I Want to Talk About Dysphoric Mania (or Mixed States)

Before I begin, I’m going to try to reel this blog back in and let it be a lifestyle blog, talking about whatever is going on in my life, whether that’s the writer side of things the student side of things or what have you. Put simply, I’m going to try and let this blog flow naturally from whatever I feel is relevant to talk about at the time so as not to alienate those who have been reading this blog for a little bit. I’d also like to try and blog a bit more regularly, but there are no promises.

The last time I blogged was at the beginning of April, probably a week or two before I started slipping into a little bit of depression; however, it was relatively mild compared to what I was used to. I still had some motivation to do things, even though it was less than it usually was (so I had zero motivation for work, just for school), my appetite was unchanged, and I didn’t have the usual fervent desire to sleep in really late and go to bed as soon as I could. (But I was binge drinking on the weekends, so there’s that.) It was just feeling down and grouchy and irritable and a little bit burnt out. A busy work day made me more irritable than it usually would–I railed against it, in fact, screaming in my mind, “I don’t want to do this! I can’t stand this,” but being able to do it anyway, so could it have really been depression?

In fact, I thought it was all just mere burnout. Once the semester ends, I told myself, and I get some breathing room, I’ll be back to normal.

Of course, that didn’t exactly happen. Even when I started precalculus I still had some of the depression, but it was starting to dip more into anxiety at that point, so I thought of speaking with my psychiatrist about getting put on an anti-anxiety medication. And, no, I didn’t call her right away. I didn’t feel it urgent enough and told myself I could wait until August to have it taken care of. I simply thought I just needed a chill pill so the pressures of getting into a DPT program didn’t seem so much.

Then, out of nowhere, I started feeling good. Really good. Things were falling into place. I was doing great in precalculus and doing much better than I expected. Things at work were going great–my clients were building back up again, my Pilates class was building up since it was moved from Friday to Wednesday. Observation hours were going great. I started at a skilled nursing facility, so three settings in the bag. I was able to fit in more physical activity.

I thought I was just gaining a new lease on life and finally accepting that I was not a fraud and that I really am an awesome person capable of doing awesome things so there is absolutely no reason for me to feel insecure or worry about how intelligent I am to handle the hard sciences and so on and so forth.

After four good days though, four days that felt perfect, I began journaling my thoughts, and I realized what it was: hypomania. It makes rational sense since such an episode can precede or even proceed depression. And so it was then I had to admit my depression was bipolar depression. It also explained my ability to suddenly be on the AMT for a lot longer than 30 minutes and then following it up with a session of resistance training and still having energy left over to do more and more things.

Prior to this, I’d been stable for a little over three years. I thought I had put bipolar disorder behind me. I thought I had finally developed the strength to be able to overcome any ensuing episodes. Turns out I was really just in remission and was tipped over the edge from all the stress in my life. I’d argue it’s positive stress, but even good stress is still stress.

So I’m on week six of this roller coaster of hypomania/mania/dysphoric mania, and I’m not going to lie and say it’s all awful–some parts are just really freaking awesome. I’m almost done with a rough draft of a contemporary YA novel, and I’ve been on a hiatus for over two years! Granted, I’m on medical leave, but even if I weren’t, I still likely would have started writing a novel. Even when I was at work I wrote enough poetry to make an anthology. You’ve gotta do something with the manic energy, after all. You can’t just let it get pent up.

So the jarring reality that I’m a bipolarite for life is daunting when the future, that is me being in PT school, will allow for no slip-ups.

But I don’t want to talk about depression or hypomania or even mania. I want to talk about dysphoric mania because I don’t think it gets spoken about enough. I’m going through a little bit of dysphoric mania right now, luckily without any suicidality–but I feel down and want to cry but with the energy to do things (I didn’t want to come home from biking and would have biked all day if it weren’t for the fact that I’m married and have a husband who needs me. And if it weren’t biking, I would have wandered off somewhere else, likely blowing more money from my savings or going to bars or something. I really did not want to come home).

Depression gets enough attention. I believe most people have experienced some sort of depression throughout their lives, whether it’s situational or clinical. The percentage of people with bipolar disorder, however, is small (2.6%) and may be bigger since a lot of people don’t seek diagnosis for it or are often misdiagnosed because they are unable to grasp when they’re manic. In contrast, 6.7% of people experience a major depressive episode at least once in their lifetimes. But 15% of people will experience some form of depression. So while there are those out there who believe you need to suck it up, pull yourself by your bootstraps and move on, no one really talks about dysphoric mania because it is so unlike depression.

It is the type of mixture of mania and depression that can get you typecast as crazy.

It is the type of state that made me attempt suicide by trying to drink myself to death (I didn’t even get to the point of throwing up since you can drink so much more and be fine when you’re manic, but not like I knew that!) and being absolutely ambivalent that I failed. I did wind up, for the fifth time, in a psychiatric ward convinced I’d be healed of the mania by the time I got out. I’m so used to being more depressive than manic, but when I think about it, there was a time when I was hypomanic for three months when I was on Abilify, but it never ping-ponged because I was blissfully unaware. I simply thought I had developed a hyperthymic temperament. If I had been aware, my mood likely would have started undulating the way it has been.

In my normal depressive episodes, I wouldn’t have even had the energy to do something like that. Or it’s more like I wouldn’t have had the motivation. I could think about it, even make plans, but I never would have followed through with any of them because dying itself takes a certain amount of energy. But with dysphoric mania? All those dangerous impulses you’ve had cycling in your head are suddenly a manic hamster on a wheel, and you just choose the most appealing way of hurting yourself to stop the insanity.

Your flights of thoughts are not fun anymore. My flights of thoughts include biking, writing, studying, reading, writing, writing, writing, more reading, wanting to go out biking but it’s too late, listening to music on full volume pretty much all day, occasionally coloring, cooking, cleaning–there’s always so much to do, do, do, and never enough hours in the day. I don’t want to slow down. What is slowing down anyway? It’s all about speed! Also, sometimes impulsive spending. My bike was an impulsive purchase, but one I made knowing I still had plenty of money in my savings.

Yet, during dysphoric mania, the thoughts darken to slitting your wrists, drowning yourself, jumping from a tall building, drinking yourself into a stupor, doing something absolutely reckless that makes you high but also has the potential to kill you, speeding really fast while raging against all that is slow and crying that you’re like this and why do you have to be like this and wishing you were just plain-old depressed because when you’re down it’s actually burdensome to be full of energy and you wanna claw off your skin and cry while exclaiming everything is so wonderful and jump of a cliff while realizing you have a book to finish and–

My dysphoria today makes me feel down and sad, but it doesn’t preclude me from wanting to do something about the energy. That can be a blessing and a curse, but I made it a blessing because I went out and biked for several hours instead of hopping on over to a bar and drinking myself into a blissful slumber. I cried a little bit (tears mostly leaking from my eyes) when I found myself at a creek and started wading through it because the sadness is just so profound, but I got back on my bike and continued on a journey that was still thrilling. There were times throughout this little trek that Iwished I could bike so fast I’d go flying, so I took a few calculated risks to get that rush, but there were times that I did temper it when I came upon an especially rocky area that could damage both me and my bike.

I have been very fearless as of late. I know I’m still at it when I wake up in the morning and ask myself if I’d still like to go skydiving, and if the answer is yes, then I know I haven’t found my way back to the rational world.

Sometimes dysphoric mania, however, can leave you not wanting to do anything, so the energy is a winding buzz of caffeine x100 that makes you want to scream–so you sometimes do–and tear your skin off because all you want to do is sleep but you can’t without downing a higher prescription of your sleep medication than what you normally would take. It was this type of dysphoria that made me try exceedingly hard to die by overconsumption of alcohol.

It’s not fun. It’s moments like these that make me want to reestablish some semblance of normalcy. I’m going to be honest: Hypomania is absolutely fun, even with the rage and irritability. Mania itself isn’t so much because the energy is too much, and when you’re in a situation where you have to temper it (it’s much easier to control when hypomanic) you might appear bizarre to the people who know you: you cannot stay still so you pace or rock on your heels or snap your fingers, you’re not controlling your rapid speech, you’re an excess of you (my morbid sense of humor was slightly out of control when I was observing at the VA), you scream in your car to release some energy, you sing really loud to release some more, and when you are in a situation where you can indulge the energy, you’re looking for thrills that will tear the most out of you, even if you are aware you will look absolutely absurd.

You can also survive on much, much less sleep. I nearly went the entire night without sleeping but decided I should probably try because the energy was starting to become unbearable; however, I survived on roughly four hours of sleep without any issues. Even hypomanic I still have some sense to try and get in at least six or seven hours. Normally, I need more than that because the Seroquel takes longer to drain from my system, but it drains from my system within 30 minutes to an hour upon waking versus the three hours it normally takes so that I stop feeling groggy.

I get mixed at least once a week, sometimes more depending. Last Wednesday threatened to do me in with a mixed state, but I biked like a maniac and was able to ward it off. I even brought myself down to hypomania the next day from having done so. So of course I went out and bought my own bike. What a great coping mechanism!

I become a completely different person when I’m mixed.

Right now I am sad and want to cry and am silent and when I do speak it’s in bursts of short chatter, but I am also thinking about how much I freaking love mountain biking and my mind is obsessively fixated on practicing on the mountain biking trail at the Augusta Canal so I can then go mountain biking at Bartram Trail of Clark’s Hill and I desperately want to do it tomorrow but I also want to mark out the path I’m going to take to work and need to bike that so that way there are no screw-ups that make me late for work or put me in any kind of danger and I bought myself a mountain biking outfit that I’m really thrilled to get and really want to start a mountain biking club and–

And that is the state of my mind right now.

Some days I simply feel crazy.

 

 

Mental Illness and Creativity

I’d like to thank litebeing chronicles for inspiring me to write this post.

People have this conception that a prerequisite to creativity is some form of mental illness. After all, don’t you have to be some sort of mad to spend hours on some piece of art that may never see the light of day? I suppose so, but then there are a variety of mental illnesses out there, some that might enhance creativity, and others that may inhibit it.

I can only speak as a person with bipolar disorder who has gone through mania, hypomania, mixed states, and depressive episodes. I can’t speak for any other type of mental illness, like schizophrenia or dissociative identity disorder or panic disorder or even borderline personality disorder. So my experiences with creativity, or lack thereof, only come from my experiences with my own mental illness.

Vincent van Gogh, The Starry Night. Oil on canvas, 73×92 cm, 28¾×36¼ in. (Photo credit: Wikipedia)

Mental illness can enhance creativity in some aspects. I never hallucinated during my manic episodes, but the fast, racing thoughts and overexcitement of life seemed to have resurrected dead creative brain cells that were lying dormant in their little graves. Stolentime was partly the product of a manic episode and mostly the product of my sanity working through what my mania came up with. Of course, the novel was a completely different story then, but only because my mania had no filter and no way to logically structure a story. So while my mania came up with an idea, it couldn’t bring that idea to proper fruition because the thoughts I had were too grandiose and I couldn’t look at reality properly. I was completely delusional, so to speak.

I once read some of Van Gogh’s paintings were a product of his mania, but there was no mention whether he painted them while he was manic or after he was manic because mania can give you thousands of ideas, most that you’re not even going to remember.

But depression inhibited my creativity. My brain was so weighed down by this thick, heavy black fog that it couldn’t come up with anything new. It kept trying to grasp on to those ideas it came up with during mania, but it didn’t have the energy to put any sort of logic to them. However, I do think some writers have used their depression to their advantage. Apparently Sylvia Plath wrote her final novel when depressed before ending her own life, so it is possible to write while depressed–just very, very difficult. I couldn’t really brainstorm Stolentime while depressed, but I had enough in me to work on When Stars Die because it didn’t take whole re-writes.

Overall, I think mental illness can enhance creativity, but after the fact. It’s very difficult to enact creative processes while ill, but that doesn’t mean one can’t use one’s illness as a source of inspiration–might as well make something good come from the bad, right?

In Honor of Mental Health Awareness Month

May is Mental Health Awareness Month, and I had no idea. I should have known, but I guess with being so busy with all this ballet and writing-related stuff, the world has passed me by. But I’ve been more mood swingy lately, and I’m not sure what’s going. Earlier today I broke down crying because I felt so bad, but now I feel fine–I think. Is all this busyness catching up to this fragile mind, or is Mother Nature about to send me her Gift, even though I don’t think I’m due for this said Gift for another month? I don’t know, but I have a psychiatrist’s appointment next month, so if it continues, I’m just going to try not to let it get to me. I might sleep in later tomorrow. That might help. I might slow down tomorrow too, take a walk on the treadmill–I get to see Man of Steel tomorrow night! Huzzah! But if my mood is about to take a turn for the worst, I don’t want to let it overpower me because I simply can’t because I have this life now, this career I want to develop, and a client who depends on me to whip his manuscript into shape. And I will do it.

But I wanted to write about the breakdown that landed me in my first psychiatric hospital in honor of Mental Health Awareness Month. I’ve never talked about it for reasons I can’t even think of, so I might as well finally talk about it.

It probably started some time last summer. My body was giving me grief in ballet. I’d be in so much pain during barre exercises that I couldn’t move anymore. My sleep also became spotty. Some nights I’d fall asleep just fine, and other nights it would take hours. I struggled with unrefreshed sleep already because I’d wake up frequently throughout the night and then go back to sleep, but it happened maybe once or twice a week. Those times sucked because I’d have to pretty much take bed rest due to pain from unrefreshed sleep. Eventually I thought I had gotten my sleeping problem under control, until the fall came, and, out of nowhere, I just couldn’t fall asleep.

I’d lie in bed for hours, unable to get myself tired enough to fall asleep, so I’d sleep like maybe four hours a night, and even then they were four hours of unrefreshed sleep. I finally got fed up and got some Tylenol PM, which did help, but the damage was already beginning. In spite of sleeping well, or seemingly well, I was moody and couldn’t understand why. It was also flare season for my fibromyalgia, so I was in pain everyday, but I couldn’t fight it like I was able to when it first emerged, probably because I realized fibro is forever. About once every week or two weeks, hypomania would claim me, which didn’t make sense to me because I felt so euphoric but my sleep was crap.

I didn’t start becoming suicidal until the crashes from hypomania. I had felt so great then and kept wondering why I couldn’t re-claim that feeling, why I couldn’t simply get over the thick despair choking me. My fibro flares weren’t helping either. I just couldn’t believe that the illness was forever, that I was always going to be in pain, and it didn’t help that I was working a lot while going to school, so the stress just made me a ticking time bomb.

My parents also think the Lyrica I was on at the time may have had something to do with the suicidal feelings, and that could have been it–at first. Lyrica can be used to treat bipolar disorder, so I suppose it’s a possibly it could have had an adverse effect on my mental health. I was breaking down though. I probably broke down at least three times a week, where I’d cry alone in my room and sometimes cut to stop the pain that made no sense to me.

Eventually my friend found my Tumblr and contacted the guidance counselors, who contacted the dean because they can’t force me to see them since their appointments are scheduled. So I saw the dean of students who was genuinely concerned about my mental health as a person, not just a student. She encouraged me to see the school counselor, even though I was waiting on the referral to see a psychiatrist. She also became my ally, my advocate. So I decided to see a guidance counselor who, because of my suicidal feelings, thought it was best I not be alone for the weekend since my parents were going to visit my brother.

My fiancé stayed with me, and I felt horrible the entire weekend. I seriously considered swallowing a bottle of Unisom sleep gels because I couldn’t take the pain anymore and couldn’t stand waiting to see a psychiatrist. I skipped out on work Sunday not only because my stomach felt horrible but because the stress from this undiagnosed mental illness just debilitated me. It was then that I decided the best thing for me would be hospitalization because it would get me in to see a psychiatrist and would get me started on a proper course of treatment. Plus, it would keep me safe from myself, and I figured it’d be a good place to “detox” from the Lyrica.

But, of course, things were not so simple. The Remeron I was prescribed launched me into a severe manic episode. I should have known something was wrong when I felt immediately better THE NEXT DAY after taking it. So it was probably within a week I went manic, and I was manic for the next two weeks before finally being hospitalized again because the psych appt. the first hospital scheduled me was too far out. But I suppose the good thing about going manic on Remeron was that I received what I’m sure is the right diagnosis because antidepressants don’t make you manic unless you’re predisposed to bipolar disorder, or so it’s believed. Wellbutrin, a med I took a few months ago, also made me manic, but it took longer to do so.

But I’m in therapy now and on meds that I pray aren’t crapping out on me. I’ll just have to really gauge my mood now, which is what sucks about bipolar disorder. It’s often a life-long illness and any change in mood that happens for seemingly no reason makes you alarmed.

Guest Blogger: Amber Skye Forbes

Here is my guest post on Charles Yallowitz’s blog!

Legends of Windemere

Today’s guest blogger is Amber Skye Forbes, who is both a writer and a dancer.  How’s that for talent?  She is an amazing woman, who has taken on a very difficult question for this guest blog.  I’m very honored that she agreed to do this.  Please, check out her blog and get to know her.

The question: Do you think art in any form is a healing and coping method for mental illness?

Without further ado, here is Amber Skye Forbes:

Mental illness is an incredibly difficult thing to deal with. It can be terrible too. I have bipolar Type I, and the depression was the hardest thing for me to treat. Mania only takes a mood stabilizer, but that pill doesn’t always want to treat depression. But I am stabilized now and feeling better than ever. Of course, during this time, I wasn’t doing as much art as I…

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My Constant Flow of Cheer

This little thing right here is part of my optimism.

Did I mention I am stable on meds now? I have no idea, but if I didn’t, now you know. My magical cocktail: Trileptal, Seroquel, and Abilify. The Trileptal controls the mania, the Seroquel does the same and helps me sleep, and the Abilify treats bipolar depression, which is so difficult to treat for most of us.

I can’t believe how happy I am now. I know it’s not because When Stars Die has a publishing contract because if that were the case, depression would still be breathing down my neck, and I’d know it. I wake up every morning, thinking, “When am I going to be not sleepy so I can live?” instead of, “I just want to sleep all day because everything feels stale and pointless.” It’s terrifying to know my brain chemicals are fully in charge of my mood–one blip, and I could wind up depressed all over again. But it’s beautiful to feel this way. I feel like an immensely different person: confident, driven, motivated, loving, sensitive, artistic.

For anyone who has ever suffered from a mental illness that took a while to treat, it truly is the little things that make a big difference. I have my appetite back. It was so strange feeling hungry for the first time in a long while. I couldn’t pin down the sensation until my stomach started growling ten thousand times. I’m also not tired all day long. I used to yawn hundreds of times each day, begging to go to bed so I could just sleep away everything. I have energy. I just want to do things all the time now and I view sleep as a hindrance to productivity–but I do sleep because I know I need it. If I were manic, I wouldn’t even care.

Because I have my appetite back, I no longer struggle with irritability and anxiety. I feel perfect, just cheery, optimistic, hopeful, ready to take on the day. When I was depressed, the fight didn’t feel like it was worth it to me, but now that I’m better, I realize the fight was definitely worth it, and I hope to remember this the next time I’m depressed. As my therapist says, “You are going to feel better because you always have felt better.”

And to think that it was just at the beginning of last week that I still struggled with suicidal ideation.

The Madness of a Writer With Manic Depression

I talk about my depression a lot, what it’s like to be back into writing even though I’m still in a depressive episode. But I have never told you what it was like to be a writer during a manic episode. Let me first distinguish between my hypomanic and manic episodes. During my hypomanic episodes I’m crazy energetic, but I’m not irritable or prone to fits of rage. I have no inhibitions, but I can still stop myself when I know I’m getting too high. The energy is just productive and a nice break from being depressed. During my manic episodes, however, I am prone to fits of rage, I can become irritable at a snap, and I cannot put a cork on the frenetic energy that pours from my brain. Because I lack inhibitions, I am not afraid to be mean or nasty or honest–and that is very problematic because I end up hurting those I love. The energy can easily turn into anxious energy, and this is when my psychomotor agitation kicks in: I have to be moving in some way, or else I explode in a fit of rage. Expecting me to sit still is like expecting a sex worker to remain celibate.

Luckily, my mania is treated.

In any case, the last time I was manic, I wrote 15,000 words in a day. In a day. With no problem. I did a million other things during that day too. I thought the story I was producing was pure genius. I’d finish it during my manic episode, revise it, and some publisher was going to see the genius in it and it’d hit bestseller’s lists all across the globe.

But that’s what happens when I’m manic. My self-esteem is inflated to obnoxious degrees. I’m not simply The Dancing Writer. I’m The Dancing FUCKING Writer. With this book, I was trying to combine my reality with the reality of a 19th century boy. So if you’ve ever read Emilie Autumn’s The Asylum for Wayward Victorian Girls, I was pretty much trying to do what she did. I was using my experiences in psychiatric wards and trying to blend it with the voice I heard in my head (I’ve never heard voices) that happened to belong to a young boy from the 19th century trying to tell his story.

It was bad. Really bad. As in, I couldn’t even revise it to save it. But my manic thoughts were not a waste. In fact, they gave me creativity–uncontrollable creativity, but creativity nonetheless. A lot of artists who are afflicted with bipolar disorder can become more creative. They might not be able to utilize that creativity during the episode because it is hard to harness and control it, but they can use it later, after the mania has ended.

For me, even though the writing I did when I was manic was unsalvageable, I never let go of the concept. And I am using that concept right now to plot my current novel, which is much more controlled and less, well, frantic than it was when I was manic. The plot is different. The story is different, but I took the concept my overload of creativity gave me, and I am controlling it and harnessing it.

I am in no way glorifying mania–not even hypomania. What comes up must come down, and it often results in a crash that leaves you a crying mess the next day. I would never wish a manic episode upon anyone. The lack of inhibitions can be dangerous, the rage is destructive, and if you’re self-aware like I am, you hate yourself more than ever during these moments because your mind will not shut up and you have no idea where all the energy is coming from. You’re like Superman on red kryptonite.