Bipolar highs: a runaway train

I’ve been delivering talks to delegates on Mind training for almost a year now. I’ve been invited to speak at a range of different courses run by Mind – many have been “open access” courses that anyone with an interest can book themselves onto, others have been held in companies that need mental health training for their staff. I generally speak for about 45 minutes about what it’s like to live with bipolar disorder, with additional time for questions. I’ve spoken to service users, carers, and people in frontline health and social care roles, as well employees at large private sector organisations.

One of the questions people most often ask is, “When you feel you are going high, are you able to stop yourself?” It’s an interesting question, because two years ago when I was re-diagnosed with bipolar, I would have responded with a definite, “No.” At that point, I didn’t really feel my mood shifts were anything to do with me. It seemed like a slide into depression or a flip into hypomania “just happened”, regardless of what was going on in my life. The changes felt unexpected, as well as downright unfair, and I looked entirely towards mental health professionals for answers. I believed that if my Consultant could just find the right drug, I would be fixed. It seemed like my life had been hijacked by bipolar and I felt like a victim, but I was sure I could return to how I was pre-relapse and get back into my job, and all would be well.

I first started seeing a clinical psychologist in autumn 2011, after six months under Consultant care. I was still searching for the perfect drug, and becoming frustrated that I had tried three meds already without “success”. At assessment, the psychologist suggested that one of the things we might need to work on together was acceptance of my condition and what I needed to do to manage it. I though she was talking rubbish. I happily identified as bipolar. I even had a “BipolarBlogger” Twitter name and email address. But wasn’t my job just to take the meds as directed? I didn’t believe that I could manage my own moods, and didn’t see why I ought to take any personal responsibility for management of my bipolar when I had a Consultant psychiatrist on the case.

It probably took me another six months to come to terms with how things really were, to accept that my moods, in fact, generally had a trigger, a kind of a seed that under the right circumstances blossomed into a full episode. It took another major step to accept that although I couldn’t always control exposure to triggers, how I reacted once my mood began to change could sometimes impact on whether it fizzled out or carried on moving in that same direction. I began to admit that a self-management plan was going to be just as important as taking meds, perhaps at times even more so.

Hypo/mania is the area where I had to put in the most work. I honestly don’t know why, but after decades of depression having the upper hand, in this episode lows have come a poor second to highs. Having little past experience in hypo/mania, I have often had to make my responses up as I go along, experimenting to see what works and what doesn’t.  And I have finally come to the place where I can say, “Yes.” Yes, if I really put my mind to it, and if I can catch it when it is small/early enough, I can pull back from a high. I always feel that a high is a bit like being put in charge a train. At first, being allowed to drive a train is fun. I feel rather special, because I am in charge of a train and other, more ordinary, people aren’t. It’s exciting to whizz through unfamiliar countryside and I feel exhilarated, energised. As the train begins to go faster, I fail to notice the scenery outside the window has become slightly blurred until I begin to feel a little bit sick. And then there comes a moment when I realise the brakes are off and it’s too late to put them on. The train has now gathered a horrible momentum of its own – and I say horrible, because elated mania is not in my emotional repertoire. It’s at this point that I remember there is only ever one destination for the train, and that’s dysphoric mania, an unholy mixed mood of manic energy and depressive despair. Now I look desperately around for an emergency exit, a way out, because feeling so horrendously out of control is unendurable. I would happily chuck myself out of my train and in front of one travelling in the opposite direction. But I’m stuck in the cab, and the only way out now is to douse the fire in the boiler. And things have gone too far for me do that alone.

It’s not unreasonable, I always thought, to want to have a try at being a train driver. Why shouldn’t I experience that thrill? Think of all the people who wish they could drive a train like that. Think of how jealous they must be! I didn’t see it was for me to control the train’s speed. Someone else, I used to think, should take responsibility. Someone else should have checked the brakes before I got on. Someone else should tested the speed gauge. And someone else should edge the tracks with crash mats, just in case I do need to dive off just when it begins to all be a bit much.

I’ve been on the train a number of times now, with the same outcome. The euphoria of the early stages of a high are deliciously seductive, but I now have to accept that I have a narrow window between stepping onto the footplate and that moment when I start to feel sick. That is the absolute last point that I can get down from the train, before it runs away with me. And if things carry on and become out of control, the dampening effect I need can only be achieved by high doses of strong antipsychotic drugs, something I hate almost as much as the high itself.

I have said that I can’t always control triggers and indeed sometimes I will find myself getting onto the train before I’ve noticed. So what do I do differently now? I don’t shovel on any more coal. The fuel for a high can be anything that gets me “emotionally aroused” – and it doesn’t have to cause elation. Anything that makes me agitated, jittery, irritated or excited can be fuel. Rushing to an appointment can be fuel. Watching a scary movie can be fuel. So can having an argument or confrontation, attending social events, or listening to fast tempo music. Exercise can be a kind of fuel, and at times writing can too. The basic rule for stepping off the train is: whatever I feel like doing, do the opposite. Switching the fast music for relaxation music is like throwing a lump of coal out of the window. So is switching running for yoga. Swapping a day of social engagements for one of relaxation exercises and aromatherapy baths ditches several pieces of coal at once.

I still resent having to slow the train down. I still complain and whinge about it, because I’m only human. I’d like to have my cake and eat it, enjoy the early, elated parts of the journey without things getting out of control. But it’s an inescapable fact that the longer I am on, the harder it is to get off, and shovelling on more coal can (for me) only lead to dysphoric mania. Not only does that kind of mixed mood state feel indescribably awful, it is also thought carry a particularly high risk of suicide. So I have finally had to accept that if I want to stay as well and safe as I can, I have, reluctantly, to get off the train.

 

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About purplepersuasion

40 something service user, activist, writer and mother living with bipolar disorder. Proud winner of the Mark Hanson Prize for Digital Media at the Mind Media Awards #VMGMindAwards 2013. Winner of the World in Mentalists Mood Disorder blog 2012. Regular guest blogger for the International Bipolar Foundation http://www.internationalbipolarfoundation.org/ Expert by Experience working with Mind training department. Working on The Incoming Tide, a bipolar memoir. Find me on Twitter @BipolarBlogger or at my Facebook page http://www.facebook.com/BipolarBlogger
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19 Responses to Bipolar highs: a runaway train

  1. Gershonb says:

    Your analogy is amazing. I’m 20, diagnosed last May with Bipolar. I have always wondered at whether I can slow down the train, but unfortunately so far I have failed to identify my triggers/ warning signs before it all goes into a blur. For me, manic episodes are downright scary, I feel so powerless it’s not true.
    Thank you for sharing your experiences, I think your very brave.

  2. Ahmed Almutairy says:

    Well done Charlotte. The more I read your articles the more I learn about BP. The next best thing to being there. Psychiatrists failed to explain or describe to me the tiny details that BP experience as you did. Thank you very much.

  3. HORUS ALLEN says:

    0 Hi

    1 Horus Allen here

    01 My output on this is filled with great sincerity. And happiness. Despite the triumphs and extraordinary struggle I continue to observe within, I somehow remain focused and optimistic – constantly re-calibrating myself – I am BP1.

    01 I am manic. I know what it is to be manic. I don’t know what it’s like to be depressed. I do know that mania can and will output maladaptive results just as depression does – just on an opposite spectrum. Therefore, if anyone here is manic, I pray that you know that you do not possess any “special powers.” (humor)

    01 There is however, an awesome power in embracing a reality. When, despite what you feel inside, you gain awareness on your external realities, I hope one can realize that they are not aligned accordingly. So for me, I changed my goal.

    01 Another round of success, triumphs, and highly kinetic risks, brought me back down to a state of Euphemia. So I said to myself, “No longer is my goal to close this business deal – such deals are tasks to me now – not goals. No longer is my goal to get another car that this time has more than 400 horsepower – cars to me are now utilities – not a means of time-travel (humor).

    01 Nope. My goal now became: “To execute a new process.”

    01 Regardless of how I “think” the medication is making me feel, I am going to take it now and for the rest of my life. This has been “best decision ever.”

    01 So after about two weeks on my medication, I was like, “Ah man, this is the reason why I stopped taking these 12 years ago. My creativity is, like, gone. Where’s my energy? Where’s my motivation, man, what’s up with this? Where’s my “voltage”?”

    01 My friends use to refer to me as a “human-walking-can-of-RedBull.” My friends would say, “I don’t drink RedBull anymore…I just call or spend some time with Horus…and I’m good for the next 6 months.” This is dangerous because this is where we can feel our mania is a benefit. It’s not.

    01 So as I pondered incessantly on why my motivation had left me, I began studying what my medication is actually doing to my neurotransmitters in my brain. This lead me to studying a bit on neuroscience, which lead me to study a bit on quantum mechanics. And as I engaged in this positive psychoeducation activities, um, all in one night (sorry – I did go to bed by 7am though), a funny thought entered me.

    01 It was hilarious – made me laugh out loud. Check this out – the thought said to me, “So you are highly motivated to learn where your motivation went?” HA HA!! Wow – Only people like us in this forum can appreciate this type of polar-opposite creative talking/thinking. (humor).

    01 You see for me, my medication did not remove my motivation at all. It just proved to me how manic I was all the time even at times when I was not consciously aware of it. I was so used to it, I thought it was, well, Euphemic, man.

    01 So that’s the part when your friend, or spouse, will glance you that side-ways type smile or grin with the erratic yes-nod saying to you non-verbally, “No…you…you were quite up there during that time…yeah…you were manic then…and you still are…why, can’t you tell?”

    01 I thought I had an advantage – the ability to remain awake and acutely aware of my surroundings when 78 hours had gone by since the last time I had been asleep. I would, like, create business model experiments during the darkest of night hours in my office or home. Then, I would often go to a spot for a drink, still with my suit on, and well, sunglasses, at like, 312am. Then come home, change my clothes, and go to the gym. Come home, kiss my wife good morning, shower, dress, take our children to school…and go to my office…Really????

    01 WTF man?? Then the bad decisions would come – if your mania remains untreated, this outcome is inevitable. The minute a business colleague would commit an avoidable mistake, or would show signs of indifference, or arrogance, or bullying, I would, well, react to it – with words that, although were with good intentions for protection of either a brand, or client, or employee, would still be…”there’s a better way to manage that type of matter than the one a manic like me chose.” Well, I’m thankful I know this now. And practice it now.

    01 Then the one disconnect would happen – the dreams. I don’t react to them now the way I use to. Manic levels (dysphoric) can trigger unreasonable thoughts/images/feelings. If untreated, they will rob you of your happiness, control, and freedom.

    01 You know what’s funny? When people act as though taking medication or seeking medical attention is a sign that you “can’t do it alone,” or a “sign of weakness.” I would be a very interesting and blunt therapist because I would be the one to say to my patient, “who in the hell just lied to you like that? What is their phone number? I must text them at once!!!” Well, that’s what happens when you as a BP1 or BP2 has a therapist who’s manic himself.” (real humor – please take time to laugh at that one)

    01 Such a therapist would be like, “What, are you OK? Here, have some champagne, 30 MG of Adderall, and here’s some Lithium. Now try to relax – so – how has your week been-you good?” (picture that – now that’s really funny and you know it)

    01 You deciding to seek medical attention and help is still you leading your cause to manage conditions.

    01 So if you manage a condition at your place of employment – you seek resources and people and knowledge to better a condition – you are viewed as a focused person.

    01 So how come humans have conditioned themselves to believe that this formula does not apply to themselves when this formula works? What’s beautiful here is each unique formula outputs the same answer – it’s what the formula does. Yes, the variables change, but the calculation methodology does not. If I add one variable to another variable, that variable’s value increases by one unit – always – that method never changes – that’s what it does.

    01 So that’s when I began to feel very good about my adherence to my medication schedule, and psychoeducation regimen. I was then able to accept my condition as not only one that I can control – I can assure you, it does not control me – I control it now.

    01 I know what it’s doing at all times. I can feel when the neurotransmitters rise and fall within my brain now. And I am so incredibly thankful now that I remain consistent in channeling cognitive conditioning algorithms to my adaptive outputs.

    01 These algorithms I created for myself. It helps me remember what to do so quickly that the behavior became an instinct for me – which is what I wanted. I wanted a way to control my condition without it controlling me…even if I wasn’t paying attention. For example, I would do something like this:

    01 Identify your triggers – I call this “Variable Identification.”

    01 Examine the condition of the Variable’s impact on your own energy level (your mood).

    01 Your choice is to keep/change/improve/eliminate the impact. This is essentially determining what to do with that Action Potential (AP+/-) that is either racing you, or depressing you.

    01 Your motivation for choice is which choice will output a positive memory for you. Positive memories bring stability to moods.

    01 Execute it.

    01 I’ve been able now to go through this process within 4 seconds. Believe me when I tell you at first, the longest time it took me to execute such a reconditioning process was 48 minutes.

    01 My medication helped me understand where my real motivation lives – mania does not promote real motivation and creativity – it is you and me that all along harness our motivation and creativity.

    01 I am not lying to you when I tell you that since I have been on my medication, I am actually more creative. I mean, my creativity, like, really makes sense now. It’s awe inspiring to me. And I got to this point because I embraced my mania as my reality.

    01 Because I am manic. Period. I’m manic right now. It’s not my fault. I didn’t ask for it. The only reason for me that I am not inhibited by it is because I decided to embrace the science and quantum mechanics behind the illness. And now, I am no longer ill. I’m just manic, that’s all. After all, I now know what the manic formula does. Therefore, my formula to counter it is sort of an anti-manic (sort of like anti-matter).

    01 Good luck on your manic drive. Just please drive straight to a doctor. When you do that, you are now beginning to control your mania and it’s no longer controlling you.

    01 There’s nothing wrong with moving at the speed of thought – just this time, please know where you are going – and when you get there – STOP AND CHILL FOR A MINUTE PLEEZE – please don’t keep going – until it’s TIME to go again (smile).

    01 My love and support is to all Bipolarites everywhere. Yes, I coined this term, Bipolarite – sounds like a British chewing gum for manics (and I’m American, but that’s the advertising mad-man in me I guess). Like, Bipolarite would sponsor Benny Hill programs (Is anyone here of that generation??)

    01 Please, please, you commanding medical resources to your condition is you controlling a condition. Now that’s something to be manic about, right?

    01 Execute condition control at the speed of thought.

    01HA

  4. whythispath says:

    I really enjoy the way you write. And even though I don’t yet know what’s “wrong” with me (working towards a diagnosis), being able to relate to parts of your experience makes me feel less alone in the strangeness of what I’ve realized isn’t other people’s problems affecting me, but my own problems affecting me.

    • HORUS ALLEN says:

      0 Good Morning ‘Whythispath’
      1 Horus Allen here
      0 Ask a doctor how to recondition your problems to not affect you
      1 If he/she doesn’t know, find and ask a therapist
      0 If he/she doesn’t know, no worries

      01 Just know that the problem or emotion that happened to you in the past, is not happening to you right now in the present. And more than likely will not repeat itself.

      01 Forgive yourself for self-torment, you don’t mean to do that to yourself. My self-torment would be a trigger for my mania. It no longer is though.

      01 Judging by the tone of your writing, I’m willing to guess you have at least 70 years left of life in you on our planet – I think you have plenty of time to begin producing new and productive experiences for yourself – well, you might as well start practicing now – and it sounds like you already have.

      01 Onward Bipolarite (humor) – move at your own speed and at your own polarity (humor). You’re good. You are going to be OK – heck, you got 70 years to get it the way you want it, sister (humor).

      01 Execute variable stimulus switch at the speed of thought.

      01HA

    • What a lovely thing to say, thank you! When I got my BP diagnosis back 2 years ago I found reading others’ experiences so helpful – like you say, less alone, a realisation that at least other people have the same weird experiences I do! 🙂

  5. What a brilliant metaphor! It’s comforting to have an expert but sometimes we have to take responsibility for ourselves too. 🙂

    • HORUS ALLEN says:

      0 Hi ‘idiosyn’…oh whatever…I’ll call you IE…typing your ID alone is a trigger for mania (humor).

      1 Thank you for your comment – I didn’t get this way overnight

      01 My mania has been my curse for 15 years, until I combined medical treatment with psychoeducation and my unique approach to matters.

      01 And now…my mania frankly is a gift – I am thankful for it. It is a gift now because I know what to do with it. It’s sort of like what happens when two opposing forces stop fighting against each other and achieve equilibrium. Everything, all of the sudden, becomes peaceful and in order.

      01 And now, I can see all of its order, all at once now. There is no more wonder and confusion. Everything is understood with purpose.

      01 It has taken me 15 years to find the engine necessary that can handle and control this neurotransmittic energy that I did not ask for, but that I do possess. It is my responsibility to manage it accordingly. I have to own it. And I do own it.

      01 So now that I own it, I am constantly adjusting it to get it to do what I want it to do. So of course, like any leader, I’m going to “employ” a cabinet or “board of directors” if you will – like, my therapist, my psychiatrist, my medical doctor, our research and development department (National Institute of Mental Health, Psychology Today, CERN, and even the Wikipedia intern (humor).)

      01 These are the sources that I would frequent from 9pm to 5am in my home office – actively working on my condition with my mindset being, “What if I didn’t have the blessing of medication and therapeutic analysis? What would I do to control a condition that I did not bring upon myself and did not ask for?”

      01 A regimen like that, I cannot fail at all. The output from such a formula – it’s impossible to output failure from a formula like that – it just doesn’t happen. You don’t fail when you change your variables to adaptive behaviors. That’s like saying 2+2=9 (humor).

      01 Thanks IE – I appreciate you highlighting that we do have the power within us all to wake up one day and say “I am not a victim,” I am not the CEO of myself. I am the Chairman of the Board of Myself, Inc. Me and my board members are tasked with discovering how to control this type of energy for our own self-common good. We must output a specific profit margin for Myself, Inc. In order to do that, we have to force this energy to do good for us.

      01 Speaking as a true Quantumanic (I coined this creative term too (humor)), energy to matter necessitates change – every time. Those extra Action Potentials (AP +/-) within our brains are matter.

      01 We can try every second to attach our ideas (energy) to that matter and transmutate it to be what we want it to be instead of helplessly accepting it for being what it is. At least we can try anyway. But we need medication and treatment – (remember, every leader has a board of directors – no shame in that – it’s expected) to do it.

      01 Because despite this condition, our daily responsibilities, and our families and children who depend on us, need us to function in that capacity. But most importantly, we ourselves need to function towards a sustainable capacity. And sustain it. Even if we’re manic.

      01 And yes – I was fair to myself as well in this process. I realized that not every day I was going to “change the world.” I accepted that some days I would not be productive. So, instead of punishing myself with worry that I’m not being productivity today, f*** it, I would go to the movies – I would take a damn nap – I’d watch the hilarious DVD ‘Horrible Bosses.’ I’d have a cup of coffee and a cigar and sit out on my deck and watch the stars or the clouds.

      01 And then you know what? Instead of me thinking that my whole day ( or night) was shot, it turned out all I needed was an hour to 90 minute break. I’d come back to my work and execute with happiness.

      01 Because it’s awesome when someone like myself has finally identified actually how slow one second is.

      01 We have the time. No one is running out of time. From 15 years of episodes here, episodes there, and I thought that it had gone away on its own, it has now taken me the past 18 months to learn how to choose how I want to feel. And how to eliminate what I don’t want to feel. It works. And my medication and psychotherapy helped me get to that point.

      01 And that’s what I’m manic about. Thanks again IE.

      01 Execute binary time oscillation to AP+/- frequencies at the speed of thought

      01HA

    • Thanks! I think metaphors really help people understand – I use them a lot in my training talks!

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  7. Katey says:

    I love your train analogy. I am like you – I find analogy and metaphor so helpful in not only communicating how I feel to others, but also in bettering my own understanding of my illness. Thank you for sharing yet another way of looking at and understanding such a complex mood disorder. 🙂

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  11. gravbeast says:

    Reblogged this on Maddening mutterings and commented:
    Interesting post by PurplePersuasion, on managing bipolar (hypo)mania – and answering the question, “When you feel you are going high, are you able to stop yourself?”

    I’m hoping to blog about my own experiences, but in the meantime, this is a very interesting read.

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