: The Phases and Faces of Hypomania
The tiredness hits. You’re grateful and glad to finally feel tired. It means you might actually sleep a decent amount. There is no predicting whether you will sleep properly or manage just a few hours again.
If you sleep a whole night, you may wake up with your eyes and your body aching, refusing to move. The crash is as much physical as it is mental. It’s a stark contrast in a very short period of time.
It can take hours to just sit up in bed. Your body is rebelling against the past string days or weeks of over exertion. It is refusing to comply. There are no thoughts: the brain also rebels, refusing to be alive. I am alive, but I feel like I may well be dead. I even wonder if I am dead or not. Did something happen and I’m not waking up? Is my body dead but my mind still active? Am I in a coma? Is this limbo before all consciousness goes?
No. It is none of these. It is just the sheer exhaustion from flying for days. There are no stores left. You’ve not been eating or sleeping yet doing so much. Your body decides that finally it is indeed human and subject to the same needs as everyone else: sleep, food and water. There is no choice in the matter. Sloth like doesn’t even begin to describe the slowness. You speak slow, you move slow, you are slow. Slow to think and slow to process – breathing feels exhausting.
They say the higher the high, then the steeper and deeper the crash. This is how I have experienced it with hypomania: mania is much more severe. Dark thoughts cloud your judgement but this time, you don’t have the energy to do anything about them. So you sit. You sit and you wait.
The advice I received during this phase was to just wait it out. Use distraction methods that are manageable: sleep when you need, and watch TV. Distract yourself until it passes. With the weather it will pass.
For as disappointing this part is, it is welcome in the way that finally things seem to be balancing out again. Finally, you can sleep and with the crash that means the ability to eat is closer to returning. It is probably the safest phase of the whole up, down, regulation disruption because there is no energy or drive to harm yourself or others.
There is desire to end it. The realisation that you’ve been horrible to the people you love, and worse to the ones you don’t. The regret and having no money due to a long list of unnecessary expenditures. These are all the facts of the aftermath that need to be faced upon returning to a more balanced place.
The worst though, is the realisation that you just had another episode. How many more to go? How much more time until the mood swings are a thing of the past? How many more times will you need to go up or very far down before things decide enough is enough and regulate?
Then I realise that there is no time limit. This is an illness that flares just as if I had recurrent chest infections due to asthma. I realise the things that went out the window that may have aided in the triggering of the episode. I realise that there doesn’t seem to be an awful lot of just putting it all behind you and moving on as I would like with mental illness. Then I start to think that I can’t.
I start to think that I can’t do this anymore. I think about how tired I am of losing control. I think about how much time and how many plans I’ve lost to running around in a purposeless fever and how I’m now behind on my training. I get frustrated about not being able to stick with my training plan because these mood swings come along and disrupt any ability to stick to a regime – yet I need routine and order. It has been established that routine and order help me to stay stable.
Then I begin to realise how much more work is required for me to just wake up and manage each day than I think and perceive it to be for other people. Even if I do have the time of my life for a few days – I lose more losing my mind to rhyming gibberish and recovering in the aftermath of the crash.
The reason I don’t work, the reason that my life feels chaotic stares me right in the face, stares me down and with my tail between my legs I have to accept it. I would like to rise up and say “bring it’, but the battering is so much that I don’t feel able to…yet. Maybe one day. It is in this phase out of all of the hypomania phases that I need to keep hold of hope. I need to believe in hope during this phase just as much as when I’m depressed. Without hope all-purpose and drive is lost under a bus and I’m done.
So I start to plan how I’m going to move forward. I pick up my trusty FiloFax again. I make lists and plans. I write down ideas of what will keep me well and stable. It’s a long list that feels very much like a full-time job in itself. It’s tiring, no, exhausting! It’s destabilising. This was just a hiccup in the road compared to some episodes – yet enough to have rocked my boat so that I’ve thrown all the life rings out to catch the debris of me floating around not yet re-connected.
My confidence has been knocked. My self-esteem and belief in myself that I can achieve and do what I want with my life, or at least, some of what I want with my life. The need to keep taking my medication is reaffirmed to the point of being fearful of not taking it. It’s a slap in the face that knocks you over when you’ve just found your feet.
Every time I stand it isn’t long until I’m bitch slapped again. I feel angry, hurt and sad. I feel confused, slight disbelief and frustration. I feel disappointed, cautious, restricted by routines and measures to try to stay well, but there is no choice.
I may not always manage to stay well but I have to try. I owe myself and those that I love that much. I have to keep trying and when I feel like giving up I have to reach out for support despite my grand desire to be self-reliant all the time. My pride takes a hit with gusto. I am humbled to the point of slightly crumbling at the seams whilst I try to fervently stitch myself back up and get my life back together.
This is my life. I need to work on accepting that some more.
A depressive episode has a way of making anyone go from actively living their life to merely existing in a matter of days or weeks. The ability to do what you love? Zapped! The ability to get up in the morning? Zapped! An interest in doing anything other than staying in bed living life through TV characters on Netflix? Zapped! Everything goes out the window, and it seems that no matter how “recovered” I feel in a good patch, each and every time I go down down down, I become the same shell of myself.
In this though, there is a silver lining. When I come out of these episodes every. single. time. I am so bloody grateful for everything, anything and the tiny things. With my illness I know these episodes aren’t behind me, and it is likely another rain cloud will come over me in a few months time, but until then I swear to myself, for myself, to grab life in the tightest grip that I can and do everything and anything that I want to be doing with my life. This means that if I can get up early in the morning and DO stuff, I do because I can. If I’m feeling well enough to go out and exercise, I bloody well go and enjoy everything my body can do for me in these moments. Even if an interest overcomes me that is out of character, I give it a go – for example when I started playing saxophone. The important thing in these times for me is to make sure I enjoy myself and learn to love myself and my life again.
There is more to this than just enjoying the well times – but by building good memories and emotions in a bank within myself during these times, I buffer the severity of impact the suicidal thoughts manage to take on me during an episode.
I view my appreciation for everything, anything and the tiny things in life as the gift of depressive episodes. I spend a lot of time hating on, sulking about and wishing I didn’t have my bipolar and BPD. In these moments of accentuated gratitude however, I count my blessings and enjoy the menial things of daily living: getting up in the morning with motivation, cooking a nice meal for myself and being bothered to do so, going out with my partner and friends and enjoying their company, studying and achieving my potential instead of submitting a sub-par version of my abilities, going for a run and feeling so alive and in the moment, reading and being able to take it in on the first read, laughing out loud and having fun. For all of the things that depression steals from me, I gain back a big part of myself and more. It is in these moments that I say thanks for my life, that I thank myself for staying alive and I stop for a moment, hating on my perspective and experience of life as it is.
From the end of April to late May I spent 4 weeks in a psychiatric hospital, hence my absence. It was a difficult admission and still now I am struggling to quite get my head around what happened, what’s happening, and what I went through. I am also struggling to get back to every day life. Having spent 4 weeks in an NHS institution with nothing to do but sit and talk crap with other patients, sleep and eat I have struggled with going out, with my desire to leave my room, with socialising, with public transport and with getting up in the morning amongst other things.
I am still, after almost 2 weeks out, trying to pick myself up and get going with my life again. It’s been a hard ol’ slog. At the moment I am focusing on getting up and dressed in the a.m and trying to spend my days doing more than staring at the TV until I’m sleepy again. I haven’t managed to start exercising again yet – for some reason I’m really scared to go for a run, or get on my bike. I think this is going to be a long process that seems to be moving at a glacial pace.
I am however, trying to implement skills and tactics in order to get going again, and in order to cope with my new found freedom, in addition to coping in healthier ways than those I employed prior to my admission which landed me in hospital for 4 weeks. My journey from public place, to police van, to 136 suite and then to hospital was quite a surreal one. I did write a lot whilst I was in hospital about what I was going through, some of which I plan to share over the coming days in order to explore my experience. It kind of illustrates my journey with my experience.
After 4 weeks of doing very little, and becoming accustomed to sleeping the days away in order to pass time and be perceived ad the “good quiet” patient, I am slowly getting used to getting up and dressed, as I barely dressed or washed whilst I was in hospital. In fact, every time I have showered since coming out (2-3 times) I have lost the knack of keeping soap out of my eyes and mouth in the shower – this is also something I am currently grappling to re-learn.
So what am I doing to get myself back on track?
1.Set an alarm for 8:30 and 9am to try and get up and out of bed in a decent time.
2. I decided from today to not watch TV before 3pm, otherwise I will sit there and watch it all day at the moment. This isn’t usually something I struggle with but it has cropped up since I have come home.
3. Making plans on sites like Meet Up to go out with people, socialise and become slightly active again.
4. Making daily To Do lists to try and do something productive with my day and to get chores done.
5. Trying to go out and acclimatise to using public transport again.
6. Planning fun things to look forward to.
7. Keeping a functioning and mood reflective diary.
Today I’ve been told that suicidal thoughts are a habit in response to a low mood. I don’t know if I agree with this. I was told this by my therapist, and I agree it used to be like that for me a few years ago whenI was told this by my schema therapist – however this was at a time when suicidal thoughts were chronic and ongoing. Now though, I do not always have suicidal thoughts when I’m down. There are may days when I am down and instead I focus on “how can I get through this?” but at the moment, unfortunately I am suicidal, and actively so.
It is a scary place to find yourself, thinking about suicide constantly. It is a very scary place to wind having to explain to people that over the weekend you tried to take your own life because the thoughts got too much. I’ve been told to think about tomorrow. Always tomorrow. There’s always tomorrow, but what if tomorrow is like today, and yesterday and all the other days that have gone by. From experience I can tell you these depressions last a really long tim end become rather torturous at the best of times, never mind when they are all encompassing. Even new shoes cannot brighten my day – not that buying your way out of depression ever solves anything, but the point is that something that would normally make me happy hasn’t had an ounce of effect on my mood for better or worse.
I am not crying. For some reason my tears are dry except at the mention of my old therapist where I let now tear go. It seems I want to cry it out on my own but in front of others I’m retorting to the old facade of keeping them in. I miss her. That’s why I cried. I miss her dearly because in times like this she was very comforting and I could do with a talk with her right now. I could with sitting in that chair across from her and her new shoes – she always had new shoes – and talking about my mood and working through it with her. Obviously, this can’t happen. We finished our work together.
I’ve been told to think about how lucky I am to be living where I am, in England, and having support around me. Which is true. It was always worse when I had no support around me, or my support networks were struggling as much as I was with my moods.
On the up side, there is talk of a medication change to a mood stabiliser. I have requested this, and hopefully it is in the motions of going through at the moment. This is my thread of hope, amongst all the advice and talks I’ve received, this is my hope that I’m holding on to. That things can get better if only I were on the right medication.
For now though, I will return to my list of coping strategies in the hope that they help because truthfully, I know I don’t want to die because there are things to look forward to in my life I just want to postpone the depression, or sleep through it and make it stop.
Yesterday I reported that my low mood was starting to become lower than healthy and unavoidable. I realised though, when filling out the results for the day in my Optimism app that I’d been rather pro-active in helping my mood. I’d done a lot “stay well strategies” such as: mediation/relaxation, exercise, healthy food choices, medication taken, social support used, and taken part in enjoyable activities alone and with others. The result was that for the day my mood point went back up to a 4 for the day overall rather than sitting at 3. I hope I manage to keep on top of it.
That’s the thing though, we don’t have a choice in having a mental illness, but we do have a choice in how we approach our illness. We could put our hands up and say, “I have two diagnosis’ including bipolar and that’s that. I’m doomed for illness for the rest of my days” or I could say, “I have two diagnosis’ including bipolar but I can do what I can to fight this and live as normal and peaceful a life as possible”.
I’d rather say the latter phrase, even though it is much more hard work to manage. Yesterday for example was effort, and every time I’m very depressed life is an insurmountable effort to manage my symptoms as best I can- but that’s all I can do and expect of myself – as long as I know I’m trying then I’m happy with however abled or disabled I may be at the time if I know I couldn’t be doing any better. I know I can’t blame myself or my actions for whatever state I may be in.
This isn’t to say I’m perfect. Sometimes I do get it wrong. Sometimes I don’t help myself as much as I could do because that is the nature of the illness, but to try my best and know I am is for me a comfort in my own disability in fighting stigma and knowing I’m not bringing it on myself.
So today is another day. I’ve woken up after not much sleep and my mood feels quite low again, but again I will try and manage this by using my stay well strategies including: enjoyable activities, exercising, resting, and meditation/relaxation exercises.