I have experienced six psychoses in my thirty years of a bipolar life, each one different from the last and each with its own dominant theme. To my well self, these episodes can be shocking even when I can’t remember all the details, and making sense of them is quite hard. I’ve yet to meet a psychiatrist who is interested in them or what they might mean, yet to me – they are a locked door to my bipolar experience and I’m not altogether sure what that door may hide.
Understanding my psychosis
Someone once said to me, somewhat mockingly, “all bipolar people want to write about what’s happened to them, don’t they?” to which I say, thank goodness they do. How else to make sense and reconcile yourself to such an experience?
I am one of those story-writing people. In my search to understand what happened to me, what psychosis means and its causes, I looked around for other people’s descriptions of it as well as scientific texts and couldn’t find many so started to record my own.
What is it like?
Writing about what happened has been quite cathartic and was quite comical in places. I still smile thinking about that damp Sunday when I took up a seat in the lobby of a well-known and posh London hotel, dressed in a rainbow outfit, clutching a hessian holdall but with bare and dirty feet. When challenged, I concocted an unlikely cover story of waiting for an incognito celebrity before being asked to leave (politely and discreetly of course). I also tried, in vain, to empty Trafalgar Square of thousands of St Patrick’s Day revellers with a story echoing the nativity, where I instructed people they needed to return to the square later in the week for registration (like Mary and Joseph returning to Bethlehem for tax purposes) in the guise of saving the world ethnic group by ethnic group.
The benefits of mania
Once on the ward and recovering, it dawned on me how vulnerable I was that day. A middle-aged woman, somewhat dishevelled, in eccentric attire and with no shoes, wandering alone in central London streets babbling about underground liberation movements springing into action to save the world.
Previous episodes had also featured a messianic role for me and I remember talking to a nurse on the ward and explaining to her that the days that lead up to full blown psychosis can be exhilarating – extreme energy and sense of purpose that bring real results – if only I could bottle that. I also remember one of my past psychiatrists telling me that in evolutionary terms bipolar traits have survived in the human species because of their characteristics of quick thinking and ability to get things done. In that way we are useful to the tribe.
But the experience of psychosis sticks with you. How could something so incredible be so believable, if only for a matter of days? Why is it that the euphoria of thinking you can save the world can dissipate with a couple of tabs of Olanzapine? If chemicals can take these beliefs away, am I less of a person?
Sometimes I miss it.
Depressive psychosis
That said, I also know that it can do me harm when the delusions are darker, as when I thought children might be at risk and I could bring down a national institution with my whistleblower knowledge. On this occasion I referred myself to the psychiatric ward at my local hospital, so at some level at least I knew this time I was unwell. I took the bus, had a close shave with a tall, burly man and his mousey wife. I challenged them for getting on at the back door without showing a ticket. He grunted back in response and took a seat opposite me, glaring. That might not have turned out well, but I was oblivious to the possible danger. I ran from the bus stop up through the main lobby and back staircase to the ward (at that time on the 5th or 6th floor and not listed on the directory at the hospital entrance) I presented myself at the reception saying I needed help and was directed to a side room. Once there I made it clear I only wanted to talk to a female doctor. The nurse went away and I locked myself inside this waiting room. It took some time for a doctor (male) to return and he explained, through the window pane of the door, that a female doctor was not available. At this point my checklist of conspiracies kicked in, was he a mason or misogynist? After some reassurance I unlocked the door, had a longer interview and later in the day was admitted to the ward.
Self-management is key
I haven’t had a psychotic episode for more than a decade now and put it down to a modified lifestyle and paying attention to self-care and triggers. My main psychiatric therapy is gardening. It literally keeps me sane, a few hours a week weeding, pruning and tidying, paying attention to new growth, planting and moving plants for best effect – all this helps me focus in a mindful way on something else. Keeping an eye on the seasons, the light levels (my episodes tend to happen in spring and autumn around the time of the equinox, so I am vigilant at those times of the year) and the weather, all these keep me grounded.
Mental health support
As mentioned above, not many people have experienced psychosis and for reasons of stigma and taboo even fewer talk about it but if you want to offload any concerns you may have or learn more about how people come through it, head for one of the mental health forums online where you can meet other people affected by psychosis and share anonymously. Or join a support group which post pandemic, are gradually coming back.
The charity, Rethink Mental Illness, has information to support people with symptoms of psychosis.