In the Thick of Mixed

I can’t believe that I’m actually writing this in the middle of a mixed episode right now, or presenting mixed features of a bipolar episode, because for the most part when my mind races like this, I can’t even articulate a relevant thought let alone write a series of them. 

What are mixed features? To put this as simply as possible, I am currently experiencing heightened energy, lack of sleep, and racing thoughts as well as restlessness and agitation. All of these symptoms are combined with the typical depressive episodes of bipolar disorder. 

I’m not overly surprised that I am in fact experiencing all of this, it’s historically ‘my time’ to do so. When you look back on my history that has been so painstakingly detailed by my psychiatrists, my charts show my two major swings a year. I go up in the spring and go down in the fall, every single year. Basically you could chart the change of seasons by my major cycles. Typically I have a warning period; roughly three days where my moods start to shift and I notice an increase in agitation and decrease in sleep. For some reason the warning signs were not there this time. One day I was okay, the next I was considering going inpatient, and I have absolutely no idea what shifted to have me in such a significantly awful state. 

What is upsetting is that I have prepared myself for this for the past year in hopes that I could avoid it. I have dutifully attended mindfulness courses as well as CBT, taken my medications faithfully and participated in one-to-one therapy as well as group therapy. 

I know my triggers, and I have become a wizard when it comes to avoiding and handling them. The distressing part of this horrific disease is that while I continue to choose healthy paths and prepare for the inevitable, I cannot avoid it. I am an advocate, I counsel others on how to navigate the waters of mental illness, but as educated as I am, it doesn’t stop the disease from affecting me. 

I have numerous supports set in place at the moment. I just spent the last 72 hours in and out of sleep on my psychiatrist’s orders. I was prescribed a higher dose of sleep aids to help me through this. Sleep is so important when trying to regulate moods, and it has proven to be a big help for me time and time again. Unfortunately in a mixed state, sleep doesn’t come naturally for me, I do rely on medication for this that will eventually require me to wean off of.

My first line of defence when entering a mixed episode is to hit it with ‘emergency meds’ prescribed by psychiatrist, who is also a medication specialist. These are meds that I do not take routinely; they consist of what my psychiatrist and I have called a ‘mania preparedness kit’. In two days I will see her for a face-to-face for an appointment and if my symptoms haven’t ceased (they’re slowing now) we go from there. 

‘There’ would be an increase of medications in a supervised setting, which is a fancy way of saying that I would voluntarily admit myself to a psychiatric unit. I’m not afraid of admitting myself; I’ve done this before and have always come out stronger. The thing about mixed episodes is that they are the brutal ones for me. I get paranoid, restless and am plagued by thoughts of suicidal ideation. 

Mixed episodes are particularly brutal for me as they completely disrupt every aspect of my life. I am no longer able to function with my activities of daily living, instead I pace restlessly starting one project to stop in the middle and start another. Chaos and disorder accompany every single mixed episode, and the loss of control that I feel is terrifying. The only thing racing faster than my jittery body is my mind, and that becomes impossible to stop on my own. My thoughts are plagued with how I am a failure and how much better the world would be without me in it. During a mixed episode I become non-compliant very quickly. I lash out in anger and frustration at those who love and support me and I also have a terrible habit of trying to convince everyone to agree with my decisions to stop my medications. Thankfully, we’ve been here before and my supports are strong.

The silver lining in all of this is that while things aren’t great, I am completely aware of what’s going on. The tricky thing about me specifically when it comes to bipolar disorder is that when I cycle, I have a small window before I go non-compliant. After years of ups and downs I have learned that the best way for me to live a healthy and balanced life is to speak up. I am not ashamed of my illness or my symptoms. I work every single day to lead the healthiest life I can, and even when I do everything that I should, bipolar still has a few tricks that catch me unawares.

I have an amazing support system that I can lean on when times get tough. I know, logically, that my illness is amped. I have put so many safeguards into place that I am confident that this to shall pass. I’m going to be okay, even though this is a terrifying feeling; somewhere inside of me I know that this is going to be okay. I recognize that because I have worked so hard to live well, these episodes no longer have the control over me that they once did. 

You can get through this, I promise you that. Don’t ever stop talking; don’t ever stop asking for help. A healthy and happy life is entirely possible; sometimes we have a few hiccups along the way.

To read more from Nicole, see her posts from IBPF here or visit her website at The Lithium Chronicles

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