A summer of Dysphoric Mania
Well, it used to be called dysphoric mania. Now it goes by the catch-all term ‘bipolar mixed episode’ or ‘mixed state’, the mental health equivalent of an electrified corpse in hot-pink lipstick.
It’s depression on fire. It’s medieval manic funeral-weeping. It’s a brain being pulled in two catastrophically different directions from the moment you wake up until you finally manage to get a few hours’ sleep.
Phase One : Kindling
It started, as bad experiences often do, with a Disney live action re-make.
I went to see The Lion King with a good friend. We’d been looking forward to it for a while, being gluttons for punishment and having been gleefully horrified by Aladdin the previous year. I’d recently been started on the mood stabiliser Lamotrigine to try and shift a stubborn bout of low mood, and I remember rocking up to the cinema with stylized, well-groomed hair but wearing an egg-yolk stained Star Trek hoodie, which should have been a tip-off that all was not well.
Then it happened.
Ah Zabenya happened. In surround-sound, altogether now:
AHHHHHHH ZABENYAAAAA
“Oh shit,’ I thought. “Something’s gone wrong.”
I started to cry. No, not cry, that sounds too passive, too delicate. It was uncontrollable heart-being-pulled-outta-my-chest weeping that started right as that music rang out, as those perfectly rendered zebras danced through the water pool, as the cranes took flight. I didn’t know what to do with all this sudden emotion. It leaked out of me for the best part of two hours, but I didn’t know where it came from, what provoked it, or how to get rid of it. My hands -wet from constantly wiping away the stream of tears - gripped onto the bag of pick’n’mix that I wasn’t able to eat.
When the film was over, my friend looked at me with smiling concern.
‘You alright?’
‘Yeah, yeah,’ I said. ‘It just hit me in the childhood, that’s all.’
Hit my in the childhood, lit up my circuitry, started the ball rolling up and down and up and down and up.
I didn’t know it yet, but a mixed episode had begun to catch fire.
Mixed episodes, or episodes with mixed features, refer to the presence of both high (manic) and low (depressive) symptoms happening at the same time. They’re classed as the most dangerous mood state for a bipolar person to find themselves in, because they come with all the despair of a down-period with the agitation and purposefulness of mania, which makes for a pretty heady suicide cocktail. More than half of all people with the disease will experience a mixed episode at some point in the course of their lives, especially if their disorder developed during adolescence. The symptoms of a mixed episode range from irritability and racing thoughts, to agitation and hopelessness. Guilt, worthlessness and suicidal ideation /behaviour are also horribly common.
The next few months consisted of constant pill-popping, trying to treat each symptom as it took hold, flared, and subsided.
Zopiclone for the eye-watering insomnia.
Diazepam for the anxiety.
Mirtazapine for the depression and Haloperidol for the restless, not-quite hypomania.
I was doing okay. Things weren’t great, granted, but they were under some form of control.
Right up until Boris Johnson addressed the nation from a sombre Downing Street, to tell us that the virus (that piddly little nuisance, easily banished with soap and water), was now causing a lock-down of our entire country.
Phase Two: Wildfire
A note from my journal:
I can’t eat, I can’t sleep, I can’t see lights, I can’t hear the noises anymore, my heart is done in, I’ve been smashing plates. I’m a danger.
I wake up every morning at 4am like someone’s unloaded a Glock by the side of my bed. I am so awake, brain burning brighter than the sun, the sun that’s beating the garden to bits in one of the hottest springs on record. I buy ten pairs of sunglasses on eBay with all different coloured lenses because the world is too sharp and too bright for my eyes — the pink lenses may make me look like an indie heart-throb but the world is too painful right now to be tinted sweetheart-pink. The blue lenses work a little better, though they turn my skin silver and my iphone unreadable.
I can’t live with any degree of noise; the next-door neighbour’s radio is so loud to my ears that every song gets stuck in my head like a nail, to be overlaid with the next song, and the song after that. By noon each day I have various artists fighting for airplay in the hell-scape that is my head; Taylor Swift singing about friends in her living room mixed with David Bowie telling me we’ve got five years, that’s all we’ve got. I cry with desperate and misplaced happiness when an insect lands on my bare chest, I cry at the shape of the clouds and the patterns on a straw hat that swirl so prettily and so perfectly they could only have been designed by angels. I cry all the time, at everything.
I develop intrusive thoughts about killing my cat, and killing my mother. I tell her to stay far away from me, not to call. When my father visits he is an alien to me, a twisted shape of tanned skin and scars with a crooked, evil smile, and as he jokes about the new protocol for greeting loved ones — the Elbow Bump — I cast my eyes away and ask myself if I ever knew this man, if I had ever met him before in my life.
In May, the real trouble begins. The magpie that I had decided to tame in January is now the bringer of all evil, the One Great Magpie that stands for Sorrow. I have invited Sorrow into my home, into my garden. The cherub statues that sit underneath the conifer are now alive, like the weeping angels in Dr Who’s Blink. Panic attacks are a daily occurrence. Haloperidol gets washed down with fruit tea.
For some reason, I lose the ability to understand the English language for a full forty-eight hours. Words are garbled nonsense poetry; my own thoughts make no sense. The thought ‘there are no bananas left’ confuses me so much that I don’t know if a) I have bananas to my left, b) I have no bananas, c) I have left the bananas somewhere, or d) bananas are not left wing. I can’t watch television when the sudden aphasia dissipates because certain lines in TV shows cause me a strange amount of anxiety. Phoebe Buffay is no longer the sweet hippy that I used to love, but a cruel, sarcastic woman whose face seems too sharp, too mean, and other. My favourite music disturbs me. I can’t read. I can’t do much of anything, except, as it goes, shop.
I’ve been online shopping, mostly in the middle of the night when my defenses are lower still: posters of literary quotes, gifts for my doctors, thermal socks, jelly beans, ties, healing crystals, sex toys, coffee mugs, maths books, ornamental skulls, two hundred felt tip pens, books that I can’t read, films that I can’t watch, two full suits, silk shirts. The packages keep coming and coming but I can’t open the front door, so I shout to the postman to leave it all outside, just keep leaving everything out-fucking-side.
I am exhausted. I want to die, not because I don’t want to live, but just to escape my head. I am everything all at once, and nothing to boot.
Phase Three : Who chucked the water on me?
Depression comes like an old friend. Mixed episodes often resolve into depression, in the same way that fires will always eventually turn cold.
It’s more peaceful, the despair. The simplicity of it. It’s almost elegant. The silence, the selective mutism, staring into space wondering how life got so bad and resolving that it will never again be any good.
I’m comfortable, here. I know who I am. Phoebe is Phoebe. The magpie is just a magpie — wondering where I am, wondering where all the food has gone.
Now it’s just a case of putting my life back together again, one piece at a time. Dinner comes in the form of meal replacement drinks, to pile on the stone I need to pass as merely underweight. Anti-depressants will be gobbled. Sleep will happen. Diazepam will finally make a dent.
The mixed episode is over.
And I’m here.
