Author: Melissa Howard
This post discusses sensitive topics, including sexual assault and suicidal ideations. Reader discretion is advised. If you or someone you know is experiencing distress, please seek support from a mental health professional or a trusted resource.
I experienced my first manic episode shortly after enduring nine months of debilitating depression, which evolved into a psychotic break. During this time I was replacing my psychiatrist who misdiagnosed me throughout my teen years, to a specialist whose specific area of expertise was on mood and eating disorders. I was unmedicated when she took over my care when I was nineteen years old.
She recognized right away that I was not solely living with major depressive disorder.
I had developed disordered eating during my late childhood which advanced into an eating disorder by my mid teens. This, along with my history of rapid cycling moods—which I shared with my new psychiatrist during our initial appointments, she was able to identify that I was living with a complex condition that was not limited to depression.
For years I was seen by a psychiatrist who viewed my cycling moods more as teenage angst rather than a symptom of bipolar disorder.
As my care with my new practitioner progressed, she witnessed my depressive psychosis evolve into hypomania, mania and then reaching its pinnacle— a manic psychotic break which inevitably led to hospitalization and my bipolar 1 diagnosis.
Looking back at my years in high school, I was able to deduce that I cycled through depression and hypomania often. Hypomania felt exhilarating compared to depression. My productivity, focus, charisma and energy were viewed as positive traits. They were the complete opposite of my draining symptoms of depression. My hypomanic mood was praised up until I began displaying irritation and anger towards inconsequential interactions. I lost my temper often, which made living with me chaotic. My untoward behaviour was considered a character flaw the entire duration of my teen years and into adulthood.
My initial experience with mania at nineteen years old felt magical. I was full of energy, I wanted to engage with the world and I truly believed I knew everything. My behaviour was a stark difference to the depressive psychosis I had just lived through, however, both were equally alarming and it was essential that I received immediate medical intervention. What made my manic psychosis even more complicated to treat was I developed the symptom of anosognosia. By definition anosognosia is a deficit of self awareness or lack of insight. To paraphrase from my.clevelandclinic.org;
Anosognosia is incredibly common with certain mental health conditions and experts estimate about 40% of people who have bipolar disorder have experienced this symptom.
With my newfound elation came a rush of ideas that I believed would revolutionize the world. During that time, I felt I could convince people to do whatever I asked of them. I looked for proof to rationalize that I had this special power. If I wanted to purchase something and my mother agreed to buy it, I felt I caused her to make that decision. If I wanted to try a restaurant and made a suggestion to my friends and we went, I believed I influenced their choice.
When I requested a ride and my father said he could take me, bingo—I thought I made that happen as well.
As one can see, none of these occurrences were out of the ordinary. They were reasonable suggestions or asks, but I viewed them very differently. I believed I had telepathically got into their minds and convinced them to do as I said. Another talent I believed I possessed was control over the traffic lights. I would predict the colour of the upcoming light and I believed I got it right every time. Again, this was not a phenomenon and there was a simple explanation. Traffic lights run on a sequence and at any given time, I had a fifty percent chance of guessing it correctly. Whether it was going to be a red to green or a green to yellow or a yellow to red light. In addition to my special powers, I was convinced that my control over not eating or sleeping made me invincible and those who needed food and sleep to survive were weak. Again, there was a simple explanation. I always lost my appetite and ability to sleep when I experienced manic episodes. I did not have a special power. I had common symptoms of a manic episode.
In my previous blog about my experience with depressive psychosis, I wrote I had lived with suicidal ideation and made an attempt on my life. During my manic psychosis, I put myself at a higher level of risk. I did not make direct suicidal attempts, however, my reckless behaviour created passive suicidal ideation. My experience may somewhat differ from others who live with bipolar 1 disorder.
During mania, my ability to take risks was much higher than any other time in my life. My decisions were impulsive, I was careless with my finances, experienced hyper sexuality, made poor choices about partners and would abuse substances when given the opportunity.
My thoughts during my manic psychosis were convoluted, disjointed and lacked all forms of logic. I was of the mindset “if it’s my time to die then it’s my time to die.” I made zero adjustments to reduce my uninhibited behaviour in order to prevent myself from being in harm’s way. If I decided to cross a busy street and was hit by a car, accidentally overdosed while consuming illicit substances and landed myself in a ditch, or drank too much and ended up sexually assaulted and murdered, I deserved what happened to me because of all my rash decisions. I had no regard for my life, continuously putting myself at a higher risk of death.
During my depressive psychosis I was alone more often than not. I isolated myself in my bedroom. I had minimal contact with people other than my immediate family members. My suicide attempt was calculated and I knew what I was ingesting.
Mania brought with it additional variables that could not be controlled when I left my home—which was often during manic episodes. For instance the speeding car coming towards me as I stepped off the curb. Taking an unknown substance from a person I did not know, or becoming inebriated and going home with someone who only had bad intentions.
My inability to make any sound choices during that time in my life left me impaired and vulnerable. If I’m being completely candid, I wished I would not wake up after making impetuous choices or that someone would put my chaotic mind to rest.
Though my family and close friends could see my drastic and concerning behaviour throughout mania and psychosis, to others that did not know me, I appeared as an overly enthusiastic and energetic young woman, who spoke rapidly and had unrealistic ambitions, and was classified as a free spirit.
Mania can feel great until it doesn’t. It actually became quite terrifying when I would have brief moments of lucidity and I could see my behaviour was threatening to my well being but I had no way of managing it. Those split seconds were far and few between and they never compelled me to seek help.
I’ve lived through one depressive and three manic psychotic breaks. Not all of my manic episodes have led to psychosis, however, my experiences with c-PTSD contributed to the severity of this acute and potentially fatal symptom.
The manic psychosis I experienced twelve years ago was life altering because it did not involve just myself. It had the potential to destroy me and it nearly tore my young family apart. In fearing a potential relapse or causing any more trauma to my family, I focused on my recovery and took it very seriously. I found a supportive care team that I could trust. With their help and guidance, I was able to discover a combination of talk therapy and medications which created a strong foundation to support my stability. This is something I am proud of. I contribute my success to a daily routine which includes:
-Taking all prescribed medications morning and night
-Standing appointments with my psychiatrist and therapist
-Getting 7-8 hours of sleep nightly
-Exercising
-Walking my dog
-Eating three well balanced meals throughout the day
-Connecting with people who are uplifting
-Engaging in volunteer work
-Having hobbies that I am passionate about
I am vigilant with regard to my mood and I do my best at managing my stress levels. I am always going to be faced with triggers that are unavoidable, however, therapy has helped provide me with the tools I require in order to mitigate the fall out as well as get on top of my symptoms before they evolve into an episode.
This is not a conduit for self diagnosis. This is my experience of living with bipolar 1 disorder and navigating a manic psychotic episode.
If you or a loved one are in crisis please call the crisis hotline at 9-8-8 (U.S and Canada). Alternatively call your local emergency line for immediate intervention or proceed to your closest emergency room.
The content of the International Bipolar Foundation blogs is for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician and never disregard professional medical advice because of something you have read in any IBPF content.
