The upside of feeling down.
On the information a diagnosis provides us and my experiences with mixed episodes and rapid cycling in bipolar disorder.
March 23, 2023
Mixed episodes are a bitch.
Both depression and mania.
A lot of tears.
A lot of laughing.
A lot of shedding tears while laughing.
A lot of, yes she will definitely save the world one day. And a lot of it’s 6:00 pm and she hasn’t found the energy to brush her teeth yet today.
A lot of irritability.
A lot of agitation.
Everything makes her want to fight. And though she’s hyped up on pseudo energy and no sleep; the presence of depression keeps her from just reaching the line of insanity.
The thoughts are constant and the sadness is heavy and she can’t help but wonder when this shit will inevitably take her out?
Mixed episodes and rapid cycling.
Mixed Episodes (WebMD): 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.
Rapid Cycling (WebMD): a pattern of frequent, distinct episodes in bipolar disorder. In rapid cycling, a person with the disorder experiences four or more episodes of mania or depression in one year. It can occur at any point in the course of bipolar disorder and can come and go over many years depending on how well the illness is treated
A diagnosis is critical to recovery.
I know that the history of stigma and medical mistrust, especially within the Black community, is to blame for the number of people who go undiagnosed. But, I still stress the importance of, and encourage people to seek, a diagnosis; if not a treatment plan. It provides you with critical information about yourself. Information that can help life be a better experience for you in the throes of episodes.
I experience rapid cycling, especially while being unmedicated. Right now I am experiencing a mixed episode. I know this because:
I am incredibly sad and despondent. I learned about Anhedonia, the inability to feel pleasure during depressive episodes, this year and it blew my mind to have such a clear-cut explanation of some of the periods of time where I am just unable to enjoy anything at all.
I am incredibly angry and irritable. Everything and everybody upsets me. I wake up mad that I’m awake and I go to bed mad that I have to feel so on edge. And the current state of the world? I’m so mad at the feeling of hopelessness I have that the “bad guys” will always win because they hold the money, resources, and power. I am fired up about everything. My skin is constantly hot with rage. And I want to box a brick wall.
I have grandiose plans. I feel I have the answers to a lot of the world’s problems and my own. Not exactly delusions of grandeur, but surely ambitious. I have developed a new business idea. Outlined the collection of essays I want to publish as my first book. Wrote over 1000 words, and counting. And later I will clean up.
I am dangerously impulsive. If I had the money to spend, it would surely be spent. I created a “things I want but don’t need” list on Amazon to add things to when I have the urge to shop. It gives a similar hit of dopamine without the same hit to the bank. I also don’t give a lot of thought to potentially dangerous situations for myself because invincibility and impulsivity are two that should be kept apart.
I am paranoid and anxious. If I’ve seen someone too many times in the store, they’re following me. If a car has been behind me too long, they’re tailing me. If something feels “off” when I speak to someone, they hate me. I can’t fully say that I feel I can currently trust anyone, which I am able to recognize as a false belief, but it currently feels real.
I am not sleeping well. Sleep is interrupted and I am often woken up around 3 am and unable to get back to sleep until well after 7 am when the day needs to start.
I am fixated on my death. I don’t want to die. I just want this version of myself to cease to exist. I talked about suicidality in bipolar disorder here on TikTok. I have thought about my funeral; and about things to leave for Ava so that she understands a bit better in the future.
A diagnosis is information.
Something I learned from my last therapist is that, even if hard to accept, a diagnosis and known symptoms are just information about ourselves that we can use to experience life better. Receiving my diagnosis led me down a rabbit hole of research and because of this I now understand myself and my brain better.
I now have the information to say “Hey, maybe it’s not best I travel right now. Or be in uncertain environments. Or be around a bunch of people. Or drink. Or commit to much.” because my feelings and reactions to certain situations may not be proportionate to said situation to the neurotypical mind.
Receiving a diagnosis also gives the people around us information about how we function and why we may exhibit certain behavior. It provides an opportunity for more empathy and grace to be extended where judgment and conflict would normally be present. I talked to my Dad this week and casually mentioned that when he joked that I was being a brat because of my refusal of a request, he was unaware that I was fresh out of a breakdown, my mind was frazzled, and I needed a moment to settle.
Having this information started the foundation for building a treatment plan around my experiences and episodes. Big things like medication and small things I know are in my control. For example, I know that I should spend less time on social media during this time, but I don’t always. I know I should question my first thoughts, feelings, and judgments just a bit before reacting, but I don’t always. I know I should enforce a bedtime and take my prescribed sleeping pills, but I don’t always. I know I should stay away from caffeine and sugar during this time, and that is extremely difficult.
I’m not always consistent at using the information I have about the way my brain functions, but life has been made a bit better because of this knowledge. The times that I do utilize this information intentionally, things almost always work out for me in some way.
Anywho, it’s almost 7 am. I’ve been up since 3 am, and I don’t think I’ll be going to bed anytime soon so I’ll write and maybe read a bit until I eventually fall back asleep. I know the holiday season is a rough time for many others, so I am sending my love to anyone who may be where I am.
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Thank you for sharing this. I appreciate opportunities to understand how other people’s brains work. The line that jumped out at me was, “ I’m not always consistent at using the information I have about the way my brain functions, but life has been made a bit better because of this knowledge.” I have OCD and several chronic health conditions, and I struggle with being unkind to myself with I don’t apply the knowledge I have as to what helps me feel more stable and healthy. But the truth is that I’m a wildly inconsistent human, as all of us are, and it would probably be better for my brain to celebrate the moments when I successfully do apply the knowledge I have than berate myself for the moments I don’t. Thanks for sharing your wisdom!
Lots of love on this post! I appreciate you sharing your journey, I was a mental health counselor before I started my own business. I have been tossing in my head if I want to return and do more expressive arts of just coach versus counseling. So many things to decide. Your post resonates with me. Thanks again.