Mixed-state beware

The hallmarks of bipolar disorder are mania and depression. The illness used to be called manic-depressive disorder until someone decided calling it bipolar disorder is more PC. The semantics do not matter a whole lot to me, but calling it manic-depressive is more descriptive and informative. The word bipolar lends itself to word play, so that’s fun.

I think bipolar disorder is largely misunderstood by most people. When I was in middle school, I had a teacher who had a temper. He could be fun and carefree, but little things would set him into minor rages. My classmates frequently made comments about him being bipolar. My sister had been diagnosed as bipolar by that time, so I was more familiar with bipolar than my classmates probably were.

Just because someone has a temper, doesn’t mean they are bipolar. Yes, people who have bipolar disorder suffer from extreme mood changes; however, those mood changes are not relegated to going from calm to suddenly angry. It is much more complicated than that.

My first psychiatrist explained it to me helpfully during my first or second appointment. He told me everyone has a range of emotions to which they have access; bipolar people’s range is just wider and more volatile. Everyone has highs and lows. Being bipolar takes those points to the extreme.

He explained that my medication’s purpose was to normalize the range of my emotions. My antipsychotic keeps me from flying into mania, and my mood lifter helps me from falling into despair and depression.

After eight years on the same medication and without any more episodes, I’d say my medicine has done its job adequately.

I still experience higher highs and lower lows than most people. That’s just the nature of the beast. I’m not too worried about either extreme these days. My highs are wonderful, and I can’t complain at all. My lows are a bummer and they are annoying because I have a hard time seeing the good in things in the midst of my mild depressions.

Understanding the manic and depressive sides of bipolar isn’t that difficult, and it’s easy to explain to people unfamiliar with the illness.

There is one thing about being bipolar I still don’t understand, and I’ve experienced it a fair amount over the years. It’s hard to explain, even to people who are knowledgeable about the illness.

Sometimes, I will be energetic and hyper whilst simultaneously being despondent and depressed. This phenomenon is known as a mixed-state, and it is the most dangerous place for someone who is bipolar. I think Terri Cheney wrote it’s when the most suicides occur in bipolar patients. I have no problem believing that.

During truly debilitating depressions, someone with bipolar may feel like they want to die, but often, they don’t have the energy or motivation to carry any suicidal plans to completion.

It’s different in a mixed-state. Someone can have the desire to die and the energy and motivation to implement a plan. That’s what makes it so dangerous.

When I’m in a mixed-state (which hasn’t happened in a while), I feel reckless and hopeless in conjunction, and it is exactly zero fun. In the past, when I’ve been in a mixed-state, suicidal thoughts are not far behind. I’m not always explicitly suicidal, but I tend to feel an urge participate in dangerous activities.

I know I’m in trouble when I have random and strong urges to jump out of planes, get tattoos, and tell everyone I know how much I love them.

I have never experienced deep or debilitating depressions. I’ll sometimes go a couple weeks where I’m sad and lethargic and require an inordinate amount of sleep. For the most part, they are not dangerous, just annoying.

My mixed-state is miserable. It feels as if I’m being pulled in multiple directions and I do not know which way brings relief from my suffering. I’m not entirely sure how mixed-states are brought on, nor how to get rid of them once they hit me.

Thankfully, my mixed-state mood is rare these days. I’m healthier and better able to cope with setbacks. I don’t let myself fall into despondency haphazardly. Therapy has helped greatly, and I have a few friends with whom I can share and process my feelings before I reach the point of recklessness.

I’ve also read several books the past couple of years that have given me tools by which I can live a healthier emotional life. I’ve put in the work, and though I’m not perfect, I am a lot better now than I was less than two years ago.

The work is worth it, and I want to continue to mature and gain more command over my emotions. It takes me a while to learn things because I learn best from experience. A friend could tell me something that is absolutely true, but I won’t believe it until I’ve tested the waters and seen for myself.

Practice makes perfect, and I have many years left in which to learn and grow.