A bipolar mixed episode is a uniquely confusing experience and can result in a state of extreme agitation and despair, but you can prevent this by recognizing early signs of a coming episode.
I sat at dusk, my arms around my knees, at the junction of a turbulent and muddy river and the slow, dark water of an ocean inlet. As I sat at the convergence of two vastly different and yet similar things, my mind, too, found itself at its own convergence. Somehow, two moods-vastly different and yet somehow similar-had merged into something terrifying, feverish, and inexplicably sad.
Hours earlier, when I was overflowing with love and grandiose dreams, I spent several hundred dollars on gourmet cookies and bouquets of roses and lilies to hand out to friends. Later, as day turned into evening, mania and depression blended together into the unique and startling pain of a bipolar mixed episode….
Read more at https://www.bphope.com/blog/agitated-despair-mixed-episodes-and-bipolar-disorder/
I’ve been reading a lot about PMDD a lot lately. It stands for Premenstrual Dysphoric Disorder (sorry to all the guys reading this). Every month, when I get PMS, my bipolar gets out of hand. I begin to worry, to cycle, to feel terribly insecure, to get this fluttery feeling of anxiety in stomach, but most of all, I become suspicious and even a little paranoid. I know it’s the bipolar making me feel that way, but I still can’t help it. I hate the feelings of suspicion most of all. I begin to think that my husband is tricking me. I begin to think that my colleagues hate me. I worry about everything– money, love, my marriage, my work. I often also have trouble sleeping through the night, or I have nightmares, or I wake up in the middle of a cycle.
I have trouble going to work. I hate being alone. I am constantly scared.
But then I seem to have three weeks of euthymia (at least lately). My husband, my therapist, my mom, my doctor, they all remind me that it’s temporary and will go away after a few days. But I hate it.
But, spring is coming and I need to be prepared. I start a new job next week and I really want to make a great impression. I am hoping it is less stressful and that my much-shortened commute will decrease my stress, although I am taking a major pay cut.
In southcentral Alaska, spring begins in April. For me, April is the cruelest month, bringing with it a violation of my circadian rhythms because of the sudden and dramatic return of the sun. April is the transition between the long, dark days of winter and the brilliant, long days of summer. It’s a period of adjustment, but for me that “adjustment” is rough and tumble, as the sunlight interrupts my sleep and completely turns my world upside down.
The instability usually begins in mid- to late March and continues into the first half of May. It is early February now, and, being a naturally anxious person, I begin to be afraid of what spring will bring.
I believe I am going into this spring strong and stable. I have help from my psychiatrist, my therapist, and, most of all, my husband and family. I am starting a new job, which can be stressful, but I believe this job will be enjoyable and less stress-inducing then my previous high-paying, high-pressure previous job.
I’m not sure if you too suffer from the season change and the disruption of your circadian rhythms, but I often wish I lived at the equator, where I sometimes think that the adjustment will be easier and less dramatic.
Here are some suggestions from my doctor that may help, as well as some things I have learned over the years:
- Wear dark sunglasses and a baseball cap when the sun is shining bright
- Try to avoid over-stimulation (for me, even the return of the spring songbirds can be irritating)
- Make your house dark if possible beginning at 6 p.m. and don’t engage in outdoor activities after 6 p.m.
- Use dark, opaque curtains
- Have PRN medication at your disposal (I often increase my Seroquel as needed during these times)
- As usual, don’t drink alcohol and limit your coffee
- My doctor had a new one for me– take melatonin three hours before bed
- Keep your sleep schedule exactly the same (don’t even change your wake-up time on the weekends)
- Use your therapist to your advantage (I also call a free, anonymous counseling hotline as needed)
- Avoid stress and your known triggers (if possible)
- Keep your support system close and make sure they are aware of what’s happening (for example, it’s really important for me not to have my husband leave town for work during this time because it bumps me off my routine)
- Keep a budget and give financial control to your partner or someone who is in your support system if you feel like you are starting to act impulsively
- Be self-aware– watch out for those racing thoughts
- Eat healthy and avoid too much sugar (sugar makes me go up and then crash)
- I use essential oils, like melissa (lemon balm), lavender and Roman chamomile
- Remember and practice your spirituality, if you are so inclined
- Remember that spring can be hard for all bipolar people and that it is not your fault
I know we can never be “perfect” but maybe we can do our best to make it easier on ourselves through self-love, self-compassion and gentle self-care (like the ideas above) during our times of struggle.