This really can't be as good as it gets

It's early - 6am - as I write this. I didn't sleep well and I've been up since 5. I've broken down sobbing once already, something I haven't done in probably 3 weeks. I don't know where I'm going with this post, I'm not sure what I'm going to get out.

Maybe some background:

It's been 2 weeks since my last ECT treatment (I go again on the 19th). The first couple of days after I felt pretty good, pretty "normal" (whatever that is). Then on Thursday the 8th I was manic. I started out hypomanic and was very giggly, fidgety, anxious, distractible, in therapy. But Thursday night . . . that's a whole other story. Hubs was very scared and was very close to taking me to the hospital. I was manic, plain and simple. He was texting my 2 best friends, asking what to do. Now, sadly, I don't have any more Xanax or Ativan that I can take to calm me down (I threw it all out 6 or 9 months ago as it was all at least a year past the expiration date). Hubs offered me Benadryl. Unbeknownst to him, I took an extra Seroquel (sorry I didn't tell you - I was kind of ashamed). It knocked me down enough that I could kind of sleep.

I remained hypomanic Friday through Monday, but it moved away from euphoria (I was crazy fucking euphoric that Thursday), and into the irritable kind. What does that look like? Racing thoughts, anxiety, panic attacks, hyper-irritability (I become a raging fucking bitch in seconds flat for no reason), and insomnia. Sounds fun, right?

Then Tuesday morning (this past Tuesday, 4 days ago) I woke up and I just knew. I knew my mood had shifted. The cloud of depression was over me again. I felt the familiar despair and hopelessness, but it was coupled with irritable hypomania. A mixed episode. Oh goody.

Mixed episodes are NOT fun. At all. They're also considered the most dangerous state to be in. Why? You have the depression, despair, and hopelessness coupled with impulsiveness. Not a good combo. Luckily, all I've done is cut.

I had therapy again this past Thursday (2 days ago) and M didn't even have to say a word to me to know something was very wrong. He made it abundantly clear that I need to talk to Dr. M about all of this when I see him for ECT on Monday.

But that terrifies me.

I mean, I know I need to let my psychiatrist know that hey: I spent a week hypomanic with a very scary-but-thankfully-short-lived manic day and now I have feelings of depression again. Of course he needs to know that. But what scares me is what he might say . . .

See, I'm worried that this is my new norm. That this is as good as it gets for me. I'm worried that Dr. M is going to tell me that I need more therapy, I need more DBT to learn how to better manage my moods. That there's nothing more he can do.

That really. Fucking. Terrifies me.

Because here's the thing: I am definitely way better than I was before starting ECT. I feel an improvement. People have pointed out that I seem better. I know it's helping. I don't want him to look at my symptoms and say, "well, it's obvious the ECT isn't helping, so we might as well stop." If it wasn't helping, like I know it is, I would be dead right now. That's the truth. It's a fucking shitty truth, but it's the truth. That's how I know it's helping. I'M FUCKING ALIVE, PEOPLE.

And here's the thing with therapy - I'm really kind of an expert now at using CBT and DBT techniques to help manage my mood. How do I know? I haven't been hospitalized in over a year. I'm functioning better than I was a year ago. Two years ago. Three years ago. And people have commented to this. I feel like I'm better in control. My fucking therapist has told me he sees a huge improvement in me.

I'M DOING EVERYTHING RIGHT.

I really, actually am.

And I'm so scared that I'm going to talk to Dr. M on Monday and he's going to wash his hands of me and I'm going to be left scrambling.

So then I overthink things and I think, wait - what if this is as good as it gets for me. That my stupid fucking bipolar truly is this difficult to manage and I need to work on accepting this so I can move on and learn to even better manage my symptoms. . .

But I don't want to settle. What if I give in and accept this as my lot in life when I could truly be doing so much better? I had a little over a week where I was enjoying myself. Where I felt happy. And I think I deserve to feel happy. I deserve more than just trying to make it through the day.

I really, truly, fucking hate bipolar disorder.

Yesterday I was mostly okay. Kind of.

I tend to overthink things, and not just big things - everything.  I overthink all the things. Sometimes this is good. Mostly, it's bad.

Yesterday I was overthinking things. About my mood swings. You know what? It would probably be helpful to tell you about my day to lend context to what I was overthinking. Maybe.

But that's what I'm going to do, so you'll just have to deal with it.

I worked yesterday, in trans (meaning in the transition nursery, where I attend deliveries and care for the newborns). I woke up feeling mostly okay. Not great, but okay. My jaw locked first thing in the morning - like at 7am (I have lock jaw from an old karate injury from high school and it's been flaring up bad lately I think from ECT - bite block and tense, tight muscles during seizures probably not good for my jaw). Luckily I was able to relax the muscles and get my jaw to open before my first delivery (at 9:30). Not that I needed to to do a delivery, but it's much comfortable when you're able to actually open your mouth to talk.

So mom smokes pot (legal in Colorado for adults over 21 - not legal for an infant to be exposed. DHS gets involved, baby gets drug tested through the umbilical cord and urine). Pot crosses into breast milk and we encourage these moms to either quit smoking pot, or to not breastfeed. But we can't stop them from breastfeeding. We give them the education and they make their own choice. I was informing mom of this when grandma starts going off on me. Yelling, rude, obnoxious. I managed to stay professional. Now, she wasn't going off because her daughter smoked pot - she was going off because how dare I imply that smoking pot could be bad and maybe I should smoke a bowl because I'm way too fucking uptight.

I did my teaching and left. Vented in the nurses station. But I noticed something: an exaggerated emotional response brewing. I had gotten angry and frustrated, I vented (and cussed), and that should have been the end. But oh no, not for my brain. No. I felt completely overwhelmed, anxious, angry, and as if I was going to completely lose my shit and break down sobbing uncontrollably. I felt despair taking over. I wanted to curl in a ball and hide away from everything. This is not okay. I argued with my mind, with my thoughts, reoriented and centered myself, used all my little CBT and DBT tricks that I know, did everything in my power to be okay. And after about an hour of wrestling with my thoughts and my feelings I was approaching mostly okay again.

I ate my breakfast with B (charge nurse), talked, tried to joke. And it was okay. I was okay again.

Until I wasn't.

My next episode came out of nowhere for no reason. I was chatting with the L&D nurses (trying to be normal over here . . .) and then WHAM! Despair, hopelessness, on the verge of breaking down sobbing. I have no idea why. I got up and went to the locker room to be alone. I fought my thoughts, countered them, constantly, over and over. No, you don't want to die. You aren't going to cut - no, not even a little. You're not stupid or fat - you've lost weight! NO! You're not taking all of your pills tonight - you want to LIVE. Everyone isn't out to get you. They care about you. Stop this ridiculous thinking. You can get past this. You have before, you will again. Over and over and over. Reorient myself (you're at work in the locker room. You're sitting on the bench. Take some deep breaths. That's it. In . . . out. You're wearing your new shoes and fun new socks - taco dinosaurs for fucks sake! You want to live and your going to live. Just breathe . . .).

After about 30 minutes I felt okay enough to leave the locker room. I didn't feel mostly okay yet - but I felt like I didn't have to hide. I chatted with our CNAs, trying to interact, not withdraw, appear/be normal, joke, everything's fine here people. And it was again, for a little bit.

Until it wasn't.

A little before lunch (like 1pm or so) I was blindsided by overwhelming despair. I felt exhausted, like I couldn't possibly keep going. It was bad. I needed 2 things - a hug and a nap. But I'm at work. I can't nap. I can get a hug though. From B (we're friends). I start walking over to post partum to awkwardly ask for a hug but I never made it. No, I had to pop into an empty patient room to sob uncontrollably for 10 or more minutes. And then I stayed hiding in there for awhile - I'm not even sure how long. I calmed myself, reoriented, centered, wrestled with my thoughts and emotions. When I left that room I wasn't mostly okay. I'm not sure I was even slightly okay. But I was functional and I could put on my mask.

And this is how the rest of my day went. Over and over I had to struggle against my mind, bring myself back to reality, fight against my thoughts and emotions. And this got me thinking - what if these types of mood swings aren't related to bipolar disorder? What if something else is going on?

What popped into my head was borderline personality disorder - which is characterized by intense mood swing lasting hours to days. So I started reading about it, comparing what I read to my life, overanalyzing/overthinking. I certainly match some of the diagnostic criteria. But other stuff? Not so much. But still I kept thinking about it and thinking about it. I had J read the diagnostic criteria when I got home to see what he thought. He said no. And what would it matter anyway? The only real treatment is therapy, which I've already been doing for 4 years.

But why then? Why were my moods so labile? Why did I get so bad so fast? And why was I (mostly) able to get a little better?

Well, in a word I think, I'm bipolar. And regardless of what the DSM would have you believe, people with bipolar disorder can and do have mood swings that occur this rapidly. It can happen the other way too, with mania, and it has with me.

As to why I was able to mostly be okay? I'm trying insanely fucking hard to counter my errors of thinking. I'm trying insanely fucking hard to be okay. I'm actively using everything I've learned in 4 years of therapy - both CBT and DBT. I'm doing everything I fucking can to battle this illness and take back my life.

You know what? I'm not entirely sure I made any sort of point with this post. And I don't really care.