At 11, I had a mouth of crooked, overcrowded teeth and needed a lot of dental work. The anaesthetist came on Fridays, so I had regular visits travelling into town for extractions. Fifty years on, I recall that each time I went, I sat in the waiting room thinking: “I can’t remember what it feels like to go under the gas.” And then sitting in the dentist’s chair as the black moulded rubber mask loomed over my face and came down to meet my nose and mouth, it came back to me as I counted down from ten: “Ah, yes, it’s like this – a sickly smell with a quick and sudden numbness.”
It’s a bit like that for me with psychosis; I’ve had half a dozen psychotic episodes so far, the first, depressive and very frightening, partly because I had never experienced anything like it before. Five more have seen me in a state of ecstasy of full-blown mania. I have been sectioned only once but had five month-long inpatient stays. My manic episodes do have similarities: I am always special and often messianic, but they are also distinct with their own theme (end of the world; secret societies and underground liberation movements) and with a storyline, often reflecting recent events or characteristics of my life.
I’m now familiar with the signs of onset. My prodromal symptoms include:
- Suspicious thoughts about people I know or random strangers. The colleague who had been following me from work. It’s illogical since we all left the office at 5:30pm.
- Excessive punning and wordplay. Declaiming a university essay title from two decades before and nonsensical to everyone else.
- Extra energy on lack of sleep. Extra energy can be a boon for employers and sleep is a very important barometer for me.
- Speeded-up thinking. I am the naturally quick thinking, but when becoming unwell this soon gets incoherent to others trying to follow.
The final tipping over from being rational to becoming nothing like that can happen very quickly and usually for me, it happens at the weekend. Yes, I’m sure Mondays are busy for mental health services.
While I’m no longer frightened of psychosis, It’s not something I want again and I try my best to avoid it, this often means relying on feedback from others.
A friend, who does not live nearby listening to me rattling on the phone, advised me to stop working at the weekend (good advice for anyone)and relax.
A manager checked in with me when again I seemed a bit speeded up in a meeting.
The last time (over a decade ago) I remember bumping into another good friend in the street and as I’d felt for a few days that I wasn’t quite right, I asked:
“Do I seem myself?”
“Oh yes, you seem fine to me.”
So I carried on. The next day, a Friday, at the GP I had an appointment about my foot, I omitted to mention my mental health concerns. Later on Saturday after trying to relax with a massage and a quiet afternoon at home, I tipped over and spent Sunday wandering barefoot around central London playing out another wild delusion. My neighbour came to my help and I was taken to hospital in an ambulance. On Tuesday after a long, sedative-induced sleep finding myself yet again on the ward.
Since then I have taken mood tracking more seriously and use an online tool (True Colours) to review mood variations on a weekly basis. This has served me well and I weathered the pandemic well, albeit hypomanic for a large part of the lockdown.
Long may it continue.
You can connect with the author on Twitter @UKBipolarlife.