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Monday, 28 March 2011

Bipolar


I feel like a fugitive from the law of averages. ~William H. Mauldin

What does it feel like to be manic, to slacken ones grip on reality and for a few days, weeks, or even months and erupt into an altered world from the rest of the human race. I’m not sure I can explain it in terms that people will understand, because I’m not sure I can explain it to myself using metaphors and words. It’s like the world around me has suddenly become so bright and stimulating my mind can’t keep up no matter how fast it races and yet the world is actually exactly the same and it’s my mind that’s been turned up a notch (or at least that’s what the doctors keep telling me).

I feel like I am rejoining the normal world. It’s a slow process... the meds don’t work instantly. I don’t just pop a pill and all of a sudden my brain starts to work conventionally again. In my opinion I’m not even sure that it was working wrong in the first place, there is a part of being manic that feels good, at least its not depression, which in my opinion is the nasty side of Bipolar. Who wouldn’t want to be europhic and feel like they have the strength to lead the world into the next spiritual and emotional revolution? Obviously it has its down side, being that everyone else was so terribly alarmed, but for me at least 50 percent of the time I was happy (the rest of the time I was either frantic, confused or anxious)... still the intense elation was (almost) worth it and I repeated “at least I wasn’t depressed”.

I’m starting to feel well again, because my agitation and anxiety have lessened to a more manageable level. My doctor told me a couple of days ago that he is pleased with my progress, he tells me I’m about 25 percent on my way to being well I was thinking more like 75 percent but I’ll take what I can get. I ran into someone I work with today when I was walking to my appointment in town and I swear she must have thought I looked perfectly happy and well. I felt the need to inform her that it wasn’t my choice to be off work so long but it’s hard to explain. Hypomania is wonderful, it’s like mania with only a fraction of the hassle, and I think many people with Bipolar want to stay hypo manic (to some degree). Unfortunately according to the psychiatrist it’s not good for you. I realise that there is a scale of mania, and I did not reach the top of that scale because I was able to have my rational moments, all the same it is scary to recognize in retrospect just how high I got without any self awareness of what was happening to me.

"the intensity, glory, and absolute assuredness if my mind's flight made it very difficult for me to believe once I was better, that the illness was one I should willingly give up....moods are such an essential part of the substance of life, of one's notion of oneself, that even psychotic extremes in mood and behaviour somehow can be seen as temporary, even understandable reactions to what life has dealt....even though the depressions that inevitably followed nearly cost me my life."
Kay Redfield Jamison

So what is it like being manic, I think coming down I am in a good place to give a little insight into what actually happens because I can still remember, and to some extent I am still experiencing much of the symptoms just to a much lesser degree than before. For me (and I understand it can be manifest in different ways for different people) it started with a decrease in my natural need for sleep. This is not the type of insomnia one generally complains about because it feels like you don’t need sleep. You don’t feel tired and there are so many wonderful and colourful ideas speeding through your mind that sleep seems like an enormous waste of time. So I started to get up in the middle of the night, just thinking about all the things I wanted to do. I had ideas about opening my own shop, I had ideas about work and how I could improve things for everyone there, and I felt exceptionally productive and happy.

Slowly I started to feel like I had a small adrenaline rush going on most of the time. This wasn’t a bad feeling because it was the type of adrenaline that makes me perform better. A little nervous zeal is often a good thing when it comes to getting stuff done. It was the kind of excitement that I could compare to going on a rollercoaster, or the anticipation of waiting for something really fantastic to happen. My heart would race and I felt exhilarated. It started gradually until I was feeling “exhilarated” most of the time.

Around about this time the anxiety kicked in. So I started swinging from exhilaration, to extreme anxiety. Usually at home or at times I spent in areas of my life where I was free to do as I pleased I was exhilarated and at work and places where people where expecting things from me I was anxious. I also felt really irritated when people where asking me to do stuff, I felt like what was going on in my head was far more important than anything other people might want or need me to do and so I would snap at people and just feel really irritable. It felt like if I was left alone to do as I pleased the world was full of colour and potential, everything else was holding me back from doing something really profound and interesting. Note at this point I was feeling like the most important person in the world. For anyone reading this with any knowledge of Buddhism; I was “self grasping” on a whole new level, in-fact it was way past self grasping, I had a God complex. Unfortunately and ironically my Buddhist knowledge of self grasping was useless because I was becoming deluded at this point into believing that it was justified and thinking I may in-fact be the personification of God, or the very least his little helper. I would like to add that in my less manic mode of being I don’t actually believe in that kind of God, still nobody said I’d be rational J

It was around this time that I noticed something wasn’t right, predominantly the anxiety and irritation where bothering me and those where the symptoms I wanted treated. With the mania came lots of glorious and eccentric ideas, I wanted to be outside all the time (but when outside I felt paranoid that I was being watched), I wanted to talk to people and socialise but the anxiety and irritation made this difficult. I was also aware that some of my thoughts were a little strange. At this point I had the wherewithal not to share those thoughts with other people but they where building in the background. I realised that I couldn’t cope with work because I was close to panic much of the time I spent in an environment that had expectations of me. My impulse was to simply walk out the door most of the time and that impulse was becoming harder to control. I was feeling suspicious and mistrustful believing that people where out to get me and this was especially related to work. People at work where noticing something wasn’t right and that made the paranoia even worse, in the end after talking to my GP who immediately noticed I was manic, convinced me that time away from work was essential if I wanted to keep my job. (I don’t want to dwell too much on what went on at work for me during that time because I am hoping to go back and repair some of the damage in the future).

When the doctor mentioned possible mania it did make some sense because I have been manic before and after taking some time to reflect I noticed the feelings I was experiencing now where very similar to how I felt back then. Years ago after taking Prozac for the first time it pushed me into a manic episode, however because it was after taking Prozac that I experienced mania the doctors did not want to assume I had Bipolar because it is possible that I was just sensitive to this type of anti-depressant. I had other issues that where causing depression and anxiety and I was working at resolving those or at least learning to live with them. After stopping Prozac I quickly crashed to depression again and the episode of mania was soon forgotten.

I agreed to see someone more specialised in Bipolar to find out if this was Mania and if so to see if they could help me calm down. This is despite the fact that my experience at the Royal Edinburgh hospital in the past, (through depression/mania) was not a positive one, In-fact I was meant to be monitored after my last episode of mania to see if it did happen again but I had been so royally messed around that I had stopped attending appointments and forgotten all about it. I had little faith that the mental health profession could or would help me (my faith has since been restored and I have been lucky enough to have the support of 2 lovely psychiatrists and a team of Psychiatric nurses all of whom have been respectful of my wishes and kind). In the mean time all sorts of wonderful, frightening, crazy things where taking shape in my head. To list some of those things;

I started to hear people whisper my name, I would be on the bus and people would be whispering Julianne under there breath, at home alone the same thing would happen it was peculiar, and creepy at the same time. The voices where coming from outside my body so it was like they where actually in the room with me (not in my head) and sometimes when I was really high they would tell me to do things, such as draw a picture of an eye, or to recite prayers.

I started to see colours and shapes at the corner of my eye,

I saw shadows move around the room,

I had the feeling that I was being watched. Sometimes I would see a person in my peripheral vision just watching me,

The TV started to give me special messages about things that would happen in the future, so did books I read, adverts I passed in the street and anything stimulating all had a hidden message. The messages usually revolved around Rick being the next Buddha, spiritual religious leader. He was “apparently” about to become enlightened and start a profound spiritual revolution.

I got messages telling me that we where being watched by the governments economists who wanted to prevent Rick reaching enlightenment because if he did so people would stop buying things and making weapons. I believed they had plans to kill us both if they suspected he was anywhere close to enlightenment.

I started to believe he was not only the reincarnation of the Buddha, but also Jesus, Allah, Guru Nanak and every other world religious figure. I started to truly believe that he was going to unite all the world religions and that he had the power of the universe to do so.

Everything great in the world is done by neurotics; they alone founded our religions and created our masterpieces. ~Marcel Proust

I believed I was the reincarnation of Mary Magdalene, and the Buddha’s wife.

The list goes on and on, I had many special and powerful beliefs some of which made me feel really europhic and others made me feel terrified. I did have rational moments too when I would stop and say, “What am I doing/thinking”, “I MUST be very ill” and then I would have some not so rational moments where I felt the need to share my views with people and wanted to do something to prove to the world that I was right. Such as but not limited too, hurting myself so Rick could heal me.

In the mean time I also saw a lovely psychiatrist who very firmly told me that this was Mania and I was Bipolar and so I MUST take medication. He was very keen to put me in hospital which I was very determined to avoid. Trust me the Royal Edinburgh is not a fantastic place to be crazy. I don’t care if it’s a mental hospital I am certain that had I been admitted I would have gotten worse and not better. My Psychiatrist, who is exceptionally nice, was kind enough to give me the option of having help from the “Intensive Home Treatment Team” who basically visit people at home and are available 24/7 to anyone who would otherwise be in hospital. I can tell you it is the strangest experience ever to go from being a support worker myself helping people in there own homes, to being a service user. Nonetheless I am incredibly thankful because these people have really helped me, kept me out of hospital, and I am starting to feel like I am on the road to recovery and on the bright side the experience of being at the other end of a support service has given me a tremendous insight.

I’m not back to my usual self just yet but I am getting there. Mainly I am aware that the medication is keeping things at bay, but not completely. If I am over stimulated I quickly become more and more high. Meditation, mindfulness and a shit ton of Chlorpromazine and Quetiapiene are keeping things at a level where I can think rationally, however the odd beliefs still come (I’m just able to ignore them most of the time). I still hear people whisper my name and at time it still feels like I’m in a different world to everybody. On the plus side there are far more rational moments and the meds that I have really are helping keep me calm. I can mostly function if I plan my day well and keep my environment calm.

My confidence is in ruins and the idea of going back to work and taking on any kind of responsibility is frankly terrifying, but I know that eventually I will be ok and life will get back to normal. When I saw the Psychiatrist yesterday and he told me that he thought I was 25percent better I felt really positive. I can’t be objective so there are moments when I believe I am completely well and there are moments when I know that I’m not. In reality I am relying on other people to tell me what they think and thankfully I have people I trust around me who will be honest. The doctors think that once this episode is over if I take the medication and work hard to pick up on the signs that mania is returning then I should be able to get back to normal and hopefully lead a normal life or at least minimise the damage to my life if and when this happens again. From everything I have read I know that it won’t just go away, there isn’t a cure but it can be managed and the good thing is that now I know that I have Bipolar a lot of the problems that I have put down to my past issues are actually part of Bipolar and so can be treated with Bipolar medication.

I’m not quiet ready to re-join the rest of the world, I have another 4 weeks to work with the home treatment team and to get used to my medication but there is definitely a light at the end of this tunnel. My main worry, and I am sure it’s a big worry for anybody with Bipolar who is trying to come down from Mania, is that I’ll crash to depression. Without medication this would usually be my pattern but I’m hoping that I might escape that at least this once, now I am doing everything I can to manage things with meds and lifestyle. Hopefully I will have something else to write about other than my general craziness soon J

Thanks for taking the time to read

Jools

Monday, 14 March 2011

Mania

Mania,

I wrote in my last blog a little bit about mental illness, I thought it might be useful for me to update a little, even though I’m not actually sure I’m going to be able to write anything that will be useful to anyone else reading.

I’m still not feeling myself but the good thing is that I am getting treatment and this time I really am going to stick to it no matter what because I know that my being like this is making everyone around me stressed , including Rick and I feel like this is just so unfair on him.

I’ve been treated in the past in regards to my mental health but that has always been mainly for anxiety, depression and sorting out issues from the past. (Lets be honest we all have something to mess with our heads and some are better at dealing with that kind of shit than others) – I didn’t used to be so good, but I thought lately I had got better and any problems I did have where under control and I was happy. I am happy; my problem at the moment is that I’m too happy.

I’ve been like this several times before, and the one time that I did get treatment for what they call Mania was soon after starting Prozac and so my doctor presumed that the mania was likely to be a reaction to the Prozac and took me off it pronto, I got put on another med and was given follow ups with the hospital to make sure the Mania didn’t come back and all was good. The problem was the hospital didn’t seem so helpful, (cancelled appointments, changed times and shitty receptionists) and some doctor and nurse making me feel like the biggest waste of space to walk the earth. .. so I never did follow up with that fully (after a few months I said fuck it and stopped going) I did carry on seeing my GP and things seemed ok in my head mostly so I felt that it was ok, I’d take the meds I was given and hope for the best. Any other issues were all under control.

A number of weeks ago I had a familiar feeling building up. It was a nice feeling, an excited feeling, an indestructible feeling. I knew I’d felt it before, it was mixed with anxiety and all of a sudden I couldn’t sleep anymore. My mind started to race, and race, and race, until all these connections started to happen between what was going on around me, books I was reading, adverts on the TV etc... I have moments of believing Rick is the next religious saviour (I know it sounds crazy but in my head it makes sense) feeling like people are spying on us, or that he is the reincarnation of something important like Jesus or the Buddha.

Ideas started to crop up in my head, things that I could rationalise and yet things I knew where odd. The idea that something big was about to happen to us religiously, spiritually, I felt people where watching us (I still do) I felt excited and wanted to share this with everyone, I can’t calm down. I still have the ability to rationalise things when I talk to people or Rick but at the same time what I believe is making sense (to me if not anyone else) and there are moments when I’m not even sure what’s real anymore. I hear people whispering my name when I know that can’t be possible. I see things out the corner of my eye and I feel elated most of the day and if I’m not elated I’m terrified or anxious.

I’m lucky that I have people around who encouraged me to talk to my doctor and she confirmed what I already knew deep down that I was manic again. This week I have been assessed by a lovely psychiatrist who confirmed that this 2nd (official) appearance of mania in my life means that I most defiantly have Bipolar. This is a good thing and a bad thing. The good thing is that it’s treatable and many of the issues I thought where just personality traits or hang-ups for things long past are possibly treatable now.

Currently I feel confused as hell. I trust Rick, I trust my doctor, and yet everything I feel and believe at the moment feels so real to me that it’s hard for me to accept its all just mania. Currently it makes perfect sense to me that Rick might be about to channel a cosmic universal power into the world and save everyone and yet Boy do I know how crazy that makes me sound.

I have hang-ups about being Bipolar, I feel like a disappointment and a failure and then I hate myself for feeling like that because it seems so unfair that I should hold myself to that stigma when really it makes me no more of a bad person than any physical illness. Part of the reason that I am writing this update despite that feeling of” OMG what will people think” is because no matter how manic I may be my intellect is still very much in-tact and I am very aware how vital it is that the sort of stigma attached to mental illness is crushed.

At the moment for me there is a constant adrenaline rush, and a feeling of urgency. My heart is racing and is now (according to the doctor today) tachycardic which can be a symptom of mania itself and can be made worse by the various medications given to treat mania. It means he is worried about putting me on a higher dose of medication but at the same time he wants to get the mania under control and so it’s a catch 22. I need to calm down but I can’t. Someone asked me today if I could just try grounding myself in the present and calm my mind down. If I could calm down I would, I want to relax!

The good thing is that I know I could be worse; I could lose my ability to rationalise with myself at least some of the time and thus lose my entire grip on reality. At present although there are periods where I have no rational there are still periods where I can talk myself down from a crazy idea by talking to Rick, my doctor and others. Going over what my head is thinking with some people I trust seems to help me ground myself back in reality. I have medication now and I just have to find the right tablets and the right dose. So this will pass, (eventually) and normal life will resume. In the mean time I am lucky enough that I don’t even have to stay in hospital I have a choice between that and being visited at home. Staying at home is really good for me, I have been in hospital before and it was an exceptionally stressful time although I’m sure much good work is done there, I am terrified of going back and being locked in, kept away from Rick and my home.

In the mean time, really sorry to anyone who has spoken to me in my less than rational moments and hopefully I will be back to normal soon.