THE Mixed Episode

(Trigger warning later: cutting, suicidal ideation)

For whatever reason, I always consider writing about this–my first mixed episode. I’m not sure why I’m drawn to writing about it. It’s probably because I was too freaked out to really tell anyone honestly what happened because they’d get freaked out. Here goes, though.

I spent the entire summer before my mixed episode off and on hypomanic. It was the only time I had been like that for an extended period of time. Needless to say, it felt pretty great. I was doing well at my job–my boss loved the energy and creativity I had. Everything was super easy. Still, in part because of how long it was lasting, it felt different. I told myself that this would be the year that decided if I would need medication or not.

In August, everything change. I could feel the depression coming on and I knew it was going to be a big one. A lot of job stuff was going on, making it worse. I had very little energy and was pounding Monsters just to keep up. The Monsters used to give me a kick into a better mood, but my depression was deep enough that they stopped working. I went from therapy-free to having an emergency appointment mid-month. It was terrible to say the least.

I rallied at the end of the month though and bounced back up to mania, or so I thought. It got pretty intense really fast and felt different from the summer. After about a week of this elevated mood that felt really positive, I found myself starting to get really anxious and this was about 2 days before my birthday on September 17th. I came into work and all of the sudden thought “I should slit my wrists, I haven’t done that before.” Nothing like seeking novelty through suicide attempts. (I don’t think I mentioned this to my therapist, otherwise I’m sure he would have had me go to the hospital.)

Then my boss started acting weird. He and I used to be really close–we were friends before I started working with him–but he got really business-like all of the sudden. I wasn’t expecting it and my mood instantly switched.

I was still manic, I could tell that much. My energy was really high. All of the sudden I felt myself wanting to cut. Something about my boss really hit me and caused me to want to cut. Rather than doing what I normally do on the rare occasions when that happens–wait it out–I left work to go home and cut. I couldn’t stand it without the cutting, so I gave up nearly 2 years of not cutting. As a lot of people can tell you, it helped with the anxiety in the moment. The self hate that comes after is another matter, but it felt better.

I think that was the day I called to get an appointment with a psychiatrist, maybe it was earlier. All I know was that I needed to make it until the 26th and it felt like a really long time.

Later that night or the next, I can’t remember, I started to get really agitated. I noticed it when I was trying to sleep. for some reason, my skin became hyper-sensitive and I itched everywhere. It was also really painful. I remember laying up, trying to get sleep, and whimpering because the AC would turn on and hurt my skin. I was starting to really crack up.

Things really started to get bad on my birthday, September 19th. My coworkers–the only people that I really had around me–didn’t realize my birthday (my boss told them the wrong date). As you can imagine, I took it really hard. I spent the day full of energy that I was using to be resentful and  full of self-pity. And crying in my office. There was that. And trying to get a hold of my therapist.

I finally got a hold of him later that night. He usually doesn’t return calls in the evening, but I think he could tell it was an emergency. I told him I was agitated and having a mixed episode. He called and agreed. I told him that if it got much worse I’d go to the hospital. I knew I needed to go whether or not it got worse, but I was afraid I would lose my job. First there’s the whole mess of having to get myself committed and on top of that was the need to miss work for an indefinite period of time.

Focusing entirely on my job, I made the brilliant decision to wait it out for another week until the 27th when I was already cutting and impulsively suicidal. The rest of the week is a blur for me. I just remember it being a week that went incredibly fast and incredibly slow at the same time. It also finally got it into my head that I needed to be on medication–no more bullshitting it.

Finally, after about 3 weeks of a manic/mixed state I got into see a psychiatrist. One of the first things she asked me after I told her my history, which, of course, included my previous feelings about medication, was why I wanted to be on medication if I hated it so much. I told her that I couldn’t do it anymore and we started Abilify. It took me over a week of 15 mg of Abilify where I was taking naps during the day to come off of the mixed episode and I’ve been on it since.