1.2.1 Episode I

I’ve gone through two full blown manic episodes in my life so far. Mania is the most intense and destructive human experience. I’ve seen a lot of people wondering what the difference is between a hypomanic state and a full blown mania. It is very simple if you consider the environment rather than the bipolar patient per se. In both cases you are euphoric. In the hypomanic case you can live an almost normal life from the perspective of society whereas in the manic state, you’re sent to the nearest psychiatric hospital. When you think of it, it is not the patient who decides to be hypomanic or manic, it is society. Nothing is black or white in this thought but one needs to bear in mind that, all in all, the difference is a mix between patient state and the rules of society or more generally speaking, the environment.

My first manic episode was the strongest one ever. Studies suggest that there is a triggering event to the mood swing. A summer morning of 1994, I woke up completely paralyzed. I could see but all my muscles were numb. It was not something psychological, it was physical. My body would not respond to my brain command. Moreover I could barely breathe. This lasted maybe only ten seconds but it was enough to trigger a huge fear. I called the emergency service, they sent an ambulance and I was taken care of at the hospital. I did not know that it would not be the last time in hospital in this year 1994. Long after this trauma, in 2010, I understood the cause of my triggering event thanks to the internet. It was in fact a so called hypnopompic state which is as impressive as it is harmless.

Source : wikipedia, sleeping paralysis
The disorder known as sleeping paralysis can be experienced both at sleep onset (hypnagogic sate) and at wake up (hypnopompic state). The person wakes up completely immobilized and cannot breathe deeply. Only the eye lid can move. Sleeping paralysis is often accompanied by delusions, which makes it particularly frightening for the patient. Sleeping paralysis lasts from several seconds up to 10 minutes. The patient recover spontaneously back to his normal state.

I never really recovered and began a manic episode. The mood went up progressively and I ended up being really high. It went to such an extent that I attempted to commit suicide. I told my mother that I was god. Manic are not made of excess in modesty. Fortunately, this episode occurred when I was a student. Therefore a lot of social damages were avoided. I ended up being sent to the psychiatric hospital against my elevated will.

Source : Charcot Psychiatric Institution (Plaisir Grignon, France)
EPS Charcot – Pavillon jaune
Nom : XXXXXX Date of arrival  : XX.XX.1994
First name : XXXXXX Departure date : XX.XX.1994
Birthday : XX.XX.XXXX
Address & tel : XXXXXXXXXXXXX
– First manic episode of a young man. 22 years old. Student…
– This episode occurs after significant phases of overwork: 3 summers were dedicated to finance the purchase of a motorcycle, 2 months internship in a company
– Energetic temperament, strong will. He denies his own weakness.
– He downplays the events and their consequences. He asserts that he feels stronger and he has made his decision.
– Family: X children, he’s the youngest one.
– I let him go given the quick psychiatric recovery obtained under treatment (Loxapac) and he strongly insists to go. He wants to resume immediately his studies. As far as I’m concern I recommend a one year break.
Treatment:
– Loxapac…………..100 drops in the evening (neuroleptic)
– Tercian 100……….1/2 pill before sleep (neuroleptic)
– Athymil 30………..1 pill before sleep (antidepressant)
– Sulfarlem………….2 pills once a day (meant to alleviate dry mouth syndrome due to neuroleptic)

A few remarks can be stated about this exit report delivered by the hospital. The description of my temperament strongly looks like manic symptom (energetic, strong will, denial of any weakness). Whenever I read it now, I always draw the same conclusion: I was released from the hospital way too early. It is obvious that I did not come down but I did sufficiently to be declared psychiatrically “solved” as they say in France. Moreover, I would have done anything to get out of this hospital. It was really foolish from my side so much so I returned to the dreaded institution:

Source: Charcot Psychiatric Institution (Plaisir Grignon, France)
EPS Charcot – Pavillon jaune
Nom : XXXXXX Date of arrival  : XX.XX.1994
First name : XXXXXX Departure date : XX.XX.1994
Birthday : XX.XX.XXXX
Address & tel : XXXXXXXXXXXXX
– Anxiety driven relapse which translated into extrapyramidal contracture. He requested another hospitalization
– Symptoms have disappeared under appropriate treatment
– I could discuss with him
– his propensity to use is body as a mental short-cut of his affective suffering
– his temerity to believe he has recovered
Treatment:
– Loxapac…………..50 drops in the evening (neuroleptic)
– Tercian 100……….1/2 pill before sleep (neuroleptic)
– Athymil 30………..1 pill before sleep (antidepressant)
– Sulfarlem………….2 pills once a day (meant to alleviate dry mouth syndrome due to neuroleptic)
– Lepticur……………1 pill in the morning (meant to get rid of the contractures)

Sometimes I wonder how my life would look like today if I had been diagnosed bipolar at that time. It seems that this illness was not considered at all. Indeed, there was no mention of a mood stabilizer in the drug list. It seems that, in 1994, nobody knew that the likelihood of having subsequent episodes was 90%. On the contrary, I was prescribed antidepressant which I find retrospectively peculiar in a manic state treatment. The pdoc was extremely influenced by Freud. I was recommended a book list which had nothing to do with bipolar disorder. As a psychoeducation I was recommended a reading list containing symbolic fairy tale which I could not relate to. Welcome to the marvelous world of Freud confusion! I did not read these books. Neither did I take the one year break. All in all, life as usual resumed and I would not know the looming Damocles sword over my head. All that remained from this manic episode was this sharp and guilty ignorance which illustrates the difficulty to spot bipolar disorder which can be left undiagnosed for an average period of 10 years in France. After my episode, I did not fall into depression. Fortunately I’m rarely extremely depressed. So it was time to think about the episode in itself. This thinking has never stopped. There is one thing that can be said and fall immediately into oblivion: the manic behavior. It doesn’t deserve to be thought. However I can list them in order to illustrate how it feels to be manic.

  • I drove to a big TV network headquarter. I firmly intended to talk to the president of France. I see myself pushing a glass door and then, the dumbfounded eyes of the security guard are my only recollection.
  • I walked 20 miles. I thought I would be able to travel on foot. After 20 miles I changed my mind (not that crazy) and hitch hiked my way back home. The driver talked to me in a way that made me think he was sure that I was a drug addict. Something with my eyes, I guess.
  • I attempted to commit suicide by swallowing a whole pack of downers. I was not desperate. I found it funny to die and to see what’s next. I was imposed a stomach wash-out. It was worse than death, I can assure you. I believe my attempt was the trigger of the legal process leading to the psychiatric hospital. In France your parent or your relatives can request this confinement. I don’t blame them. On the contrary I thank them. My behavior had become uncontrollable.
  • My head was stuffed with grandeur thoughts. I thought I could take off with my car. I was expected by all powerful men on earth. However these thought were never expressed. They remained within my head because some rest of rational grip thought they were crazy.
  • All what happened to me was filtered through a bible prism. For example, just before I entered the room where I underwent a stomach wash-out, I thought “Armageddon”. I was not that far from truth!

That was it for the manic pranks. They are not the main subject of this blog; they are of little interest as regard to the main topic I want to tackle. However this illustrates my capacity as a bipolar to distinguish what’s real and what’s utter craziness when I come down. Some other things happened which do have a major interest, they are vivid in my memory like these event awaiting light to be shed on them. Patience, I need some articles to explain them.

Dead Kennedys / life sentence
You’re a chained-up dog fenced in a yard
Don’t see much, you can’t go far
Pace and froth, you’re getting sick
Run too fast and it’ll snap your neck
You say you’ll break out
But you never do
You’re just another ant in the hill
That’s your Life Sentence

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