Tag Archives: bipolar

The Health of Our Heads

In retrospect, I can recognize the signs. It starts with agitation. I mismatch and contradict what people say. My filters are gone and I sometimes say insensitive things, things I wouldn’t normally say or would have said more diplomatically. I don’t sleep well that night. And the next day – well, the next day is unbearable.

*

For most people, Mental Health Awareness Month means educating ourselves about mental health and acknowledging its importance. It means that for me as well. I’ve always been intrigued by various mental disorders and learning about them and how they affect people and their families. But over the last two years since the commemorative month was designated, the awareness part of it means something much more personal, much closer to home. May is Mental Health Awareness Month. For me, it’s every month.

My typical bipolar episode is one that most people don’t really know about: the mixed state. It’s when you experience both mania and depression at the same time. There aren’t that many references to it, and when I find one, it’s very short, almost dismissive. And that’s dangerous because of the 10-15% of people with bipolar who commit suicide do it while in a mixed state – you’re depressed but you have the energy of mania to do something about it. One minute you hear raging and wailing in your head, and the next minute you can’t stop crying. You don’t rest. You don’t lie down waiting for it to pass because you can’t. You pace, you walk in circles around the kitchen table, you feel like throwing your head into the wall, and sometimes you do. You’ll do anything to stop the relentless churning. It’s like having an egg beater in your head. And usually the only thing that stops it is the right medication.

Often when people feel better after taking their medication, though, they think they don’t need it anymore and stop taking it. And they immediately go into an episode. I knew that I wouldn’t stop taking my medication because I felt better, and so I developed this false sense of security that if I just took it every day, I would never experience another episode.

But if I don’t manage my stress, I can easily have what is termed a breakthrough episode. It will seemingly come from out of nowhere because I wasn’t paying attention to my triggers, and I wasn’t aware of the signs I exhibit when I’m beginning to go into an episode, the signs I mentioned at the beginning of this post. Over time and vigilant self-awareness, I have come to recognize the signs much earlier and can take some backup medication that my doctor has prescribed for these situations. It usually does the job, and I am back at my baseline within 2-3 days, very grateful that I didn’t advance into a full-blown episode, which sometimes feels like a glimpse of hell.

There are worse disorders than bipolar, worse diagnoses and outcomes. This is not a poor-me post; it’s an attempt to increase knowledge during Mental Health Awareness Month. We are not just in treatment centers and residential facilities. We are among you every day, working, paying bills, taking our kids to scout meetings, grocery shopping, lobbying for our children who have developmental disabilities, trying to function even when our neurotransmitters misfire, hoping like hell that when they do, we’ll gain the upper hand.

[image credit: Gifts for Awareness]

Tired But Wired

Stress over $16,000 bill from USDA? Check. Erratic sleep schedule? Check. More-than-moderate alcohol consumption? Check. Hypomanic episode? Done.

*

I got back from the concert feeling pretty ramped up. Earth, Wind & Fire were awesome! We had a great time! I felt so full of life and energy, and at 11:30PM I texted my boyfriend, “I’m not even that tired!” A half an hour later I tried to go to bed, reminding myself that I had work in the morning, and as I lay in my bed, head on the pillow with my eyes closed, it hit me. I felt a familiar but unwelcome whirring in my brain, and I knew: I was hypomanic. Uh-oh.

For those not as well-versed in bipolar terminology, hypomanic literally means “below manic,” meaning mild- to moderately manic. It’s how I usually experience the mania part of bipolar, which determines my diagnosis of Bipolar II, instead of Bipolar I, which includes full manic episodes that can cause major life disruption and can result in hospitalization. So that night I had the luxury of knowing that I wouldn’t get out of control along with the dread of knowing I would not sleep that night and probably the next, no matter how tired I was, no matter how thoroughly I cleared my mind, and no matter what medication I took, short of something a hospital might administer.

I knew it was pointless to fight it, but I still felt compelled to run through my mind-clearing meditation and try deep breathing. And actually my mind cleared rather quickly, since I have a good deal of practice in that area. My mind, with all of its musings, plans, thoughts, and analytical ramblings, is under my control with little effort. But my brain is at the mercy of my neurotransmitters.

I used to experience insomnia when I had depression and would toss and turn in bed for hours, letting my mind wander. It took me years to learn to rein it in, to train it to let go of all conscious thought and allow myself to sleep. But during times of depression the neurotransmitters do not make the brain whir, this constant sensation of being switched on, even if you are exhausted. During hypomanic episodes, my tactics of clearing my conscious mind still work, and then I’m left with a wired brain that keeps whirring all night, even going so far as to produce random, racing thoughts that I do not recognize. Words and images flood my brain, and I don’t know where they come from. It’s almost like I’m in someone else’s head, trying to make sense of their day, their memories, when I have no idea what they’ve experienced. And no amount of mind control makes it go away. Prior to my diagnosis and being put on medication a year ago, my brain would go so far as to cause auditory hallucinations during these episodes. Not voices, but sounds that my subconscious knew would disturb me, since I was already unable to sleep. You know, adding insult to injury.

This week was actually my first hypomanic episode since starting my current medication nine months ago, and I figured (hoped) that the medication would keep it in check. I was right – I only had two nights of disturbed sleep (and the second night responded fairly well to some OTC sleeping medication, surprisingly) instead of the usual four nights or more. My brain unwired itself more quickly than before, and I am nearly back to “normal.” I’m also more determined to keep a closer eye on my triggers – stress, irregular sleep patterns, and not keeping alcohol to a minimum. Awareness, as with any difference, leads to understanding.

*

I can make jokes about it, like making a hypomanic episode sound like an ad, because humor is what gets us through the day, through our often overwhelming lives, but I never lose sight of the fact that bipolar is a typically misunderstood, mystifying disorder that can cause real misery as much as perceived elation. But sometimes, if you’re lucky, the elation is real too, and life is good.