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.