Borderline Bipolar Sanctuary

A hypomanic episode is not a disorder in itself, but rather is a description of a part of a type of bipolar II disorder. Hypomanic episodes have the same symptoms as manic episodes with two important differences: (1) the mood usually isn’t severe enough to cause problems with the person working or socializing with others (e.g., they don’t have to take time off work during the episode), or to require hospitalization; and (2) there are never any psychotic features present in a hypomanic episode.

A hypomanic episode is characterized by a distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days and present for most of the day nearly every day. This hypomanic mood is clearly different from the person’s usual mood.

During the period of mood disturbance, 3 or more of the following symptoms have persisted (4 if the mood is only irritable) and have been present to a significant degree:

Inflated self-esteem or grandiosity

Decreased need for sleep (e.g., feels rested after only 3 hours of sleep)

More talkative than usual or pressure to keep talking

Flight of ideas or subjective experience that thoughts are racing

Distractibility (e.g., attention too easily drawn to unimportant or irrelevant external stimuli)

Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation

Excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., the person engages in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

A hypomanic episode is associated with a change in functioning that is uncharacteristic of the person. For example, the individual may be far more productive or outgoing and socialable than they usually are. This change in functioning and in mood is not subtle — the change is directly noticeable by others (usually friends or family members) during a hypomanic episode.

A hypomanic episode is also not severe enough to cause serious impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features. The observable symptoms of a hypomanic episode must not be due to substance use or abuse (e.g., alcohol, drugs, medications) or caused by a general medical condition (e.g., hyperthyroidism or diabetes).

People who experience a hypomanic episode are often diagnosed with a type of bipolar disorder called Bipolar II.

A hypomanic episode brought about by the effects of a drug or psychiatric treatment (such as starting a course of antidepressants) is generally not diagnosed, unless it continues to persist beyond the physiological effects of the treatment.

“I feel like I'm a snow globe and someone shook me up and now every little piece of me is falling back randomly and nothing is ending up where it used to be.”

“Depression is a painfully slow, crashing death. Mania is the other extreme, a wild roller coaster run off its tracks, an eight ball of coke cut with speed. It's fun and it's frightening as hell. Some patients - bipolar type I - experience both extremes; other - bipolar type II - suffer depression almost exclusively. But the "mixed state," the mercurial churning of both high and low, is the most dangerous, the most deadly. Suicide too often results from the impulsive nature and physical speed of psychotic mania coupled with depression's paranoid self-loathing.”

I am feeling burned out of late. Exhausted by fighting and struggling with an illness that takes so much more than it gives. I have so much more control over the Borderline Personality Disorder and I am grateful for this but the Bipolar still torments me.

I have to be honest about the consequence of coming off my mood stabiliser - it has left me without a safety net so to speak and I have no one else to blame for my current instability than myself. I am wrestling with the uncertainty of what is best for me - to be medicated or non-medicated? I try hard to accept the side-effects of the drugs that keep the Bipolar in line. I try really hard just to take them and get on with it but my rebellious side still wants to be drug free. I don't want to be walking around in a fog all of the time, I hate the weight gain and loss of motivation. I am different when medicated - anyone who knows and loves me will tell you that. It takes the spark out of me......... 

My moods have been fluctuating between hypomania and depression for a few weeks now. The longer I am off a stabilizer the more I swing and the stronger the swings become. I lost control this morning and frightened the hell out of myself. I was feeling cornered, depressed, highly agitated, hopeless, frustrated and felt a surge of adrenaline and rage course through me. I was holding a plastic cup filled with water - I was trying to drink and remember noticing that my hand was shaking. I was trying to calm myself while telling my Husband that I had to get out of the environment we are living in. I had packed my suitcase and put the dog, pillows and a few other belongings in the car. 

He said something and I threw the cup towards the sink - I pegged it so hard the window it hit cracked. If it had been glass the window would have exploded. I did not notice the damage because after throwing the cup I was in the car - crying hysterically and wanting to run. A pattern for me - running from whatever is hurting me and sometimes (in vain) running from myself. Silly really because there is no fucking running from what is inside me.

I calmed down eventually and noticed the window - I was not surprised but felt fearful because I know this is a huge red flag. Tonight I feel washed out - no energy but unable to sleep. I feel pretty undone and I am worried about slipping into that place one can go when all reason leaves the brain. My I don't give a fuck risk taking behaviour is increasing. I have been spending money another red flag. I am not hungry when hypomanic or manic so my weight has dropped. I am depressed enough to drive into the ocean one minute and sunshine hopeful the next. It really is fucking exhausting! 

I was conditioned to please as a child by both my parents in different ways. My Father expected us to please - his needs had to be met at all time. Good children said 'yes Daddy, no Daddy three bags full Daddy' or all hell would break loose. I remember rubbing his shoulders till my fingers ached because I was too afraid to stop. I bit my tongue all the time because you did not want to make Daddy angry. Angry Daddy or at his worst raging Daddy was not a man you wanted to mess with. All sorts of bullshit would come out of my mouth just to please him. To say I would have sold my soul to the devil to please my Father would not be an exaggeration. I even went to the extreme of trying to control my Brother and Sister's behaviour so as not to set him off. Be quite, do as you are told, don't say that, sit straight and so on were demands driven by my extreme anxiety. Verbal or physical beatings by my Father were to be avoided if one wanted to survive. 

With Mum it was a little different - our willingness to please came from instinct. Keep Mummy happy and calm at all costs because again it was just easier for everyone. Mum like me lived with mental illness so we crept around her most of the time. When she was depressed and sleeping we kept very quite mostly playing outside. It was again important not to upset or set her off because doing so would end badly for everyone. Again I played little mummy to my siblings in order to control an environment that was chaotic and unsafe.

What was the result of all of this. In the end my people pleasing became automatic to the point of insanity. I would do anything to please or avoid feelings, emotions or situations that might be painful or harmful to me. I have not mentioned my fear of rejection - another reason to morph into people pleasing mode. Can you look after my kids next weekend? Yes. Even though I already had something on or was just not up to it. Can  you jump off that cliff for me? Yes. Can you not move out of this suburb because I need you here. Yes of course!!!!!!! Seriously this actually happened!

I am a little better at saying no these days but still will automatically people please at times. I did it only the other day and only after a few hours had passed did I think - why in the hell did I commit to that with that person?!

In the end I think it is something many abused children struggle with.......

Something hopeful for today 6th March 2015. I am going to have to dig for my courage today. I am going out with my Sister, Niece and her beautiful son today. I am so looking forward to seeing them but am fighting the want to go back to bed and pull the covers over my head. Feeling low this morning and exhausted to my core - probably the result of days of anxiety. Just feeling a little vulnerable I guess.

Using DBT Skills:

Observe 

Describe

Participate........... And probably most of my other DBT Skills today:) 

Grateful I have them.

“Those who fail to exhibit positive attitudes, no matter the external reality, are seen as maladjusted and in need of assistance. Their attitudes need correction. Once we adopt an upbeat vision of reality, positive things will happen. This belief encourages us to flee from reality when reality does not elicit positive feelings. These specialists in "happiness" have formulated something they call the "Law of Attraction." It argues that we attract those things in life, whether it is money, relationships or employment, which we focus on. Suddenly, abused and battered wives or children, the unemployed, the depressed and mentally ill, the illiterate, the lonely, those grieving for lost loved ones, those crushed by poverty, the terminally ill, those fighting with addictions, those suffering from trauma, those trapped in menial and poorly paid jobs, those whose homes are in foreclosure or who are filing for bankruptcy because they cannot pay their medical bills, are to blame for their negativity. The ideology justifies the cruelty of unfettered capitalism, shifting the blame from the power elite to those they oppress. And many of us have internalized this pernicious message, which in times of difficulty leads to personal despair, passivity and disillusionment.”

“In every way that counted, I was dead. Inside somewhere maybe I was screaming and weeping and howling like an animal, but that was another person deep inside, another person who had no access to the lips and face and mouth and head, so on the surface I just shrugged and smile and kept moving. If I could have physically passed away, just let it all go, like that, without doing anything, stepped out of life as easily as walking through a door I would have done. But I was going to sleep at night and waking in the morning, disappointed to be there and resigned to existence.”

Neil Gaiman, Fragile Things: Short Fictions and Wonders

“I suffer from life and from other people. I can’t look at reality face to face. Even the sun discourages and depresses me. Only at night and all alone, withdrawn, forgotten and lost, with no connection to anything real or useful — only then do I find myself and feel comforted.”