Abilify, Not I : Adventures in Antipsychotics

Lately, I have written a series of posts over the last two months describing certain troublesome symptoms I associated with the worsening of Bipolar Disorder, or the potential for comorbid disorders.

In my last post, When Medications Go Wrong, I briefly wrote about my recent discontiuation of the pharmocological treatment using Abilify as part of my medication regimen:

Recently, I stopped my Abilify.  Admittedly, it was because I noticed an interaction between the Abilify and my weekend consumption of alcohol.  I started to find that I would fall asleep soon after taking it on Friday’s while we drank.  I decided that I would just stop over the weekend, and continue during the weekdays as normal.  But, eventually, I just forgot to take it at all.  And soon, I started to notice an improvement in my worsening condition.

I went on to describe some of the awful side effects I was experiencing as a result.  However, the list was truncated for the sake of keeping word count down.  The description is rather limited in terms of accurately depicting exactly what I was subject to.

• Cognition Disturbances and Memory Fragmenting.  Originally, I wrongfully blamed Lamictal in Vitamin L : Medication Adventures for my aphasia-like symptoms.  The disturbances felt like aphasia.  At first, it was almost indescernable.  I started word dropping again, meaning I would be reaching for a word, but was unable to grasp it.  Instead, I would be able to get to every synonym around it, however, those words did not fit the exact context.  Eventually, it became a more severe form of word dropping, and I found myself dropping sentences entirely at the loss of any word or synonyms around it.  It progressed into entirely dropping conversations at the loss of a sentence.  Then, I found myself

  I started forgetting things again.  These were simple things, like losing my purse or shoes in the house.  It seemed like just a simple case of forgetfulness, maybe stress related.

• Emotional Blunting and Partial Flattening.  I had never had too much trouble with emotional blunting in the past.  While I’ve found myself in times where it was difficult to express my emotions, this didn’t indicate a lack of emotional response.  I describe it as a partial emotional flattening, because it wasn’t an entire lack of reactivity.  It felt like my spectrum of emotions had been significantly reduced, although not completely removed.  There was a certain inaccessibility to certain strong emotions.  Rather than completely removing extreme emotions, it threw a wet blanket on top of them, leaving them to bubble under the surface.  So, the emotions still existed, but were muted and unable to be adequately expressed.

  At it’s worst, I began to lose most feeling entirely, with the exception of irritation and the sensation of boredom and fatigue.  I began to lose love and my attachments to meaningful people and my relationships with them.

• Dissociation.  I touched on a summary of the dissociative symptoms that Abilify had brought on.  I have been writing articles on the experience throughout the last few months on the subject, describing the feeling in great detail, but remained unable to exactly identify is appropriately.  The dissociation probably occurred as a response to the prior bullet points.

  The dissociation cited was experienced as a removal of self and removal from my own life.  I had felt as if I had been separated from myself and my world.  It was a feeling of something being stolen from me, or something fundamentally inaccessible.  Like, I was being locked out of my own life, or becoming transparent and just fading away.

• Worsening of Depressive States.   This is probably a direct result of the first three bullet points.  I started to disengage from my life.  I lost interest in just about everything.  Most things were considered to be either boring or tedious.  Important things started to lose meaning.  This was experienced as a part of the emotional flattening, but it caused a concerning and distressful reaction.
• Exacerbation of Social Anxiety.  Since I had lost the ability to carry on a conversation and found myself completely disinterested in socialization, my social anxiety went through the roof.  I simply didn’t care about anything anymore, especially trivial things I used to find interest in.  Therefore, I found it difficult to carry on a conversation.  This caused extreme distress in social situations, and encouraged further isolation.
• Disturbed Sugar Levels.  While I have no concrete proof in terms of tests, certain symptoms have come to my attention.  They are notated below in the next two bullet points as thirst and weight gain.
• Loss of Sensation of Bodily Hunger, Thirst, and Fullness.  Within the last few years, I started to become more in tune with my body.  I was able to feel the sensations of hunger through my sugar level, which probably caused the loss of bodily hunger.  The disturbed sugar levels probably also caused an extreme thirst that could not be quenched.  At first, I craved water.  Eventually, I started to put the soda back down, which probably caused part of the weight gain mentioned below.  And I felt an extreme pressure in my stomach, which was also exacerbated by the influx of so much fluid.
• Extreme Weight Gain.  Truthfully, I don’t dare get on a scale at the moment, so I am unable to notate at this time exactly how much weight I’ve gained.  By the fit of my clothing, I will estimate that I have gained somewhere between ten and fifteen pounds in the last three months.  That is a substantial gain for me, especially since I was losing weight prior to the start of this medication.
• Exacerbation of Eating Related Problems.  By all definitions, it’s completely possible that I am living with an undiagnosed eating disorder.  However, I am not entirely convinced, since it isn’t an ongoing and prevalent problem.  Therefore, I define it as eating related problems and difficulties.

  The concern for weight gain and the sensation of fullness caused a very terrible reaction of binging and purging.  I was unable to control my eating, as notated above, therefore the sensation of extreme fullness would cause me to perceive the overeating as worse than it actually was.  Unfortunately, this led to a very vicious cycle and encouraged further weight gain.

• Disturbed REM Sleep.  I was waking up tired, and noticed that it felt like I had stopped dreaming.  This caused my mental state to take a considerable dive.  It caused extreme fatigue and excessive, unproductive sleeping.

While I am cleared of most dissociative symptoms, emotional flattening, and my depressive state is lifting a little, some side effects have remained.

• Cognitive Disturbances.   The aphasia-like symptoms remain, but to a lesser degree.  I am back to just being a little forgetful, and have some minor word dropping.
• Memory Fragmenting.   Some of my memories remain dull, but seem to be returning.  However, most of the last three months remains inaccessible.  It may never become accessible, due to the disruption in the formation of short-term memory.
• Disturbed Sugar Levels.   I am still thirsty, but I am no longer engaging in carbohydrate seeking consumption behavior.  I figure it will take awhile before my sugar is regulated properly again.
• Weight.   Thankfully, my weight does seem to be coming down.  I have only been completely off of the medication for less than a week, and my clothes are already fitting better.  I’m going to assume that in addition to the weight gain, I was retaining water and constipation.  My regularity has come back, and I don’t feel as puffy as I did

Unfortunately, I am experiencing a return of some of my milder psychotic symptoms.  In Imaginary Enemies, I described a cognitive disturbance I described as “The Voice”.  “The Voice” can be characterized as a singular persona, as I wrote about in Conscious, Subconscious, and Extraconscious, where I described a theory of a third consciousness that exists between the subconscious and the conscious mind.

The Extraconscious is postulated as where the persona(s) reside, laying in semi-dormant waiting, perfectly aware of the current reality that is being experienced.  “The Voice”, in more severe psychotic states, can be experienced as a separate entity entirely, detached from the consciousness.  That is the defining line between a cognitive distortion and an auditory hallucination, when a persona detaches itself from the extraconscious as an external sensation.

As an extraconscious persona, “The Voice” can best be defined as a quasipersona, lying somewhere between Dissociative Identity Disorder and psychosis.  It is experienced as a semi-active part of the conscious mind, as the dominant persona is well aware of it’s existence and there is a certain interaction that occurs between the dominant persona and “The Voice”.

That is the best theory I can offer as to the existence and function of the quasipersona, known to me as “The Voice”.

The mild auditory hallucinations and visual hallucinations have returned, probably defined better as a sensory disturbance, rather than a symptom of psychosis.  When experiencing a sensory disturbance, it’s not full on hallucinations as described in the definition of psychosis.  There are not entities separate from the body.  They are recognized as a disturbance in the current reality, distorting shapes, colors, and contrast in the vision.  In the hearing, it is experienced as a distortion in sound, causing sounds to be sharper, duller, muffled, or louder than they actually are.  It can only be sensed by a sudden shift in perception.

So, instead of hearing things at a normal sound level, the sound volume may increase to deafening levels or may become muted and difficult to discern from nonexistent static that occurs in the mind.  My visual disturbances may be perceived as viewing the world in high contrast, extremely bright colors, and / or extra high definition resolution.  Or, they may be seen as duller than usual, muting colors, distorting shapes, and / or clouding the vision with that appearance of a veil or foggy goggles.

Intrusive thoughts have returned, but not with the same extreme nature as experienced several months ago.  In truth, they were never completely removed by the Abilify, and at some points were made worse by the drug.  Instead of experiencing them as a truth in reality, I am now able to separate them using logic.  I can talk myself off of the ledge and separate them from the reality of a situation using DBT techniques of mindfulness and distress tolerance.  Prior to the cessation of Abilify, I was unable to utilize those techniques.

I don’t mean to put anybody off of treatment with psychiatric medications, but I felt this was important to document and have as a resource on the internet for anyone who is thinking about taking the drug.  Some of these side effects aren’t listed in the pamphlet, as they are probably isolated to a condition.  But, I feel they are still a distinct possibility for anyone who is being treated for similar conditions.  It is vital that this information be notated and readily available for medication education purposes.  This information probably should not be generalized to all psychiatric medications, especially in the class of antipsychotics.

 

The Friday Confessional : Baby Weight

TRIGGER WARNING : This post contains material that may be a potential trigger for some.  It’s contents include talk of eating disorders and self-injury.  If you are sensitive to this material, please use your discretion before reading.

I am by no means a thin woman.  As a matter of fact, according to my BMI, I am actually slightly in the overweight range.  It’s not really unusual for a person who lives in the good ol’ US-of-A.  Obesity is considered an epidemic in this region of the world.

I have bad body image.  This started as a very young child when the other kids would pick on me for being overweight.  At that point, it wasn’t my fault.  I wasn’t responsible for my diet, and my family had terrible eating habits.  In fact, as I started to notice while my parents were watching my child, they encouraged recreational eating for lack of other engaging activities.  As a result, I ended up a fat, miserable kid.

I remember I stopped eating my lunch at one point.  A lunch aid came over and asked what was wrong.  I recall telling her, “I’m on a diet.”  She looked shocked and appalled.  Now that I’m an adult, it’s completely understandable.  I was eight, and I was confessing that I was unhappy because of my weight.  To her credit, she attempted to explain to me that I had a lot of years to grow into the weight, and it was unhealthy to deprive myself of food.

Essentially, she was trying to talk me out of developing an eating disorder.  Unfortunately, talk is too cheap when you’re eight.

Eventually, people close to me stopped mentioning my weight.  And I continued to grow.  By the time I was in the fifth grade, I was obese.  I was eleven, 4’8”, and weighed approximately what a fourteen year-old 5’1” teenager should have weight in a healthy weight range.  My clothes continued to shrink rapidly, and the only excuse my mother could come up with was that I was just “having a growth spurt”.

It wasn’t lost on my peers or teachers, though.  While I had the brains, I didn’t have the body.  And the outside was all that mattered.  Summer break came, and I was about to enter middle school.  It was at that time that I decided that I would shed my “baby weight”, as people were so eager to call it, and become a slender woman.

That was the summer where it all began.

The real secret is something I’ve hinted at throughout the last year, but could never bring myself to actually come out and say.  Even now, I find myself typing and retyping the sentence that will start to change everything.  It will change how people think of me, and how people treat me.  It will have people worry and watch me like a hawk.  And those are all things that I’ve tried to avoid over the years.

I have undiagnosed disordered eating.

As a child, it developed from recreational eating into comfort eating.  I would gorge myself far beyond bursting, to the point of where it felt like the contents of my stomach were backing up into my throat.  The act of eating was comforting and satisfying.  The sensation of fullness seemed to fill this hole inside of me.  It took away the emptiness that I had tried so hard to fill with accomplishment.  Even for a moment, I was full.  I was whole.

That led to another problem.  Childhood obesity.  And the lack of friends I had resulting from my obesity and the intimidation of my perfectionism and accomplishment created an even bigger hole.  What started out as a small snag in the woven fabric of my life started to unravel into a gaping hole, threatening to tear seam to seam.  Comfort eating turned into binge eating and created a cycle that continually fed into itself.

The summer before middle school, I decided to start dieting.  How absurd – an eleven year old on a diet.  I restricted my food intake to half of what I was eating.  I refused to eat between meals.  I started both biking and running once a day for at least an hour.  When my clothes started to become loose, it only served to encourage all of these behaviors.

I was a child on a mission.  I started only eating half of what I was eating, leaving me eating meals off of saucers.  I added running stairs onto my exercise regimen.  I would spend a half an hour each day running the basement stairs, as to not bother my parents.  My clothes became so loose that I became reduced to wearing my 90lb mother’s clothes.

I had done it.  In fact, I had done so well that most of my peers didn’t recognize me anymore.  Many people started referring to me as “the new girl”, as I didn’t have any friends to correct them.  And much to my surprise, those shallow little girls I had come to despise welcomed me to their clicks with open arms.  I was no longer intimidating or disgusting.

Throughout the years, my weight bounced up and down.  I would binge and then go on an exercise craze.  In my mid-teens, I discovered those ephedra pills that could be found at any gas station.  Friends and I would take handfuls of them and stay up, bouncing off of the walls, for 72 hours at a time.  I remember lying in bed just vibrating, desperately mentally exhausted, but completely wired.

My relationship with my first love, my high school sweetheart, started going south around the time that I was seventeen.  And the binging started once again.  I hated myself for it, and I watched myself grow out of my clothes once again.  I knew he had to have found me repulsive, and I knew he was eyeing other women.  But, it only served to make it worse.

I will never forget this.  I had my eighteenth birthday at my boyfriend’s place.  I was surrounded by many of my friends, and we ordered several pizzas that I paid for.  I watched all of the girls daintily eat one or two slices of pizza, when I realized that I had gorged myself on four.  I looked at their slender bodies with envy.  What a disgusting pig I am!  I thought.  No wonder I’m so fat!

I went to the bathroom and locked the door.  I leaned over and stared into the bowl.  I was about to do something that we all had accused and ridiculed thin cheerleaders for.  It was this, or being doomed to a life of obesity and loneliness.  I extended my index finger and pressed down on the back of my tongue.

The vomit came pouring out like a fountain into the bowl.  The taste was awful, like orange juice mixed with something foul.  But, the sensation was incredible.  I could feel the load lightening, and my stomach shrinking.  I did it again, this time making myself gag harder, almost to the point where I made an audible noise.  It felt like all of the awful feelings were just pouring out from inside of me.  It was almost like cutting, but without any noticeable tell-tale scars.

I purged until there was nothing left but stomach acid.  I sat against the door, breathing heavily and relishing in the hollow feeling in my belly.  There was something so beautiful about feeling that emptiness.  It ached, along with my raw throat, and the bitter aftertaste of vomit in my mouth.

This doesn’t happen regularly.  It only happens when I have a severely awful body image.  My clothes start to get tight, and automatically, my stomach starts to churn, as if it knows what’s about to come.  If I’ve eaten just before a fight with someone, I find myself getting queasy and running for a bathroom.  If I am rejected, I automatically assume it’s because I’m not attractive.  I find myself hell bent on getting back a body I once had.

But even worse is when I do it as a form of self-injury and control.  I binge, feeling the sensation of my belly swelling with all of the emotion I can’t experience.  The contents rise into my throat, without a place left to go.  I excuse myself and wrap myself in an awful embrace with that cold, unforgiving porcelain.  For a moment, just a brief shining moment, I stare into the bowl, trying to talk myself out of it.  There’s no other way.  I lean in, and the deed is done.

And each time, the whooshing of the flush brings shame to my already teary eyes.  I stare at the bloodshot eyes, ringed with raccoon eyes.  My face is red and looks exhausted.  All I can do is take to cleaning up the mess I created.

BPD and Me

A post by Angel, concerning Avoidant Personality Disorder, had me thinking again about the possibility of me having Borderline Personality Disorder.  This is a suspicion that has plagued me throughout the course of my treatment within the last year or so.  Instead of going straight to the Borderline Screenings, I went to a personality disorder screening to see the possibilities of what I may be dealing with.

Disorder	Rating
Paranoid Personality Disorder:	High
Schizoid Personality Disorder:	Low
Schizotypal Personality Disorder:	Moderate
Antisocial Personality Disorder:	Low
Borderline Personality Disorder:	Very High
Histrionic Personality Disorder:	High
Narcissistic Personality Disorder:	High
Avoidant Personality Disorder:	High
Dependent Personality Disorder:	High
Obsessive-Compulsive Disorder:	High
— Take the Personality Disorder Test — — Personality Disorder Info —

I really never imagined that I would be symptomatic of multiple disorders in Axis II.  Since BPD still remained the highest, I decided to take a specific screening.

Results of Your
Borderline Personality Test

You scored a total of 43.
Severe Borderline Personality Disorder Likely
You answered this self-report test in a way that’s consistent with people who have been diagnosed with severe Borderline Personality Disorder. This suggests that these concerns may be an issue for you as well, and something that you should seek out further assistance with this issue from a trained mental health professional immediately. Borderline Personality Disorder is characterized by a pattern of unstable and intense relationships, as well as frantic efforts to avoid abandonment — even if it’s not real.

I thought about the entire year and the instability of my own marriage – the most solid thing I can think of.  I had all of these paranoid delusions that my husband was cheating on me, although in the back of my mind, I knew it was not a possibility.  I sabotaged myself at work with the line of thinking that everyone was against me.  I started severing ties with coworkers and hiding in my classroom.  I had always thought that was characteristic of bipolar psychosis, but now, I’m not so sure.

Using the same site that Angel used, I discovered something kind of shocking:

You may be at risk for developing BPD if:

• you have a family member who has BPD
• you felt emotionally unstable or emotionally vulnerable as a child
• people in your household were impulsive when you were a child
• you were emotionally abused as a child

And all of those were true.  My mother does not have a confirmed case of Borderline Personality Disorder, but it seems she is symptomatic.  When she was a very young child, she was put into foster care.  She has absolutely no memory of this, and none of her family members will detail what happened.  My mother married her first husband on a whim, because his draft number came up to go to Vietnam.  She had an extremely turbulent relationships with him, and he mostly left her alone all of the time.  That’s how she met and fell in love with my father.

Their marriage isn’t much better.  In private, she has gone on and on about my father’s faults.  They have had a rocky relationships, where I recall them throwing around the word “divorce” probably far more often than they should have.  She binge drinks and sometimes takes too much medication.  Medication that isn’t even hers to begin with.  She is as impulsive as she can be in her restrictive environment and goes through so much emotional turbulence.  But, she will never leave my father, no matter what.

I was an emotionally unstable child, and I wasn’t the one to immediately notice.  My preschool teacher had mentioned to my mother that I needed to “toughen up”.  That one little phrase was enough to spark years of tough love and general emotional abuse and neglect.  It gave them a free pass to call it “good parenting”.  As a result, I developed this need for achievement as a means of recognition.  I was designed to people please.  Regardless, another comment came from a teacher stating, “Doesn’t take constructive criticism”.  And the idea that criticism was encouraged compounded what I was already going through.

Impulsiveness!  My father used to just go drive off in his car without telling my mother where he was going.  He’d be gone for hours, and she’d be a wreck.  One time, he went through the house waving a gun, terrorizing us with suicidal gestures.  Honestly, I can never get that scene out of my head as hard as I could ever try.  My parents have both run their credit into the dirt over impulsive shopping sprees.

Now, here’s where things get tricky.  Friends and family in the past have suggested that I may be suffering from Borderline Personality Disorder.  An ex used those weaknesses against me.  So the presentation is convoluted because my actions are purposefully deceiving.

frantic efforts to avoid real or perceived abandonment

I self-sabotage in this area.  When I perceive abandonment, I start to shut that person out of my life.  I have this funny idealization that person will perceive my own emotional abandonment and come running back.  It’s what my parents and my ex did to me, and I seemed to have picked it up.

I’ll also become more sexual and start having defensive sex or performing certain sexual acts to peak someone’s interest and entice them into staying with me.

I also have this habit of changing everything about myself to appease my partner.  This is an effort to avoid abandonment.  And it’s one that’s been preyed on before.

pattern of unstable and intense interpersonal relationships, characterized by alternating between idealization and devaluation (“love-hate” relationships)

People that are close to me are also subjected to this regularly.  Honestly, this is a major reason why I don’t let people get too close to me.  At first, I idealize someone and pick out the best of their characteristics.  Then, I start to idealize how the relationship with them will go.  Soon, I will become disillusioned at the first sign of trouble.  And it is at that point that I begin to demonize someone.  Everything about them is bad, and I have ever right to be suspicious at their deceptive behavior.  Except, it wasn’t deceptive.  I perceived them to be something that they weren’t and assigned them to the task of living up to my unrealistic expectations.

extreme, persistently unstable self-image and sense of self

I’d like to paraphrase the way I perceive myself.  I have lived a dozen lives, and each time, with every death, I’ve risen like the phoenix out of the ashes.  In my life, I have been a dozen different people and will be dozens more, each with their own birth, life, and death, only to start once more.

I take one aspect of my life and characterize myself through it.  I’ve been a baker, a mother, a wild child, a caretaker, a housewife, a teacher, a crazy woman, a bipolar woman, etc.  And for some reason, I can’t seem to integrate all of those periods of my life into the same entity.  They are just all separate from one another, as if I were living so many different characters in the same skin.

impulsive behavior in at least two areas (such as spending, sex, substance abuse, reckless driving, binge eating)

It is well known that I have a substance abuse problem with alcohol. But, here are a few facts that are the most difficult things for me to admit. I am guilty of day drinking every now and again. It is never when I’m alone with my child, for the record.  I am also guilty of taking too many benzodiazepines to escape reality from time to time.  Yes, I abuse my medication every now and again.  But, it’s not a dependence kind of thing.  I don’t find that it’s necessary, until I get into a frenzy of hysteria that produces so much distress that it’s unbearable.  The drugs quiet my mind.

And the other one is very difficult to admit as well, and I’m not sure if I can spell it out in detail.  I have a difficult relationship with food, dieting, and exercise.  I am guilty of binge eating.  I am also guilty of purging if I am distressed.  Especially if it’s about my weight.

And lastly, I recently made a confession of my sexual exploits in my youth in Promiscuously Yours, in the series The Friday Confessional.  I had multiple reasons for cheating on my ex, which is something I wouldn’t normally do.  I have a better moral compass than that.  Sometimes, I was so distressed that I just wanted to feel some kind of love.  Sometimes, I was trying to prove to myself that I was something special.  And other times, I did it out of spite.  Any which way you look at it, I did it in highly emotional moments.  And I always regretted it later.

recurrent suicidal behavior, gestures, or threats, or recurring acts of self-mutilation (such as cutting or burning oneself)

My cutting has been well documented in the past.  Unless I make a mindful effort not to self-harm, I will engage in the behavior.  I’ve written posts about the whys and wherefores in Why Self-Injurious Behavior?.  It’s complicated.

unstable mood caused by brief but intense episodes of depression, irritability, or anxiety

The mood episodes aren’t brief, so it leads me to believe that I may have a co-morbid diagnosis instead of a misdiagnosis.  However, I’ve always said this, and people have disagreed with me.  The only two constants for me and my disorder are reactivity and irritability.  I was under the impression that everyone with bipolar disorder is reactive and generally irritable most of the time.  Apparently, I was wrong.

I always have this underlying anxiety.  It’s made worse by social interaction, certain phobias I’ve developed, and worst of all, having to make decisions on my own.  It’s difficult for me to take care of my personal affairs, because I am always waiting on another person’s approval.  I get anxious when I make a decision by myself, because I often second guess myself.  I am constantly seeking reassurance about my decisions and guidance from others.

chronic feelings of emptiness

This one is complicated.  I don’t often feel empty.  I often feel lonely or distant.  Sometimes, I feel invisible, rejected, or ignored.  Most of the time, I actually feel too full.  I’m too full of emotion, noise, and stimuli.  I often have several voices and personas that follow me and make commentary on my life.  It’s too much.  But when medicine gets rid of them, though I am relieved by the lack of conflict, I am lonelier.  It feels like a piece of me is absent.

inappropriate and intense anger, or difficulty controlling anger displayed through temper outbursts, physical fights, and/or sarcasm

I recently wrote a post called, “I Want My Yellow Dress” using the analogy of a little girl in a movie in the most epic temper tantrum ever known to describe my own inner child.  My anger is often out of proportion for a given situation.  I have a bad temper, and I know it.  It’s something I’ve tried to deny for a long time.

In Love the Way You Lie, I described a mutually abusive relationship.  It was the only time in my life I have ever lashed out physically, but the point is that I did.  Whether a person could classify that as self-defense is questionable.  There were times I did it because I wanted to inflict pain on him.  I felt like he needed to know my own pain.

stress-related paranoia that passes fairly quickly and/or severe dissociative symptoms— feeling disconnected from one’s self, as if one is an observer of one’s own actions

I’ve written scores of blog posts and theories about this.  I am prone to paranoia, and I experience it rather frequently.  With my recent medication change, I can say that I usually only go through it once weekly.  Prior to the medication change, it was much more frequent than that.

The dissociative symptoms have been documented in Conscious, Subconscious, and Extraconscious, where I described a theory of multiple personas rather than full blown personalities residing in a place between the conscious and subconscious mind.  It’s complicated to get into, but it’s worth a read honestly.  It would give you a better idea of what I’m talking about in terms of dissociative symptoms.

When I’m doing something out of character, I often feel like I’m not the one who is doing it.  I feel like I’m trapped inside myself, or even completely outside of my own body, as a helpless observer.  When everything is said and done, sometimes I don’t quite remember the details of what happened.

It’s something I’m going to have to talk to my doctor about, because as I get older, it seems to get worse, rather than better.  Sure, I am not self-injuring in the sense that I’m not cutting.  But, I am still engaging in impulsive behaviors, and I can’t tolerate distress or disappointment.  My anger is out of control most of the time.  And that’s not when I feel too doped up to do anything.  Sometimes, I have symptoms regardless of the medication.  When I relapse, it’s usually very bad, and feels like it’s worse than the one prior.  I don’t just have a blip of an episode, but a full blown, complicated one.

Invitations to Narnia : 30 Days of Truth

Day 05 : Something you hope to do in your life.

As it stands, one can find me within the wardrobe amongst the coats, between the real world and my Narnia. This is not the Narnia as others know it. It is the absolutely surreal, ever shifting landscape, containing both horrific monsters and beautiful, majestic creatures. All of that world is tucked away, within a wardrobe, in an innocuous cranny of my home. Many unsuspecting people could stroll up to it, jam their coat in, and never give this unassuming wardrobe another thought.

Lunaria

But, this world is not meant to exist tucked away.  This world lives inside of me, wrapped up in an old world map, tied with a satin ribbon.  It waits to unfurl for all of the world to see.

Snapshots of this map are contained within every word, in each piece that I carefully create.  Some have been privy to view them, scanning the terrain, gazing upon the horrors and magesty.  Others have been lucky enough to set foot on the Terra Amici, The Land of Friends, specifically set aside to welcome guests who have braved the Sea of Aliquim.  And others, those closest to me, have journeyed through the deepest, darkest places of Lunaria.

I dream of the day that I allow Lunaria to emerge from the wardrobe.  This is the day that the earth will quake around me to birth Lunaria from within.  I will invite others to explore at will, without the requirement of the confines to Terra Amici.  To brave the fiery mountains, volcanoes spewing molten rock,shifting and shaping the landscape daily.  The mountains grow higher, only to be whittled away by the erosion.  Bask in Bad Wolf Bay.  Peer deeply into Mare Demersi, but still fear to tread too closely.  Lose themselves in Vac Saltus, and navigate the sullen, sunken lands of Val Mergullado.

All of this, one day will be accessible to all.  Lunaria will rise.  I can openly narrate the tales and history of Lunaria without fear of persecution and ostracism.  I hope to accomplish my quest of bringing this all out of the wardrobe.  I want others to see what my world, one world of a woman with Bipolar Disorder looks like.  It possibly connects to other places, to weave a global patchwork of personal worlds, connecting us all, to encompass every single person who has been hiding their own Narnia.

I hope to have a voice that can bring this all to the world.  And I hope to build the strength to do it.

Theories on the Development of Disorder

When something, an emotion, an urge, an impulse, is so severely suppressed that a person becomes oppressed, we can often observe extreme opposite reactions. This is consistent with the laws of physics and the universe, “Every action has an equal and opposite reaction.” Except, one thing. I believe when it comes to emotions and behaviors, the opposing reaction is more like equal plus. The plus being an x-value holding place for a value with the meaning “a little more.” Determining that exact value in numerical terms may be difficult, since there is no numerical value for emotions.

It basically conveys the message that the situation perpetuates itself. Any potential absence of behavior or action can still be perceived as a positive value. Inaction can still be considered an action in this case, because there isn’t really such a thing as a complete absence of behavior.

This is potentially a huge factor in mental illness. Obviously, we are aware of the psychological damage abuse and neglect in childhood can cause, even throughout adulthood. It is thought to manifest in anxiety disorders, particularly Obsessive-Compulsive Disorder and Post-traumatic Stress Disorder. However, that does not account for people who did not experience what is typically considered childhood trauma.

Even as adults, we are susceptible to psychological damage. This is a fact that is well established through research involving war veteran and victims of sexual assault. However, we only consider extreme forms of trauma as something qualifies as such. Such is also true of childhood trauma.

Other qualifying trauma often happens over a period of time, and goes consciously unrecognized. This does not mean that it is also subconsciously unrecognized as well. In fact, the subconscious is likely keenly aware, but unable to translate to the conscious mind.

Once the conscious mind becomes aware that there is something amiss, the traumatizing behavior seems commonplace. The person has likely become desensitized to what was once a subtle, but generally constant external stressor. By then, it becomes internalized and often mistaken as an internal stressor.

Those are the seeds for maladaptive behaviors in both children and adults. At this point, unhealthy coping mechanisms have already been adopted as part of a person’s behavioral repertoire. This is directly the result of an extreme reaction to the accumulation of what may be considered subtle long term stressor(s).

The maladaptive behaviors are recognized as such, and perpetuate trauma through mistreatment of oneself. It can be behaviorally observed by an unusual response to certain unpleasant stimuli. Unfortunately, the subject is often unaware that their responses are abnormal. By the time it is either pointed out or realized by oneself, the original cause is well buried under layers of self-abuse / neglect.

The result of this is much larger than anxiety disorders. It reaches out to grab behaviors typical of a variety of psychological disorders. Behavior repertoires are often observed in personality disorders and mood disorders. it would stand to reason this is true, due to the nature of long-term external stressors, particularly subtle abuse and neglect.