Saturday, March 16, 2019

Hypomanic tiefling goth girl

Note: this post contains frank and straightforward discussions of mental health issues. This isn't a request for sympathy. This isn't a request for help. This is me getting things off my chest, and being open about the significant impact a recent diagnosis has had on a lifelong condition.


Not a manic pixie dream girl. Not the girl next door. Not normal.

Nature and nurture both contributed. (But diving into that isn't where we're going today.)

The last few years have been a mess/whirlwind/nightmare/time of growth/catastrophe, depending on my current frame of mind, and how I look at them.

I hunkered down, closed in on myself, survived a bunch of tumultuous life changes that still have me pretty shook, if I'm being completely honest.

Since my last post here I've had two major medical diagnoses. I've been to the ER three times. I intentionally severed relationships that, back when I wrote that last post, I thought would last the rest of my life.

Some parts of it I'm not ready to talk about yet, like the severed relationships. I only cut those ties back in July, and those wounds still hurt. Sometimes, when I'm sad and weak and down, I question if I did the right thing in cutting those folks out.

…but this isn't what this post is about so…

Let's pick apart this post's title working from the end: "hypomanic tiefling goth girl"



Girl is easy: I'm was assigned female at birth and that still feels right. Actually, these days it feels a lot better than it used to, thank goodness for the almost 4 years of therapy I've done. It has helped me work through a lot of baggage that made me feel bad about being female.

Goth is pretty easy too: I wear combat boots and black tops most days, I listen to beautiful sad norwegian goth post rock, I can paint on a mean winged eyeliner, revel in unnatural colors of lipstick, and recently traded in my natural ginger locks for a glorious shade between plum and aubergine. I skew a bit more towards "industrial" with my gauges and jewelry choice, but -shrug- goth is still the best catch-all.

Tiefling is a bit weirder, but not too much: They're the spawn of humans and infernal beings in D&D — they're pretty much the same as nephilim, just with more horns and glamours and slightly better PR.

Hypomanic is the tough one: This is the "take a big breath, be vulnerable, and be public about something you've been horrified to talk about since you got your diagnosis in fall 2017" word, which makes it so much more entertaining since it's the first word in the whole damn phrase.

I'm bipolar. Somewhere between bipolar II and cyclothymic, if we're being specific. From what I can tell I've probably been this way since I was young. Like… 10-12 years old. Maybe earlier. I intentionally forgot most of my childhood as I was growing up because it was pretty fucking abysmal (that's fun post for another time, but y'all could probably guess it from Butterfly's Tale, if you've read it).

"Yes, but, what does hypomanic even mean? Like, we get manic where you're just up up up, but wtf is hypomanic?" you may be asking.

Hypomanic is a catchall term that gets used for anyone who doesn't go super "up" on the non-depressive curve of being bipolar. For me "hypomanic" is a horrendous blend of rage, irritability, and viciousness. It's like my brain gets taken over by a rabid, wounded, feral velociraptor — almost anything can set me off when I go hypomanic and I lash out verbally. There can be this short, brief little window where I get kind of "up" and expansive at the start of an episode but it's a window of days in a hypomanic storm that can last months, or even years. Worst of all, I can only remember shards of what happen during a hypomanic episode, so I can't even be sure how much damage I leave in my wake.

Part of the reason it took so long to get my diagnosis was that my hypomania presents as anger and rage and irritability, and… those are all legitimate emotions that I can and should feel in relation to a non-trivial portion of my life's experiences. I'm also pretty high functioning so I can be somewhat productive through most of my hypomanic episodes: sorry to the folks in my life back in 2006-2009 and 2011-2017 — I spent most 2006-2009 in a hypomanic irritable/vicious state, and 2011-2017 was cycling back and forth between depression and hypomania with brief patches of almost normal interspersed.

"You're talking about this kind of like you weren't in control of your brain or yourself, but you're so smart, shouldn't you be able to control your brain and yourself?"

Hahahhahahaha ahahahaha. Ah, good one brain, go for the old "but you're so smart…" wound. "But you're so smart, you should be able to figure out how to make friends" and "but you're so smart, you should be able to control your temper" have been my lifelong companions.

Trouble is, it doesn't matter how smart you are when your brain works itself into a feedback loop of a given emotion so strong that it just… takes over. Also giving a bipolar brain certain types of chemical stimuli, like the ones in common SSRI antidepressants, can effectively tape a brick to the brain's emotional feedback loop gas pedal, and rip out the breaks.

That's what happened to me, not long after my last post. The antidepressants weren't working, so my doc upped my dose. A few months later, still nada, so we up the dose again. Throw in some environmental triggers and…

Oops.

By the summer of 2017 I was in the worst hypomanic episode I've had to date. I entirely lost control. There was another dose increase and by fall I was starting to feel physically ill, in addition to being an ever increasing rage monster. I started snapping at people for the dumbest things. I ranted at people. I lost all control of my emotions and would just start sobbing uncontrollably all the time, instead of just once in a while.

By November I knew something was wrong and dropped the antidepressants and booked a psych appointment. It didn't quite go "congratulations, you have bipolar" — the psychiatrist I saw used some very… strange word choices. I got my first bipolar medication and worked with my therapist to take some time away from work while I titrated up my dose, so I could hopefully get back enough emotional control I wouldn't randomly start sobbing and shaking or screaming at people.

Shortly after I started the medication I found out I was allergic to it by breaking out in a rash. A $300 trip to the ER later I had 7 measly days of prednisone and a "cold turkey this and get on a new medication (tbd by not us)" decree from the ER staff. Another psych visit, this time with a different doctor, who I have to stand my ground with on not taking a medication that could screw up my autoimmune disorder(more on that in a minute). On to medication 2 and extending my medical leave since I had to start titrating back up from scratch. Unfortunately I couldn't afford to stay on medical leave for long enough to get my dose high enough, and I had to go back to work. Before the end of the first week back I knew I couldn't stay at that job.

In mid January 2018 I quietly exited my job, and managed to scrape by until May when I got a new job. In April it turns out I'm allergic to the second medication, and I have to stop taking it too. Thankfully I'd put my unemployed time to good use and worked my ass off in therapy -- figuring out the behavioral warning signs I have prior to hypomanic episodes and how to mitigate them while I've still got control of my mind. I get cleared to not be on medication, but on the understanding that I have to watch myself like a hawk with my therapist's assistance — if I slip and can't stop a hypomanic episode I have to come back in and take a spin at another medication.

It's been almost a year since then. I've gotten pretty good at keeping an eye on how my brain is doing, and have done a pretty good job of keeping myself within what feels like a "normal" range of emotions and feels. I've gotten pretty good at identifying and managing changes in my other "new" diagnosis — I've got a thyroid based autoimmune disorder which when untreated (or when triggered by chemical changes in my body) can swing basically all of my other body functions hypo (below) or hyper (above) the expected normal range. …and it can also trigger depressive or hypomanic bipolar episodes, which makes things super "fun" in my day to day life.

On one hand, it's easier that my latest health diagnoses swing between two poles, since there are similar patterns. I've spent the better part of the last 2.5 years learning what "happy medium" means for me personally because I finally have the information I needed to know what is "wrong" with me. It's meant I've gotten to know my brain, my emotions, and my body a lot better. I've expanded my social support network so I actually have supportive folks around me. A lot of this culminated with getting my first tattoo back in September, but that's a post for a different day. Which isn't to say that I'm done at getting better at knowing, understanding, and maintaining control of myself — it's going to be a lifelong project of working to stay in this happy medium.

So, yea… I'm bipolar. I have been most of my life. I'm doing my best to keep myself in a good middle brain space. It's a lot of work and it's meant that I've had to rethink and change huge chunks of my life. Thankfully I'm at a place where I've found a healthy work environment, I've cleaned up my social circles, and I'm working to state and maintain the boundaries I need to be healthy and functional. I'd say "happy" as well but I'm still sussing out what healthy and unhealthy "happy" look like for me, which is probably the most painful part about having my bipolar diagnosis. Nothing sucks more than second guessing if you're genuinely happy or on the cusp of turning into a rage monster.

I feel bad for the damage, hurt, and trauma I undoubtedly caused during the time before I started to get my bipolar under control. I can't undo the past — all I can do is move forward, do better, and be the best me that I can be.

There are still a lot of unknowns in my future. I don't know if I'll ever go back to being a part of organized online technical groups since the vast majority of them can't grok the importance of soft skills or fostering communities that are safe and welcoming for folks who aren't cis-het neurotypical men. I don't know if I'll ever give another talk or training outside of work. I'm not sure if I'll ever attend another technical conference.

I have utterly hated spending the last 2.5 years hiding from everything. I'm not going to hide anymore. If folks want to use my honesty about my lived experiences as a way to attack me I know how to use block buttons and how to /dev/null emails. I also finally feel comfortable and confident enough to call people on their bullshit, whether intentional or not.

For now I'm done hiding. I'm not sure how much or how often I'll post here or on Twitter, but I'm done being silent.

Here's to the future.

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