I am Bipolar and not the cozy kind. I am Bipolar 1, marked by full-blown manic episodes and psychosis. And the past 19 (!) months have been mostly manic to one extent or another, with this year in particular presenting as fully manic more often than not.
When the seeds were sown last year of the horrors of this year, including an 8-day stay in a psychiatric hospital in the late Winter, it did feel cozy and welcome. I was writing music at a fever pitch and generally accomplishing great things. I welcomed the then-hypomania and I reveled in it. Yeah, ok sure, I was releasing albums at a rapid clip and at strange times of the day and, also ok sure, I wasn’t sleeping much, but it felt like a fucking superpower at the time and at that particular intensity.
I became a serotonin junkie. I needed that natural high. I leaned into it, as the creativity and near-euphoria of it all were as sweet as any manna from the heavens. I would begin my ascent up the mountain, chasing its obscured, but ever present crimson summit.
Yeah, well that turned into horror this year. I began hallucinating, nearly stopped sleeping in full, and generally ran the most amok I’ve ever done so in my life. It’s honestly a dark miracle that I am still around typing these words at fuck-all in the morning today.
Hospitalization is never fun, and especially not when it’s for psychiatric issues. I made some ant pals, had horrible food, had to mostly give up smoking (!) (don’t worry, that didn’t last upon discharge), and was a prisoner of those walls and courtyard for over a week. Not fun. I got put on a shitload of Depakote, and was discharged and returned home where within a week or two I was back on my bullshit, even though I was all but theoretically maxed on the drug.
Finally got into a psychiatrist, and by this time the episodes were starting to “mix”: meaning that depressive and manic symptoms were present at the same time. So now you had a suicidal-in-thought manic woman running around looking for any escape from this mortal coil, all the while hallucinating and generally holding onto sanity by the finest of threads.
I was put on Latuda. And not the basic starting dose, but a mid-range dose, because it was apparent this was going to be a fight. Didn’t work. Dose increase after dose increase was made until that too was maxed out, and yeah, no relief. Everyone on my care team – therapist, primary care, and psychiatrist – could see this was going nowhere good.
So the atom bomb of mood stabilizers was prescribed, Vraylar. This was one we had to do in order … no starting on a mid-range dose this go-around. Initial dose didn’t work, twice the dose didn’t work, three times the dose finally ended the hallucinating but the mania still raged, now I’m on four times the initial dose, the literal max that the medicine is authorized for.
SO WHAT HAPPENS IF THAT DOESN’T END THE HELLRIDE?
Lithium. If Vralyar is an atom bomb, lithium is fucking tsar bomba. The “gold standard” of mood stabilizers, it comes at a great cost physically. Kidneys, heart, any and all organs you can think of, can and often will be negatively impacted by popping lithium. So now, at the time of writing this, I’m sitting here praying that the recent max dose increase of Vraylar ends the mania, my once-friend that now I’ve come to loathe.
Mania has changed me. I now accept the strange and fantastical reality that comes with it all. I don’t necessarily mean this in a delusional sense, but in that I am far less rigid about everything I once held true. I’m early middle-aged and the dreams of the white picket fence and shit are gone. What has replaced it is a chase for finding whatever remains of my being. And sure, we’ll go into my, uh, alignment at some point down the road, as I was always an agent of Chaos and Discord, as decreed by Chance and Fate, before, but let’s suffice to say I’m finding myself in this manic certainty and eventual, I pray, post-manic reality.
I still have shit to say. I’ve found meaning again over the past few days of intensive therapy and metaphorical (and literal) bloodletting. It’s not going to be made up of words or songs that many or most want to hear, but my moment has come.
No gods, no masters, and that includes bipolar 1 and it’s damnable mania.