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I love mania it's just like, yeah! I feel amazing!!! But I also feel like I'm going to burst into tears and a puddle of self-loathing at any moment!! But let me do ALL THE THINGS jesus christ I can't sit still I have to do something constantly otherwise I'm going to die and fucking hell I can't sleep but I feel good oh my god I want to die

#mania #mixed mania #mixed episode

Trying to Return from Mixed Mania and Effexor Withdrawal

A/N: This post describes the aftermath of mixed mania/a mixed episode of bipolar disorder. Mixed episodes are high-risk times for bipolar patients, because there is extreme agitation and mood swings that can be accompanied by suicidal thoughts and severe anxiety. The increased energy associated with this state of being can make someone more likely to harm themselves as a result of the extreme discomfort linked to this state.

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Crisis Text Line

I know that I wrote a behemoth of a post this morning, but I’m going to try to type another post before I force myself to go to work today. I am using all the willpower that I can muster while still being faint, clammy, and experiencing minor versions of some of my old symptoms. I managed working yesterday, but that was only by telling myself, “Just take this one day at a time. If you go today, it doesn’t mean that you are going to be able to go tomorrow, but you have to at least try to get moving.”

“Just do it for today.”

I slept extra hours for the first time in weeks, getting up briefly just so that I could take my morning medicines, before going back to bed. I had terrible dreams though, that my parents were taking me to doctor’s appointments (in addition to the ones I already go to) and that the doctor kept increasing my medicine and I couldn’t keep up. The pills were literally multiplying in their containers, getting mixed together and overflowing to where I couldn’t put the tops on them. It is quite an appropriate reflection of how I feel right now.

Even if it was fitful, being able to sleep a little more is a good sign that my mixed mania/hypomania is coming under control. That, or maybe it was just all the Hydroxyzine I took yesterday (still not a fan of that pill).

How I dealt with the anxiety and paranoia of going back to work, though, was to tell my boyfriend about my fears and have him point out the inconsistencies (he dragged me, y’all). I’m still worried about my performance, but I am trying to accept the fact that it needs to be okay that I can’t give my best effort right now. I’m still sick but showing up is important.

Also, the bipolar group facilitator told me, “You feel guilty” when I told her I was anxious about returning to work yesterday. It startled me, but I quickly agreed. She said, “There’s no point in you feeling bad about missing, and then you going there and being unable to concentrate.” She gave me a lot of helpful information about medication and helpful activities to do when I’m stressed. She was also the only one who fully agreed that my symptoms were withdrawal; even the ER staff believed that it might be lithium toxicity. So, they connected it more to something being added than something being taken away.

To be fair, though, I was experiencing some of my stomach problems before the Effexor was removed, and those could honestly be attributed to anxiety like my psychiatrist suggested. The issue is, though, that I usually have a very strong stomach, so the persistence and severity of the symptoms didn’t line up with anything I have previously experienced.

I have to say, though, when I looked over the activities that the group leader gave me, I couldn’t help but be taken back to my early recovery. Things like “take a bubble bath” or “go for a walk” just seem so basic to me. I already have hobbies and things that I enjoy, but I’ve been slammed so hard lately that so much of it just went away. I hadn’t been able to type up Tumblr posts because I couldn’t even really sit up straight—or think straight— enough to do it. I had become very active, walking in the park multiple times a week, but that became impossible as my physical symptoms progressed. Thankfully, I was able to still take showers, and even though I had tons of food aversions I could still eat. I kept recording my voice diaries and tracking my symptoms in my Keep app.

I’m not trying to say that it isn’t helpful that the group leader gave me mood diaries to fill out, lists of activities, etc., but I realized that I have been doing these things all along. I’m a veteran to this game and I’ve been fighting tooth and nail for my recovery. I do find them helpful in that it’s easier to send a written report to the doctor or talk about a written report in the group, than it is for me to try to recite things from my phone. Also, the group facilitator brings up aspects of bipolar that I didn’t even know existed or could affect me. Overall, I’m happy that I started going to group again. If anything, it’ll give me something to do while I’m waiting for classes to start. I plan to still go even if I do get to do summer II (all online still). I’ll get a certificate of completion after 12 weeks of group, and maybe that will tell my treatment team that I know what the heck I’m talking about.

This has been one of the most difficult times I have ever experienced in my recovery. I felt like I was just inches away from checking myself into the hospital on multiple occasions. It was never recommended to me by staff and my boyfriend and Mom were quite against it, but I think I was ready to just withdraw from my life. I knew that depending on how long they kept me, I might end up so behind financially and with work attendance that I might lose my apartment and job, but I felt like I was so out of control. I can see now the role of anxiety, and I will continue pressing for a GAD diagnosis. With what happened with the antidepressants, though, I will research any anti-anxiety medication thoroughly before I agree to add it to my regimen and will mostly seek out non-medical solutions.

Also, another thing I am considering is enrolling in schema therapy. I am experiencing some progress with CBT, but it’s been a little slow this time around (I was in therapy before with excellent results). I can’t seem to be rid of this rigid, perfectionist, and highly self-critical “schema” that I seem to exhibit. I know, I know; we don’t self-diagnose in this house, but I just feel like I have a certain script that I’m just following, even if I know the script is flawed. Sometimes I feel like I’m watching myself freak out and self-destruct and I know that it’s unnecessary, but I don’t know how to stop. Lately, I’ve found myself just telling my boyfriend (when he advises ways for me to let go of perfectionism and relax), “I understand what you’re saying, I just don’t how to do that.” I know that when he tells me I obsessively try to pick apart and analyze every aspect of my life and actions and that it’s harmful to my recovery, that he’s right, but I don’t know how to turn around the behavior.

My therapist tells me that I must challenge negative thoughts at every turn and use kinder language regarding myself. Her favorite thing to say when I say something negative is, “What’s the evidence?” If I say I’m lazy, are being a student, holding down a job consistently, and being a graduate of community college the attributes of a lazy person? Isn’t “foolish” an awfully strong word to use for missing the deadline to return a rental to the school bookstore? My progress is slow, but I wouldn’t say that I haven’t made any. I think that I just need a clear goal. I did write down on my New Year’s Resolution sheet that I want to experience less self-doubt, and there must be a way to get there.

Right now, I’m trying to live life post-relapse, and yes, I would definitely consider this a serious relapse even if it didn’t require hospitalization. Routine has always been crucial for keeping my mind from going off the deep end, so starting group and trying to return to work have been essential for me. Leisure activities are also huge, so I’ve been making plans with friends. I’m still set to go to a concert with my younger sister, and this is her first concert, so I want her to really enjoy it. The day after the concert is my nephew’s fourth birthday party. In the more immediate future, I plan to start walking in the park again, and doing my laundry and getting things cleaned up around the house. I’ve already collected some money together and scheduled some bill payments while I’m still able. Next Friday’s paycheck is going to really suck, but I think I should still be able to pay rent, thanks to my mom helping me.

Miraculously, I seem to have survived this, so now I just have to take it one day at a time. My worst fears were nearly realized, but I climbed the highs of mania without falling off the mountain. Mixed mania is one of the worst things I have ever felt, in that I maintained my cognitive abilities but at the same time felt like I was going completely crazy. It nearly destroyed my life, but with determination and the help of loved ones and my treatment team I made it through.

You can, too. Don’t give up!