Not all hypos are equal: when things get nasty

When I was discharged from hospital a couple of weeks ago I thought it would take me a long time to recover from the experience. I was actually quite shocked by the depth of my own pain; I’ve been experiencing low mood since I was 12, but this was above and beyond (or below and beyond). I was prepared to have to look after myself very gently and carefully for several weeks. I saw Dr HTT two days after discharge and he commented in a kind, human way that I seemed “thoroughly miserable” with my life.

The plan had been to start me on a new antipsychotic, but bearing in mind how depressed I had been for so much of the year Dr HTT wondered if it was time to consider something to lift my mood. The next step then was to think about an antidepressant. I had a week to mull it over and get back to him.

And then I went high.

I was totally unprepared for this. It never entered my head for a moment that it might happen. And I really reached the upper reaches of hypomania, about as high as I get – about as high, probably, someone can get without been in true mania.

It wasn’t even a nice high. “The highs must be great!” is something I hear a lot and the answer is, well, mainly. But not all hypomanias are equal. They all involve elevated mood – emotional arousal, agitation, huge surges in energy, insomnia. But not all of them are happy (elated). I’ve had elevated moods that were characterised by sheer panic and fear. Mostly however if I am having an unpleasant high it will be an “irritable” one. I used quotes because that’s how it’s referred to in books, but actually that “irritability” is more like anger or aggression. Rage, even.

I felt bitter about that. After all the distress I’d experienced so far this year, if I was going to have a high I wanted it to be an elated one, thanks. I wanted to feel at one with the universe. I wanted to feel sexy. I wanted to be super productive. I wanted to see beauty in everything. I wanted to love all the people.

Instead, what I mostly did was hate all the people. OK, not all the people. I didn’t hate my nearest and dearest. But the day after I saw Dr HTT my first thought on waking was, “Uh-oh, I’m going high” and within three hours I was verbally abusing a nurse and a social worker from Home Treatment Team. I arrived quite bouncy, but their insistence that I wasn’t hypomanic planted a little seed of irritation that instantly began to grow into something more. It wasn’t long before their earnest little faces began to really annoy me. I told them so, and they took it fairly calmly, but that anger was swelling and swelling and I began to feel like I couldn’t keep my frustration and disdain in check.

Things came to a head when I realised that the SW didn’t even understand what bipolar was (“I do know that people who have bipolar can have other conditions on top, like depression”) and I lost it. I can’t remember what I said at that point but I know I yelled, I know I was talking (shouting) very fast and I know I slammed the door as I left, saying, “You want to know what hypomania is? This is fucking it.”

I walked to the main door. It’s the “push button to exit” kind; you can let yourself out but then you can’t let yourself back in. Hand on the button, I paused. No, I thought. I’m going to go back in and have another fucking round.

I banged the treatment room door open. They were still sitting there, probably waiting until I was well out of the way before passing through reception, undoubtedly discussing me.

There is a real sense of being out of control when I’m in this type of high. There’s a kind of pressure from within. The words come pouring out. It’s unstoppable. Mouth opens and out it comes, way before brain has time think up the horrible things to say. Part of me hovers above myself, looking down, hearing myself say the same things I always say in this state, unable to reel myself back in. Cringing. Mostly, though, I feel totally justified.

What happened at this point was me expanding on my prior diatribe and stopping any response by shouting, “No! Nnnnnnnnnnno! Nu-nu-nu-nu-nu-nu no, I’m talking, DON’T TALK, you don’t get to talk, I’m speaking, I AM SPEAKING, nu-nu-nu-nu-nu-nu no, OK???”

The main focus of my wrath was the social worker. “You!” I shouted, “What’s your name?” As far as I can remember, the rest of it went something like this, but I am paraphrasing. “Right, Bethany, I don’t ever want to see you again. You hear me? Don’t even think about coming down here until you’ve educated yourself. If you don’t know what you’re talking about, don’t fucking bother. You need to EDUCATE yourself. ED-U-CATE YOURSELF. Don’t come back to me until you’ve read a fucking book. You-” (I turned to the nurse) “you’re all right, but you, fucking educate yourself.”

At this point the nurse stood up and blocked the space between me and Bethany, moving me towards the door in a “let’s get this aggressive person out of the treatment room” kind of a way and saying, “Charlotte, I don’t think we shout be shouting at each other.”

“I’m not shouting at you, I’m shouting at her. Now I suppose you’re going to say you won’t see me on Monday.”

“No, Charlotte, we wouldn’t do that. We’ll see you on Monday.” And I was kind of…gently pushed out of the room.

My daughter was arriving to stay for a few nights. She’s 16 now, she’s seen me in aggressive hypo mode a few times, but I really didn’t want to be that way around her again. We went to the cinema and I kept it together really well but on the bus home there was somebody behaving ridiculously – late getting off, blocking the stairs, holding the bus up, laughing about it, then berating some poor guy who was just trying to get up to the top deck.

I squeezed daughter’s hand muttering, “Don’t say anything, don’t say anything, don’t say anything, OH FUCK OFF!” Tom turned round in his seat and shushed me. The woman said something in response and I yelled back, “WELL, WHAT THE FUCK’S HE SUPPOSED TO DO??”

“Shh!” said Tom again. “You’re only saying what everyone’s thinking, but you don’t have to say it!” and I stared out of the window and cried because I was so frustrated.

My hypomanic insomnia at this point pretty much involved lying awake thinking deeply angry thoughts about people I felt had wronged me. It was all tremendously self-righteous. Over the next few nights I directed a lot of mental anger at Bethany (if that was even her name, having made a big thing out of it I had kind of forgotten by then), feeling very sanctimonious. I thought about the aggressive woman who had been on the ward with me. At the time I’d been scared but now I kept thinking stuff like, “If I have to go back and she’s still there, I tell you what, I’m going to fucking knock her out.” I thought about those people on Twitter who had said I lacked compassion for the aggressive lady without even considering that sometimes I might be an aggressive piece of work myself.

That level of intensity lasted for a couple more days, and it did become more positive in that the flavour was one of elation, but it still wasn’t a nice elation. It was being happy in an unpleasant way. Colours were incredibly bright and beautiful, but hurt my eyes. I was preoccupied with sex in a way that was a tiresome even to me. I did love everyone and everything, but kind of desperately, exhaustingly.

Even then I wasn’t feeling the level of remorse that I should (and now do). I believe that in fact I am a compassionate person, but I remained grandiose and felt infallible.

It was in this state that I saw Dr HTT again and we decided that perhaps…

Perhaps my mood didn’t need elevating after all.

 

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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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