“Check in with yourself and communicate when you think you’re starting to slide into a depression, mania or mixed state.”   I even preach that gospel on this blog. Sure, OK.

It would have been great if I’d taken the advice.

I spent a week cooling my jets in the hospital because I let things go a bit too far and entered a mixed episode.  Thankfully, a change in medication that was ordered the week before the hospitalization started to work while I was in The Bin. It shortened my stay and I am home now, and on the mend.

For those who aren’t familiar with mixed episodes, it’s where elements of both depression and mania are present at the same time.  The Vivien Brand of Mixed Episode inevitably involves depression with severe agitation.  That means instead of sitting in a corner crying, I am not sleeping, running around doing everything with a heavy hand, being overly agitated with the universe and everything in it  and crying.

Working through one of these mixed states is pretty hellish.  Depression meets adrenaline!  Filters be damned!  Everything is worthless and annoying! And nothing is sacred. Nothing.

I’ve agonized over how I should write about this experience. Do I satirize the whole ordeal, using my razor-sharp Mixed Episode Witt that had my husband and son laughing when they would visit me?  Do I describe the impatience and generally unkind Mixed Episode Agitated Thoughts I had toward my Club Mental Health cohorts?  Do I tally and publish the number of times I sat in my room and cried ’cause there’s no putting the brakes on Mixed Tears?

Well, no.  That’s the point  These damn mixed episodes are just so jam-packed full of emotion and mayhem that I really can’t compose a meaningful post within my self-imposed 1000-1200 word limit.

American Hotel, Amsterdam
American Hotel, Amsterdam (Oh, the irony!)

But, I must say this.  For those keeping score, you will no doubt have noticed the hospitalization this past week took place in The Netherlands while my previous stay in 2010 took place in the US.  Both facilities were dedicated mental health hospitals for the not-so-insane.  The experience here in NL, however, was a night and day difference from what I experienced in the US.  Here, I wasn’t locked on a ward, I was given my own room and my shoelaces weren’t taken from me.  It was more along the lines of a hotel for crazy-ish people.  At no point did I feel my dignity was compromised or I wasn’t being respected as a person.  Maybe it was just the crap hospital I was admitted to in Kirkland, WA (Google away…) that handles their clientele inappropriately, but it’s been my overall experience mental health here is handled with much more dignity and grace and less stigma than I experienced across the pond.  So, in my next edition of ‘Round the World for the Mentally Ill, I will have to give The Netherlands accommodations more stars than those in The States.

I suppose when you are Bipolar I and didn’t treat the entire spectrum of the illness for over 20 years, extended periods of extreme stress are bound to put you in the hospital, if you don’t ask for help when it all starts to go bad.  OK, fine.  Lesson learned.

Mixed episodes, how I do not love thee.

Wow! What a gutsy person you are to write it down! Thank you. And it’s great that you are feeling better. Coincidentally, my sister has just spent the last month in a manic episode (possibly mixed like yours because irritable and weepy as well as extremely elated) and then coming down from it. She is also on the mend. She also loves to play with words wittily when manic and has me laughing – and crying too. Take care of yourself, for you and your family’s sake – it is not fun to watch people who are manic most of the time, it is really upsetting to see someone you love being someone else in a sense. Of course you and my sister are the ones that are suffering and going through a really hard time that is out of your control. But I find it very hard to deal with personally. I’d hoped it got easier – but it doesn’t. It terrifies me really. However it is wonderful that medications do their job better these days. She spent a couple of weeks in a public hospital in a southern city in Australia, then one week in an ‘intermediate care facility’ – both places seemed ok – yes people did seem to be treated quite well and with respect. There was one male nurse who got up my nose. His manner towards my sister was off. However she may well have said something nasty to him because she does that when she’s sick. Except of course he’s supposed to be a professional and know how to deal properly with someone who is ill. The one thing I did feel was missing was a consistent contact or information for her supporters/family. I always find I have to do the running myself to find out what’s going on, no one sought me out to let me know how she was going. Anyway, take care, I really look forward to your posts. p.s I think the Dutch have always been more enlightened in terms of mental health compared to other countries but that’s not based on any careful research on my part I have to say. Might be interesting to ask for different people’s perspectives on mental health care in their locality. 😀 Australia has its good and bad examples but things have improved certainly in terms of knowledge and treatment and stigma over the 40 years I’ve been involved through having family members with mental illness. A lot seems to come down to how much emphasis and funding the government allocates to the sector.

Hi, Lynnpinny – thanks so much for the thoughtful reply! Yes, thanks, I’m on the mend. Pretty mad at myself for getting into such a state in the first place. I made the mistake of losing perspective of how bad the stress had become over the last five months and just didn’t get to the doc on time. I did consider not even posting about my hospital stay, but if you’re going to write a mental health blog with the aim of helping at least one person…hey, you’ve gotta be all in. 🙂 I’m glad your sister is getting better, too. You’re the first person I’ve ‘known’ from Australia who has any experience with the hospitals there. It’s nice to hear you think your sister was treated well. I wonder, is there the same hysteria about privacy there as in the US? Maybe that’s why you had a hard time tracking down information about your sister? In any case, I hope she is on her way to a nice, long period of stability. Oh, and yes! I’ve found the Dutch are a lot more progressive about many things. I had an interesting experience yesterday. My docs are located in a building that is attached to the local hospital (not the one I was in, though). There was a woman who was wandering the halls, lost, and when I explained that she was in the mental health wing and not the orthopedic wing, she didn’t even give me a strange look. She just thanked me for directions and went on her way. I figured she’s at least look at me like I had two heads or something, but, nope. No big deal. How cool was that?

Sounds like the Dutch have a clue that mental illness is a physical illness just like diabetes or asthma. Glad you’re back on solid ground. Those mixed episodes are hell. Last one I had, I didn’t go to the hospital because the hospital where I am is Bedlam-esque and makes me worse instead of better. I really empathize with you. So glad your husband and son are on board with you. Hey, though: don’t beat yourself up for not seeing it coming. The damn disease is sneaky, and creeps up on you from behind and whacks you right over the head! When I had a partner, I had a list of warning signs taped to the refrigerator. If he noticed that one or more were becoming persistent (paranoia in my case is a pretty sure indicator), I had a contract with him that I would listen to him if he alerted me that I was heading for the edge of the precipice, and I would then call my doctor for med-change instructions. It usually worked, but now partnerless I have to try to keep track of my own symptoms, not always such an accurate thing as you know so well.
It sounds like you do a lot of traveling. I would love to know more about that–have you written about it? And travel, as lovely as it is, must add to your stressor list. How do you cope with it?
Be well and take good care!

Hi! (First, thank you for dedicating your blog to Child Abuse Awareness Month! I’ll hop over there and comment further.)

Yup – mixed episodes are a bitch. When I sit here now, writing away under the influence of alprazolam, I can’t believe how bad I felt the last time I really sat in my office chair for any length of time. This disease really does a number on you sometimes, using the cunning of surprise to whack you right upside the head. Ugh.

Yeah, the Dutch really do have a clue. I feel for you, having to go through the Bedlam-esque experience. Nothing turns people off to getting help more than being treated poorly when they reach out. My husband and I were reading your comment before bed last night, and we think posting a list of warning signs is a great idea. I’ve always had a contract with him to call my docs if I’m in trouble, but I’ve always asked him to do so first. I think I’m going to follow your lead and give him cart blanche to call whenever I start acting crazy -er. 🙂

I used to travel quite a bit. And, yes…sometimes the stress around traveling is off the charts. I’d love to talk to you more about it. Whenever you get a chance, drop me a line manicmuses at gmail dot com. Have a good weekend!

Thanks! I’d love to talk more. My Saturdays are devoted to the Jewish Sabbath, so that leaves Sundays in the American version of the weekend. My PEM is moxadox at gmail. Let’s connect!

Well, shitsky. Those mixed episodes suck the big one. But, it does sound like you had excellent care. All my hospital stays have been similar to your Kirkland adventure. If we had NL-style care here, I maybe wouldn’t feel the need to white-knuckle it so much when my rapid cycling and mixed states take off. Just to go someplace where other people make the decisions and bring you trays of hot food. Crazy Spa.
So glad to hear the crisis is behind you, my friend.

Now, *there’s* our business plan! ‘Crazy Spa.’ I bet if we offered massage, whirlpool and mani/pedi services most of the clientele wouldn’t even want their meds. LOL (I’m joking, kids. DON’T try this at home!) Thanks for the well wishes. Out of the darkness but just maybe heading too much into the light. (But, hey…I’ve painted the living room, gotten all of the laundry done and cleaned the bathrooms since I was sprung.) Hope all is OK in your world!

My hospitalization kept me from phsychiatrists for over 15 years. The dude came in and said, “Behave in here or I will have you committed.” That’s it. So I shutdown and because I wouldn’t talk and didn’t act crazy, they had to let me go when I signed the AMA papers. My son’s story was even worse. The psychiatrist had a policy that he didn’t talk to the parents, only his staff. What a crock. I hate mental health facilities, they make you crazier then when you go into them.

What can I say, except – OMG – what a bas*ard! He really threatened to commit you? Like I said to Soul Survivor, nothing turns people off more than to be treated that way when you’ve reached out and asked for help. And, your son! I bet he is completely turned off to getting any sort of help now. That’s just great. I’m not too proud to admit I had a mini-breakdown the first hour I was left alone in the hospital. I was reliving The Kirkland Experience all over again, but in a foreign language. It wasn’t that way at all, though. Ugh. I really hope your son is well again/stable. And you’re doing great, too!

Hm. Your description of a mixed episode sounds a little disturbingly familiar. Not on scale, I’m willing to bet (no one’s ever threatened me with The Hospital), but that feeling-bad-but-driven sort of thing? Yeah, not much fun. My sleep patterns are usually “normal” though – as though down and up symptoms cancel each other out.


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