‘It feels like a long way down.’ Yes it certainly does. The crashing fall from the highest peaks of manic elation to the deepest depths of despairing depression is devastating.
My mood swings are like clockwork and for the past few years I would become gradually more elevated from October until my mania would peak in February/March. May would bring a mixed state and then I would start the slow decent into depression, eventually hitting rock bottom in July/August. This year however, in the second week of March, my seemingly controlled hypomania suddenly turned into an extremely agitated and suicidal mixed state in the blink of an eye. The only time I had experienced this was when I had first been diagnosed with bipolar disorder. At the time, I had just been commenced on mood stabilisers and was being tapered off the anti-depressants that were causing the mixed state.
This time, it was not expected, there was no identifiable cause (I was compliant with my medication regime), and it threw my moods into sharp contrast, bringing home just how unpredictable and deadly this disease is. When things are going well I often forget how turbulent and chaotic this illness would be if I let it run riot. I couldn’t comprehend that just days before, I was up early, sitting at the kitchen table with mum talking about grand ideas for the day and the unrelenting motivation and excitement I felt. If only I knew that in the next few days the motivation would dry up, there would be no excitement and I would be so agitated that I couldn’t achieve anything even if I wanted to, then maybe I would have been more pro-active in getting better sleep.
That’s the problem though, once mildly elevated your rationale begins to lessen because you become overly optimistic and you feel that nothing can go wrong. Maybe I was naive in thinking that if I prevented ONLY a full-blown psychotic manic episode then my depressions would lessen. It turns out that even when hypomanic, my elevation still becomes mixed and then slides into a depression. Lesson learnt. I won’t be seduced by the mania next time.
What added to the devastation this time was because even though I was slightly elevated things were going well. I was back at work, studying, writing for a few online newspapers, preparing to volunteer with a mental health organisation, thinking about further study in the middle of the year and planning a trip to Italy. I had more to lose and I felt like I had let everyone down. These things coupled with being open about having a mental illness and a passionate advocator for mental health made me feel like I had a new reputation to maintain.
So yes, it felt like a long, long, long way down this time. To top it off I had spent all my money during a recent manic episode and had to go on a disability pension, which put a dent in my pride. It felt like not just a fall from elevation but also a fall from what I had achieved during this period of wellness and productivity.
But it didn’t turn out exactly like that. Although I had to take time off work because the depression, agitation and irritability would have affected my performance, things didn’t stop completely. I had a speedy course of ECT as an outpatient thanks to my very pro-active psychiatrist, my mum took time off work to watch me so I didn’t have to be admitted into hospital and give up all autonomy, and I completely focused on quickly getting back on track. I could still play and compose music, and write, so that kept me occupied. And when I was ready to return to my responsibilities it was an easy transition because everyone was so supportive.
I’m used to being unwell for months, and had expected that, but this time I was very pleasantly surprised when it didn’t take as long to get better and that I was soon back on my feet.
I have a chronic illness with a recurring nature. I’m learning how to identify triggers, recognise early warning signs and how to manage symptoms, but I need to start learning that being unwell is OK. I have to learn not to feel guilty when I become unwell and blame myself for my mood episodes. Some things are outside of my control, and most of the time my bipolar mood swings are one of them. If I had diabetes I wouldn’t feel guilty about becoming hypoglycemic from time to time. My new goal is not to beat myself up whenever I experience an episode. Besides, we all get sick sometimes.