Hypomanic Hogwash (and Seeing the CPN)

Having finished my posts on the first stint of therapy that I had with Paul, I’ve been left feeling surprisingly disenfranchised as regards my writing here. By that I mean that I have no idea whatsoever about what I should write. I mean, when I hadn’t finished the stuff on Paul, I procrastinated and procrastinated, and avoided having to tackle those posts by thinking of other inane stuff to throw at these pages. Now, in stark contrast, I can think of nothing. This is what might be known as a ‘fail’.

So, then. Let’s go with an obligatory ‘I had an appointment’ post. This one was with Christine, my CPN, on Tuesday.

The weekend had been an odd one. If you follow me on Twitter, on Friday night you might have seen why. I was behaving in a completely out-of-character fashion: gushing about how much I loved everyone, ravingly extolling the virtues of random Babylon 5 YouTube videos to people whose names I failed to correctly spell, wittering on (admittedly with my tongue firmly planted in my cheek) about how fucking awesome I supposedly was, asking people to participate in C(o)untdown contests (what the fuck?!) and generally going about screaming (or whatever the equivalent is on Twitter) “WAH!” and “WOOOOO!” and suchlike. What. A. Freak.

Saturday was better, but marginally so. The in-laws, who are selling their house, were throwing a party – ostensibly for no reason, but it felt like a ‘goodbye to Nice House in Shite Town’ kind of event (though, that said, as far as I know there have been no offers or any meaningful inquiries about the sale). Anyway, after visiting A’s father and step-mother who live relatively close to his mother and step-father, off we headed to the abode of the latter. And, although I was conscious enough of how mental I’d been behaving on Friday night and sought to curb the obvious signs of same on Saturday, I generally behaved like a twat then too. My sister-in-law, very drunk at one stage, welcomed what she appeared to see as my enthusiasm (ha!), as my mother-in-law seemed to do also. My own mother, however, was less impressed. (I forget the expression she used, but it was probably something along the lines of “catch yourself on,” a Northern Irish colloquialism that I have always loathed due to the unavoidable fact that it makes absolutely no sense in terms of syntax).

At one point my mother particularly riled me by throwing a blithe back-handed insult in my general direction. I can’t be arsed to go into the specifics, but Clarissa has cogently written about her own mother’s infuriatingly similar behaviour here, so read that if you want to get a feel for what I’m on about. This remark ignited an underlying irritability, masked by my ostensibly great mood, and I called Mum up on it, but of course we ended up getting sucked into the usual pointless circle of blame: “I’m always to blame”, “No, I’m always to blame,” yadda yadda yadda. So rather than fight it out with her, I sat down silently beside her, then suddenly started telling her why Anthony Burgess had decided to write A Clockwork Orange. My mother eyed me with bewildered suspicion, and after listening to 10 minutes of myself rabbiting on, I felt compelled to join her. A Clockwork Orange is an incredible book – one of my favourites ever written – but seriously, what the fuck? My pseudo-scholarly analysis of the background leading up to it was one of the best examples of a personally acted-out randomness that I can remember since my school days with Daniel (one such recollection: my mother was out at golf one evening, so Daniel and I ended up playing the fools by wearing cushions on our head, grabbing an abandoned curtain pole, and running up and down the quiet street squeaking, “weeeeeeeeeeeeeee! WEEEEEEEEEEEEEE!”, all whilst each holding one side of the pole. And that’s just one such example).

So yeah. I was mad. Someone’s going to come on here and ask if I had been drinking; well, that’s in the affirmative, but honestly – this was notlunacy fueled by alcohol consumption. If anything, knowing things were a bit weird, I was more measured in my imbibing that I otherwise might have been. And alcohol, even mixed with the current medications that I take, has not in and of itself ever affected me like this. Other people’s mileage may vary, but that is mine.

On Sunday and Monday, although I behaved apparently fairly normally, my brain was certainly hyper, and thoughts seemed to race through it faster than the speed of light. Until Monday evening, that is, when I promptly and suddenly fell about 80,000 figurative parsecs, and was paralysed by a deep – but mercifully brief – depression.

Essentially, the above tale characterised my meeting with Christine on Tuesday morning. She asked a lot of questions about my behaviour and mentality over the weekend, to the point where I was beginning to wonder if I was in some sort of bizarre Capgras situation wherein she’d been replaced by a GCHQ operative quizzing me about whatever act of criminality or terrorism they might like to pin on me (not really, by the way. That was a demonstrative hyperbole, not my actual thought process):

  • Had I been irritable (yes)
  • Had I been sleeping normally (no – if ‘normally’ means well, that is)
  • Had I slept at all (not to any meaningful extent – a couple of hours here and there maybe, were I blessed with a lucky night)
  • But had I not needed any extra sleep (apparently not – highly unusual)
  • What had my energy levels been like (jumping around the place like a twatting hyena on crack)
  • Had I dominated conversation (it varied from person to person, but in most cases I must have seemed like a self-obsessed bastardface – so yes)
  • Was I able to curb any compulsion to talk (no, fucking babbled endlessly on about every piece of meaningless minutiae pertaining to any given subject)
  • Had I been afflicted with racing thoughts (yes, to the point where it felt like a cognitive kaleidoscope was exploding over and over and over again in my head)

You get the picture. She had started her analysis by saying that it may be difficult to distinguish whether this wankery had been a simple good mood or an episode of hypomania, but as I answered the questions put to me one by sorry one, she noddingly came to the conclusion that it was, in all probability, the latter.

The distinction is one I find hard to make myself especially as, as Christine noted, a genuine good mood is a very, very rare thing in my life. On this occasion, however, my behaviour had been so horribly out of character that I had to agree with her final assessment: I was probably mental.

I got myself into quite a tizzy about it. Firstly, I tried to claim that it could not have been a hypomanic episode, because it only lasted a few days. She refuted that, stating predictably and reasonably enough that there was great variance in the duration of such moods across everyone afflicted by them.

OK then, but the last time I remember being hypomanic to any notable degree was – fuck me, it must have been 18 months or more ago. (There have been very minor instances of it since, in the sense that they’ve only lasted for one evening – and, curiously, seem to be the exclusive…er…privilege (ha) of my visually impaired friends. I cannot stop talking when I see them, and I’m restless and jump about and make too much noise and pace and flit from topic A to topic B to topic fucking Z). I’ve certainly had what I believe to be mixed episodes in that time – those have been a sorry staple of my life for quite a few years now, though I only realised they had a name after I started writing this blog – but hypomania has been relatively and curiously elusive (and, indeed, its big brother – the full-blown euphoric mania – has been more or less non-existent).

Given the good mood that accompanies episodes like this, I was, on Twitter, heard (seen?) to express a murmur of regret about the paucity of them in my life. However, La-Reve promptly and correctly reminded me that hypomania – whilst better than actual mania (which she has experienced, even if I haven’t) – is actually rather shit. This is true, for two key reasons. One: the higher you are, the lower you fall. Two: actions have consequences.

By the latter point, I mean that, when I had calmed down, I was absolutely and completely fucking affronted by my behaviour. I am not like that. I am known in certain company, that of my in-laws for example, as someone who enjoys a laugh and a bit of craic – but not as someone who jumps around elated, squealing in wide-eyed delight because someone suggested putting a fucking CD into the presiding hi-fi. I am, I hope, known on Twitter as someone who really does care about the people with whom she’s developed genuine friendships – but (I hope) not as someone who wastes bandwidth CAPITALISING EVERYTHING SHE FUCKING TYPES TO TRY TO MAKE THE POINT THAT SHE LOVES EVERYONE SHE’S EVER SPOKEN TO (BECAUSE, WHEEEEE, ISN’T SHE JUST SUCH AN AWESOME PERSON) EVEN MORE CLEARLY THAN SHE ALREADY HAD (or, in greater likelihood, quite the opposite).

So yes, I was (and am) embarrassed, and I told Christine so. She shrugged it off a little; whilst she feels that this was a hypomanic intrusion, she also thinks that I behaved as some more extroverted people might generally act as standard. The assertion irritated me slightly; it is, indubitably, true – but it is not true for me. If I were a natural extrovert, laden heavy with an arrogance that blinded me, then of course it wouldn’t matter – but I’m not. I’m me, and the person I was last weekend didn’t correspond to my self-perceptions at all. Other people’s norms do not matter in this equation.

Christine asked me when I was next seeing NewVCB, and I responded by stating that it was next week (Wednesday, I think). She appeared glad to hear this, and asked me if I was still OK with possibly going down the mood stabiliser path. I confirmed that I was, especially in light of all this shite. She acknowledged that she had some concern in that regard too.

We talked about Lithium versus Lamotragine. Reading between the lines, she seems to favour the former, but my preference is distinctly for the latter. Despite the contents of this post, as most of you will be aware, my symptoms – if I even have a form of manic depression at all – are very predominantly depressive. Secondarily, I’ve heard of people putting on weight on Lithium – and since that’s the primary reason that I want to reduce my Seroquel intake, it feels like taking it to mitigate Seroquel’s lost mood-altering effects could be a false economy. Lamotrogine, by contrast, seems to carry a greatly reduced risk of weight gain; indeed, I’ve read that in some cases it actually seems to reduce the bulge.

Not that I’m unwilling to experiment, mind you. It’s just that my first preference is for Lamotragine – if, for whatever reason, that fails to function as I hope, then I’d be ready to at least try Lithium.

At my mention of depression, Christine asked had that more generally characterised my mood since I’d last seen her. The answer to this was ‘not really’ – but, when a greater timeframe is applied to the question, it would have to become ‘yes’. In June, say, I was feeling pretty positive, and felt that my outstretched fingers were within mere inches of grasping the branch that is recovery. Now, although I don’t feel hideously awful, that former optimism has become a shattered reality, unobtainable and out of reach.

I exemplified it to her thus. A has observed over the last four or five months that things with me have been on a slow but definite downwards slope; apparently, at increasingly frequent intervals, I have exhibited a general aura of malaise and despondency, I have all but completely lost interest in leaving the house alone, and I’m really avoiding things that have traditionally given me pleasure. Although of course A cannot be said to be entirely objective – he is, after all, emotionally invested in me and my well-being – he sees things without the internal bias that the mind of a mental (or of anyone, in relation to themselves) inevitably creates. I might have said that I was plodding along with relative ease; his testimony highlights a more truthful version of reality.

Christine said that she would discuss what came up in our appointment with NewVCB before my meeting with the latter. She went on to ask about psychosis (nothing much), dissociation (nul points) and then, to my consternation, therapy. It wasn’t her fault that I was slightly dismayed – it’s Nexus’. I reapplied to see Paul again about five weeks ago, and although they confirmed I’d go back on his waiting list, I’ve heard absolutely nothing from them since. This is, as you might imagine, frustrating.

Christine asked if it were possible that my decline in spirits was related to the absence of therapy. Although I believe that I have melancholic (as opposed to reactive) depressive moods, it would be churlish of me not to entertain this as at least a possibility. Indeed, I think A has noticed a slight correlation, and I told her so.

It was therefore agreed that if I haven’t heard from Nexus by the end of this week (ie. tomorrow, since I’ve heard fuck all in the time between seeing Christine and now), that I would send a polite and brief follow-up email asking what the craic was. I kind of feel uncomfortable about doing so, as it seems to me that I’m making demands on the charity’s time – but in rational terms, I suppose a quick email is hardly the work of a servant of Satan. At the end of the day, I’d rather know what was going on than not.

The session (with Christine) drew to a close with a conversation about the awards ceremony, and my going to London at the end of the month in general. I shared with her that although this crappy blog being short-listed for something so prestigious, something so fucking big, is an honour of the like I cannot adequately hope to express, that I have a certain amount of anxiety about the ceremony itself. It’s a big deal; there will be a lot of people there, and many of them are household names (that said, that will probably mean damn all to A and me. We know nothing about most celebrity types). Let’s not forget that I have social anxiety on top of everything else!

She amiably and empathetically acknowledged this issue. “But,” she added, “you have as much right to be there as they do!”

Well, because of the appalling taste* of the short-listers, apparently I do πŸ˜‰ [* Comment applies to this entry alone, and not the other four in my category, nor nominees in other categories either. The short-listers have great taste in some of those!]. I mean, yeah, I’m nervous – how could I not be? – but although I honestly don’t think I have a cat’s chance in hell of winning anything, I still see much opportunity in going to the event. So I’ll be shitting a brick, but I’m still excited.

Also, I seem to have organised a fuck of a lot of things during our sojourn, meaning that I’m not actually 100% sure if I can ‘do’ a mini-Mad Up or not 😦 I’m finally meeting the wonderful bourach for the first time, I’m seeing my best mate Daniel, plus another lovely friend, CVM – and, when you take the ceremony into consideration, that leaves me with very little free time. Christine provided wise counsel on this; it is not a good idea to over-exert myself on the trip, especially when I’ll probably be an anxiety-ridden mess anyway. I’m not completely ruling it out, you understand, and even if I am, I’ll be back in England’s green and pleasant land in the not-too-distant future anyway. Let us see, yes? Please forgive me in advance, if it doesn’t happen? *begs like a puppy*

Christine and I parted after arranging another appointment just before A and I head off to the mainland. To her credit, she realises the magnitude in my life of this trip, and accordingly wants to offer extra support where she can. Not everything about NHS mental health services is completely shit.

Anyway, things are mostly back to normal here. I’m aggrieved that I’ve had so little time to hermit this week because of the aforementioned appointment, having to get new tyres on the car and, tomorrow, having to take the car to my mechanic in preparation for his MOT (‘his’ in that clause is not a typo. I do anthropomorphise my car). Next week is even worse, and I crave solitude and social tolerance of my agoraphobia. But I don’t seem to be even remotely manic, which is good, and I’m not overtly particularly depressed, which is even better.

If you notice anything out of the ordinary on Twitter this weekend, I want you all to beat me with a big stick. OK? OK. Good.

Good night, lovers. ❀ xxx

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6 thoughts on “Hypomanic Hogwash (and Seeing the CPN)

  1. Just written a few words and lost them, will try again tomorrow 9figure of speech).

    In case I don’t, have a wonderful time in London!

    David πŸ™‚

    p.s. your blogs are NOT crappy in fact, and I’ve read a few in the last few years, they are so good that I keep coming back for more.

  2. Hi Pan, Just a thought on the medication front. I’ve been on lamotrogine for over a year. Weight gain has not been an issue for me on it. My psychiatrist added Topiramate, starting at 25mg going up to 50mg, as i was having break through episodes of depression. This can also work as a mood stabiliser for some people too. One of the most interesting side effects of topiramate though is that it can cause weight loss, a rare thing in psychiatric medicine. Unfortunately for me i am going through a bad patch and they are re evaluating my meds. Because i have dropped a stone in weight in about 4 weeks and am still losing weight they have dropped the topiramate as they thought that was the cause (I’ve been on it for months). What has happened now is that i have flown up to the rafters after being in the pit and i await their next move with the medication. I can’t tell you what they have added taken away and replaced over the last 3 weeks. It would seem I’m a pain in the arse when it comes to meds as i just don’t respond in the manner the drug companies blurb says i should.
    Hope what I wrote makes sense. Good luck with your meds xx

  3. Hey Pan,
    My best friend is Bipolar (I) and she has, like lost, tried both Lamotrigine and Topiramate. She found both extremely helpful, with limited side effects – not gaining weight on the former, and losing it on the latter. In fact, on the former she doesn’t even have her old psychotic episodes frequently anymore, and doesn’t even have to take the antipsychotics she’d been prescribed for years.Of course it’s not always easy for her, but she’s coping so much better now. Just thought I’d throw that out there – I agree that out of your options, Lamotrigine seems like the better option to try first, with less side effects and such, but that’s just my opinion.

    I hope you have a wonderful time in London, well done on the award nomination lovely!

    Take care xx

  4. Please keep writing., your blog is great, and it achieves something vey important which is the discussion of mental health. You also write with passion and in some detail, which is not found through accessing government publications or by watching health promotional campaigns. Enjoy London

  5. I hate hate hate when you come back down, look at what you’ve done (or undone, in my case) and have that “oh sh!t” moment. I’m sorry you’ve experienced this. Social networking is a fabulous platform for the manic/hypomanic, you can share your mind-blowing ideas with the world and if they don’t listen the first time, you can just keep on saying it. I’m surprised I still have any friends on Facebook.

    outwardly x

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