Living with Bipolar Depression and Psychosis

by @bipolarnerdgirl

I’d had depression as far back as I could remember, and the only thing that had ever punctuated the darkness had been the odd extreme highs, paranoid episodes and obsessive thoughts. If I wasn’t drowning in an ocean of despair, I’d be tangled up in distress about intrusive thoughts which filled me with anxiety.

Thinking back, it’s actually surprising to me that I’d never self-harmed before now. Suicidal ideation was deeply familiar to me; I’d attempted several times unsuccessfully, which in its own way is a form of self-harm. I realise that now.

The stereotypical idea of a young person, probably a teenager, causing injury to themselves was what came to mind when I thought about self-harm, so I never thought of myself as part of that group. But I had caused myself harm in the past when I was in crisis, I just hadn’t recognised it.

I was now 37, diagnosed with Bipolar Affective Disorder and Generalised Anxiety Disorder, with a strong suspicion I also had a form of OCD. A familiar path to crisis was opening up and I felt worse day by day. Depression was taking over my whole being and any minor stressor was like an additional weight around my ankles, speeding my journey into the darkest depths where no light could reach. As I started my journey home that day, a thought entered my mind that I needed to harm myself when I was alone.

The first self-harm experience

Being so deep in crisis already, I felt numb and there was no-one left in my mind to defend against these thoughts, no infantry there to fight back and challenge whatever my Bipolar voices whispered into my psyche. Even if it hurt me. My head was a void and I was merely an observer, powerless against the condition that had taken over now. Psychosis had twisted and blotted my reality with blank ink, changing my perceptions and obscuring truths to suit its plan, whatever that was.

As I got home, I still had a razor-like focus on the plan to harm. The thing was, I’d never done this before so directly. I’d never purposefully taken an object and caused physical harm to myself and I’m not sure what the driving force was. All I can say is, it didn’t feel a part of me, I simply felt as if I was doing what I was being led to do.

Initially I did try to shake the thought for a moment; I physically shook my head, trying to almost dislodge the directions by banging my head against the wall over and over until I felt dizzy. It didn’t work. I sat on the kitchen floor and drew blood several times, the slow streams of blood mirroring the silent and empty tears that ran emotionlessly down my cheeks.

Several days after this episode, my therapist asked about how I felt at the time. What had I been thinking, what had I wanted to achieve by doing it?

I didn’t have an answer. Afterwards I tried to find understanding…maybe it was to test if I could still feel, perhaps I figured I could “release” the darkness like a 16th century physician rebalancing my humors.

I did have to admit, however, that I did feel a sense of relief from the act. Again, I couldn’t express why, and I certainly felt guilt after I’d calmed down and cleaned myself up as I knew I’d have to explain to my partner what I’d done, but I wouldn’t lie and say it hadn’t helped in the moment. Seeing how upset those around me were by my actions, I did promise to try my best to avoid harming myself again this way, but I had to ensure I had something in place should the urge come.

The aftermath of the episode

My arm wasn’t badly injured and healed up after a few weeks with virtually no signs of the cuts, and the bruising to my eye sockets had all but vanished within the same time. The urge to harm myself hadn’t been back again since and having talked it through with my therapist, I created a list of soothing techniques which I printed out and stuck to the fridge. I could use the list to choose a distraction if I felt I may end up in the same situation, and for a few weeks it helped.

Distractions can only work if you catch it early enough though. Sometimes, if I’m quick enough, I may be able to move my thoughts away from harm, but on occasions my Bipolar episodes can consume so rapidly and stealthily that I can be completely beyond these early interventions. This is where I knew I had to try and focus and practice.

During a session with my therapist, I had been told that some patients continued to self-harm as a way of coping and she offered advice on how to do so safely. I respected this approach, and was grateful for the information should it ever happen again, but I wanted to try and find other coping mechanisms.

I’d told a couple of close friends about the episode; one was very supportive, the other practically ghosted me after I disclosed what I’d done. This made me feel even more guilty at the time, as if I was something dangerous that people should avoid. I realised afterwards that actually, I was simply struggling and being honest about it wasn’t a bad thing.

Speaking openly about experiences is hugely important, whether they’re regular struggles or new symptoms, because we need to help shatter the stigma around self-harm and mental illness in general. It’s important to shift the assumptions even I was guilty of around who typically self-harms, and the fact that it can start at any age and for a whole range of reasons. Whatever the reason is, it’s valid and we shouldn’t shy away from sharing and certainly shouldn’t shame sufferers for being open about it.