Fact-checking. What’s Real?

I’ve had doctors who were surprised that I can distinguish most of my hallucinations from reality, so I’m led to believe it’s not common, but I am not a professional.

I know when I’m in a psychotic episode and I can use logic to detect most hallucinations. I call it “fact checking”.

adult automotive blur car

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If I’m in the car and I hear the driver (I don’t drive. I have a license, but it scares my family. It’s disheartening at times.) singing along with the radio, I look at the driver’s mouth to see if it’s moving. Sometimes it is, and I’m hearing them singing. Sometimes it isn’t, and then I realize I’m just hallucinating them singing.

sunglasses girl swimming pool swimming

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Once, I saw a young, blonde-haired boy in a blue and orange swimsuit floating motionlessly near me at the bottom of the pool. I panicked, yelled “Help!” and dove down to grab him and bring him to the surface. When I reached out to grab him, he disappeared. I returned to the surface with a pounding heart and told the lifeguard that I was mistaken, nothing was wrong and thanked him for coming to help. My whole body was shaking for the next hour. Finding out you’ve had a hallucination is comforting in that the problem it presented is not really there, but your adrenal system will continue to flood you with panic chemicals long after you’ve found out.

I frequently have visual disturbances, the most common of which is smoke or bent light in the air. Imagine billowing smoke, and then take the same curves and lines you would see and turn that into light. It’s a lot like the reflection of light at the bottom of a swimming pool. It doesn’t obscure my vision, it just passes over it. This is usually the first sign I’m having psychosis.

Following the billowing light, I usually become very frightened, with the cause being some vague danger, a threat to my loved ones’ or my safety. I frequently ask if we’re safe (anyone in my life knows to expect this, and fortunately the answer is always “yes”) and sometimes need my fiance to search the house for strangers on my behalf. This fear is paranoia. I actually consider myself lucky for not having more specific fears. The more specific the fear I’ve had in the past, the more intimidating it was. Sometimes, if I’m in public during a psychotic episode, I will believe that I can hear everyone’s thoughts and that they can hear mine. I’m afraid I’ll think the wrong thing and everyone will hear me and get upset. That’s a great example of a paranoid delusion. In this state, I know I’m in an episode, which allows me to continue to move through the world looking a little bit normal (with the guidance of a loved one) even though I’m inside of an absolutely insane situation. I can experience it as real, the way I’m being forced to experience it, but pretend that nothing is happening and just do the things I’m told to do, like walk next to someone, get in the car, or stand in a line. This level of coping with psychosis is ninja-level. I cannot express how hard I have worked to get to the point where I can actively fear for my life and stand in line at the grocery store at the same time.

Being 12 years into my treatment for bipolar, nothing now is nearly as scary as it used to be. I used to be completely entranced by horrific hallucinations and believed completely that they were real. I once sat next to Satan on an American Airlines flight (I really was on an airplane). He had a little boy in his lap, and I was trying to figure out how to signal to the stewardess that the boy needed help, but I was nearly paralyzed by fear. I looked down between my feet so he couldn’t see me crying, and the floor of the aircraft had disappeared. I was sitting 40,000 feet above the earth with nothing between me and the tiny lights below but air. That was real to me.

By 3 years ago, I’d come around to being aware of almost all my hallucinations. I once saw a flock of black angels/bird people flying over the car I was riding in. I knew it was a hallucination, but it still mattered to me. I wasn’t at all afraid. It was beautiful. I watched them swoop and dive around each other. They were fast and graceful. I watched until they disappeared. That memory is still special to me. That experience was only mine. No one else in the world can possibly have that memory, not even the people that were there.

Knowing I’m having hallucinations is much easier than knowing I’m having paranoia or delusions. Paranoia and delusions are less tangible. Seeing something is easy to disprove, especially if it disappears while I’m watching it, which is frequent with my visual hallucinations. If the person is singing in the car, I can watch their mouth. But if I believe I’m not “safe”, for whatever vague, paranoid reason, it is very hard, and sometimes impossible, not to trust my gut. Instead, I have to trust someone else’s gut. My fiance is my partner in life, and we have been through enough episodes together to have each other trained in what to do. If he’s the person I’m with, which is usually the case, I have to ask him questions, sometimes repeatedly, about the nature of actual reality as he is experiencing it. I use him to check what is real. I ask him about the validity of things I see, hear, and think. I will ask him if we’re safe, and he’ll say yes. If I don’t calm down, he will describe why we are safe. If I’m far enough gone that I can’t calm down, it’s probably all terror-crying from that point on anyway, so he just takes me home, stays with me and reiterates that we are safe. I much prefer hallucinations, as you can imagine. They, at least, can sometimes be fun. Paranoia, so far, has never been fun for me.

I am self-aware enough now that I know when I’m in an episode most of the time. Sometimes someone else will point it out before I’ve figured out what’s happening, but as soon as I realize it, I am able to stay grounded in that knowledge. Knowing that I’m in an episode and that I can’t stop it sometimes feels like falling, only I never land. It just goes and goes, without my permission, and I can’t change it. The intensity of it can be ridiculous. Humans shouldn’t be able to manufacture that level of intensity, especially with no external source. It can be quite incredible, in the original meaning of the word. In fact, that incredibility is part of why fewer people understand or validate mental illness. It sounds made-up.

Knowing I’m experiencing psychosis keeps me grounded and safe during episodes. I know to alert my fiance or family, and I follow their lead, at least until I get out of public. At home, I am better able to cope with whatever counter-reality comes my way.

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Scared of What’s Next

Over the past month, I’ve been declining.

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The other night, my husband made a minor comment that made me feel bad, and I fell into a thought spiral on the thought “It’s not supposed to be this hard.” I started crying. I sank deeper into dark ideas, feelings of hopelessness and worthlessness and meaninglessness. When the sadness became too great for my brain, it turned to pure fear instead. My mind’s solution to fear is often to ascribe meaning to it that isn’t there, just because it needs to have a reason to be afraid. This time, my mind picked ghosts. The room around me was full of ghosts. They all stood still, with their hands at their sides, all silent, all staring at me. There must have been at least 30 of them. There was not enough space between any of them for me to leave the room or even get off the couch.

 

I called out to my husband to help me and told him about the ghosts. He tried to help me fact-check by telling me that there couldn’t be ghosts because ghosts are not real. That didn’t work this time. I could see them. I could feel them looking at me. My husband is a creative problem-solver when I’m in crisis, so he was on top of the situation. He told me that there were no ghosts in the bedroom, so we could go in there and be safe. He made a path through the ghosts with his body so that I could follow behind him without touching them. It worked. The ghosts stayed out of the bedroom, so I stayed in it. I moved on to other troubling beliefs, but none as bad as the audience of 30 translucent spirits in the living room.

 

Those ghosts were a psychotic symptom, somewhere in a mix between hallucination, delusion, and paranoia. Mental illness symptoms are rarely simple or plain. Everything is a mixture of gradients. It’s been a long time since I’ve had such a striking and problematic psychotic episode.

 

I also had a night when I put together many pieces of “evidence” that my husband was cheating on me. It was full-fledged paranoia. I was seeing meaning and clues in everything. I spent the afternoon in a perpetual fit of Continue reading

Memories That Almost Break Me

Yesterday in therapy I told the story of the last days with Sophie and my first days of incapacitating mental illness, just before I was officially diagnosed. I was surprised at how upset I became in therapy, and by the clarity of my often faulty memory. Timeline was:

 

I started to feel like I was becoming invisible in October, right after I started dating Sophie, right when I turned 19.

 

My depression increased. I started to disappear.

By Christmas, I knew something was wrong with me, but I didn’t know what. I remember saying “Something is really wrong with me,” to my mom when I came home for Christmas break. When my folks drove me to Austin at the New Year to put me on a plane back to Ohio, my dad gave me a giant teddy bear in the parking lot, and I hugged him and cried very hard. My mom took a picture of us that I have here in my house. Our eyes are red, even though we’re smiling. His arm is around my shoulder, and we both look like we’re holding our breath.

 

January was something called “Winter Term,” which exists because it’s basically too cold to live in Ohio in January. The campus empties out. Everyone did an individual project during Winter Term, appropriately called a “Winter Term Project,” and you could complete your project anywhere in the world. Oberlin is mostly wealthy, so students would do their projects in Hawaii or Barbados or Portugal. Wherever they wanted, basically. A tiny minority of students would stay on campus, so the ice-laden, snow-covered campus stayed partially open. The libraries had some limited operating hours, and one of the cafeterias was kept functioning. I chose a listening/research project on mezzo-sopranos of the last century. My roommate, Laura, went away somewhere for the month, so Sophie and I had a giant room to ourselves. We hid inside, only leaving to find food or go to the conservatory to research. Baldwin had a large, round practice room on the first floor with a piano in it, directly below my own round room, so we didn’t even need to go to the conservatory to practice. There were two places near us that delivered food: a Chinese place on Main Street and a Dominos about 30 miles away. With temperatures severely below zero, it was worth the money and the wait to not have to leave the house. We binge-watched TV and movies on her laptop, ate takeout, and existed naked with the radiators cranked. The sky was only ever grey or black.

 

I started to think that I would marry this girl, and soon after I had that thought, I started Continue reading

How An Episode Unfolds, and What It Feels Like

conv fishes sophie2.jpegIn case you don’t already know, I have bipolar II, mixed state, rapid cycling episodes with psychotic features. I get hallucinations as well as paranoid delusions during manic and depressive episodes, which is part of having mixed state episodes. A mixed state episode can lean one way or another so it can be helpful to refer to them as manic or depressive for purposes of communication, but every mixed state episode has features of both mania and depression.

A real-life example of a troubling psychotic episode would be that I can hear the clouds above me whispering (hallucination) and even though I can’t hear what they’re saying, I know they are talking about me and are going to come down and hurt me (paranoid delusion). This happens often in episodes that lean toward mania. In an episode that leans toward depression, it is common for me to believe that there is an intruder in the house (paranoid delusion), or to feel very afraid and not know why (paranoia). Every episode has features of both mania and depression at the same time often in conjunction with hallucinations or paranoia. My episodes are rapid cycling, which means that they are short and intense, usually between 4 hours and 12 hours, and I have them three days in a row at about the same time of day, unless I am able to get 14 hours of sleep in a night, which interrupts the cycle and prevents an episode the next day.

I usually use the metaphor of a thunderstorm to explain how an episode unfolds. Continue reading

My Paranoia, Delusions, and Hallucinations

Delusions, hallucinations, and paranoia. I can only speak to my own experience. During the delusions of grandeur during mania that I’ve had, I felt really, really good about myself and thought without a doubt that I could achieve very difficult things, like using a chainsaw to illegally cut down all the trees on a road near my house overnight because the trees had grown to block the formerly beautiful view of the lake, and I was outraged. I believed that was a good idea, and that it was achievable. Fortunately, I got distracted from that plan. I also had a recurring delusion that I was going to write a book about bipolar and publish it. It would be so meaningful, insightful and true that it would become a best seller, and I’d go on a book tour to publicize it. I’d end up telling my story to Oprah herself. I started that book about five times and didn’t get far, but now I have a website about bipolar that has all my best wisdom in it, and I’ve had a lot of people reach out to me lately to share their stories and tell me that my words have helped them. Educating people about bipolar was always a goal, but during a delusion of grandeur I took it to the extreme, and I felt good about my future.

Now, what is it like to have these delusions of grandeur in the first place? All I can explain is how it feels to me. In the very few times that I have had pure mania with delusions of grandeur (almost every episode I’ve had is mixed-state, with features of both mania and depression at the same time. I get dysphoric mania, the opposite of euphoric) I have buzzed with energy, felt like I could lift a car, been quick to make witty remarks, laughed often and too loudly, talked too fast and believed I could do many different extremely difficult things if I just put in the effort. I also believed that I could put in that effort, ignoring the fact that my illness precludes me from even having a job because keeping myself alive is a full-time job itself. It was such a positive headspace that anything felt possible. I was just along for the ride, trying to have as much fun as I could. Of course, this has only happened to me a handful of times, since most of my episodes suck very much, even manic. Continue reading

What Is Madness?

I’ve been asked what the difference is between mental illness and madness. I absolutely love language, and words are important and fascinating to me. While some people find the term madness to be outdated or even offensive, with me it is a word that resonates deeply. I do not want to step on anyone’s toes here, because there are many valid ways to view mental illness, especially if you have it yourself. My answer is mine alone, meant to reflect my own experience and opinion.

I have mental illnesses, and I sometimes experience madness. Madness feels like the world is burning down around me. I can see things others can’t, I know truths others never will, and I can feel the source of universal pain flowing through me and out into the world. Madness is powerful. Madness is bold.

If I experience madness in a grocery store, I can hear the thoughts of all the shoppers, and I know deep within myself that they are all in danger, and I cannot save them. Continue reading

What Is Madness?

I’ve been asked what the difference is between mental illness and madness. I absolutely love language, and words are important and fascinating to me. While some people find the term madness to be outdated or even offensive, with me it is a word that resonates deeply. I do not want to step on anyone’s toes here, because there are many valid ways to view mental illness, especially if you have it yourself. My answer is mine alone, meant to reflect my own experience and opinion.

I have mental illnesses, and I sometimes experience madness. Madness feels like the world is burning down around me. I can see things others can’t, I know truths others never will, and I can feel the source of universal pain flowing through me and out into the world. Madness is powerful. Madness is bold.

If I experience madness in a grocery store, I can hear the thoughts of all the shoppers, and I know deep within myself that they are all in danger, and I cannot save them. I weep as I walk the aisles because surely they don’t all deserve the fate that only I know awaits them. Some of them stare at me, my red eyes and snotty nose, and one even asks if I’m okay. That makes me cry harder. In the produce department, I feel hope when I see the oranges because they came from the earth. I realize that all the fruits and vegetables came from the earth, and a calm settles over the department. As soon as I turn away from the produce, waves of hostile anxiety rain down on me, and the other items in their bright-colored cardboard boxes and plastic containers are more toxic and threatening than ever.

Madness, for me, happens during psychosis. Not all of my psychotic experiences feel like madness, but madness only happens when I’m psychotic.

Words are very important to me, which is why I wanted to address this concept. I identify with the word madness because to me, madness is a concept that goes back into ancient civilizations as a common experience among a small minority of people. I know how some of the ancient prophets, shamans, and mystics felt. I can feel the rich inheritance of my insight, regardless of whether it is currently productive or not. Geniuses, artists, and mystics down the ages have experienced madness. Some were revered for it. Others were executed. Madness is as old as human history.

The difference to me between madness and mental illness is timing. Mental illness is something that is with me all hours of the day and night. Even when I have no symptoms, mental illness is with me; it’s just resting. The goal is for it to rest as often and for as long as possible, but it’s always there, waiting for me to falter so it can wake up again.

Madness only happens sometimes. I do not feel I have gone mad just because I’m currently psychotic. There is a specific feeling that I identify as madness. It happens when I’m having hallucinations and delusions (psychosis) that are particularly intense. During madness, my emotions are overwhelming. I am at the mercy of my episode. There is no calm inside of me to hold on to while my world spirals out of control. I need my partner to watch over me because I have no reasoning power left. My mind is madness. The world is madness. I cannot differentiate between my thoughts and reality. I am very frightened but unwilling to back down from the chaos around me.

My psychosis during normal mental illness, the psychosis that happens outside of madness, is easy to manage. I’ve had 12 years to learn how to keep myself safe during episodes, and I’m fairly competent at self-care. I can use coping strategies effectively, and I can self-soothe. I still suffer and hurt immensely, but I have skills now. Psychosis doesn’t have to disrupt my entire day. It may just be a couple of painful hours of self-care while doing nothing externally productive before returning to real life to wash dishes and nag my partner to pick up his socks.

Madness for me is much further removed from my control and subjective reality than most of my psychosis. There is an intense feeling inside of it that contains vast knowledge and deep pain. Everything else is just mental illness. Mental illness, I cope and manage. Madness, I merely observe.

 

By Emily Harrington, The Goldfish Painter

 

My disclaimer:

I am not a doctor or any sort of mental health professional. I am a psychiatric patient with multiple mental illnesses that I have survived for 12 years now. My secondhand knowledge comes from doctors, psychologists, therapists, books, college courses in psychology, and the internet. My firsthand knowledge comes from the feelings, experiences, thoughts, symptoms, problems, and solutions that I have lived through. I know myself well, but again, I am not a professional. The information on this site is not a replacement for getting an actual diagnosis or professional help. Coping skills are fantastic, and I hope you learn some here and that they help you, but please seek and continue real medical treatment if you are struggling with mental illness. I wish you the best. You can do hard things.

My Paranoia, Delusions, and Hallucinations

As far as delusions, hallucinations, and paranoia go, I can only speak to my own experience. During the delusions of grandeur during mania that I’ve had, I felt really, really good about myself and thought without a doubt that I could achieve very difficult things, like using a chainsaw to illegally cut down all the trees on a road near my house overnight because the trees had grown to block the formerly beautiful view of the lake, and I was outraged. I believed that was a good idea, and that it was achievable. Fortunately, I got distracted from that plan. I also had a recurring delusion that I was going to write a book about bipolar and publish it. It would be so meaningful, insightful and true that it would become a best seller, and I’d go on a book tour to publicize it. I’d end up telling my story to Oprah herself. I started that book about five times and didn’t get far, but now I have a website about bipolar that has all my best wisdom in it, and I’ve had a lot of people reach out to me lately to share their stories and tell me that my words have helped them. Educating people about bipolar was always a goal, but during a delusion of grandeur I took it to the extreme, and I felt good about my future.

Now, what is it like to have these delusions of grandeur in the first place? All I can explain is how it feels to me. In the very few times that I have had pure mania with delusions of grandeur (almost every episode I’ve had is mixed-state, with features of both mania and depression at the same time. I get dysphoric mania, the opposite of euphoric) I have buzzed with energy, felt like I could lift a car, been quick to make witty remarks, laughed often and too loudly, talked too fast and believed I could do many different extremely difficult things if I just put in the effort. I also believed that I could put in that effort, ignoring the fact that my illness precludes me from even having a job, because keeping myself alive is a full-time job itself. It was such a positive headspace that anything felt possible. I was just along for the ride, trying to have as much fun as I could. Of course, this has only happened to me a handful of times, since most of my episodes suck very much, even manic. Continue reading

Hallucinations

My favorite hallucination I’ve ever had was a flock of black angels flying over the highway. I leaned out my window to look as we drove under them. I was severely sleep deprived, manic, and on a medication that I hadn’t yet figured out was affecting me badly, so I didn’t know right away that it wasn’t real. Usually, I can fact-check and try to reason through the situation if something comes up that doesn’t make sense. These angels felt very real to me. I got to watch them for about 45 seconds before they were gone, and because they disappeared, I could confirm that it had been a hallucination.

My hallucinations are caused primarily by bipolar episodes and sleep deprivation. Depression can sometimes play a role, and mania is a guaranteed hallucination factory. Sleep deprivation, though, causes the most intense visions, and they last all day. I’ll see smoke billowing in the air everywhere I go, people dressed in black walking up and down stairs, hundreds of birds in the sky, and bugs on my skin. Less often I have auditory or olfactory hallucinations, where I hear or smell things. Least often I have the physical sensation of touch. That one throws me for a loop every time.Meeting Myself CC

There are good, bad, and irrelevant hallucinations. Now that I’m on beneficial medication, most of mine are just irrelevant; they don’t actually impact my life. I count myself lucky for that. Most people who hallucinate don’t know or believe they’re hallucinating at the time it happens. I don’t know immediately, but I can often use logic to determine what’s real and what’s not. Continue reading

Suicide; The Perpetual Question Mark

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The truly tempting thing about suicide is that it’s a solution to pretty much everything. Not a constructive solution or a solution other people want you to use, but still a solution. We can opt out. Once you realize you’re strong enough to end your own life, that knowledge will never go away. When you’re happy and engaged in life, that knowledge makes your life better because of the profound meaning there is to be found in the awareness of death and the empowerment of choosing to live. But when you’re feeling awful and you get to feeling awful enough that you think you’d do anything to change the way you feel, the knowledge that you could kill yourself becomes lethally dangerous.

Suicidal ideation is a very dangerous symptom. It can be caused situationally or purely chemically; by life events or medicine and chemical imbalance. If you’re experiencing suicidal ideation, it can be tremendously difficult to ask for help. If you’re past ideation and you’re fully suicidal, seize any moment of doubt in your plan that you find and TELL SOMEONE. There are way worse things than going to a hospital. If you’re strong enough to kill yourself, you’re definitely strong enough for a 3-day hold. Sometimes those three days is all it takes to restart your life. You see a psychiatrist and a therapist, and they prescribe medicine and evaluate you during your stay to make sure the medicine is working and you are safe from self-harm. You go to the hospital to get better.

I’ve had two failed suicide attempts and three psychiatric hospital stays. The first attempt Continue reading