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I kid you not I had a lightbulb idea for a blog to write, and as I quickly ran to turn on my laptop, in the minute or so between lightbulb and power button, I completely forgot what I was going to write about. And I swear, it was going to be good, you just have to trust me… Unfortunately, due to some medications I take, I lose my memory really easily.
Sometimes, bipolar disorder is funny like that, like in a light chuckle kind of way. I laugh at myself because I need to find the humor in something that has made my life very difficult.
I had a stress dream recently; the stress kind that when you wake up you are short of breath and your heart is racing and you’re perspiring a little…And its not quite a nightmare because it’s rather realistic, something that could absolutely happen, but that’s probably what makes it so stressful….
The dream? I had a manic episode and got a face tattoo (a heart on my right temple) and I could no longer be a therapist. I woke up absolutely alarmed; what if I actually did that one day?
After texting my partner about this dream, someone who also decorates their body with ink, he gently reminded me that most tattoo shops would never tattoo the face of someone without their entire body covered, and even then it is more rare. This allowed me to exhale. Phew… And then I exhaled a soft “ha” at my silly dream.
That “ha” felt complex. I could recognize with my wise mind that this was only a dream, a projection of a subconscious anxious thought, and that made it feel a little silly. But the other part of my brain, the emotional mind, told me that this dream was not entirely impossible; I could one day have a manic episode that could ruin my career, or my relationships, and that terrified me.
In grad school I had a lecture on bipolar disorder from a woman who works with people with the disorder. I listened thoughtfully, but also carefully. Don’t make a face, don’t offer insight, don’t ask questions, they may find out you’re one of them. I carried a deep fear that if my bipolar-ness came out, I could never be a social worker.
This lecture did paint a nice visual for me to understand the intensity and fluctuation in mood. The lecturer asked us to picture the globe. If the equator is “stability”, then the average person without a mood disorder oscillates between a +2 when they are joyful and a -2 when they are sad (see image). But a person with bipolar disorder leaps to a +5 at the North Pole when they are in mania, and a -5 in Antarctica when they are depressed, and they can do this very quickly with seemingly few triggers. Triggers include, but are not limited to, changes in weather, temperature, sleep, stress at work, jet lag, too much sunlight, not enough sunlight, menstrual cycle, conflict with loved ones, missing a dose of medication, or sometimes without an identifiable trigger at all.
What does this look like, exactly? Well, it can be different for each person, and each type of bipolar disorder. What’s important to note: a manic episode can make a person act outside of their values when they are stable. For instance, they may spend thousands of dollars that they don’t have, they may have an affair, they may put themselves in incredibly dangerous situations, they may steal, they may abuse dangerous and addictive substances, they may run into the street and play chicken with cars because they think that they have superpowers and cannot die if they were hit by a car (oddly specific but not uncommon). Again, I cannot stress enough, the person acts outside of their values; they can act completely out of character with little realization they are doing so. This is important to keep in mind if you are the loved one of someone with bipolar disorder. Your loved one may feel unrecognizable when they are in either polar state- mania or depression- and they can leave a trail of pain and heartache wherever they go during these times.
To provide a personal example, let’s go back to my freshman year of college. I knew when I went in I wanted to be a social worker, but my school lacked the specific degree, and I knew I would have to get a Master’s anyways, so I wanted to study something I would enjoy. At the beginning of the year, a new move and huge transition triggered my mania, and in this time I acquired 2 majors and 3 minors and was projected to be in school for about 7 years. I thought to myself, WHAT A GREAT IDEA! ….a few months later, I was convinced that God told me his plan for me was to drop out of school entirely and be, get this, a “professional volunteer”. My pitch: I would volunteer at a new nonprofit every day for the rest of my life, never earning a penny, and couch surfing forever. THIS WAS GOD’s PLAN FOR ME. Right?
These examples are a little comical looking back, and maybe you look at them and think “aw, that’s not so bad”. No, they left little consequences. But I had a strong support system that knew my values when I was in a balanced state. They made me drop to one major and one minor. They did not let me drop out of school. Thankfully, I listened.
In college, during my brief stint as a creative writing major, I read a graphic novel about an artist who details her diagnosis and treatment of her bipolar disorder for over a decade (Marbles by Ellen Forney). She followed up with a how-to graphic novel on managing your mood disorder (Rock Steady). I recommend reading these books if you: have a mood disorder, treat people with mood disorders, love someone with a mood disorder, or love creative nonfiction. She paints (or draws) a vivid portrait of what it looks and feels like to have extreme mood changes relatively out of your control.
The highs are so fun, until they’re not. I stop sleeping, once going 2 weeks without more than 2 hours of sleep a night. But when I’m in it that feels great, I mean think of all the things I could do while everyone else is asleep! Slackers… I also stop eating. No time for that, and nothing sounds that great anyways. I run on pure adrenaline. My senses are heightened. I remember being at a stoplight at the beginning of a manic episode and I could taste sound and feel color. It was incredible, everything was so vivid. I often make playlists when manic because I feel like I’m creating a feeling I can manifest later; I create the perfect blend of sounds to light my brain on fire. I can also lift an insane amount of weight when I workout manic; I equate it to mom strength when their child is trapped under a car- super strength.
But then, after a few days, the paranoia sets in. I shake uncontrollably, like when you have too much caffeine. My breathing is rapid and shallow, for hours at a time. I don’t just think- I know- someone is hiding around every corner waiting to hurt me. I am irritable; whether you chew too loudly or you punch me in the face, I lose my composure and want to rip your throat out. I start to feel like God is talking to me; in a previous post about suicidal thoughts, I mention that I thought God had told me one night that I would die in my sleep. I was convinced. And happy. I was ready to go. But then I woke up….I was so confused why I was alive.
And then I crash. I weigh a metric ton. My chest feels like it’s caving in on itself. It takes all my strength to sit up, I spend most of my time horizontal. Again, I stop eating, why bother? I sleep, and sleep, and sleep. I once slept for 3 days straight without food and water. When I finally left my room on a Sunday night, my roommates (all 6 of them) thought I had left for the weekend. Nope, I was just resting my eyes…And yes, the suicidal thoughts are LOUD. I am afraid of myself sometimes; what if I accidentally hurt myself on purpose? I stop cooking (knives aren’t safe), stop showering (I could drown myself), and stop driving (I could crash my car)—> This is more my OCD talking, a blog for another time…It’s an interesting contradiction because I am so miserable I want the pain to go away, but I am also afraid I’ll kill myself. It would be so much easier if I was just hit while crossing the street, or had a terminal disease. Yes, actual thoughts I have had, and I know I am not alone.
People who experience mania often enjoy it so much they stop taking medications that prevent it. I get why they do it. The high feels like you had caffeine, cocaine, and Adderall mixed in a cocktail sprinkled with LSD. (Or so I’m told). People go to great lengths to recreate this feeling artificially. But the high always ends in a crash, a deep, life-stopping depression. And that usually lasts much longer than the high.
With healthy habits, I have learned to identify what Ellen Forney calls “flag poles” and “red flags”. Flag poles are like triggers, or situations or environments, and the flags are like signs or symptoms of an episode setting in. For instance, I recognize that my flag poles are changes in sleep, alcohol, work related stress, and weather changes. My flags are: less sleep, or more sleep, apathy or maybe indifference (?) towards my safety, high libido (I’m talking insatiable), and lack of appetite. These are things I know to look out for, or even prep for, in order to manage my self care. I know that if I will be traveling and changing time zones, I will need to prioritize sleep, minimize napping and caffeine, and traveling with extra meds, especially the ones I take as needed (PRN). Unfortunately, it’s hard to recognize you are in mania until you are deep in it, if at all. But it is possible to recognize and manage triggers to either prevent or dilute an episode. I also know during these times I need to communicate in depth with my psychiatrist, my therapist, and my support network of friends and family. These pillars of support keep my head above water.
I recognize this blog is especially personal; you may be thinking “she’s, like, really mentally ill. How is she a therapist?”. Great question, sometimes I ask myself the same thing. But then I recognize that living with this condition allows me to understand an array of clients because I have felt what they feel. I still feel what they feel, sometimes. And without getting on my soap box, you can have a severe and persistent mental illness and have a job, and have one that helps people. You don’t have to be 100% sane (who is?) in order to be a therapist. Secret: we are all either a little nuts, a little traumatized, and/or carry our own baggage; it’s why we chose the field, for most of us. I think my BP and my years of treatment have prepared me for being a therapist.
Living with a mood disorder is messy and sometimes unpredictable and dangerous. We have higher rates of suicide and divorce. We struggle to maintain steady jobs or a career. We have a shorter life expectancy than those without a mood disorder.
But there’s hope. Symptoms can be managed with medication and therapy. Exercise is wildly helpful for the lows and the highs. I can live a happy and fulfilling life with BP, I just have to pay extra attention to my environment and changes around me. And I have to be radically honest with myself, if my coping skills are healthy or not, and if I am living a life that fosters stability and longevity or impulsivity and recklessness.
Even with my bipolar disorder:
I am worth loving
I am worth knowing
I am worthy of happiness
I am worthy of respect
You are too.