Between July 2016 and June 2017 I was hospitalized four times. We’ve been over this. The anxiety was crushing, the depression debilitating, and the agitation dangerous. Two of the hospitalizations failed to thoroughly treat the symptoms, so I returned shortly after discharge. In retrospect, I can see warning signs that built over time and contributed to the necessity of the hospitalizations.
Before the first stay, I was clearly hypomanic and agitated. I took on too many projects and failed to recognize my hypomania for what it was: I thought it was anxiety. My second stay and first stay were only separated by ten days. But there had been too many med changes to keep track of in that first hospitalization, so when I began to crash and the agitation returned with vengeance, we had no idea what was working and what wasn't working.
I stayed remarkably healthy for the eight months following my second stay. I had one mild hypomanic episode and some mild depression that was curtailed by a medication increase. But then school ended. And I began to work four days a week, closing once or twice. Educational tidbit: social rhythms are incredibly important for those with bipolar. That means shift work is not ideal. That means Annie feeling more energetic April 2017 and having more time on her hands and taking on closing shifts is asking for trouble, because that means getting off work at 11pm or 12am one to two nights a week. And then the energy leaves and the agitation remains and the soul sucking depression takes over. And then what? What could I have done to stop it? Nothing. It moved so quickly. There wasn’t time to call the psychiatrist and for the psychiatrist to send in new prescriptions and the pharmacy to fill them and me to take them and changes to be effected.
And similarly, after my third hospitalization, I was only out two days before the depression came back strong enough to steal my words. I sat mute in therapy and in the psychiatrist’s office. Maybe if I had the words, I would have said, “help.” And maybe we could’ve made some changes to reverse the depression, but I couldn’t speak. And before I knew it I was back in the hospital.
So what have we learned? Honor your social rhythms (don’t close at work). Watch out for energy: don’t feed it; try to ride it out with grace and gratitude. Beware of the agitated depression. Speak. Or write. Well, try to, anyway.