“When I’m in a manic state, it’s not really me. It’s like my brain is on Mars, and my body is having a parade to celebrate its absence. The things that you are interested in will be the things that inform your episodes… like, I’m interested in Greek philosophy, which is why I was running around like a cynic, like a dog, looking for Diogenes. That’s not something that I would do, but it’s like a character based on me. A cartoon version of myself. It’s like the source material for a play about my life.”
[Content Warning: Depictions of Heavy Current and Past Drug Use, Depictions of Mania and Psychosis, Involuntary Commitment]
Reading Time – 14 minutes
Self Medicating and The Nightmare Election
I woke up at 3am this morning, because I had a nightmare about Donald Trump. That’s been happening fairly regularly for a while. I’m gonna smoke a little weed again, because I’m trying to take a nap after this. But I guess that’s a good place to start, the comorbidity of this stuff… because I know this isn’t a good way to get myself back to sleep.
I’m taking Trazodone, but it makes me so groggy. I have this melatonin, so I’m gonna try and start phasing out smoking pot all together, because it’s expensive. I could see it as something I could become dependent on, because I like to smoke pot, and I don’t want to stop. It helps with the insomnia… also period cramps, anxiety, stress… It also slows my thinking down enough so I don’t go off on as many different paths. It’s worse for my disorder overall, because I’m using that artificial stopper to keep myself from getting too amped up. I’m using a serotonin agonist to control a serotonin agonist problem… and it’s just going to keep compounding on itself.
I do use pot as a coping mechanism, but I don’t recommend that. Like, you shouldn’t be smoking pot to go to bed. It will give you nightmares. That’s probably why I’m having Donald Trump nightmares. I think pot is more of a hindrance, especially when you’re in a recovery situation. In your healthy days, you need to be able to control your marijuana consumption, or in your illness days you will not be able to control it… and it will exacerbate things. It’s a toy, not a strategy. But, the worst coping mechanism is better than no coping mechanism at all.
Experimenting with Your Personality
Drugs are so far in my past now. One thing about my drug use, I think it actually helped me navigate my manias. Having tripped on acid so many times and navigated so many social situations… you get to know yourself under so many different conditions. It’s almost like you’re experimenting with your personality as a way of forming responses to negative situations. I already knew how to calm myself through deep breathing from using it to calm myself when using heavy stimulants, so it was very easy for me to stop those emotions when they came up in my illness. I don’t take acid anymore, because if you’re on Lithium and you take any kind of hallucinogenic, you will have a seizure. So, I can never take it again, unfortunately.
For example, yesterday I was feeling pretty anxious, because I’m going off Risperidone, which can itself cause withdrawal symptoms similar to mania. I just knew that I didn’t have this drug in my system anymore, and suddenly I’m feeling manic. I’m pacing, really bored, feeling anxious… having trouble stepping on escalators, because I couldn’t figure out where to put my feet.
Then I Googled it, and there’s this list of withdrawal symptoms that describes everything I’m feeling. I’m like, “Oh! So there are other explanations for this.” Mania is not a necessary conclusion for these feelings. It made me feel much better, and I was able to recognize these feelings because of all my experiences with the disorder, as well as my past experiences with drugs. Then I can calm it, because I have the techniques already mastered. It’s not perfect, because I have had relapses… but I’m very fortunate to have practiced coping prior to my diagnosis.
Early Warning Signs
One pre-indicator of future mental distress is divorce early in life. I was seven. It wasn’t a nasty divorce, but it was unusually dramatic. I ended up in therapy, because I stopped talking for about a year. I used to be the kid that would raise her hand as soon as the teacher started asking a question, because I already knew the answer. I still already knew the answer, but I didn’t feel like raising my hand anymore. I stopped going to therapy a few years later, because that’s when I was doing a lot of drugs. I knew my therapist would make me stop using drugs, so I stopped going. I really wanted to experiment with those things. I don’t regret it at all, because I learned a lot about myself, and not just in terms of my illness. It was a really important growth period for me.
In high school, I always felt like I was darker than most people… morbid and prone to stronger feelings. Then, I would think I was saying those things for attention, because I wanted there to be something to explain myself that was dramatic… like Girl, Interrupted. I thought I wanted to do it because I wanted to feel important. I thought I had a personality disorder, but my therapist told me that I was probably just a teenager with hormones. It was good advice, because it got me off of medicalizing my deviance. But, it also gave me this impression that there was nothing wrong with me, that I was just acting out for attention.
Emerging Bipolar Disorder: The Fugue State
There was one incidence in particular… the first time I took acid, I went into a fugue state the day after, during the comedown. It was very black. I had no personality… a depersonalized, delirious state. That was probably an early warning sign. I knew about fugue states, because my friend plays the viola, and fugue is a musical term that refers to a repeated, haunting kind of state. The psychological state is similar. I just attributed it to drug use.
I have this theory, that maybe you write scripts for yourself when those kinds of things happen. So maybe the reason my mania looks like acid is because I took acid so many times. So maybe my brain knows to treat the chemicals that way. The three people I’ve told think my theory makes sense, so I’d say it’s logical.
Emerging Bipolar Disorder: No Time for Therapy
It wasn’t until law school, specifically the last year when my grandfather died, that I started having real symptoms. When I would drink, I would experience hypergraphia. I’d write in spirals and weird shapes on the paper… trying to express the emotional component of the text by writing it, kinda like House of Leaves, but not as organized. I started overspending and over-drinking a lot. I broke up with my boyfriend, which needed to happen. I started getting more and more erratic… didn’t go to graduation. I really only wanted to go for my grandfather, but he had already passed away.
I started studying for the bar exam, but couldn’t sit still. I couldn’t focus on the page… couldn’t memorize anything or concentrate on anything. I started to get this delusion that I was driven mad by stress, so I should just finish the bar, then afterwards I’d get therapy. No therapy right now, because I didn’t have time. I almost got into treatment in May, but I was like, “Fuck no, I need to go study for the bar exam.” That was a mistake.
Emerging Bipolar Disorder: Bad Directions
There was a practice test for the bar at Duquesne Law, and I didn’t really know my way around downtown that well. I hadn’t studied at all, and it was three weeks before the exam. I had only done 7% of the prep course. As soon as I found out I would have to take this pretest, I stopped sleeping. I got downtown at 6am, operating on pure video game logic, like I was in Zelda.
I see this guy in a Steelers shirt, so obviously he’ll give me directions. I go up to him and stick my arms out, asking, “Do I go this way or this way to get to Duquesne?” My hair was all over the place. I’d been wearing the same statuesque maxi dress for a few days, so the fibers were dull and losing their buoyancy and clinging distressingly to my body. I doubt very much that I was wearing shoes. Everything about me screamed “target.”
So, he ended up following me and giving me bad directions. He was walking next to me, like, “Oh, I’ll take you there. It’s the next block.” Then, we’d get to that block, and he’d say it again. I tried talking to him, but he wasn’t following along with the conversation, so I started to feel bad for him… I thought he was lost, but really he had a violent intent. Finally, I saw the street I was looking for, so I just ran away. But, I felt bad for abandoning him, so I stopped, turned around and said, “I’m sorry we couldn’t find it together. Thank you for helping me triangulate it!” And I ran off! It wasn’t until months later, looking back on the episode for clues into my illness, that I realized how narrowly I’d escaped.
Emerging Bipolar Disorder: Living Apocalypse Now
By the end of the summer, I thought I was living in Apocalypse Now, walking all over Pittsburgh aimlessly for ten to twenty hours a day. I’d walk from my house in the South Side Slopes to the Strip District four times a day. Or, I’d walk in circles around Oakland all day. Compulsively, until my feet bled and my spine ached like it was full of broken glass. This one day, I packed a bag full of crap that I liked… decorations from my house that meant things to me. I just walked to the Cathedral of Learning and left them on the steps, along with my phone, wallet, shoes, and keys. And I just walked away.
I went up to that little kiosk police station near the Cathedral, and I’m pounding on the thing like, “Please let me in! I really need help!” They literally wouldn’t let me in. So, I accosted the first person I saw who looked trustworthy, this woman who was moving her son into his new apartment, like, “Please help me! You look like such a good mother, and I really need help!” I was talking three times as fast as I am now, so I was hoping she could understand me. She called the police, they came… and I just sat down cross legged in front of them and started lecturing them on how lawyers have lost touch with the people… how I wasn’t going to do that when I was a lawyer. All this grandiose stuff about how evil the bar exam was, because it had literally driven me insane.
Two weeks later, after I got out of the hospital, the police called and returned my stuff. I didn’t get my shoes back, but everything else was untouched. Pitt is amazing. What other major city in the entire country/world could you leave a wallet, keys, cell phone, etc and they steal your Birkenstocks?
Emerging Bipolar Disorder: The First Hospitalization
The first day I remember after I came in, I was putting my fingers in people’s food, speaking in multiple languages that I didn’t speak… utter nonsense. All they could manage to make me do is play with glitter glue. I remember I was running around with a fake lantern in front of my face, yelling for Diogenes or an honest man. I was obsessed with purple, because it was right after the gay marriage decision. I felt safer with people who understood human rights, so if a nurse wore purple gloves, I would trust them. I kept complimenting people on their shoes.
I was obsessed with getting out. I hated being locked in there. They had this sunroom, where the water would come in through the cracks. I would just sit there… paw at it and cry. Like, “You came from outside. You are sacred.” I thought that if I fell asleep, I would die and wake up in the Bastille, because they had Castile soap… I hadn’t slept in seven days before they took me in.
By the next week, I beat the one nurse in chess, which I had just taught myself in there. They put me on this super powerful medication, which turned out to be too powerful, but it brought me out. The doctor was the one who had to tell me I had bipolar disorder, after I’d already been locked in there for days. I started yelling at him about how I never would have signed myself into a place like this, how I was a hostage, habeas corpus and all of this… And he shows me this paper with my signature. The next day I went in there after reading it, and I apologized and shook his hand. He looked so surprised.
Putting Yourself First and Passing the Bar
I was at my parents’ house for the rest of the summer, and when I came back to Pittsburgh I went into intensive outpatient care; basically a coping skills class plus group therapy. In November I got a job. December I started studying for the bar exam again. In February I took it, failed by 10 points. Then in April I had my second episode when I went to Portland to help my friend move. The time zone difference, and it being spring, and working 40-60 hours a week and studying for the bar exam… Definitely had to be hospitalized again for four or five days.
It was interesting, because the first time was a really slow buildup with a long psychotic episode. During this episode, the first day I didn’t sleep, I had to go into the hospital. It was a much tidier thing. They were messing around with my meds at that time. It drains you so much to have episodes, a neurochemical storm they call it. You lose all those chemicals and dip into a depression, though I always had a dysthymic depression. I really lived a very charmed bipolar life… as much as it’s given me in suffering, on the whole it’s not so bad. I couldn’t imagine going through psychotic depression, how much worse that must be.
I quit my job to study for the bar, then I failed the bar again in July by 15 points. It was frustrating, because my meds weren’t working out. I would sit there and stare at the book, trying to go through the material, but I couldn’t pull it from the words on the page. It wasn’t until my doctor added Wellbutrin to my schedule… I finished almost all of the prep course, then passed the bar with flying colors recently.
If I would have just given myself six months of a break, I would have probably recovered faster… but I don’t think I would have been happy with myself. It’s a trade off. You’re always putting your bipolar identity against your self identity. By not making my bipolar a priority, I was able to continue to feel like I prioritized what was important to me, even though from a medical perspective, prioritizing bipolar was what I probably should have been doing.
Navigating Life and Finding a Job
Finding a job is hard… I have five months of work experience, when I should have two years. If someone asks about the gap in my work experience: “I had medical issues that have since been resolved, and I’m looking forward to getting back and working for you.” I’ve already used that one; that’s how I got my last job! Plus, mentioning your illness in the interview establishes things, so if it was to flare up again, there would be some context for it.
Moving to DC really helped, because the opportunities in my field are way more expansive and varied. Things are close to working out. Finding a therapist around here is hard, but I think I finally pulled it off. Pittsburgh is very fortunate to have some very good doctors, and Western Psych is fantastic. It’s hard to find good doctors that take insurance here. They want you to fill out all these forms, and I want a doctor that will do that for me. Some of them don’t even take insurance… they just want you to pay cash.
Identity and Labeling
I don’t identify as someone with bipolar disorder. I just see it as a bunion, how that gets medical treatment… like the controllable diseases that are reoccurring, like herpes. They’re not things that become your identity. Your physical body – the better it feels, the better you will feel. But you don’t have to make the present condition of your body the way you feel about your soul the entire time. If you don’t like feeling like a “bipolar person,” don’t subscribe to Bipolar Monthly, don’t go to those support groups… Go to therapy, accept that you will need to pay attention to your sleeping and eating, but also remember that everyone has to do that. Your consequences are just more intense than others, but anyone can have an episode of psychosis under enough stress.
I do like that there are labels that I can Google whenever I need to know something about it. I get a kick out of knowing that Peter Gabriel is bipolar, or that William Styron has felt psychosis. Finding it in literature is more helpful for me, because then I can connect it to the human experience in a way that I can feel like my experience fills a unique niche in explaining a certain aspect of human behavior. Things like this project, which the public reads in order to learn about experiences other than their own, right? That’s kinda cool. I get less out of shared experiences like group therapy, though. There’s no single right way to cope with these things.
Advice for Others Living with Mental Illness
There’s an app called Daylio, which is a really simple mood tracker. It gives you smiley faces from “great” to “terrible” and options to track your own activities. It helps to observe what you’re doing on your good days, can help identify your positive activities and help you remember what to do more of on your negative days. Life hack your illness; something as simple as reflecting on your mood for the two minutes it takes to fill out a Daylio entry can help identify an episode before it starts, can show you a downward spiral before you hit the first curve.
Always track how much sleep you’re getting on average. You don’t have to write it down, but you should track it on paper for at least a month to see how much you’re generally sleeping when you are baseline. Track your eating, and eat clean. Practice radical acceptance… just say “fuck it” and do what you have to do, because you can’t be anything other than who you are… but always be striving to improve who you are. If you’re not happy with who you are, it’s not a bad thing to strive for more, but you have to give yourself reasonable goals. I’m trying to plan one hour of a healthy activity every day for myself… therapy, an exercise class.
Advice for the General Population
I think trigger warnings need to be used responsibly, so people who need them can continue to have them, because people who truly care about free speech have legitimate arguments against their overuse. When people say something is obscene, when it’s proven not obscene, it puts too much power into the hands of the state to tell you what is acceptable.
This is especially true with things that have demonstrative artistic value, like A Clockwork Orange, which has graphic depictions of rape. If you’re watching that movie in class, the professor should tell you about it, and you should have the option to do something else and make up the assignment. But, if you tell the government that they are allowed to tell you whether or not you are allowed to watch that movie at all, then you are telling them that they are allowed to police your sexuality and police your body. This solves nothing; it gives them the power to censor your own experiences too, if they aren’t convenient to the dominant narrative. If they have more power than you do already, then don’t give them more power. It won’t keep you safe.
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