A manic break, like I had in my first year of college, is what separates bipolar I from bipolar II. Bipolar II patients have hypomanic episodes in which one may experience elevated mood symptoms without quite the level of impairment that a full-blown mania imparts. I knew something significant had happened to me, I knew I had lost my fucking mind — possibly tipped off by other students, the school counselor had been after me, but I managed through dumb luck to evade her. I was definitely impaired enough to warrant hospitalization, even involuntary commitment, but by the time the men in white coats came for me I had crashed. A Tylenol overdose is serious, and I had waited three days to inform anyone I had done it, thus damaging my liver and landing me on the transplant list. After three days, I figured that I wasn’t going to die and I had started vomiting. Since our dorm had one community bathroom it seemed I couldn’t go unnoticed for too long, and I called 911.
Depression can distort your thinking, and I was hearing my voices ordering me to kill myself and was convinced my dormmates were plotting to kill me as well. I was absolutely terrifying. I had no toehold in reality; I was fully psychotic with both auditory and visual hallucinations and suffering paranoid delusions, and and my actions made complete sense to me at the time. I felt like I was nothing but a lunatic who would do nothing in life but drain the planet’s resources, and that everyone I loved secretly was hoping I’d die as well. Remember that when you accuse the suicidal or suicide victims of weakness, selfishness, and stupidity — I’ve been called all of the above and more from the moment the ambulances arrived, and I feel that’s it’s fucked up to make judgment on anyone’s character when their illnesses actually set these thought processes in motion.
Moving to Olympia was, in retrospect, a very bad idea. As I was misdiagnosed by my own designs — I was not honest with the stream of mental health professionals that suddenly appeared in my life and they missed out on seeing me at all manic. I never fessed up to my psychotic symptoms because they terrified me and I thought I’d be forever institutionalized. I was beginning to see my psychosis for what it was — an aberration, not part if the “normal” experience my friends were having. It was like putting on those purple glasses.
I wrote a lot about depression when I got to Oly because I was mired in it. I immediately realized my Pamelor was mucking me up even worse, keeping me crazier than I’d been without it and it made me extremely irritable, which was hard to live with due to the problems it caused in my relationships and friendships. Walls were punched, drinking glasses shattered. Antidepressants tend to push bipolar patients into mania and it got pretty scary in my head. I decided the pharmaceutical industry was a scam, discontinued it without telling anyone, and became a nice safe depressive again.
I didn’t know how the health care system in our country worked at all. I didn’t think I could get help without my parents knowing about it, and they were already skeevy about my transfer to The Evergreen State College but didn’t know what else to do with me. I remained depressed and suicidal during my time there, but for whatever reason my psychotic symptoms were manageable again. I did a horrible job making friends, because deep down I knew something was desperately wrong with me and that opened a chasm between me and the rest of the student population at Evergreen. Isolation is a huge problem for all those with mental illness, but it tends to be insurmountable as a psychotic. I sludged through a couple of very dark years before finding a general practioner to prescribe the antidepressant Celexa. And I started to feel better. A lot better.
I returned to the general practitioner a couple months later. I had developed an issue in which I was getting recurrent UTIs with no symptoms, and these would eventually spread to my kidneys, so I was frequently in the ER and then in the hospital. My doctor prescribed a prophylactic dose of the antibiotic Macrobid, and told me to take it every time I had intercourse. Since I was wildly hypersexual at the time, I cheekily asked him what’s the most I can take in a single day? He looked very alarmed.
“Has anyone ever told you that you are bipolar?” he asked with panic in his eyes, desperately scanning the pages in my chart (I’m old enough, this was before they had computers). I laughed hysterically, and he switched my Celexa to Wellbutrin. Again, antidepressants will push a bipolar person into mania, and I knew I was crazy again but he eventually said it was just the meds and it would go away with the switch in antidepressants.
And then I got a job as a phone sex operator at a fetish line…
Suddenly, I was having the time of my life. I got to talk to people that were into way crazier shit than I ever imagined. I covered the overnight shift, and stopped sleeping again. I was incredibly successful, as I am with most things I try (save for having a baby, but I’m putting that on the back burner right now). I went off my Wellbutrin and onto Paxil and my mood went from elevated to euphoric to completely grandiose, and in the business of being a phone dominatrix these qualities will serve you well. I somehow got promoted to manager, but my phone calls were racking in so much money for the company I still mostly spent most of my time on calls. When I wasn’t on calls, I was shopping, buying thousands of dollars worth of fetish wear and ridiculous things, like a $75 keychain.
One day, I was speaking to a regular client of mine who was a psychiatrist. Since I was so grandiose and an ardent feminist, I usually refused calls that cast me in a submissive role, but this poor dude was tormented. I’d walk him through horribly sadistic and misogynistic fantasies, and afterwards he would cry and apologize over and over for hurting me. One day, he started asking me a lot of questions and told me he suspected I was schizophrenic or bipolar because I answered very honestly (I prided myself on being completely honest with my clients). He begged me to talk to a doctor, and then apologized even more for traumatizing me. And just then it hit me that I needed serious help.
I might add, becoming a phone sex operator and subsequently a fetish model, was completely out of character for me, a former honor student. And it got worse. I started abusing drugs and alcohol, favoring the euphoria of cocaine and oxycontin, which I would crush up and snort (you can’t do that any more, they’ve added some sort of coagulent so it won’t go up your nose). I met a guy I thought was wonderful, a bipolar man who moved me out of my phone sex job (I actually had been living in my office) and provided all sorts of pharmaceutical enjoyment. He was most likely still married, despite claiming he was divorced. Since I mistook being manic and high for love, I decided I needed to get psychiatric help, since I didn’t want to fuck our relationship up like I usually did with boys. I’d also quit my job in a very dramatic fashion, and was unemployed. I was twenty-two years old.
The drinking and drugging made me very anxious, and very psychotic. I began having daily panic attacks, and couldn’t distinguish my hallucinations from reality anymore. I began having ideas of reference, which continue to this day — these are delusions in which you think every little thing in the universe pertains to you. It’s hard to describe. I go outside, and see a leaf twitch. This appears to signal a man to come around the corner, watching me. His appearance causes a car to drive by slowly and when it passes the driver signals a bush to shake in the wind, and in response a woman exits the building across the street. The whole experience is reminiscent of paranoia, and often will turn into full-fledged paranoid delusions.
The police become a regular fixture in my life. I am often picked up on the street and dragged to the Crisis Clinic in handcuffs, or else I am screaming in my apartment and the neighbors call the police and off I go on another ambulance, or, they manage to deescalate me and life goes on. The police here are well trained in dealing with the mentally ill, and I retain a pristine criminal record and am never brought to jail. Being a small Asian girl with a middle class upbringing, I am lucky in this regard.
My mom starts visiting regularly. I frighten her, one day finding myself unable to stop walking in circles for hours, the next by being unable to move and listening to Leonard Cohen’s Songs from a Room on repeat while screaming that I wanted to die — both these episodes required a visit from the CDMHP (County Designated Mental Health Provider, a woman in charge of evaluating whether or not a person needs to be involuntarily committed). I spend time in the hospital, while my mom sits hopelessly alone in my apartment, as I’m only allowed visitors for an hour a day. She bonds with my cat and ate at Taco Bell (she didn’t know where else to eat as the city was unfamiliar to her).
I am diagnosed with bipolar disorder and given meds. I have freaky reactions to a lot of them, and my new cocktail of pills messes me up even further. I try everything. I admit to my doctor that I hear voices, all the while taking illegal drugs. By now, my boyfriend has left me and I’ve become terrified to leave my house. I stop using coke and oxy, and start taking ridiculous amounts of benzodiazepines, obtaining them dishonestly through my new provider at the low income clinic and buying them on the streets. I continue drinking. Eventually, I am granted disability through Social Security for a diagnosis of bipolar I. The disability determination psychiatrist says schizophrenia would have to be ruled out. I often awaken in four point restraints in the ER, I am hospitalized a couple times.
And then I am prescribed the antipsychotic Geodon…
Despite the major addictions to booze and pills, I start feeling a tiny bit better. The Geodon works fast. I had tried Zyprexa (it made me so confused my boyfriend caught me trying to pee in the trashcan — I really thought it was the toilet), Risperdal and Seroquel both turned me into a zombie and I would fall asleep anywhere — my boyfriend was continually carrying me home from various locales, after being unable to wake me. Within hours of taking my first dose of Geodon I felt sharper, unlike the other pills that seemed to work by dulling all my senses. The psychosis didn’t go away, but it was manageable. My moods stopped swinging, but I didn’t become super depressed. I attempt to regulate my alcohol and tranquilizer habits, but am unsuccessful. I enter a partial hospitalization program at the hospital across the street. I am still agoraphobic, but the hospital is so close to my apartment I am able to drag myself there. My Geodon dosage is increased, and increased again. I make a couple of friends.
Eventually, I am busted and it comes out that I have a dual diagnosis (this means you have both a mental illness and a substance abuse problem). I am sent to outpatient chemical dependency program, where I meet even more friends. Against all odds, I get clean and sober, throwing myself into twelve step work. My best friends from treatment are dead now, one from overdose on painkillers and one from COPD as a result of his smoking. I grieve, I meet new friends. There is a lot of grieving because addiction kills. This is still a reality in my life today. But back the…I was so so young.
My diagnosis is now in question as my care providers struggle with sorting out substance-induced symptoms from my mental illness. I now have Medicare and see my provider at the outpatient psychiatry clinic at the hospital I know so well. My new therapist (the old one was batshit nuts and would just show up at my house to meddle with my medications and bum precious cigarettes, which I could barely afford anyway) is one of the coordinators of the partial hospitalization program and sees primarily patients with diagnosed mental illness, especially psychosis. Initially, I am terrified of her but I learn to talk about things I’d never talked about before. I still experience constant auditory hallucinations, the occasional visual hallucinations and have those ideas of reference, and I’ve accepted that I always will. I’ve actually had them so long, I can’t imagine living without them. I believe that my drug use (especially stimulants) exacerbated my psychosis but there’s no fixing that now; what’s done is done. I also believe that drugs increased my panic attacks — to this day, I still experience them daily. My diagnosis now is schizoaffective, meaning I am bipolar and schizophrenic, but my schizophrenic symptoms are mild compared to other schizophrenics that I have met in recovery. Medication and regular talk therapy have allowed me to retain a good deal of functionality. I am still on disability, but have not had a major mood episode since starting Geodon until recently, when I realized losing four babies had sunk me into depression.
This probably all seems looney tunes to you guys. Sometimes, I cannot believe this is my life — I fucking am psychotic? Wtf? Sometimes I feel more comfortable conversing with the guy on the corner screaming that Mr. Rainier is going to blow up on Wednesday than the average college educated middle class lady who likes the same bands as me and shares my interests in literature and film. I definitely live life differently than I ever expected to, and there is a lot of grief in contemplating what this illness has robbed me of — a satisfying career, solid lifetime friendships, and now a family of my own. But I’m not alone. I have Geoff, and although I may occasionally accuse him of wanting to kill me, he good-naturedly takes care of me on the bad days and is here to celebrate the good ones. Life with a psychotic disorder is not the end of the world. My life is hard, but it certainly is worth living.
Today, I have to take care of myself. I deal with my symptoms by carefully structuring my day. For example, I have to go to bed relatively early at the same time every night. It doesn’t matter If I wake during the night and can’t go back to sleep, it seems, but I need to be able to fall asleep at a consistent time — I don’t know why this is, but it works for me. If I can’t sleep, I contact my prescriber to tweak my meds and start taking long walks in the daytime to wear myself out a little — regular sleep is vital to controlling my moods. Lack of sleep is both a cause and an effect of mania, and I have to be meticulous about my sleep schedule, no exceptions. I can’t travel too many time zones because it takes me about a month to get over jetlag.
I also need to take my medications at the same time each day. Geodon has a short half life, and you need to eat with it so it can absorb. Therefore, I must eat three meals a day at the same time every day or I start getting fuzzy around the edges. In addition, I notice that if I’m not exercising enough (and I’m not talking about anything extreme like CrossFit or anything, just light exercise like walking), my mood plummets.
My rigorous time scheduling can be awful inconvenient, but is essential to my wellbeing. In addition, I attend weekly psychotherapy sessions and track my moods carefully. I’m willing to do all these things in order to stay on planet Earth, even though I must sacrifice spontaneity. My friends don’t really understand when I can’t stay out later to finish watching a movie or something, but it’s something I have to live with.
I realize by posting this, I’m opening myself up to a lot of judgment from friends and strangers alike. I’m willing to take that risk because the mentally ill are getting a pretty bad rap in the press today, and I hope to be one voice out of many. So my backstory is a little seedy. I was young and sick. Despite living with a chronic illness that is really no different than any other chronic illness — well, I’m really just a normal girl that wants what everybody else wants. I live a somewhat dull life, I am clean and sober, I have never posed a threat to others, and I take medication like a diabetic takes insulin. My neurons misfire; my neurotransmitters are unbalanced just like an infertile’s hormones, to use an example part of my readership may understand. Yes, it’s a struggle, but I live an honest life now and have for over a decade. I have achieved a sort of partial remission, and although for the last three years I have been battling grief and trauma, the bottom has not yet fallen out of my mind. But I have to live like it’s always a possibility, which is a burden a lot of you wouldn’t understand. Still, I’ve learned to take care of myself. I think, even if I cannot conceive and carry the baby I want so desperately, I might end up being okay.