A New Learning Curve

With the return of my bipolar symptoms comes an opportunity to begin working with my compulsive behaviors in a new way.  What I’ve discovered so far is that agitation seems to be the underlying energy for the compulsive eating and spending as well as the restlessness and urge to “Get Out of Dodge” that sends me tooling down the highways.

In a bit of synchronicity, Vivien over at ManicMuses just posted a piece about new emergency room treatment of agitation in psychiatric patients, which got me thinking more about the shape and origin of agitation.  I’ve also heard from other folks who live with bipolar disorder that this type of mixed state can be fairly common.

This from Wikipedia:

In the context of mental disorder, a mixed state (also known as dysphoric maniaagitated depression, or a mixed episode) is a condition during which symptoms of mania and depression occur simultaneously (e.g., agitationanxietyfatigueguiltimpulsivenessirritability, morbid or suicidal ideationpanicparanoiapressured speech and rage). Typical examples include tearfulness during a manic episode or racing thoughts during a depressive episode. One may also feel incredibly frustrated or be prone to fits of rage in this state, since one may feel like a failure and at the same time have a flight of ideas. Mixed states are often the most dangerous period of mood disorders, during which susceptibility to substance abusepanic disorder, commission of violencesuicide attempts, and other complications increase greatly.

Yes, this would be me.

In a way, I’m relieved to learn that a mixed state is serious and difficult to treat.  It pumps up my ego to know that I’m fighting a worthy adversary and helps me take in stride all the times the compulsion simply runs me over.  Learning a new way to work with this agitated energy won’t be easy.  There are no other guidelines out there except the use of powerful drugs.

The results of a mixed state are the scariest, craziest part of bipolar disorder for me.  I feel like something takes possession of my body and my brain, and there’s nothing I can do except ride along until I’m released.  The impulses are so strong, and the drive to flee from them so ingrained, that it will take time and much effort to even begin to imagine something else.  But, that’s what I’m doing.

When I’m able, I get still, either by sitting in a comfortable chair or lying on my bed.  I breathe.  I start to explore where the agitation manifests in my body.  Sometimes I feel it in my gut, sometimes my chest, and sometimes it seems to be only in my head.  And then, I stay with that sense of placement for as long as I’m able—sometimes just a few moments.

When the compulsions are already in control, I try to at least acknowledge them, watch them as they push me into eating or spending or fleeing.  When I resist, the compulsion only grows, so instead I try to choose a lesser target (Subway instead of Dairy Queen, buying one item online instead of a dozen).

I’m also using meditation as much as I can, but there’s a resistance to that as well.  I’m not sure what part of me is fighting this very useful tool, but I find I “forget” to meditate a lot and brush it off when I do think of it.  This resistance is something else to learn from, I think.

So, while being symptomatic again truly sucks, there are lessons to learn and maps to chart.

I’m on an Adventure.

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18 Comments (+add yours?)

  1. Kathryn McCullough
    Aug 22, 2011 @ 13:41:23

    You are, indeed, on an adventure. These days the mixed states bother me the most–the rage and frustration, especially. You are smart to partially give into your urges–that releases some of the pressure, but prevents me from going to an extreme.
    Great post, Sandy!
    Kathy

    Reply

  2. strugglingwithbipolar
    Aug 22, 2011 @ 15:07:28

    I am sorry to hear that you are symptomatic. It sounds like you are using some great skills to deal with your mixed episode. I really like the idea that you are able to sit and find the areas of your body where agitation lies. I need to try that.

    Reply

  3. pegoleg
    Aug 22, 2011 @ 16:39:55

    Would it be rude of me to say your adventure is not one I wish to take? But congrats on the attitude – I can’t imagine being that philosophical in your shoes.

    Reply

  4. Sherry
    Aug 22, 2011 @ 17:37:56

    I remember that the Dr. in Minneapolis diagnosed you as mixed bi-polar in 2007 before she did the ECTs. Since we all seemed to agree that those were not good for you, after the fact, perhaps we ignored her diagnosis as well? Surely there is more out there on mixed BP that you can add to your arsenal to kick it in the ass.

    Reply

  5. ManicMuses
    Aug 24, 2011 @ 05:47:59

    I’m a bit behind reading my posts for the week – belated thanks for the mention 🙂

    These mixed states are almost worse than the deep depressions. Since you’re an artist I have to ask…Although you are so very good at what you do, are there times when you get into such an agitated state you look at everything you’ve created as crap? (I know I do. And I’ve wound up trashing some pieces that were actually quite good.) Just wondering!

    Reply

    • Sandy Sue
      Aug 25, 2011 @ 07:53:51

      I don’t do that any more. It makes me sick that I burned my novel when it ultimately got rejected. I threw away every disk, draft and note. I have nothing left of it except the Heaving Bosom stories I wrote on the side (and have posted). Now I know—really grok it in my body—that even the crap has value.

      Reply

      • ManicMuses
        Aug 25, 2011 @ 09:03:22

        OMG – I didn’t realize you burned *everything*! Promise you won’t ever do it again. (Heaving Bosoms is fabulous, BTW. You need to write another novel if you haven’t started already.)

      • Sandy Sue
        Aug 25, 2011 @ 09:07:10

        My god, you are a sweet woman. I’m verklempt that you actually read my stories. It means *a lot*.

  6. bwoz
    Aug 24, 2011 @ 13:43:55

    This is the most informative post I’ve read on mixed episodes. Really like your blog too btw.

    Reply

  7. Lisa Z
    Aug 24, 2011 @ 16:04:30

    I’m sorry you’re dealing with this – this is me, too, on many occasions. I’m rapid cycling and frequently find myself in a mixed episode. They are painful. I try to recognize it as early as I can and be as kind to myself as possible while I ride it out – which often requires a drastic reallocation of meds. My body gets that lurching feeling as if an elevator in free fall has come to a sudden halt. I have an exceptionally good psychiatrist and that helps.

    Be kind to yourself, Sandy Sue.

    Reply

  8. James Claims
    Aug 24, 2011 @ 20:13:16

    It’s great that you can still do some things while in a mixed state. They are definitely the worst of the possible states one can be in. The mixture of manic energy and depressive mentalities can really do a number on an individual. I’m glad to hear that you don’t have the worst of it and still have a somewhat functioning mind.

    Some of the things that I’ve tried to help get through mixed states are self massage for the physical symptoms, music of some sort (I prefer metal when I’m mixed), and for the agitation, I set an alarm to go off every 15-30 minutes as needed to have me sit down and take a few minutes to breathe. Also, not wearing socks seems to help enormously, especially kneading my toes into carpet. There’s something about the constriction of any clothing that increases my agitation and the diversionary sensation of kneading that helps distract me and calm me down. I have no clue if this is unique to me, but it’s worth a shot.

    That said, I hope these help to get you through this quickly.

    Reply

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