“It is a brave act to despise death; but where life is more terrible than death, it is then the truest valor to dare to live.” – Thomas Browne
Unfortunately circumstances necessitated that I make a slight disappearance this past week. I had been anticipating this trip in seriousness for several weeks, mentally preparing myself each day should the occasion arise. My last psychiatric hospitalization was in August of 2013, and I set myself on a personal endeavor to avoid future hospitalizations at all costs. I have successfully done so up until now. I built such an aversion within my mind to the possibility of requiring a higher level of care in order to ensure safety and promote emotional stability. Over the past few weeks, I began to chip away at this aversion and allow the notion of the need to seek inpatient care creep into my mind, acknowledging the benefit and worth I could derive from such a stay. My moods have been vacillating between significant mania and significant depression, consisting greatly of mixed episodes (episodes in which one experiences mania and depression simultaneously or within short periods of time. These episodes are especially difficult to treat). Intellectually I saw myself approaching hospitalization, but emotionally I adamantly resisted it. However this past Monday, the barrier was broken.
As per my mother’s suggestion, I have had a bag packed for several weeks containing essential clothing and toiletry items, my journals, and The Hunger Games: Catching Fire, also an essential item. I brought these items with me to each of my electroconvulsive therapy treatments at the hospital these past few weeks, should they decide to admit me. Well, this past Monday a collective decision was made between the doctor, my mother, and myself. I could no longer contract for safety and my moods were debilitating and all-consuming. The greatest determinant for my admission, for me, was that I was tired. Tired of battling these ups and downs constantly, of battling the constant slew of appointments and the exhaustion that arises from receiving electroconvulsive therapy treatments, and from just battling life. I needed a rest and a safe place to be.
Following my electroconvulsive therapy treatment, the psychiatric unit sent a nurse and a wheel chair to transport me to the unit. I was pretty drugged up at that point from general anesthesia, a paralytic, and major sedatives, but I was determined to make sure Puppy made the trip from the surgical prep area to the unit closely in my care. Puppy is a stuffed dog that has been with me to each of my thirty-two electroconvulsive therapy treatments. After arriving and completing my intake, life resumed to as I recalled it to be from past stays. Treatment at this center has far surpassed in quality the treatment I have received at the three others hospitals at which I have stayed. The program is DBT – Dialectical Behavior Therapy – based, focusing on distress tolerance skills, mindfulness, and how to manage our emotions and symptoms effectively and to the best of our abilities. The days consisted of class after class, all varying in content. The basis for many classes were DBT topics, but there were also meditation classes, outdoor activities, and cooking classes. I learned how to make fruit nachos, so if you are ever curious for the recipe, please send me a message! One of the greatest highlights of the program was the camaraderie I developed with my fellow patients and the experiences we shared together, especially rousing games of Apples to Apples and Pictionary. My greatest regret was the unavailability of the vegan lentil soup each day I spent there.
Most puzzlingly, during my stay, I experienced what appeared to be a miraculous recovery. I was bubbly, chatty and talkative – albeit probably too much, a possible harbinger of moods to come – and quite amicable. I believe the electroconvulsive therapy provided an emotional respite and residence in the unit provided a much-needed rest and an environment in which I could be safe and unable to act on self-destructive urges I may have. Since being home, many of my symptoms have returned, possibly in less intensity, but I feel rested and better equipped to tackle and address them head-on. While no medications were changed, I received a reinvigoration and condensed refresher on my DBT distress tolerance skills.
I needed this rest. Yes, self-destructive urges have reared their ugly heads once again and I am cycling pretty quickly, but my body and mind are rededicated to my seemingly endless fight. I know I can never rid myself of this illness, but I can ardently commit to the fight – both for the sake of myself and for the sake of those around me whom I love. I have been closely monitoring numbers – numbers of medications I have been on, for how long, and their doses, or the number of hospitalizations I have had, which now has reached eleven. However I believe this may be both productive and counterproductive. I know I must acknowledge the worth in closely following my progress, but I also must ground myself in the here and now and do what I can to win this battle. I will not concede to my disorder. It must face my ironclad box of skills I have developed, and I know, with a certainty, it will not win.
We, as humans, have an unbridled potentiality for depth
Open our bodies, splay our interiors
Butcher us, make us naked and exposed
Prepare us to meet our end
Tread in shallow water
Or venture, delve into the deep
For it is within the cool, shadowy depth
That our souls rest, unmistakable, ever so hidden
Our faults and indiscretions, our failures
Made known to the discerning eye
Or examine the ailing tree
The marks of trials and tests
Visible only if you glance closely at the weathered bark
Open our souls, and you will see the madness
That affects those privileged to dance in this life
Count ring by ring, knot by knot, recorded with careful consideration
And yes, the madness shall be visible
Glorious as it is soul shattering
A beauty incomparable and incomprehensible
You will wish ardently to be overtaken, engulfed
By this insidious, all-embracing force
There are those who suffer and those who long to suffer
To be bestowed the gifts and blessings awarded only to the mad
The sane are the sick, the ailing and the afflicted
For they will never know the darkness of this world
Have the talents and abilities that far surpass
The capabilities of those who waltz in ignorance
Who live boring, uneventful lives, free of misery
Those who swim in the depths, who are brave enough
To chop down the sacred tree
Existing eternally in the forbidden garden
Cursed, damaged and marred they may be
Who are able to taste, salted caramels on their tongues
Madness and the tryst, the romance it has with morbidity
They will pray, sacrificing youth and mortality
And the fresh, healthy blood coursing through untouched vessels
To succumb to madness
Map pristine bodies with scars and blemishes
Accumulate marks indicative of the wedding and marriage
Of the soul to the darkness of this existence
A life destined to be forever tainted
Stained by spilled desires and stifled breath
Such a desirable state is this madness
Gifted are those who tread in its depths
Unfortunate and pitiful are those confined to the shallows
Destined to be deprived of the ripe fruits of this world.
© 2014 Alexandra Shall
There are numerous misconceptions concerning bipolar mania. The romanticized perceptions include the classic euphoric state of mood, delusions of grandiosity, impulsive behavior, such as spending money, promiscuity, drugs and alcohol, and rapidity and inhibition of speech. Yes, these symptoms are quite prevalent for people experiencing bipolar mania, but they are not all inclusive. The less recognized symptoms of bipolar mania include extreme agitation, uncontrolled and inappropriate behavior and speech, lack of inhibitions and boundaries, marked psychosis and delusions, obsessions, and intense thoughts of suicide and self harm. There is a dangerous dark side to the high-flying kite. What must be acknowledged is that there rests a painful and devastating component behind the perceived elation and excessive energy of a person experiencing mania. Then there are those who can appear composed, yet be hiding the intense demons and debilitating components of mania, only to inevitably explode, percolating over with water of boiling temperature. The masters of disguise.
I am a master of disguise, and I have been one my entire life. I was able to suffer incognito throughout middle school, deftly hiding the mania and depression plaguing my life. I excelled in music and writing and received numerous awards throughout the three years I spent in middle school. When I reached high school, my thick ceramic mask cracked, and I could no longer suppress the pain and emotional dysfunction. I experienced my first psychiatric hospitalization two months into my first year of high school. The psychotic depression necessitated a stay at the UCLA adolescent unit for five weeks. I returned to school, albeit unsuccessfully, following the end of that hospitalization. And then I began to fly as high as a kite, again necessitating psychiatric hospitalization, although this time a succession of four over the course of a few months. This is not the first time I flew too high. Two years later I experienced another hospitalization for mania.
The mania I experienced manifested in a multitude of ways. My kite flew both with the grandiose symptoms characteristic of bipolar disorder and also with the darker side – agitation, psychosis and delusions, and self harm, all part of a cornucopia of other debilitating symptoms and behaviors. My bipolar episodes are often what is medically referred to as mixed. I experience both mania and depression simultaneously, jumping back and forth relentlessly. I managed to remain out of psychiatric hospitals for six years, until I experienced a major crash in December 2012. This hospitalization became the first of four occurring over roughly the next seven months.
I began a perpetual cycle of my kite flying dangerously high, only to make a devastating crash to the ground. I became obsessed and deluded with contamination and developed compulsive behaviors and rituals to prevent the spread of whatever I deemed to be contaminated or a causer of contamination. Then psychosis initiated thoughts of suicide and self harm, and I could see and hear these desires. An overhaul of medication and inpatient treatment brought my kite lower, and I was able to live again, but this respite was disappointingly brief. My kite soared and dove in a prolonged mixed episode. Somehow I managed to survive these ups and downs, the rising and plummeting of a slowly weathering kite.
My kite has been flying high as of recent, hence my reluctance and inability to keep up with this blog. I switch from elation and extreme hyperactivity to agitation and off-the-wall behavior in the blink of an eye, with things going a tad bit too far, as I like to refer to this switch. I am impulsive, spending exorbitant amounts of money on things I do not need and probably will not use for a prolonged period of time, if ever. I speak too much and with great rapidity, sharing insignificant thoughts and information and at times speaking nonsensically. My behavior is erratic. I thought it was absolutely hilarious to throw food and silverware at my family in a restaurant several weeks ago. Then comes the agitation, verbal combativeness, delusions and psychosis, and other symptoms I do not wish to describe. An emotional and psychological crash. I am trying desperately to regulate the altitude at which my kite is flying. Such a process is trying and tiring and one that slowly chips away at your ability to fight.
I am unsure of why I have chosen to relate my experiences with bipolar mania. I have been so consumed with the highs and lows, fighting hospitalization. This has been a cathartic experience, perhaps one that will provide the emotional release and rejuvenation to continue the fight. I have not succumbed to the disease yet, and I am doing everything in my power to regulate the cycling of my mind and emotions and become well, whatever measures I must take. I hope sharing aspects of my journey will help me to heal, to raise awareness and prod others to challenge themselves to understand mental illness and the daily fight those afflicted experience, and to inspire others to open themselves and share their own stories and struggles. I beg you to understand the rough path I have trodden and to appreciate my willingness and trepidation in relating my story. I thank you immensely for such a consideration.
My soul has hungered for years, starving and craving a source of sustenance to ease the pains and growls of an empty stomach. After years of searching and seeking, I have come to find a sustenance incomparable to all worldly materials and desires that quenches the thirst and satiates the hunger of my aching soul. It has been a long, tumultuous road, but spirituality has offered me a solace that has been both soul-enriching and a remedy, a salve, to the sickness and perpetual instability of my mind, rocking me softly in the arms of an all-encompassing, infinite and ever-loving God. A bringer of a peace my being could never have imagined nor attempted to comprehend.
My path towards finding peace and solace within my being and my soul began years and years ago. I was raised a Baha’i for many years, but for various reasons our family became inactive in the Faith. Though I was not actively participating in the activities of the Faith, my thirst and desire for meaning and to feed the growth and enrichment of my soul never waned. Subsequently I embarked on an ardent journey to find these qualities within my life. I studiously researched the religions of the world and attended religious gatherings at various faith institutions, including Jewish temples and Catholic, Presbyterian, and Methodist churches. I went so far as to sing in a church choir, which, in retrospect, was a poor choice, as I have no singing ability nor talent. I am surprised I was not gently asked to cease my participation in the choir for the wellbeing and safety of those listening during church gatherings. In my searching, I attended confirmation classes at two separate churches. The first class did not satiate my hunger and left me with a multitude of questions and uncertainties, so I attempted to address my growing discontent and uncertainty by enrolling in another confirmation class. Still my soul was not entirely content.
By work of what I consider a miracle, I was reintroduced to the Baha’i Faith in my mid teens. In our home we had a massive, towering book shelf, so tall it required a ladder to reach the upper shelves. As the years had passed in my life, I ventured shelf by shelf, seeking and discovering book after book. It seems that with the passing of each year, my search advanced higher and higher. When circumstances permitted, my family and I had the opportunity to return to the Faith. It was around this time that I discovered the shelves containing a multitude of Baha’i books. I soon began to devour the content within these blessed pages and attend Baha’i gatherings with my family with such fervor, that my soul ignited a burning flame within me that consumed all inquisitiveness, confusion, and discontent that had danced through my mind. I had found my source of sustenance, of solace and peace. What a wonder! With this flame, I could not be stopped. I began to love the Faith with such intensity, a love and connection incomparable to any I had ever experienced before. My searching concluded, and I found a home within the Faith.
The Baha’i Faith has nurtured my soul, but has also attended, with the care of skilled physician, to my ailing mind. When my mind battles demons, the Faith disarms them with swift and deft ability. When loneliness ensues, prayers enable me to converse with God, providing a listening ear and an eternal companionship and friendship. I do not believe I would be alive today had I not found and been fed the sustenance that spirituality – and the Baha’i Faith – provide me. My illness is life threatening and debilitating, yet the Faith is my bringer of eternal life and the opportunity to one day transcend the pain and suffering I experience in this world and live forever in peace and solace in the next world.