I’m encountering something new lately in my bipolar world. For about a couple months or so, I’ve felt a little bit off… and it’s been getting worse the past few weeks.
My thinking is sharper but still slows down so I don’t feel elated. I get frustrated at nothing and ponder why I’m frustrated, hence getting more frustrated for no reason. I find I need to spend more patience than I need to. I don’t feel sad, blue, particularly happy, or even normal. I just feel the way I do, and I’m confused, and I didn’t like it. However, it’s very subtle and doesn’t always feel like the funk is there.
I took the Goldberg Depression test and scored a 14, and took the Goldberg Mania test and scored an 8. I fell in the “minor depression possible” category on the depression quiz and on the upper end of “no mania likely” category on the mania quiz.
These aren’t a replacement for therapy but they can be useful tools for dealing with moods and gauging how depressed or manic I am. Seeing this shows me yes, it’s very minor… but there’s possibly a slight depression going on and I’m also a little bit more up than usual on my test scores.
I’m not positive it’s a mild mixed state, but that’s my best guess at this point. I’ll be seeing my psychiatrist soon and this is a very minor thing at this point, so I’ll ask his opinion then.
So, how does someone with severe bipolar appear to become psychotic out of the blue? Does one typically snap into a psychotic state or out of one?
The answer my therapist gave me is true to my experience: No. Psychosis is a long, slippery slope towards falling over the edge, and recovery is a long, gradual, up and down slope out of the pit for acute psychosis. The trick I found is to learn how to catch it earlier and earlier to the point where I can maintain and not have to worry about it happening anymore. A significant part of staying away from psychosis as someone with schizoaffective/bipolar I disorder is staying on my medication, no matter how unpleasant the side effects can be. I’ve had two psychotic breaks: first was when I was diagnosed twelve years ago and the second one five years later when I stopped my medications.
What are some general things that go through my head when I’m psychotic?
Fortunately, I do not experience anger or aggression for the most part towards anyone. The only way I can briefly describe it is that I feel like everything I can possibly conceive of is going through my head at the same time. It feels like I’m transported to a different reality, which is a wondrous new place, or hell depending on what episode I’m talking about. With all this information overload, little details begin to form more delusions: religion, personal, ideas, world events, and reality itself all become torn open and full of mysterious riddles.
While all this is going on in my head, what do other people see?
I remember leaving my physical body and conversing with other people around the ward, conversing with patients and staff, and visualizing unimaginable things. However, my hospital records document me sitting in my room those days scribbling away on papers about a girl I was obsessed with years ago at the time. I remember having glimpses of writing about her in what seems like my subconscious. True reality was a dream to me and I was living in a dream (the kind I have when I’m typically sleeping). I likened myself to the living dead at the time, awake and asleep at the same time. My friend also visited me in the ward and he later told me that he could see it in my eyes that sometimes I left and came back right in front of him. When I came back, he pleasantly said to me, “Welcome back!” Then we’d converse for a few more seconds before I returned to my psychosis trip. The same would happen with staff as well – I faded in and out and the staff were very excited to see me back when I came back, before fading again seconds or minutes later.
Another interesting note: as I fade in and out of reality, so to speak, what happens when I call someone on a cell phone? Well, I did… I called my friend, and I heard his voice loud and clear, then felt myself go to the other reality and all I heard was static coming through on my phone – with a full signal. I’d come back and hear his voice again, then fade away again. I wrote a post about this earlier.
I remember trying to tell myself and hearing other people tell me that all those experiences are in my head, and they may be. However, whether real or not, they are what they are. I’m not concluding that I merely sat in a room as an empty shell of a body working out my obsession with a girl in the hospital is the whole story of what happened there. There are many more precious experiences to be told.
Some day, I hope I can do justice to describing what it is like to go through a firsthand psychotic break. It’s like getting lost in a fractal without any reference points, then coming back out again and seeing everything so differently.
If I could do everything over again, I wish I had set aside my mission of interpreting my psychotic experiences aside for later to work on after I had recovered more. Think of it as allowing the fresh, immature flavors of the experience to steep for a while and come back in a truer form that turns into something remotely consumable.
A psychotic experience is inherently an experience so great that I can’t wrap my mind around it. As every month passes, I understand more of it, and every few years, my interpretation of it may completely shift in certain aspects of it. Not only can I not wrap my mind around it, I have no frame of reference within my experiences in real life to contain it or frame it or allow my mind to interpret it.
The stories of my psychotic experiences have taken years to unravel as much as they have and allowed me to start understanding them. I liken these stories to a fractal. I can zoom in on any part or aspect of it and it has a seemingly infinite number of interpretations and implications, no matter where I look, and I find myself getting lost in the beginning.
If I need to revisit my experiences before I’m ready to, I do it in two ways.
The first is to talk about it with people I trust, to vent and to describe to them what happened. This helps me expose some air to all those experiences I had.
The second way is to deal with them more in my journals. If I have problems obsessing about them, I write down the content in my journals, and develop a mental plan of action as to how I can ignore these thought patterns in the future and explain to myself why I need to do so. I need to focus on what is important, recovery, and deciphering fractals of psychotic experiences right after they happened is not the road to recovery. It only leads to more grief.
That being said, after I get to a point where I can handle doing so without triggering my bipolar symptoms, I find it helpful to write down snippets or stories in great detail of what happened during my episodes. This serves two purposes: 1. It helps provide a fresh look later on when I reflect on my journals and look to see and remember what actually happened during my breaks in the forefront of my mind. 2. It helps me process the experiences at face value and understand what content there is in my psychotic breaks to allow me to recognize thought patterns I need to avoid.
In both of my psychotic breaks, God did not abandon me. He was there on every level each step of the way. Sometimes I was aware at the time, sometimes I wasn’t. In any case, God gave me a lot to handle but never anything more than I could. The same is true today. Always.
I saw my doctor today and I’m quite excited about the visit! We decided it’s best for me to cut my antidepressant Wellbutrin 150mg from my medications to take, which leaves me with only two that I now take for bipolar. Only a few years ago, I was taking five different medications for bipolar every day!
I’m now only on Lithobid 1500mg (Lithium carbonate extended release) and Abilify 20mg per day. It feels good to reduce the medications I need as I progress in my recovery and treatment process. It isn’t that I didn’t need all the medications before, but that I no longer need them at this point. I’m not afraid to add medications as long as I need them in the future, but I admit it’s wonderful that I don’t need as many atm.
I imagine if I start becoming depressed in the future, I’ll add the Wellbutrin back on temporarily.
I used to take a steady dose of Zyprexa as well, which I find to be a debilitating but effective medication for mania. If I start becoming manic, I add a small dose of Zyprexa temporarily.
The lithium acts as a mood stabilizer and is the foundation of my medicinal treatment.
The abilify prevents depression as well as mania and psychotic symptoms associated with both. Overall, I find it to be another miracle drug with no perceivable side effects at this point.
Well, that’s a snap shot of my medications as of now. Anyone else dealing with medication changes these days?
I suppose it may be better for me to just move on and forget about my past two psychotic breaks. However, as I learn more and experience more things in life, I’m realizing they play a big part in how my worldview is shaping up. Although it may be true I’ll never understand them till I die, I understand more about them as time goes on. What does not settle well is that it depends on whether the world as we know it ends first or my death happens first. Part of my psychotic breaks dealt with the end of the age and the commencement of the new.
I don’t expect anyone to understand. I continue living life as though nothing happened. I try to be generous, kind, loving, wise, and understanding. In my alone time, I spend some of it pondering all the big questions. I’ve been one to do that most of my life.
I think it’s a happy medium to spend some alone time thinking about my worldview and my breaks how they fit in. If I leave the psychotic breaks alone, then they have begun to drive me up the wall in the past. I have not reconciled the content of my breaks with how I understand reality yet. I still hope to write a book on them, what they were from my point of view and my inpatient notes’ point of view. They are drastically different.
Apparently, when I’m abysmally depressed, I’m susceptible to obsessing about suicide for one reason or another. In some cases, the feelings I have contain little or no warrant is there for me to feel that way. I would be open to the notion that demons channel their will into my head in those cases, gathered from what I’ve seen and experienced before.
When I have been truly manic on the other hand, which has happened twice so far in my lifetime, I walk the line between the physical and nonphysical. I walk with other people and other beings who seem to be part of what many would call God, yet there’s a strong connection between all parts of the universe itself. I kiss wisdom on the lips and slide back into reality at an utter loss of words at what just happened. I spent part of a decade trying to unwind these 2 experiences, and have hardly gotten anywhere, it seems.
One thing that shines through it all is a certain voice, whether mine or someone/something else’s that always walks the path of love in the level I do not fully understand. Love as a parent’s unconditional love for his or her child. This voice comes from the center of my confusing existence. I can choose to shut it out, like I have been lately.
This past week, I’ve noticed that my mood has been off a little bit. Other people haven’t picked up on it, which indicates I was not hypomanic or anything, but I noticed things internally.
I’m also aware of what brought this on. I recently learned my current job position is being eliminated, which caused a lot of negative stress. I’ve been staying up too late on my own and that has added fuel to the fire. I haven’t been eating very well, either, and that combined with lack of exercise can cause problems. Also, reducing my Zyprexa about three or four weeks ago may have gradually brought this on. There are other personal reasons as well I will not get into at this point.
There have been positive happenings as a result of being up. I’ve been very creative, and able to ponder my spirituality, myself, and the universe in great depth. I’ve been more witty, spontaneous, and outgoing than usual. I found I could talk much easier with people in person and didn’t think too much about being judged socially. Writing and ideas came easier to me, and my mind was much sharper. I had more energy than normal. I sometimes felt a bit euphoric. My eyes saw colors more vividly, I could notice more details, tastes were much more pronounced, and my sense of smell was better than normal. Meditation came very easily, and I could find the balances and the voice efficiently. Basically, everything was a little magnified.
However, there were negative things as well. I felt a lot more impulsive than normal, I said weird things to people that I normally wouldn’t say, and sometimes wished I could take them back. I became more obsessive about thoughts and sometimes people, concepts, ideas, things, and couldn’t stop the obsessions at will at some points. I tended to overanalyze everything and it started to drive me nuts. One example of this obsessing and analyzing was my manager who broke the news to me about my position. I couldn’t stop thinking about her and the situation at hand, which led to bad conclusions. Fortunately, I was not so “up” that I was hypomanic and didn’t actually act. It all mostly stayed in my head, but not all of it, I’m sure.
My course of action? To start going to bed on time, for one! Also, I am starting to eat healthier again and I am noticing a difference after a few days already. One night, I had to take a prn dose of extra Zyprexa to slow my mind down. Also, I need to come to terms in that this is the beginning of falling off course, so I’m not tempted to just “go with it” and fall way off course. Instead, I am being proactive and preventing the mood swing from turning into a significant one.
Meditation also helped, along with keeping my heart on a very short leash. When my heart gets carried away, the mind goes with it. When the mind gets carried away, the heart wants to skip away. When the mind or heart begin to drift away, that’s a warning sign. It’s hard to recognize, as I largely perceive things through the two.
However, I look from within myself, my center, if you will – the mind and heart are extensions of me. I am getting to know them and learn how to keep them close to me. When they drift off the ground is when other people will begin to notice and not just me, which is a place I don’t want to be. It can lead to doing things, big or small, I’ll regret doing later on.
So, keep your minds and hearts on a short leash! Learn what little nuances show up when you’re about to have an up swing. Don’t be in denial, and do something about it when you have that inkling something’s not right – it could save you from crashing and burning down the road!
If you don’t have a plan for when you’re starting to swing up towards (hypo)mania, talk with your doctors about it and come up with a preemptive strike!
In part 1, I described my experiences with phones during my second hospitalization for psychotic mania. My second break was more of a trippy, metaphysical journey I had, and very different from my first hospitalization. During my first hospitalization, I was in hell.
My first break happened while I was on a family Christmas vacation out of state. I completely decompensated on or around Christmas day, and the only place I could go was a seedy crisis stabilization unit. There, the patients were far gone to begin with, and I was in tune with what was going on around me spiritually. It was truly horrifying. Unfortunately, I don’t have my records as a reference point to what was happening in reality, so I just have the memories of what I experienced first hand.
I noticed that when patients would start talking on the phone, they would fade away and start changing into a different person. I didn’t know what was going on at the time, so I just stayed away from the phone. However, curiosity got the best of me, and I tried listening to the earpiece. All I heard were pops, crackles, and a feeling of me being sucked in. I put the earpiece down immediately.
Then it was time for me to see the doctor. When I heard that, all I felt was dread. I sensed he was a truly evil man. When I got in to the room to see him, he basically asked me why I was there. After my manic strings of answers, he replied. I cannot remember his face other than that I saw two voids for eyes and he looked like nothing I had ever seen before. “I can FIX you,” he said. He handed me a phone and told me to talk on it. I refused. He tried pressuring me hard, and I opened the door and ran out.
Later, I had a brief memory of me in a dark room wearing some sort of helmet that someone was dialing in signals that I could feel into my brain. I felt myself going out of my body to some place else, and entering a realm that I experienced later during my second break, verbatim. I saw many things, and I felt like someone was trying to steal me. I fought back hard, and snapped to in the dark room, threw the helmet off, and ran back into my unit.
I believed they were “curing” these people by attaching healthy souls to them, and part of it had to do with the phones they were strongly encouraging people to use.
That psychiatrist prescribed me Geodon. I refused it, because I could never trust a doctor who tells me “I can fix you,” in such a calm, matter-of-fact demeanor; someone whose face I couldn’t see.
Fortunately, they had another psychiatrist on a different day and she seemed trustworthy. I took the Abilify she prescribed, brand new at the time.
The one thing that can throw my bipolar management off most efficiently is a disturbed sleep pattern, caused by chemical imbalance, life situations, or irresponsibility. Most of the time, it’s my own irresponsibility. A disturbed sleep pattern often means difficulty falling asleep and an inception of hypomania and/or mixed states, causing more troubles falling asleep and staying asleep, and the spiral begins unless I get the sleep under control.
Sleep medication hasn’t helped me much in the past. In fact, ambien made me sleep walk and hallucinate, and other classes of drugs didn’t seem to have an effect on me. However, what have helped are music, binaural beats, and isochronic tones.
Ambient music is my number one choice for music to fall asleep to. Sometimes, it’s drone metal or other genres, such as trance and classical. It depends on what I want. One good source for a legitimately free, diverse selection of downloadable ambient music is Jamendo.
I then add binaural beats and/or isochronic tones to my headphones. I choose ones designed to induce sleep or progressive relaxation ending on sleep wave frequencies. When my sleep is disturbed, the induced hypomania or mixed state causes me to be very sensitive to all stimuli, making it hard to clear my head and fall asleep. Yet it also amplifies effects of the beats and tones because I’m so sensitive. When I’m functioning normally, they don’t have as a pronounced effect.
A binaural beat is basically two very similarly pitched frequencies being played simultaneously, one in one ear and one in the other ear. It has a very hypnotic effect on the listener. While listening in both ears, beats appear and have a fluctuating pattern, fast or slow depending on how close the two pitches are to each other. Listen in only one ear and it’s simply a sound pitch. Put both on, and it’s like listening in 3D. Higher frequencies are associated with stimulating effects, concentration, and meditation, while lower frequencies induce sleep and relaxation. There are an incredible variety of beats out there: search “binaural beats” on YouTube for some examples.
Isochronic tones are simply one pitch of sound being played repeatedly quite rapidly. The pitch is played for a certain length, followed by an equal length of silence, over and over again. The sound is the same in both ears, and it also has a hypnotic effect on the brain. They can produce states of reduced anxiety, better focus, stress relief, meditation, concentration, and others. One does not need headphones while listening to isochronic tones.
I’ve seen some places where binaural beats and isochronic tones are combined as well, sometimes even to music all at once, to produce certain effects.
There are phone apps out there which allow one to pick ambient noises, music, tones, and beats, mix them together, and play them all at once. I use AmbiScience from Tesla Software on my iPod touch, specifically the AmbiScience 300 program, which is $2.99 on the AppStore. I understand some versions of AmbiScience are also available on Android. The 300 has many sleep and relaxation effects, both isochronic and binaural, along with an exclusive interval feature. This allows the user to program additional effects on, say, a 15 or 45 second timer. For example, I can add extra thunder during a rainstorm track, or bird sounds, electronic effects, and more.
Otherwise, one can peruse the YouTube videos, find some you like, and use an internet YouTube video to mp3 converter to download the audio if desired. In any case, tones and beats have been powerful sleep aid tools for me, medication free! Let me know what you think!
A follow up to part 2 of “Bi-polarized Perceptions.” I remember especially right before my first break, after a manic episode had been revving up for 5 months and I was running on 2 hours a sleep per night for months, I experienced rapid changes in my perceptions of things. For 15 seconds, I felt like I was on top of the world, ready to change it, and then for 15 seconds all I could think about was cutting myself or worse, just to get rid of this unbearable pain.
My moods flipped back and forth rapidly: 2, 3, 4 times per minute: really manic, really depressed, really manic, really depressed. I forced myself to keep going. Often, talking to people such as the chaplain in my school helped me out and set my mood back up for a little while, before it crashed again. Still, it was some relief.
Along with my moods about things in general, specific things were stolen away with my mood shifts wherever they went. I’d love my mom, hate my mom, really love my mom, really hate my mom. I’d sense demons were there to overpower me, angels come and relieve me of my battle, then the demons would come back after the angels left, and so on.
I could make it through this calculus class, there’s no way I can do this class right now, I’ll finish my homework in about 5 minutes for calculus, I don’t understand anything that’s going on right now. Colors would become incredibly vibrant, then fade into almost gray tones; food became an amazing, delectable treat, then a cupcake tasted like cardboard after I chewed on it for a bit, and my mood plummeted again.
This phenomenon is called “rapid cycling” bipolar, and it’s a nightmare. I lost my reference points pretty quickly when I experienced it. Soon afterwards, around Christmas 2003, a family Christmas vacation made me snap when I couldn’t sleep for about 4 days straight. Mind you, I was not on medication nor was I diagnosed at the time.
Future parts may follow to “Bi-polarized Perceptions.”