Understanding a Bipolar Crisis
My recent article about crisis prevention talked about what we can do to reduce the risk of a crisis, but in this article I want to provide true insight into one of my mental health crises where professional intervention was needed.
I want others to know they’re not alone, and also to help friends, family and others to understand what some of us face.
I hid at the top of my garden. My house didn’t feel safe and I didn’t trust my family. They couldn’t understand my outbursts, aggression and antagonistic behaviour, and I couldn’t either.
I knew if I listened to any reprimanding I would explode with rage and the outcome could be catastrophic. I didn’t want to hurt anyone but I was terrified I might not be able to control myself. I had just stormed out the house with impulsive thoughts telling me to jump through a window or bang my head repeatedly on a wall. I wanted to get my surging energy out and the only option seemed to be hurting myself. I pinched my arms, scratched my wrists and punched myself in the head.
I dialled a UK helpline (The Samaritans) and begged for help.
I told them my situation and said I was completely out of control. I couldn’t calm down. I was trying to do some deep breathing but nothing was working. I was crouching down, tears streaming, shaking and in so much distress.
My thoughts were sending impulsive ideations about self-harm and suicide and I wanted everything to stop. I was using all of my power to try and bat them away with a visualized baseball bat but there were too many thoughts and they were flying in too fast.
I tried to find my voice of hope but found nothing. Everything was blacker than black, and more petrifying and distressing than imaginable. As a writer, to find no words to describe the intensity of the pain and feeling is impossible to fathom.
How did I get to this point? Why am I so impulsive? Why can’t I consider anyone or anything apart the intensity of my thoughts? Why do I feel that anyone asking me to consider my family while having these suicidal thoughts is selfish on their part? How could anyone ask me to live for them while suffering this demonic torment?
That was me at crisis point and I honestly don’t know how I got through it. Survival instinct must have kicked in because I had no willpower. My brain was encompassed in misfiring chemicals that changed the way I thought, triggered inexplicable feelings and forced me to self-harm for release.
Out Of Control
I don’t remember much of those few weeks before and after. I think in really traumatic moments the brain blocks them from your memory so you don’t have to relive them over and over. But I remember that night, when something else happened.
I tried to attack my dad.
Violence is not a symptom of mental illness. In no way do I associate violence with mental health. We are not dangerous. We are not violent people. There is usually a trigger and if anything does happen it is normally to someone we know, not a stranger.
However, this time my dad said something that upset me deeply. I take responsibility that I behaved unacceptably but because I was very, very poorly with no patience or rationality, I acted impulsively. I felt rage and flung my arms out without a second of thought.
My mum’s response was shouting that she would call the police and I screamed back. I told her to do it, to get someone to take me away because I couldn’t take it anymore. I’d lost it, I couldn’t guarantee my own safety and I no longer cared. I even offered to get the phone.
I was desperate, completely alone, misunderstood and out of control. My illness was morphing me into a different person. I was chaotic and completely terrified.
The following day I still felt angry and I was reprimanded, sending me further into the zone I was trying so hard to escape from. I couldn’t feel their pain because my head felt deathly and I was using all my effort to fight my thoughts.
I sat in my home and considered my situation. My suicidal thoughts were thick and fast I planned everything. I wanted everyone to know it wasn’t their fault and they shouldn’t feel guilty. I simply couldn’t fight it anymore and needed peace. The frightening thing was it felt normal to be planning everything.
Instead of feeling sorry for my behaviour, I labelled my family as triggers. I was petrified of what they might say or do that could make me lose control, resulting in self-harm or suicide. I wanted to run, hide and find a safe place but I didn’t know where that was. Everywhere was dangerous because I felt completely out of control.
My sister swooped in and saved me. She took me in and gave me a place of quiet, dedicating her time to keeping me safe. She sat with me, talked to me, held me, even waited outside the toilet for me, concerned I might impulsively hurt myself. She recently told me she used to sit outside my bedroom door while I fell asleep.
I was in contact with the crisis team and they sent nurses to see me, but it was obvious I needed intensive treatment. A family member travelled to see me. We had spoken on the phone and he said usually he can cut through my thoughts and help me, but this time I sounded dead. I had no hope, no reason and no one was cracking the impenetrable shell I was holed up in.
I remember sitting on the sofa with my sister and feeling agitation. The normal process was agitation, fear, surges of energy and the inexplicable explosion to hurt myself. I grabbed a hair brush with fine metal spikes and self-harmed all down my arm. I am gutted that I look down at my forearm and it will forever be scarred. But I couldn’t stop. My brain and body was completely taken over.
Self-harm is a very difficult, emotive and misunderstood subject. Often people judge with thoughts such as, ‘Oh my God, how can anyone do that to themselves?’ But it must be remembered that it is often a chemical surge where there is no rationality. Pain blanks a fearful, overactive brain and the release is indisputable.
It’s important, however, to learn safe self-harm strategies, which include pinging elastic bands on the wrist or rubbing ice on the skin (being careful not to burn). Sometimes it is recommended to use red food dye in ice cubes if there is a need to see blood. For an excellent support guide on self-harm see this article. I’ve written about self-harm before, too.
We Do Recover
Crises are terrible things and those struggling often lose the ability to cope. We rely on friends, family and health professionals to intervene and help us. Every time someone receives acute treatment (often involving medication) we are given a chance to recover and live as the people we want to be.
I did recover from my crisis but it involved inpatient treatment for three weeks and a strong network of outpatient support afterwards. My symptoms were conducive with a mixed episode where you feel symptoms of depression whilst experiencing the agitation, impulsivity and irritability of mania. It’s a high-risk place to be because you have the energy to act out your disturbing thoughts.
It can feel impossible to find hope in situations such as these, which highlights the importance of those around you being able to recognize that we are in extreme distress and understanding that ultimately, we need help.
Recognizing a crisis and intervening with care and sensitivity saves lives.
1-800-334-HELP – 24-hour crisis hotline in the U.S.A.
1-800-273-TALK – 24-hour crisis hotline in the U.S.A.