Monday, June 22, 2015

Psychosis, Psych Drugs and the Crumbling Foundations of Self - Part One

In 2007 I was forty-eight years old. Age can be many things but one of them is to give you more opportunity to gather, accumulate and make use of what we call "life experience". In that year, at that age, I thought I'd done pretty well on that score. I'd done a lot of things, I'd conquered a lot of barriers and challenges. I had few fears. Not like youth who fear little because they know no better, but because I'd faced and conquered most of mine, I'd faced and slain many dragons. I'd been through many bipolar manic and depressive episodes and all of that I seemed to have put well in my past as well. I'd taken on, learned and become very good at many different jobs. I'd moved to and lived in a completely foreign country and culture. I'd learned the language there and integrated, as much as  foreigners were allowed to, into its society. At forty-eight, I felt I could do anything I put my mind to. It wasn't the cocky confidence of youth, it was the confidence, belief in oneself and a self-assureness that comes with accomplishment. 

I felt it was time for me to realize my life long dream of becoming a professional photographer. 

It was a big life changing (to say the least, as we'll see) point in my life. I was in a dead end job and I was, at my very core, "bored" (in quotation marks because few people understand what boredom can mean to bipolar people and to many others, something we'll examine further when we look at what "stress" and stressors are all about). So I walked away from that ($45,000CDN a year) job. 

For a month I did not know what to do. Pressure was mounting; pressure about paying my mortgage and bills, pressure to support my family, pressure from my family to find a job, but worst of all - for me - the pressure of alleviating this deeply restless boredom. In bipolar people this kind of stress and pressure can (though not necessarily) trigger mania or hypomania.

And so it did. 

The manic (or hypomanic) mind can be a lot of things but a few of them is that it removes fears and doubts and clears a path of absolute belief and certainty. 

So despite a lifetime of photographic study in which I learned how very difficult it was to earn a living as a photographer, and further knowing full well how the digital camera revolution further diluted the photography pool rendering most work almost worthless, I felt sure that I could realize my dreams and - insanely - pay my mortgage and bills and support my family doing it. 

Not only that, but I felt that I could do it not in an established market for photography like weddings, or fashion, or portraiture (where most people made their money), I felt I could do it doing what I loved to photograph. 

I didn't actually have any experience in the field I was about to enter (high end nature photography, an extremely competitive field). I had no experience in or prior success at managing a business or generating income on my own (IE: outside of a salaried position). I had nothing, really, on which to found this venture. 

All I had was this well founded belief and confidence in myself and my abilities and growing pressure fueled mania. 

Which, actually, could well have worked. It does work for some. 

But it didn't for me. 

In the summer of 2008, with mounting failures, no income and the financial foundations I'd worked so hard for so long to build crumbling around me, the psychosis began. 

I know now that in that summer that I was going through mixed episodes. Mixed episodes are elements of mania and depression taking place at the same time. I wrote a few years after that period that this was "manic bear" and "depressive bear" (of "polar bears" fame) going at it in my mind at the same time. Mixed episodes kind of mess you up; with a cacophony of wildly competing mental states, thoughts, ideas absolutely pounding you all at once and relentless so, it really tends to mess up your mind (to put it very mildly, to say the least). A lot of things can happen while in mixed states, among them psychosis. 

It was hard to do anything productive (or even go outside at all) with "the bears" battling in my mind (raging mania along with massive depressive negativity) so there were times I'd just try lie down on the bed, close my eyes and hope that it'd go away. And when I did this, it started. 

It started with a voice. A loud, booming frightful voice. It came from not inside my head. It came from a corner of the room. It thundered over and over again, "Must die!! Must die!! Must die!!". 

When I opened my eyes to see where the voice was coming from, I could see a large pool of thick, dark red blood spreading out over the comforter. It was, as you might well imagine, quite a sight. When you see it and you're alone and you know it couldn't be coming from anyone else, you're quite stunned. At first I just stared at it, the pool of blood growing ever larger, soaking into the blankets now. I knew blood of that volume and flow had to be coming from my jugular vein and I thought "how on earth could that have happened??". Meanwhile, the voice kept booming over and over again its message - "Must die!! Must die!!". 

Finally I reached out and felt the comforter. My fingers told a different story than what my eyes were telling me; the comforter was dry. I couldn't feel blood. I felt my neck. I couldn't feel any wound or gushing blood. My throat couldn't be slashed. My mind began to sort things out. The voice faded away, the "blood" disappeared. But I was badly shaken. What the hell just happened? And why? Auditory and visual hallucinations can do that to you. 

This happened several more times within a several week stretch, each exactly as described above. But each time my mind would eventually sort it out and gradually these episodes just stopped happening. They shook me badly but in time I forgot about them. I seemed to be okay.

Fast forward to the summer of 2010. My photography venture was a spectacular failure. I'd lost all the equity and savings I'd worked a lifetime to build. I had nothing. But I still had the ability to work. I still had (I thought) my mind. I still had a lifetime of work experience. I was trying to simply just move on. The previous fall I'd found a new job, a job that I felt offered the kind of challenges and opportunities for growth that I needed. I was right only on the first part. 

The job was pressure packed and unstable. I often didn't get paid or if I did, I was paid much later than I needed. Almost every month I had trouble paying rent to keep a roof over my family's head, the landlady often threatened us with eviction. My boss was mentally unstable himself (he too was bipolar, a double edged sword in that he understood and was very supportive of what I was going through but he also went through very bad mental state swings himself, which were greatly destabilizing to me). I looked and looked but could find no other job and my own declining mental states and foundations of self made job searching even more difficult. 

Then I made a very bad mistake. A project on which everything for me was riding - future work, money on which to live, my stake in the company, everything - fell apart. Literally. It crumbled before my eyes. Something in me just snapped. And it began again. 

It started with a swirling column of white mist, like a mini tornado. It rose from the shop floor to the ceiling thirty feet above. Scary, contorted faces appeared in the mist laughing and mocking me for my failures. Scenes of my failures flashed by. It all appeared as real to me as the screen in front of your face. The faces and scenes were flashing by at an incredible speed. I just sat mesmerized and transfixed. 

Then that booming voice came again. It thundered, from somewhere above me and to my left, "This is going to end and this is going to end NOW!!" The voice was so commanding and authoritative and I was so horrified at what I had done (both in that instant and in the previous two and a half years) that I felt completely in its control. Next, visions began to appear of what I had to do. I had a boxcutter knife that was razor sharp. I was to take that, kneel down, slash each wrist and watch as I bled out. The booming voice was also giving instructions. I watched the visions and listened to the instructions transfixed for several moments. Finally, the voice boomed "NOW!!". And then I was consumed in a rage and my body was taken over. It just simply began to carry out the instructions. 

But my body and eyes could not find the knife. The more I looked, the angrier the voice became and the more rage and urgency I felt within me. My body and eyes began to look for other instruments that would do the job but none were sharp enough. The fury and urgency continued to mount. The voice had made it clear that I could not let anyone else know what I was doing, I had to keep my actions hidden (I was out of sight in what was an otherwise busy manufacturing shop). My mind was becoming beyond frantic. The voice, this force, was demanding action to carry out its commands but my body and eyes could not find a suitable instrument. Finally, my body and mind could not bear the inner rage and fury any longer and my legs just collapsed underneath me. I fell to the floor and sobbed. Just then, someone called out to me for help with a problem, my role as shop supervisor kicked in and it all passed. 

But my god, that incident shook me to my core. My mind, body and actions had been completely taken over by something else, a power that was beyond me, that appeared for all the world to have come from outside of me. It was terrifying. 

But life marches relentlessly on; bills to pay, rent to pay, a family to support and actions needed to be performed to earn the money to do those things. I just focused on those things and tried to put that strange incident behind me. 

But deep inside, I knew something was breaking down. Other things (which I shall have to save for another time) were beginning to happen in my mind. 

I managed to get through the next two weeks but my crumbling mind and the mounting pressure meant more bad mistakes were to come (not just any mistakes, but mistakes that could cost my company contracts and vital income and thus my ability to earn income). I again broke down. It wasn't a psychotic breakdown, but it was a powerful force to take my life, a force that told me that I just had to end my life. And I did want to end my life. Yet a part of me knew that I had a daughter to support, a family to support. My mind was not that I could not take me away from them, but that I could not leave them with nothing, with no financial security. I couldn't leave them like that. There were many massive forces going on in my mind and I felt very sure that my mind was breaking down. I knew I could not go on like that. 

So I drove home, told my family that I was "not well" and asked them (my ex-wife and daughter) to take me to the hospital. I was admitted the next day to a psychiatric hospital. 

I was initially diagnosed with a minor designation among the bipolar spectrum and I was put on lithium. I was released after a couple of weeks and after a month break, I went back to work. I felt pleased that I was finally "diagnosed" and "under the treatment and care" of a "doctor". I felt sure that things would be better from then on. 

But in reality nothing changed. I wasn't better. Life wasn't better. The psychosis continued. 

It always involved severed body parts on the shop machinery (I worked in a wood products manufacturing shop and as such we had a lot of very large machinery for cutting and milling wood). I'd be operating a machine and despite doing it with great experience and safely, I'd "cut off" my hands. I'd look down, see my severed hands, the stumps at the ends of my arms and blood gushing and spreading everywhere. Often this would happen just out of the blue, with nothing really going on in my mind, just going about my job and enjoying it. It messes with you, it messes with your sense of reality, your sense of self, your sense of everything. My mind was feeling more and more messed up. I still had during this period (through the summer of 2010), despite the "treatment" I'd received at the hospital, a lot of racing thoughts around planning suicide. I was having more and more trouble sleeping. 

In September of 2010 my medical doctor put me on an anti-psychotic, Risperidone. 

It blessedly seemed to work. The racing thoughts seemed to stop. I could get to sleep at night. The lithium and Risperidone seemed to be a good combination. For about a month I felt that I felt fine. I was happy. "Okay," I thought, "I'm beginning to beat this son of a bitch, I'm going to be okay." And most importantly, the  incidences of psychosis ended.

Then slowly, gradually, it began to happen - "I" seemed to begin to disappear, my core "me" began to fade. My normal thought processes were always based on creative thinking. I began to lose that ability. My emotions began to feel blunted and numb, not just negative emotions but all emotions. I began to lose pleasure in all things that normally brought me pleasure. Creative writing had long been a pleasure of mine and I lost all sense of and interest in that. I began to feel like an empty shell. Everything in my mind and how it worked that I relied on all my life began to disappear. This was about October of that year.

I'd looked into the side effects of the medications and knew that what I was experiencing was part of that. I did not want to go back to the inner chaos that had led to that bad psychotic episode so I felt that the side effects were something I had to accept. I tried to compensate. I tried to learn other ways to think. I tried to let go of my creative self. I tried to tell myself that this was the new me that I had to accept and get used to. 

But as fall stretched into winter it got and felt worse. I felt numb, I felt emotionally blunted, I felt empty. I'd gone from having racing thoughts and raging emotions to seemingly having no thoughts or feelings at all. I felt listless, lethargic and lacking drive and motivation. I felt, for all the world, like I was losing my soul, my self, my me. It was becoming unbearable. 

I began to consider going off the medications. I looked into the consequences. The "danger" of a bipolar person stopping medications was that they would go "manic". "Great," I thought, "a little burst of mania is just what I need. With me, it'll just give me a little creative burst."

So I carefully planned it out. I'd stop the medications on a given day. As my mind became freed from the shackles of the mind numbing meds, I'd go a bit manic, I'd do a bunch of writing and thinking and then after ten days and ten days precisely, I'd go back on the meds. And that's what I did. 

And it worked beautifully and just as I'd hoped. I was hit with a burst of manic energy and mind activity. I channeled it all into writing. It was wonderful and beautiful. The thoughts, ideas and words just flowed effortlessly. I wrote and wrote and wrote. It wasn't, in hindsight, anything special but it just felt great. I felt "me" again. I felt pleasure and wonder and awe and curiosity and creativeness. "Row, row, row your boat, life is but a dream" and all that.

But when the ten days were up, I dutifully went back on the meds. The mania settled down, I settled down and it seems I entered a state of relative normality - not too up, not too numbed. I felt okay. 

Then about four weeks later while driving home from a very enjoyable night out with a very good friend, something began happening in my mind. I lost all ability to focus. Some weird energy seemed to be coursing through my mind. Despite being on a route I had been extremely familiar with for decades, I began to lose any sense of where I was. I felt very confused and disorientated. I managed to get off on my exit to get home and as I was driving over the freeway overpass it happened - something seized me and I veered the car into oncoming traffic. I did not think to do it, I did not plan to do it, I did not want to do it. Some part of me just did it. 

But the glaring lights and blaring horn of the car coming at me snapped me out of it and at the last second I veered back into my lane, narrowly avoiding the collision. I have no memory of driving home from there but when I got home I just went to my room, closed the door and my entire body trembled and trembled. It wasn't a brush with death that so terrified me to the core, it was how I seemed to be losing any sense of control over my mind and even actions. After some time, I somehow I went to sleep. 

The very next night - it was a Friday night late February 2011 - as I closed my eyes to go to sleep it began. 

I remember something like the energy of an electric current coursing through my mind and body. Then the voices and visions began. 

At first there was a kind of trial. Voices and visions told me of and replayed for me - just like a movie - my past transgressions. I'd done a lot of shitty things to people through the previous twenty years or so and had badly hurt a lot of people and all of this was "replayed" for me in graphic detail. It was very bizarre. It was like being strapped into an amusement park ride going through a tunnel and on the walls of the tunnel were "screens" showing the faces of people I'd hurt and the actions I'd done to hurt them, all of it very graphic, very real looking (though at the same time surreal). I could hear their voices screaming at me. I could clearly seen the pain and hurt in their expressions and in their voices. 

And I could not stop it, I could not shut it off. It was if I was strapped in and could not escape. This went on for perhaps half an hour or more. 

Then there was a "judgment" of sorts. The booming voice returned. I'd have to "pay" for all this. A punishment was handed down. 

I was directed to get into my car and drive to a quiet place. I was to take the sharpest kitchen knife I could find. I was to park and then start slashing myself with the knife in as many places a possible. I was to really carve myself up. As with the previous psychotic episode, all of this was shown in visions to me that were extremely graphic and real looking. And I could not stop it or turn it off. 

But something within me managed to fight it off, managed to not let my bodily actions carry out the demands and commands of the voice and visions. Some part of my mind held on to visions of my daughter and of how if I did what I was being commanded to do would affect her. Somehow I managed to fight it all off but my whole body was literally trembling with the effort.

After about perhaps two hours, it finally passed. 

But I was very, very badly shaken. I knew something had to be very wrong. With the incident of the previous summer still very fresh in my mind, the incident just the night before of something making me veer my car into oncoming traffic still very vivid in my mind, I lost all sense of belief and confidence that I was in any way in control of my mind. 

The next day I was taken in to the psychiatric hospital and again admitted. This time, however, I was officially committed. 

Then the real fun began. 

To be continued.