Bipolar Mixed States and PTSD – Finding Doctors Who Can Deal

FreudIn the last city I lived in I had a Freudian psychiatrist. Don’t ask me how it happened because like many things in my life I didn’t really plan it. He looked very much like a short version of my father and that just made the whole Freudian thing a lot weirder. In his narrative regarding my bouts of anxiety and workaholism, I was always trying to save a man who couldn’t be saved. It was true that I tore through a number of jobs in establishments owned by dysfunctional men but when I tried to tell my doc that my interest in improving the business was selfishly motivated he would shake that conviction.

It’s weird for a psychiatrist to be Freudian. Usually they have more interest in cocktailing drugs than rehashing the past to fit an analytic narrative. But I he listened to my stories and responded with meaningful questions and suggestions (most of the time_. We had a good rapport and for the most part we had the meds on track. Until I went hypomanic. I don’t think he was quite ready for that.

Bipolar disorder is extremely hard to diagnose accurately in a timespan less than a year or even two. In my experience, the psychiatrist or psychologist has to witness the mood disruption first hand to really believe in the diagnoses. Most bipolar people don’t go to the doctors when the hypomania takes hold because it feels good. But I did, finally. I have found that psychiatrists, used to seeing me in a depressed state, when confronted with my crazy, they balk. My psychiatrist in the new city pretty much dumped me as a client when I fell into the K hole of a mixed state and wound up in the hospital. It did not make the whole thing any better

I could tell the difference in Dr. F’s assessment of me. I was experiencing a mixed state which is usually what drives me over the edge. I am miserable but with energy that is turned against me in the form of panic, restlessness and agitation. Unfortunately he upped my dose of Lithium at the same time he reduced my Wellbutrin. This did bad things for me including amping up the tremors. As a Reiki practitioner and artist this was a problem–my hands would shake on my clients which was distracting to say the least. That mixed state unraveled my life. All of my traumas that been coiled tightly in the realm of my subconscious broke free.

Mixed states are hard to treat. For me, the most effective method is heavy sedation in the form of Klonipin. It takes the anxiety down a notch or two and while it doesn’t allow me to function, it does allow me some reprieve from my adrenals. Now this has become almost a pattern–it happened again this year. I don’t know what the answer is because the BP and PTSD are tied up in knots, together.

Has anybody experienced this recurrence of mixed states that is triggered by PTSD? All of my self-care like meditation, Reiki, exercise and balanced meals may help prevent these episodes but once they are upon me, nothing seems to work. Any suggestions?


Out of Whack

Nothing says “I’ve reached my breaking point” like a visit to the ER for a quasi-psychotic episode. It stopped my downward spiral dead in its tracks. I actually don’t think there was any further down to go–ok maybe heroin addiction or joining a biker gang–but I wasn’t motivated enough to do either of those things. I was looking in the abyss in a bright orange jumper that would have fit a Yeti, spreading margarine on a crappy bagel with a spoon because they wouldn’t trust me with any other utensils, and although it was slightly less intense than looking into the time vortex, it really put things in perspective. There was literally nothing in my life that even resembled balance.

Healthy bodies trend toward homeostasis also known in Yoga Journal, by Dr. Oz and Psychology Today as balance. The term tends to have a picture of a meditating Tibetan Buddha or stones stacked in a way that looks like they should fall down but don’t. But it’s not just a new age thing. It’s the way the body works. When the body is balanced (or close to balanced) organs function like they should, vitals are all good and systems are operable. It’s also known as being healthy. As someone with a disorder that’s with me for good the idea of being healthy is some sort of unattainable grail. Balance is something to move toward. It doesn’t require perfection because nothing is ever perfectly balanced.

I could go off on a tangent about the philosophy of chairs (also called ontology) but I will spare you. I’ll spare you the metaphysics. When I refer to balance I am not talking about the alignment of chakras or taking lavendar baths and drinking a lot of tea (not that there is anything wrong with any of those things.) I’m talking about thoughts, behavior and the things a body can do as a result of being out of whack.

At the time of my ER visit I had violent hormonal acne that seemed to have appeared overnight, I had gained a fairly significant amount of weight (although some of it was because I stopped smoking…go me!!!), my IBS was a-flaring and I was having the most extreme night-time akasthia I have experienced since being off Abilify (which gave me a horrid case of the kickies much to the displeasure of my husband and cat). My heart was racing all the time, or so it seemed, like a long-winded anxiety attack.

I was diagnosed as having a mixed episode, the most dangerous state of bipolar disorder. That’s when people are the most likely to do dangerous things to themselves and others. Fortunately I was able to get myself to the hospital before taking up arms. I joke but I had violent images flipping through my brain like the slide show of Freddie Kruger’s summer vacation.

The sum total of this is that instead of being admitted as an inpatient to the psychiatric ward I was referred to the Outpatient Behavioral Health Clinic as a partial inpatient. I had no insurance, no hope of ever paying whatever the program would cost but I had to do it. It was either that or some version of oblivion. During my six weeks of care I was treated through CBT and psychotherapy along with my medicine and my own self-care.

This blog is a tactic of that self-care. If I do my job properly, I will find my people and they will help to keep me accountable. It is not going to be all about gazing at my lovely navel. I will share the things that have worked for me and the ones that haven’t and I invite you, my gentle reader, to do the same. That is all!