Sounding the Alarm: The Importance of Early intervention in a Bipolar Mixed State

Author: Ivory Smith Causey

It is shortly, after Thanksgiving 2017. I notice I can’t feel the Christmas spirit like the previous.  I start my Motown Christmas music which includes “Santa Clause Go Straight to the Ghetto” by James Brown. I play it on my phone at work in our rare free moments. My fellow nurses enjoy it but I start getting annoyed. There are only so many ways to sing “This Christmas” by Donny Brown.

1st Warning for Intervention and Prevention

I feel as if I am in a very different state. I feel as if I am chasing my tail on the job and off the job.  I notice it is getting difficult to make simple call to various doctors at work and in my own life. I can’t understand why I keep putting all this stuff off. I am starting lose track of time. For example, one day I go to the bank to withdraw just $100.00 dollars out of me and my spouse’s savings account.  It is noon and I have a therapy appointment at 12:30 p.m. The teller asks me if there are any other products he can assist me with. My aim is to talk about a better interest rate on my credit card. I end up talking to the bank officer about my recent trip to Alaska and his upcoming marriage. Somehow I end up with a new credit card!!! I get back into my car and it is 12:40 pm, but wait, I forgot about the 12:30 appointment. Distracted, dazed, and dumbfounded I drive to my appointment.  I don’t realize these symptoms could be a danger to my patients, coworkers, and my very license.  However, fearfully I know that something is not right.  At the same time I think, I don’t need help and definitely no time for that bipolar stuff.  Besides, I must work tomorrow. No intervention at that time and I do not tell my therapist about my distractions or feelings.

2nd Warning for Intervention and Prevention

I go to my bipolar support group Christmas party. I say aloud, “I think that I am manic!!”  I believe something is wrong. I say it with a smile but sadness at the same time. Confusion takes over and I think I need help, whatever that is supposed to mean.  However, I don’t think I need enough of this “help”   to call my psychiatrist. I don’t want to bother the office staff. This is the time to “bother” the office staff even on call.  I thought of myself as a good patient that does not call ever day about their “dramas”. I certainly don’t want to bother my psychiatrist. I think, “I am a nurse and I should figure this stuff out. I need to get it together. You must concentrate Ivory.”  However, what it this “it” that I need to get together.

3rd Warning for Intervention and Prevention

One day I drive to Barnes and Nobles in escape from something I can’t explain. I want to look at the various books and magazines but at the same time nothing catches my eye like it used to. Everything becomes a jumble of noodles and tangled up spools of yarn. I call my spouse saying I am out of steam. I drive carefully but fearful as she awaits anxiously at home.  After sleeping for two hours on the couch I awake and pull my emotional “fire alarm”.  “I say I need help”.  I contemplate on whatever this “help” is supposed to be.

I call my psychiatrist office in shame and embarrassment. I even apologize for calling!!! I think to myself, I am smart. I have two degrees and I am a nurse. Why can’t I of all people get it together? She increases my medications.  I am stunned and still embarrassed. I get off of the phone tearful. That night I reluctantly start my increase.  In spite of that I begin to lose words and have difficulty getting them out.  Thinking becomes cloudy and confusing.  I begin to have scary thoughts. I realize I must take time off in this state of decline.

I realize I am in bad shape and start telling my loved ones I need help. At this point I don’t care what I have to do or where I have to go.  I call one the hospitals, but definitely not mine about the admission process for psychiatric emergences. The next day I decided to pack my gym bag.

I also am able to make an emergency appointment with my therapist. I take care as to what I wear. I pick out a grey pair of pants and black turtle neck. To top that off I get a red, black, and white jacket. I cover all that with my red and grey cuffed pea coat and a red fedora hat. Of course I tip it to the side. Underneath I am a hot mess but look like a put together classy woman.  I am exhausted by the time of the appointment and my parents show up. The hospital trip does not happen but I am ready. I found out I am having my first mixed state.

The first early intervention and prevention I have is the three day rule. The psychiatrist must be called after 3 days of insanity. At that time I had waited 2 weeks due to embarrassment and wanting to fix things myself.

The second intervention and prevention is watching out for triggers which mine happened to be fall Holiday time. Your support system should know your triggers as well.

The third intervention is sounding the alarm and asking for help as if you were having a physical emergency

The fourth prevention is realize inside our innermost selves that we are not to feel embarrassed or stigmatize ourselves for calling the doctor or office staff. Must remember we are not bothering or inconveniencing office staff.

The fifth prevention and intervention is asking your support system do you see anything that is unusual behavior if so what if.

It took almost two months to recover from my mixed episode due to embarrassment and self-stigma. I was so far into the episode medication levels to time to build up into my system.  So sound the alarm don’t be too afraid to call for help.

Ivory Smith Causey has a B.A. in sociology with a minor in women and gender studies from Georgia Southern University. She has a B.S. in nursing from Macon State College. Ivory is a registered nurse at Atrium-Navicent Health in Macon, Georgia. She is a member of the American Holistic Nurses Association and hopes to be certified in holistic nursing.  


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