A Former Psychotic Episode

You are not real to me.  I know this because when I point my gun at you there isn’t a twitch or flinch or any other sign that that I’m pointing my gun at you.  So I put it down, there’s no reason to threaten you if you are not going to feel threatened.  Why do you continue to stand there like that?  Are you trying to intimidate me?  Don’t you remember? I’m the one with the gun.  Shit, no, the gun means nothing to you because you are not real.  It means something to me though, as long as I have it, I am safe.  I will be able to hold off any attack.  Even from you.  Even though you are not real.  What I really need to watch for are the pigs

If you didn’t care what happened to me,
And I didn’t care for you
We would zig zag our way through the boredom and pain
Occasionally glancing up through the rain
Wondering which of the buggers to blame
And watching for pigs on the wing.

Those pigs a very dangerous, they’re omnivores and will eat anything, even bodies that are left behind.  So be careful with me.  I’m the one with the gun.  Stop wagging your finger at me, I know that you don’t care.  But your lack of concern makes no difference to me.  You’ve been here for a very long time and you have done nothing but stand there.  You have not threatened me in any way.  I believe that you are nothing more than a figment of my psychoses.  You do not exist, the pigs do not exist, this entire room is only a construction in my mind.  That means that nothing is here, including this gun… including me.

Where and when and why do I exist.  Nothing is real so nothing matters.  Nothing is not real so everything matters.  Everything is real and everything exists.  It is all too full.  There is no room to move.  I am suffocating.  I have to get out of here.  I have to go nowhere, where everything is.  That’s where you’ll be.  At least I’ll get to see an unfamiliar face.  It will be such a comfort.

People Outside

There are people outside my window, and I’m on the second floor.  I have no other choice than to dismiss them as a mirage, or in this case, a complete fabrication of my mind.  They have a car and they are opening and closing the doors.  Well, there is a driveway out there, maybe we have visitors.  When I turn my full attention to the window and then to the driveway… everything is clear.  The ceiling fan draws my attention more often than it should.  It seems as though it is descending on me.  Of course it isn’t, it is firmly attached to its mount.  But still…  There’s some movement in the hall and I hear an owl outside.  The owl is probably there but there’s nothing in the hall but a coat rack.  My mind is playing evil tricks on me again.

So here’s the deal.  I can probably deal with this phenomena by upping the dose of my anti-psychotic.  There’s a few problems with that.  On my current prescription drug plan (Medicare Part D), Abilify costs me between $250 – $400 per month (thanks to the “Coverage Gap” or “Donut Hole”).   If I get the dosage increased, the cost would also be increased.  There’s also the possibility that side effects would increase.  I already have large muscle tremors attributed to Abilify and then there is the fact that I am already at the suggested dosage limit.

So, what can I do?  I’ve been trying to condition myself to live with these little blips.  They don’t happen all the time.  They usually come in waves, maybe once or twice a week.  I guess I just keep on keeping on.

If anyone has any suggestions, I’m definitely open to hearing what you have to say.

Some Definitions

With everything I have published to this blog I talk a lot about having Bipolar.  I use a lot of terms that, to those with Bipolar or close to us, have understood meanings.  I don’t know how many people out there are reading this blog who don’t understand the meanings of these terms.  I will do my best here to gather all these terms together and give them some meaning.  If you read through this list and find that I missed something, please let me know so I get to it as soon as possible.

Psychosis: a mental condition that affects a person’s sense of reality. Hallucinations and delusions are common symptoms.

Psychotic Break: A psychotic break occurs when a person experiences an episode of acute primary psychosis generally for the first time or it may also be after a significant symptom-free period.

Manic: People in manic episodes may spend money far beyond their means, have sex with people they wouldn’t otherwise, or pursue grandiose, unrealistic plans. In severe manic episodes, a person loses touch with reality. They may become delusional and behave bizarrely.

Hypomanic: People experiencing Hypomanic episodes are often quite pleasant to be around. They can often seem like the “life of the party” — making jokes, taking an intense interest in other people and activities, and infecting others with their positive mood. Hypomania can also morph into Mania leading to erratic and unhealthy behavior and as with Manic episodes, people   might spend money they don’t have, seek out sex with people they normally wouldn’t, and engage in other impulsive or risky behaviors.

Depression: Like any depression, Bipolar Depression symptoms include:
Depressed mood and low self-esteem
Low energy levels and apathy
Sadness, loneliness, helplessness, guilt
Slow speech, fatigue, and poor coordination
Insomnia or oversleeping
Suicidal thoughts and feelings
Poor concentration
Lack of interest or pleasure in usual activities

Bipolar Disorder:  The primary symptoms of Bipolar Disorder are periods of elevated or irritable mood accompanied by dramatic increases in energy, activity, and thinking.  The illness has two strongly contrasting phases:  1) Bipolar mania or Hypomania and 2) Depression.

Bipolar I:  Characterized by Manic Episodes and bouts of Depression

Bipolar II:  Characterized by Mostly Hypomanic Episodes and bouts of Depression

Electroconvulsive Therapy (ECT): Electroconvulsive therapy (ECT) is a procedure in which electric currents are passed through the brain, intentionally triggering a brief seizure. ECT seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental illnesses. It often works when other treatments are unsuccessful.
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Many people with Bipolar Disorder experience long periods without symptoms in between episodes. A minority has rapid-cycling symptoms of mania and depression, in which they may have distinct periods of mania or depression four or more times within a year.  People can also have mixed episodes, in which manic and depressive symptoms occur simultaneously, or may alternate from one pole to the other within the same day.

Depressive episodes in Bipolar disorder are similar to “regular” clinical depression, with depressed mood, loss of pleasure, low energy and activity, feelings of guilt or worthlessness, and thoughts of suicide. Depressive symptoms of Bipolar Disorder can last weeks or months, but rarely longer than one year.

I hope I have made some things clear, or at least haven’t muddied the waters.  Like I said earlier, please let me know of I can clear anything up or if I have missed anything.

I Am Screaming

I am screaming as loud
As I possibly can
But no one is listening
Should I stop?

I am screaming
Someone has to be hearing
Unless I’m in my own reality
Should I stop?

I am only screaming
Inside of my head
I alone can hear me
Should I stop?

I am screaming out
My front window
I hear sirens in the distance
Should I stop?

I am screaming at the men
In my apartment
Cuffing my hands behind my back
Should I stop?

I am screaming out the bars
Of my tiny cell
No help appears in sight
Why can’t I stop?

— GB

A Non-Event?

There’s something really strange happening to me.  It’s been going on for a little over a month.  When I had my cancer surgery, a very large portion of muscle and tissue was removed from my upper back.  Along with the muscle and tissue was a bunch of nerve endings.  For over ten years I have had no sense of feeling in the large divot.  A little over a month ago it started to itch.  Then it started to hurt.  Sometimes it’s a dull thudding kind of pain and other times it’s a sharp stabbing pain.  I had no idea this could happen. Luckily the two phenomena don’t happen at the same time.  Nor do they last very long.  I think that would be cruel and unusual.  What misdeed am I being punished for now?

Was I being punished for something when I died in that recovery room?  I don’t know what the popular answer is but I’m leaning towards no.  I don’t remember anything about that event.  There was no bright light; there was no serenity, no out of body experience.  All I remember is being put to sleep on the operating room table and waking up in the hospital room.  I wouldn’t even have known that it happened if my doctor hadn’t told me.  In the whole scheme of things, it was a non-event.  Why even tell me that it happened?  (I’m sure there are some rules and regulations that that my doc had to follow.)  Why do I pursue any explanations if of this non-event?  Why does it still weigh so heavily on me?  Would I be a different person today if I had never known?  Would I have had that psychotic break?  Would I have Bipolar?  Is this seven minute event in my life the root of it all?

One thing I know for certain is that the root of all my questioning revolves around evidence of a higher power.  Some people that know about my experience have told me that I am blessed.  They say that God returned me to life because I wasn’t finished with my tasks on Earth.  I didn’t know how to respond to that.  I still don’t know how to respond.  For as long as I can remember I have been doubtful as to the existence of a higher power.  Whether it’s God, Jesus, Shiva, Buddha, etc. I still get stuck when I try to wrap my mind around it.

As I touched on previously, I did not experience anything that has been reported by various religions.  Having Bipolar, having a major psychotic episode and a couple of minor ones, and all the “activities” surrounding these things have worked against any ability to embrace any type of religion or major belief systems.

Through all of this, one thing has held true for me.  People have power.  How a person does physically, emotionally, financially, etc. is tied to the ability to believe in ourselves and our fellow humans.  I’m not implying that everyone on this planet are good or to be trusted.  I’m also not trying to imply that anyone’s beliefs are bad or in any way incorrect.  I’m just trying to say that my life is better today because of the people that are in my life.  I sincerely hope yours will be too.

“We are not only our brother’s keeper, in countless large and small ways we are our brother’s maker.”  —-Bonaro Overstreet

Self-Aware

At what point in our lives do we become self-aware?  Some people would argue that it occurs as early as 18-24 months.  Today I observed some kids between the ages of 7 and 12 that didn’t seem to be very self-aware at all.  Maybe it was me; maybe it was my subjectivity that obscured what I was observing.  This interests me because I do not think I was particularly self-aware while I was going through psychoses and my psychotic break.  There were weeks (if not longer) at a time where I carried on as though nothing out of the normal were occurring.  When in reality, my apartment was unkempt, the only clothes that got washed were the ones I was wearing to work (I’m sure there were a plethora of items like that).  It all looked fine to me but in reality it was extremely dirty.  At work I was not treating my customers with as much respect as they were due.  The co-workers, whose output I was overseeing received the short end of my temper.   I was taking the management portion of my job way too literally.  I spent a lot of time proof reading and rewriting document after document.  I did all of this without realizing it was happening.  I wasn’t told about any of this until after I was hospitalized.  Where was my self-awareness?

On the other hand, I was aware of a couple of things that were “happening” during that same period of psychoses.  For starters, I told work that I had a perforated ulcer.  I’m not sure what my motive was but I knew somewhere inside that it wasn’t true. In addition to that, I told my family, who were living on the other side of the States, that I had gotten a friend’s sister pregnant.  Again, I had no idea what my motive was but I knew that my story was untrue.

In the face of all these events, these actions, these stories, I have come to a conclusion about self-awareness.  While it may be true that we first become self-aware between 18-24 months of age.  I believe that we move in and out of self-awareness throughout our lives.  It is probably even situational.  How many of us have had that (those) drunken night(s) where we don’t remember anything the next day (or maybe you would prefer some substance other than alcohol).  I’m not arguing that situational self-awareness can’t be used as a legal argument, at least where substance abuse is concerned.  What I am interested in finding out is this:  How does one prove that they had a lapse of awareness and what the lapse can be attributed to?

Mental illness is the cause of numerous actions both cognizant and unaware.  How does one determine the level of self-awareness at any given time?  I recognize this is a tough question that brings up many clinical as well legal issues.   I believe answers to these questions serve to help us all be we mentally ill or not.