Mania

I often find notes to myself written frantically in the midst of mania.
Here is what it is to be manic:

I am afizz and busy and!
My confessions: I am sleeping little; talking a lot. I could scale a mountain – I am off the scale! I keep hearing people call my name in a kind of panic but no-one is there.

Now I am hyper and high and hating it. [In hindsight, I can see that I spend money on things I can ill-afford.] A new mood stabiliser will not start for a few weeks now so I self-medicate with alcohol and sleeping tablets. Alcohol is used as a preservative. It is self-preservation. It is bad, I know, but it helps with the pain. [N.B. It is not wise to drink alcohol, especially in excess, whilst suffering from schizophrenia-related illnesses and on medications. Not only can it make symptoms worse and affect the functioning of medications, it can cause damage to the liver and other organs.]

I feel in trouble. I race through everything: I tend to swallow food almost whole (seemingly chewing is far too time-consuming) and, consequently, I suffer the most awful indigestion much of the day. I talk, I talk over people, I interrupt, I argue, I swear (a lot), I snap, I am rude and brash and lurid, I joke inappropriately and I can’t seem to help myself. I just can’t help myself. I am as likely to burst into song as I am into tears and I laugh for no particular reason.

I live on a knife-edge. Nothing seems to dispel the fear I feel – I can’t even explain it. For me, severe mania is even worse than severe depression. At least in depression I don’t get into so much trouble – indeed I don’t do anything at all. And I can escape into sleep to make the time disappear. Some people flippantly describe a hectic situation as ‘manic’. What do they know.

When you have not slept in a week or so – I lose count – the world slides on differently (or do I mean indifferently?). It is gradual – the drag upon the soul. Walls and floors flex in the swim. Outside of day-night-day, it is much like being locked out of your own house. Others come in and out of your life. I scratch upon everyone’s nerves. I am getting tired but cannot stop or sleep. Mania is like dancing yourself to death. Decency leaves you; confused company leaves you; everything leaves you. On and on, it frightens the life out of you by degrees. It feels like stale champagne now and a hangover. The mind slips and smears. I seep words continually like a weeping wound. And I am ill, but what to do? I don’t think the current medication works all that well but it is worse without it. It shortens the agonies of the cycle somewhat. But, you know, I live for the razzamatazz and all that jazz.

The Act of Eating

For it is all just an act. During my first psychosis, I was fixed on the idea that I created my own energy. I existed only on oranges; I exercised excessively and furiously. Pre-hospital, my weight was recorded as underweight at 44kg , standing at 1.68 cm in height; immediately post-hospital, I was almost 67kg. These days, what I eat, I tend to vomit. I still claim it is anxiety. But there is, I admit, a perverse sense of satisfaction in being in rigid control of oneself, even to the point of (unintentional) self-starvation. It is being so in control that is so out of control in my disordered eating. Being solely on Abilify (aripiprazole) caused me to lose weight to 50kg, but on its own, it was not enough to help me with all the symptoms. Since then, my additional medicines have caused a 15kg weight gain over the past six months, so my weight yo-yos. It all takes it toll on me. At the time being, I cannot stand to eat.

Life Seen Through Negatives

The negative symptoms of schizophrenia are characteristics which should be present but which are not. They include: apathy, affective flattening (a blank facial expression and an inability to express emotion), anergia (low energy), avolition (low motivation, lack of interest in life), anhedonia (loss of pleasure even in activities previously enjoyed), alogia (poverty of speech often due to poverty of thought), and social withdrawal/isolation.


I don’t think I can move right now. I hate to wear the same clothes without washing for so long but I hate to move. It seems like a type of paralysis of thought. My head is blank and empty. I spend a lot of time asleep. The numbness rises higher and higher. I can’t feel a think.

I have been pacing up and down because I have a starting block, a kind of inertia, which slows me down. I wear a hat to remind me of the presence of my head. What does it take to feel real? I wander round in circles or rock to and fro to try to get back in time. I am out of time. For all I know I could be screaming.

Relapse Real

It appears I suffer a serious relapse every two months – my psychiatrist knows this – and it takes about as long to recover from a relapse. I shall dissect a relapse for you:

I am utterly overwhelmed by life. I cry over laundry to be sorted. I abandon most daily tasks. I feel overstretched, over-extended, overloaded and generally teetering over the edge. The anxiety is astonishing.

I then go into a sort of drifting state: there are depressive symptoms, an apathetic boredom, a horrid listlessness. I hardly see another human being. I shuffle around. I want to get out of life even though I no longer feel real. It is much like being in an ever-stretching nightmare.



The auditory hallucinations become overruling in my existence. Sometimes I appear frantic and I have expansive thoughts, such as believing I saw and spoke to God in a tree across the road. I wonder if I am ill or if I am actually an unrecognised prophet.

I get very frightened, feeling I am going to be hunted down and killed. I can’t think to do anything for myself.

Slowly, I tend to crawl out of a relapse in the same way I went in – only in reverse order. The stages of relapse are called ‘decompensation’. In spite of a structured routine, and taking my medicines daily, I still happen to experience a complete mental collapse in a predictable fashion. I hope the addition of another antipsychotic will help in preventing a regular relapse.

Hallucinations

I have not really mentioned hallucinations much before in the same way one never normally mentions the sky – it is just always there, a constant. It is also difficult to tell reality from fiction – at least it is around here.

The voices I hear speak random phrases, rhymes and insults. “How do you do? Hullabaloo. I spit at you. You’re a shoe.” I have on at least one occasion cut/injured myself as a direct result of their commands. The two male voices have named themselves Protein McLean and Fatty Friedness. The voices often talk about me to each other; they argue amongst themselves; they sometimes start up describing what I happen to be doing; and also they talk to me. Command hallucinations are so very compelling. I often wish for some peace.

I do experience some visual, and tactile (touch) hallucinations as well, though not as much as auditory ones. For me, olfactory (hallucinations of smell) and gustatory (taste) are fairly rare.

Right now, I can hear one voice saying: “You’re a pitfall, you’re a pothole, a potluck feather duck. You’ll never amount to anything...” To me, it is just another day.

I can’t help but feel blind-sided – I have trouble with reality. I try not to think. Anxiety makes the voices worse; the voices make the anxiety worse. I have little to say for myself much of the time. I have trouble with reality and I fear I might not outlive the night. “Hopscotch top notch bare essentials.”

The Point of Exhaustion

These are words I wrote in my journal. The words in speech marks are those of my voices.

I don’t know about life – my heart’s not in it. I have had about three weeks of the same day and I have had about enough. I grow old and tired. “Old, old, old. Dentures and dementia”. I cannot feel I will ever live again. I am shattered. Yet I cannot destroy myself – for by doing that I would destroy everything around me also. I just can’t take my own life –as a gift it is too much, I just can’t take it. I am dead-tired. The passive-suicidal ache is fast becoming an active desire to end my life again. I could so easily extinguish myself. A voice says: “Don’t lose your cool.”

“Bish bash kibosh” Each word that comes out of my mouth makes a new person appear in the world. Never have too much pomphidence [pompous confidence] in your own mind: illness can strike anyone. I have such dear friends but I am just a deer in the headlights. Suicide is blitzkrieg and sanderling. It is the snap under long-term psychic slaughter, electric battery. I suffer extreme hope haemorrhage and good loss. Sometime, somewhere, I received a massive psychic injury which I cannot die from, nor fully recover from. “You slap-fat doggerel”. I am locked in a loveless marriage with life.