Properly diagnosed, in a stable, positive routine, & with a good, working knowledge of my illness & its symptoms, the last frontier of my journey with bipolar disorder is dealing with my episodes. As it is, I’m handling the day-to-day symptoms well, avoiding the scary ones thanks to being off the Prozac & on the right anti-psychotics, & balancing the destabilizing ones through practicing mindfulness alongside my mood stabilizers. But there’s still the issue of my bipolar episodes, long mood cycles that uncover those dangerous symptoms & pushes me off my stable track.
About every three months a new experience or transition comes up, & exhausted from keeping it together on a daily basis, I collapse under the weight of the new stress, falling into one of these cycles. Most recently, I tried to get back into the classroom, feeling ready to teach, but like has happened every time over the past three years trying to start a new job, I was overwhelmed by negative voices in my head, triggered by something (often minor) in my environment, & sent into this week-to-two-weeks-long spin of manic outbursts, depressive collapses, & hopeless feelings of grasping for safety.
Inevitably, my support system says a similar thing: “I’d love to help, but I just don’t know what to do.” In the episodes, I don’t have the energy to communicate what I need or have the insight on how to ask for help. At my mother’s request, I decided to create this “user manual” for my loved ones in helping me during these spells. While I’m stable & coherent, I want to give you the tools to be your best self in relation to me when I’m unstable & incoherent. I figured it’d be helpful to: 1) describe as accurately as I can what I’m going through 2) give tips on what you can & shouldn’t do 3) provide access for more empathy.
When I was misdiagnosed & improperly medicated, my spells were seemingly “random,” able to be triggered by the delusions & paranoia floating around in my head. Luckily, now that I’m properly treated, we have a better idea of what triggers them, usually a major transition—starting or ending a job or relationship of some sort, most notably. For many years, I’ve struggled with appropriately responding to embarrassment or abandonment, & we think this is related to my mood cycles. When I’m already feeling vulnerable & imbalanced, as we all do from time to time, something that feels threatening to my stability will set me off, a self-fulfilling prophecy of sorts.
This is what happened with the teaching situation. After a successful teacher work day, I was feeling a little manic in responding to the natural nerves of starting a new job, especially after being out of the classroom for so long. After a night of dark dreams & restless sleep, I woke on the day off before school started feeling very uneasy. I called my mother for some reassurance; unfortunately, my call woke her & she responded inappropriately with an “uh-oh” to my stressed voice on the other end (not blaming her, just stating what happened). This sent me into a rage-induced black-out, the beginning to what would be a week-and-half-long bipolar episode.
See, the beginning is subtle, & thankfully, these days I can usually feel it coming on—out-of-character anxiety, intrusive thoughts, & tingling in my hands, feet, & eyes. The problem comes when I am triggered into a highly manic mode before I can resolve those early feelings. Mania is where the moods are elevated, both in positive & negative feelings, with an increase in energy & reactiveness. For me, this early manic stage is volatile, marked by extreme irritability & usually rage-filled, physical responses, which is where the black-outs come in. Reduced to my lizard brain, I am completely irrational & obsessive. During the “uh-oh" situation, I apparently screamed “uh-oh” over & over while writing the phrase in sharpie & spray paint on the walls & garage door.
This type of manic outburst usually gives way to a few days of rapid cycling, the true ups & downs of manic depression (the old name for bipolar disorder). This is the roller coaster often depicted in media. Unpredictable & irrational, these days are a blur for me, alternating between the previous day’s outbursts, positive elevated highs, & big depressive crashes, over & over again. It is just a wave I have to ride, if I’m not able to catch it & shut it down. Because of this unpredictability, it is best for me to be at home & alone.
As much as you might want to intervene, there is really nothing you can do & though it might not seem like it at times, I’m safe if I’m home & alone. Just let me go through it. I might say crazy, hurtful, or confusing things; please do not ask for apologies or explanations then. I am not in a rational mind, so it is important to not feed into any embarrassment or abandonment fears, by avoiding judgmental or catastrophic language of any sort. In this state, I can twist just about anything into a personal attack or more fuel for the fire. If need be, cut off communication by being direct & kind; others have had success with something like, “I can tell you are having a hard time (gives me the sense of feeling seen). I’m going to let you focus on that (non-combative goodbye). I will check in tomorrow (anti-abandonment).”
This will take us into our next phase, which is depression, partly fueled by the exhaustion of rapid cycling & partly caused by the embarrassment & confusion as things start to settle down a bit. This is the “it gets worse before it gets better” part, a sort of hangover after the high. Though often ugly, it is where I begin to recharge, lasting as long as a week. I’m fine if allowed to chill, watching a lot of television, eating one big meal a day, & generally just trying to keep my energy low so I don’t start the rapid cycling again. This is where suicidal problems come in, when manic energy gets reintroduced & drives depression thoughts. Thus, it is important not to re-escalate, as I can easily slip back into mania.
This is where reminders can be useful—that I’m loved, that you’re there for me, that you’ll be here when I’m ready. Remind me to take my meds. Encourage me to go on a walk. Offer to join me for a walk or a sit. Tell me I’m doing what I need to do. In the depressive phase, those abandonment / embarrassment fears are the strongest. Please don’t mention abandonment or embarrassment though, as it could be an “uh-oh”-like trigger, but instead do things that remind me, while I’m home & alone, that there are people out there on my side. Above all else, just try to be proactive & on my side.
Once I’ve worked through some sorrow, I start to “try to be a regular person again,” going to the store or meeting with a trusted person. Usually, at first, I can only last an hour before its back to the couch, but each day, I try to extend that stamina. I’m able to know my limits here pretty well. It is also in this phase where I’m ready & craving human connection, though I often don’t have the confidence or energy to express that. This would be a good time to invite me over, give me a phone call, or feed me a meal. Think of this as a “testing the waters” phase.
After that, the worst is over. It takes another week or two to be fully stable, but I’m at least able to communicate effectively about where I’m at & what I need. Even in mood episodes, I’m decent at telling others what’s going on, though not great at saying needs or behaving appropriately. So, if you’re not sure what stage I’m at, just ask. Yes, I might be pissy, dismissive, or odd. Please remember that this isn’t personal or about you. This is me working through a serious chemical swell. I appreciate you wanting to know how to help & hopefully this will give you some confidence in being proactive about helping. Stable, sane Tyler sure does appreciate you.
I had the pleasure of spending the Memorial Day weekend with a bunch of new-ish buds camping down in Red River Gorge. It was full of the usual joy--campfire jokes, time among the trees, dogs trying to navigate the unfamiliar. But what added to the wow of this weekend was the fact that I had zero behavioral incidents & the most minuscule of bipolar symptoms. If you've known me awhile, you know that trips & excursions are both my favorite thing & a load of dread for me. Let's just say I don't have the best track record as an adult when removed from my comfort zone & routine.
I grew up camping with my parents, first in tents as a toddler & then in campers through my late teens, but when my symptoms started to set in in my early twenties, primitive camping became often problematic. Right after graduating from college, I organized a camping trip for a group of buds, & it quickly came to an end, when a friend's drunken mouth met one of my psychotic rage attacks. I had a couple successful camping trips in Texas, but those usually only worked when I was alone. Most recently, I tried a solo trip last summer after my wife left, but ended up shoving the tent & all my belongings in the van at 3 a.m. as hallucinations overwhelmed me. As much as I love the outdoors & adventure, something about tent camping knocks me off my psychological balance.
Knowing the possibility for trouble, I communicated with the group my concerns about the trip, but after their understanding responses & noting my recent successes in managing my illness, I decided to join, making the three-&-a-half hour trek down to Kentucky. I knew being removed from routine & comfort can cause me to become moody & unstable. I knew poor sleeping & eating habits could affect my ability to be aware of my symptoms & make the proper adjustments. I knew, in the past, responsibility, such as planning a trip or being in charge of the camp, added more stress than I could handle while trying to manage my moods. Ultimately, I had to watch out for falling into the unregistered, unaware trap of my more animalistic feelings & behavior.
I've been re-reading Waking The Tiger: Healing Trauma by Peter A. Levine (with Ann Frederick) & it's been providing me much insight on that last key to understanding my mood episodes, the big boom we were avoiding. As Levine notes, "Sensations come from symptoms, and symptoms from compressed energy" (76). I've learned it's not just about being aware of the symptoms & sensations, as important as that is, but also about releasing that compressed energy in clear, intentional ways. During the day, I made sure to step away from the campsite, be it for a hike, a walk with the dog, or a solo round of disc golf; on the site, I made sure to take moments to check in with myself, like with a power nap or a session of Dr. Weil's breathing cycle. Any success I had on this trip, compared to others, was all about awareness & intentionality.
As Levine remarks in his book, "The fundamental challenges we face today have come about relatively quickly, but our nervous system, but our nervous systems have been much slower to change
" (43). Partially removed from that modern grind, camping can be a jolt to that nervous system too, half-hung up on the quick-paced stress of modern life & well-exposed in the slowness of a weekend away. Looking back, wondering what was different this go-around, the core answer is simply that I'm taking better care of myself on a regular basis, having established some positive forward momentum--being well-medicated, developing a solid relationship with a new, trusted therapist, & following a daily routine balanced on meaningful work & reflective rest time. For the trip itself, the bookends were first being up front with the group & releasing myself of much responsibility pressure & allowing myself to pack & leave on my own internal schedule.
It is a weird thing to be proud of as a thirty-two-year-old, having a successful holiday weekend camping trip with buddies, but I can't help but smile looking back on all the good moments, knowing my bipolar disorder & I didn't ruin anyone's trip, MINE INCLUDED. I will always feel awful for the torment my rage attacks & mood episodes have caused, the fissure I've created among should-be peaceful time, often for some of my most beloved people. But with each successful trip out of the comfort zone, I have a better understanding of how to concoct such success, & I feel a little more confident in my ability to pull off such a task & prevent calamity in the future.