At last.

Hello again,

I’m in a bad way, friends...and I’m about to present to you a portrait of a bipolar down period. Some of the following may be uncomfortably self-disclosing. Consider yourself warned. I also don't want to get into specifics, so I apologize up front if it's hard to follow, or kind of elusive.

Typically when I feel the most devastated by the disorder, there’s some trigger - there’s something that stimulates all the dysfunction in my head and all my personal issues kind of balloon out and the mood swings start.

The trigger is typically relational, meaning, it’s usually an encounter, or multiple encounters, with either a single person or a group. It, for me, involves my perception of their perception of me. In other words, if I really want you to like me, or think a certain thing about me, and I don't perceive that happening, it bothers me to no end. So on the surface, it’s completely a self-consciousness thing; it’s completely an attention thing. And, even more, my perceptions are often completely wrong ("My guts have shit for brains..."), so it looks like I get torn up over nothing. And, even even more, it's usually nothing that the "trigger" is aware of or can do anything about...But, while it may sound kind of asinine, it's always rooted in something much deeper.

So, a trigger, which is usually an interaction with a person or a group of people that somehow exposes some deeper issue, starts a downward spiral for me.

The spiral consists of cycles, and, when it’s nearing the worst, they are rapid, (this is an officially recognized phenomenon so aptly titled “rapid cycling”) sometimes lasting minutes, hours, usually 1/2 days. In one cycle - the depressive - I’m inconsolable. I am the most terrible, ridiculous person in the world (in my mind), and there IS. NO. HOPE. Everything gets boring, everything is worthless, meaningless. I am overcome by pure, terrifying emptiness.

The next half of my day may be spent on the other side of the spectrum - the hypomanic- which manifests in two ways: euphoria (feeling awesome, confident, capable) or dysphoria (irritated, obsessive, worrisome, compulsive, angry, fidgety). In the hypomanic state, I’m susceptible to some pretty ridiculous, risky compulsions, even something as simple as a little overeating, a little over spending, or a little bit of ideation of something like hurting myself. This part of the disorder is the hardest for me to deal with. It’s the part where, in retrospect, I’m the crazy person who’s having crazy, irrational, obsessive thoughts, without realizing those thoughts are crazy, irrational, obsessive. I’m almost entirely unaware of myself, and that’s absolutely terrifying.

Then there’s the “mixed state.” This is where symptoms of both ends of the spectrum arise simultaneously. I don’t experience this often, but it’s the most dangerous risk of having bipolar, as it’s the state where the most suicides happen. It can be utterly incomprehensible, the amount of things you can feel and think and do at the same time, yet feel like you've not even a single ounce of control. The worse it gets, the more it transcends the initial trigger, and anything can become a trigger.

So, I’m not trying to be a total downer, but this is kind of what’s been going on for a few days, now. And it’s all the easier for me to deal with because I recognize what it is. Naming the demon is half the battle, which is the only thing keeping me above water right now - that and an awesome husband.

A little bit about the meds situation: 

I intended to write about this before, but I never got to it. I was on meds for a full year after I was diagnosed, and they worked wonderfully. I really felt like I had my life back. I was functioning well in relationships, I wasn’t depressed, I was totally steady. It was awesome - miraculous, even.

So, why would I ever decide to get off of them? Well, from what I’ve heard, bipolar pharmacotherapy isn’t necessarily permanent, especially for milder cases. So when Chase and I decided to move to St. Louis, I was lured by the potential luxury of not having to worry about filling and paying for prescriptions every month, or having to find a new psychiatrist, especially since the one I was seeing in Greenville was essentially free. So I consulted said psychiatrist about my decision and he agreed to counsel me on the slow process out.

Coming off the drugs was hell for a solid three weeks, but I was fine for a couple of months after the detox. I felt normal. The farther removed you are from the symptoms, the more you begin to doubt you even had the disorder in the first place. It really is an elusive thing. I started this blog so I could track my progress off the meds, and part of the hiatus from the last two posts to now stems from me not really feeling like I knew what I was talking about, or if what I was experiencing was legitimately bipolar.

I feel pretty confident in my diagnosis now, though.

Next steps will involve seeing a new counselor, a new psychiatrist and getting back on meds. Meds aren’t always the answer with mental illness, but bipolar typically warrants pretty urgent correctional action. I feel confident that this is the right step. I’m hopeful, but that doesn’t always make it easier to deal with the implications that I need meds, that this is a real problem, that I have to be really conscious of and avoid triggers, even when those triggers are people and things I may really like.

So, that’s all I’ve got for now. I hope to update regularly concerning my progress, as well as continuing sharing my knowledge of the disorder as it grows. On that note, I’ve lately been reading a book this new good st. louis friend named Mike Metzger gave me called “Why Am I Still Depressed?” by this dude Jim Phelps, and it’s really changing the way I view all of this. More on that next time.

Lovers and friends, until next time.

Caitlin