healthcare for Severely Psychotic

An article came out this month in the New York Times about an organization called the Hearing Voices Network. The Goal of the Hearing Voices Network is to create support groups where the symptoms of those with psychotic symptoms like hearing voices and having hallucinations are explored to understand where the voices or visions might be coming from and find ways to cope with them mentally and emotionally.

I’m not doing the article or network itself much justice so I would definitely recommend reading about this alternative form of therapy here (at the New York Times Article) or here (at the Hearing Voices Network homepage).

Without going into too much detail I wanted to mention that this topic stood out to me because in a way it reminded me of the type of therapy I have been undergoing with DBT (though certainly not the same thing). The similarity in my mind comes from my experiences the last six months having to address my internal dialogue, generally stop abusing it and being afraid of it, and allow myself to learn where these thoughts and feelings are coming from so that I can cope with them in a healthy way.

Having treatment resistant symptoms of bipolar 1 (which can include psychosis at times) has rendered other types of treatment (like psychiatric medications) useless for me up to this point so my experiences with talk therapy and particularly a group that could help me address those aspects of my illness has been paramount to helping me cope and feel more comfortable in my own skin. I’m excited to see that an exploratory type of alternative therapy like this is being offered to those with severe psychosis because the more types of treatments available mean the more people that will potentially be able to improve.

Of course, both websites mention that this type of therapy isn’t right for everyone, but as someone who has experienced what mental illness is like living as an outlier, having options of things to try before falling into the hopelessness that all else has failed is potentially making a life-saving difference.

Mental State Dual Citizenship

Psychosis has often made it really hard for me to keep things straight, and even in my younger years I put a lot of effort into trying to separate depressive or manic periods and thinking from those where I am more stable. Before I was really able to pinpoint when I was experiencing mania or depression, one of the ways I did this was to consider these situations almost another version of reality.

Trust me, the idea of reality gets rather skewed while experiencing psychosis and though I’ve been on the hunt for ways to gauge whether the reality I’m experiencing makes sense with the reality of the people around me it can be frustrating (and impossible at times) to try to truly gauge the two.

So, as I mentioned, one of my first lines of defense has often been to think of my psychosis ridden bipolar disorder as something of a dual citizenship. That means I am a resident of two worlds; one world everyone else knows and sees on a regular basis, and another where (much like Alice’s wonderland) things can get a little weird.

It might sound a little funny, and while this other reality I live in from time to time doesn’t have talking playing cards or freaky cats (that would be something) I do often find myself dealing with life seeming to have a much different pace, the truths of the reality are often a far cry from what I’m used to, and even my motivations and dreams seem very different than in my regular day to day life.

Yesterday, for example, I spent about half the day living regularly. I washed some dishes, watched Ru Paul’s Drag Race, and talked to my Grandma on the phone.

The other half of my day was spent in depression land, a different sort of reality where (pace) no matter what I did, I couldn’t seem to catch up with what needed to get done. The (truths) I faced in this place seemed to be that my relationship was totally unstable and deteriorating before my very eyes, leading my (motivations) to demand I make sudden and dramatic efforts to curb the situation.

After several hours I found myself back in regular life, the reality of depression land having vanished and been replaced with (pace) feeling on top of things. (Truths) My boyfriend cares about me, he even brought me home some chocolates. (Motivations) For the love of pete, don’t make any sudden moves!

It seems like the last few depressive episodes I’ve had I find myself plopped down right in the middle of where I left off, which is rather maddening and definitely confusing as heck. A bit like waking up from a bad dream only to fall asleep and find myself right in the middle of it again!

Mania land is a little different for me, less like I feel overburdened by the information around me and more like everything starts to fade away like one of those Bugs Bunny cartoons where he keeps screwing with Daffy by drawing him into some kind of weird half plant half platypus and the setting becomes little more than a blank sheet of paper.

The (pace) often feels like I am so ahead of the game that spending six more hours writing isn’t a big deal. The (truths) usually suggest I’ve been worrying far too much lately, leading my (motivations) to urge me to brush off all forms of responsibility or concern. Hijinks ensue.

Mixed land, well, it’s a place I try to avoid at most costs but unfortunately I’m quite familiar with it. Everything about the (pace) there usually feels much too slow, like I am ready to run a marathon but I’m trapped in a vat of peanut butter; too much energy and no way to expel it. The (truths) that seep in tend to be based on suspicion, that people are hiding things from me or are up to no good (heh), leading my (motivation) to either have a meltdown at them or try to sleuth my way to the truth in some kind of jacked-up Film Noir version of reality.

Sometimes describing my mental and emotional states as places helps people understand how jarring it is to be sitting around one minute, minding my own business, and then suddenly be thrust into another odder, often less productive version of my life. I can be sitting pretty one second and in depression land, or mania land, or mixed land without warning; sometimes it takes me some time to even recognize something has changed. After all, the people around me go on with their lives and their own reality as if nothing has changed, and if I’m having a good day they may not notice that anything has changed on my end, even though I’m somewhere else.

Ultimately, time has shown me that I am probably not actually trapped in some outrageous form of reality manipulation by warping me to suspiciously similar copies of my life and that this dual citizenship is actually coming from within me, not externally. Still… I can’t say for certain that there isn’t some kind of brain gnome in my noggin who happens to keep forgetting to turn the basement light off or something, leading me to hear a high pitched whine where there wasn’t one before.

In all seriousness though, mental health is a tricky thing to understand, even for those of us who experience mental illness every day. Having said that, thank nuggets it is therapy day today.

 

The Trustworthy or Untrustworthy Self

I have always tended to operate under a series of hard rules. Hard Rules; you know, like “oh crap, I just touched that burner and it was hot!”

New rule: don’t touch hot burners!

This is a rule that is always true. If I see a hot burner, I don’t touch it (at least, never on purpose but I’m a bit of a klutz). Having said that, many of these sorts of rules that I’ve gathered up over the years have been helpful, some even life-saving. Don’t throw temper tantrums at your boss. Don’t swim out into Puget Sound where the undertow can drown you. Don’t get in a car with a random stranger. Don’t ever wear black and brown together.

Sounds useful right? Well, for the most part it is, but I have always had a tendency of somehow shuffling all rules into the “hard rule” category. Inflexible. Rigid. Once it is there, it is there forever.

Even though that is a concept that seems useful when it comes to ideas like “don’t touch a hot stove burner,” it is useful because a hot stove burner is always hot.

On the flipside, there are aspects of my life and of having bipolar disorder that might be true sometimes and not true others. Of course, in my life having a mental illness is true, but to say that I am always manic or depressed or agitated or homicidal or suicidal is not true.

These sorts of facts lead me to strange places somewhat reminiscent of math class where these rules become much more complex.

“My suicidality warrants hospitalization if and only if it is a level three on my suicidality scale, requiring x, y, and z… (you get it).”

Despite all the nit-picking and tweaking that has gone into these rules, these ways in which I keep myself alive and relatively healthy, there is one that somehow slipped under the radar. It managed to sneak into the hard rule category without any real revisions over a period of years:

Because of my bipolar symptoms, I am not trustworthy.

These days I can see the difference between a generalization and a rule, but the truth of the matter is that despite how my understanding of myself and my symptoms have improved, there has been a wall of fear that has kept me from being able to edit this statement.

I don’t know exactly where it came from, I don’t know if it was something external that I was told or that people suggested or if it was purely created out of the fear I had of myself and my inability to control myself sometimes. Yes, there have been some incidences that have scared people, but I expect this rule is probably more about how much I scared myself.

For me there was always a big fog around my symptoms or any number of the unhealthy urges swirling around inside me at any given time. I mean, what if something happened? What if they just slipped out before I could realize it?

For many years I allowed myself to defer back to this rule. When people would ask me,

“Oh, do you want to hold my baby?”

or

“Can you watch the cash register for me for a minute?”

or

“Mind unwrapping this new kitchen knife set with me real quick?”

The answer was always no. No, sorry, I might punt your baby. Or steal all the money. Or suddenly believe I can juggle knives.

A few years ago I had a friend who had a baby and she insisted I hold him. As it turned out, I held him and he didn’t burst into flames. Or turn into a squealing pig. In fact, nothing weird or inappropriate happened. After returning the baby to her I considered two things that really shook the foundation of the untrustworthy rule I had created.

  1. My friend trusted me so much she practically forced me to hold the baby.
  2. In that moment with that baby, I was trustworthy.

This friend did not know much about my past, but she knew my diagnosis. While part of me clung to the notion that she trusted me because she didn’t know about the bulk of my untrustworthy behavior, it felt meaningful that in that moment on that day, she considered me trustworthy enough to hold the most precious thing in her life.

On top of that, the fact that nothing went wrong was kind of like a slap in the face to the rule that had been created. I could be trustworthy. Er… maybe not all the time, but sometimes, yes.

Even though this one moment was the key to begin revising this rule I had created for myself, it has taken thousands of situations and the knowledge I gain about myself and my symptoms every single day to keep reshaping it into something more true.

After all, when my symptoms first started I was really just a kid. I had no idea what they meant or why they were happening, and I had no skills or knowledge to help me keep them from exploding out from me whenever they felt like having a party. When my mind wove a terror filled tapestry for me, I didn’t know I shouldn’t believe it.

Really, getting to know how my different mental states work have been like working out any other part of my body. I couldn’t walk into a weight room and bench press 300 lbs on the first day because I had to build strength first, I needed to learn my own limits in order to push myself to my goal, and be able to take care of myself and heal up if I pushed myself too hard.

Even though having mental illness is a constant for me, my understanding of myself and my symptoms have changed over time. Living with it means adapting as my understanding and knowledge grows, and affording myself more trust over time because that unknown I have been so afraid of? Well it is shrinking every day.

 

Travel; Mental Health Hurdles

This year my Grandma turned 80 years old, and to celebrate my family wants to host a camping trip in her honor. The reality of the situation though is that traveling anywhere (whether it is just heading downtown, upstate, across country, or across the globe) while living with a mental illness involves taking a bit more into consideration than the “where” and “when”.

Things got panicky last week when some crossed communication left me under the belief that my boyfriend and I would not be able to bring our own vehicle to the camp because of it’s affiliation with the military.

For anyone else, carpooling seems like the obvious answer, right? Well for me, living with bipolar disorder means knowing my triggers, and anytime I start to feel trapped in a strange place without an exit strategy (oh, say, like on a beautifully landscaped but guarded-by-armed-men sort of military recreation site – I have no affiliation with the military personally) I melt down. And I mean total manic/psychotic, you’ll-find-me-in-the-woods-later melt down. It is almost like a guarantee, and knowing myself well enough to know this would be an issue (after kicking countless ‘vacation’ situations in the balls while psychotic and trying to escape) left me in a bit of an odd position.

Of course, it isn’t unusual for me to try to push myself through things like this. Tell myself, “well, those other times are a fluke, and you will be totally fine this time.” I start to feel like I am making a big deal over nothing, and when friends or family who don’t have to make these kinds of considerations for themselves agree, I have a bad habit of walking into the same situation over and over again and reacting poorly on ‘repeat’.

Last week’s situation was a little more special because I went in to see both my therapist and my psychiatrist, and both immediately sided with the rational, more cautious part of me.

“Absolutely not,” they both said. “You’ve been triggered this way several times before, and you know that walking into a situation like this will be more of a strain than you are likely to handle.”

Keep in mind, my situation is really pretty singular in that my symptoms are not regulated by medication. My symptoms of bipolar disorder and anxiety are treatment resistant (they have not responded to any medications), so I am largely in a position to have to cope with them on my own. That is another big reason why it is important that I am familiar with my own triggers, because knowing what could put me in a dangerous position and either preparing myself for the outcome or avoiding the situation altogether are the best strategies I have for dealing with my symptoms on a regular basis.

I have found one of the biggest strategies that helps me when traveling or heading into a potentially stressful situation is knowing I can leave at any time. If I have an exit strategy, if I can leave the stressful environment before my irritability or mania becomes psychosis things are much more likely to go smoothly.

Even though my therapist and psychiatrist both agreed this trip would be detrimental for me, I couldn’t help but feel bad about needing to cancel. I mean, my granny is 80, and you can believe she has been talking about this for a month already.

The final decision I made was to go back and double check the policy that would keep me from having my escape route. I scoured websites and even eventually called the navy to help clarify their policies on bringing in civilian vehicles to their recreational sites. And -wouldn’t you know it? The entire situation was a communication error. We should be able to bring a vehicle to the site without a problem (so long as we have the proper documentation, yada yada yada).

Ultimately, the problem is no problem at all, but I am proud of myself for taking the steps I did (talking with my boyfriend, my therapist, my psychiatrist, and looking for a solution) before responding emotionally or making a final decision about going, or not, to this event.

Sometimes living with my current mental health situation can feel like I have to live in a small bubble to survive, and while the bubble feels safe it also shields me from many of the life experiences I want to have. That bubble doesn’t guarantee I wont become depressed, or manic, or psychotic, so I don’t feel like forgoing all manner of travel and personal growth that comes with it should be kept from me because doing so does not mean I will be able to live peacefully. I will have bipolar and anxiety outside the bubble, but I have it inside the bubble as well. For me, the trick is knowing what my absolute deal breakers are (like transportation) to keep me from moving from a “moody” travel situation to an emergency travel situation.

Of course, there is a lot that goes into it beyond that to prepare, things like

  • having my doctor’s information handy and with me at all times
  • bringing all medications, and extra in case of emergencies
  • making sure I will be in a position where I can eat regularly
  • making sure I will be in a position to have the best chance of sleeping fairly regularly
  • using coping skills to help counteract instabilities
  • maintaining an awareness of my current state
  • informing my fellow travelers how to best help in an emergency situation
  • and knowing when to pull the plug on the trip

to name a few.

Even though I have gotten over the transportation hurdle regarding this short trip, it is still a few months away. I have plenty of time to worry (heh) as more things come up, but I hope to smooth over as many of the rough edges as I can before I get there.

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!