Content Note: bipolar disorder, suicide data, coronavirus
Since late April, I have been miserably immersed in a mental health crisis – first, hypomania and then, depression.
For more than two months, I have been very ill and struggling to slog through it. It has been nasty, wrapping entrails around me to distort my thoughts, trigger physical symptoms, and – worst of all – steal my hope that I would recover. The past two weeks in particular have felt immense in their despair, as if I was living in a cavern alongside everyone else but unable to see the world the same way.
There is nothing romantic or inspiring about these symptoms. I’m not more creative or open to the universe. I’m just expending every bit of energy I have to survive.
One of the worst things is that I can see it coming. And for awhile, I can muster through on willpower and my cognitive understanding of what’s happening. But the painful, vicious emotions eventually take over and I am grasping for lifelines.
Mixed features refers to the presence of high and low symptoms occurring at the same time, or as part of a single episode, in people experiencing an episode of mania or depression. In most forms of bipolar disorder, moods alternate between elevated and depressed over time. A person with mixed features experiences symptoms of both mood “poles” — mania and depression — simultaneously or in rapid sequence.
Mixed states are horrible. I act horrible. I feel horrible. I can’t predict what will happen from one moment to another.
It is a thousand times worse because we are experiencing a pandemic. I can’t be helpful (my go to method of coping with stress) and I need to be 1000x more careful about things like masks because the temptation to say “why bother?” is an existential but very real angsty crisis for me.
I”m not really afraid of the COVID-19 per se as I am afraid of the self-absorbed attitudes of people who simply refuse to acknowledge that their personal sacrifices and inconveniences are a necessary part of the pandemic response. Everyone has a good reason why their haircut, their burger and beer, their refusal to wear a mask, etc is very urgent or perfectly safe without any acknowledgement of the systemic impart of thousands of people making the same rationalization.
From my vantage inside a mental health crisis, their willful ignorance and selfishness simply reinforce the deep feelings that I am not worth being helped or protected or supported. It isn’t their intent, but it is a consequence of their choices. I know that no one is actively trying to make me sick, but the lens of hypomania and depression create a distorted sense of connection to people.
And of course it is worse for me because my capacity to participate in the nationwide response to the murder of George Floyd. I’m following along at home. I’m not unfamiliar with the issues. But I am disconnected and unsure of myself enough to make informed decisions on how to participate. So I follow, I donated to a local Black medic, I donated to the bail funds, and I try to focus on getting masks to people.
And then I cowered because it felt like the world was on fire, a fierce mixture of chaos and privilege that was already echoing through my mind. I wasn’t really threatened by COVID-19 and certainly not by the police 99% of the time, but my threat is internal – I’m the risk to myself. I felt so guilty and selfish for not being able to shake it off. Then I’m angry because I didn’t ask for this – this happened to me.
A traumatic childhood raised by parents who never resolved their own childhood traumas, years in the belly of the abusive beast, being gaslit by literally every adult. Those things set a spark to my latent propensity toward a mood disorder. This was done to me by people who loved me.
None of that is helpful or reasonable. I have an illness, not a moral failing. The self-recrimination drove me down pretty far this past week. I am angry and can be nasty. I feel alone and bereft. It is like a train has left the tracks and gaining momentum while I try desperately to get off. All I can do is cling to it and pray it will slow down.
I also experienced some medication side effects. My Pdoc increased my lithium dosage and my thirst levels were ridiculous. I’ve been drinking every hour around the clock which means disrupted sleep (very bad) and lots of trips to the bathroom. Then I am desperate for something to drink other than water. Then I feel almost quixotic to find something that tastes good. This is how I end up with elaborate conconctions of juice, lemonade, and assorted ingredients, then begging to go to Starbucks.
It was just today that my diagnosis of a mixed state was confirmed by my treatment team.
The most serious risk of mixed features during a manic or depressive episode is suicide. People with bipolar disorder are 10 to 20 times more likely to commit suicide than people without bipolar disorder. Tragically, as many as 10% to 15% of people with bipolar disorder eventually lose their lives to suicide.
Evidence shows that during episodes with mixed features, people may be at even higher risk for suicide than people in episodes of bipolar depression.
I”m both relieved to know what’s going on and scared by how many layers of trauma intersect this bout of symptoms. I’m angry that I’m dealing with this really scary stuff after almost two months of exhausting symptoms. I have a safety plan and plenty of support, but there are moments when I feel so alone. I”ll never get to leave the house, never enjoy breakfast with friends, never swim, never go to the ocean, never hug my niblings. and so forth.
It is really hard to have your head throbbing with utter chaos while surrounded by a world on fire in the midst of pandemic that cannot be seen. My mind is telling me it is my own fault for not being more responsive even though a little part of me knows this is something that happens to people like me. We get ill, symptomatic, however you define it. And the struggle to get through the symptoms is real.
I worry that not only will I not be able to do anything concrete to help, but that the need to care for me will make it harder on others.
I just continue forward.
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