First up, very important – TRIGGER WARNING. Depression, self-harm, etc. If you get triggered by stuff, read on with caution, if at all. OK? OK.

If you’ve missed some of the earlier stuff, it might help to read this and this.

So I had the psychiatric assessment on Wednesday. Much of the same as the other one, but more in-depth and, obviously, a person who knows much more about this stuff. Also different to the earlier one with the staff nurse was that I went there all by myself, and I went in on the down side of my moods. So I mostly stared at the floor while I spoke as little as possible, and as slowly as possible in order to avoid the anxious stutter I often get.

Anyway, upshot of that appointment is that Dr. F has decided that I do, in fact, have Bipolar.

If you don’t know much about it, or you think you do but probably don’t, I just recommend a quick Google – there’s millions of pages and articles and academic treatises on it: but the easy explanation is that my brain chemistry is a mess, and swings between epic hypermania and major depression.

That I’ve had this my whole life and nobody ever paid enough attention – even when I was begging for help – to see, seems to be fairly ridiculous when anyone who did pay attention could see very clearly that there has always been something seriously wrong.

That things like self-harm, paranoia, self-esteem, etc, causes complications with diagnosis and the illness in general – sure, I get that. But that things like self-harm made the very people who were meant to be there to try and help kick me right back out the door again telling me they didn’t want to deal with it, that’s about as ridiculous as it gets. It’s taken so long partly because of these “professionals” who refused to even try and look beyond the fact of self-harm to the person underneath, desperate for help, repeatedly losing all control, and scraping herself back together over and over to keep trying.

I’ve never really been like other people. Even amongst my odd groups of friends, I remain something of an oddity. I’m ok with the differences, they’re cool, and they make me who I am. That person might not be much, but it’s still me – and that’s declaring a lot more comfort in myself than I had not long ago (and if anyone wants to remind me I said this the next time I start insulting myself, that’d be ace).
But the main, the worst, differences aren’t in those things – personality, interests, creativity, etc.

The problems arise with my attempts to life a life – any sort of life. I have never kept a job for more than a few months – mostly in the past I’ve been a temp, because I have to keep changing where I am or what I’m doing, or I have to just keep stopping because I just…can’t. Even something I enjoy doing, my moods will change and I won’t be able to keep doing it. I am simply incapable of doing the same things day in, day out without going into major depression. It’s like: my brain is constantly changing what is needs/wants/can/is willing to do, and I either follow it, or I face the consequences, in which I’ll wind up unable to do anything at all.
Call it getting bored, call it liking change, call it a need to stretch myself constantly – I just cannot settle at things that can’t adjust based on what my brain needs.
It’s why I always feel like a failure, because I’ve never managed to stick to doing anything. I’ve never managed to do the things most people do. And I’ve never been able to explain the compulsive need to move, to change any more than I’ve ever been able to explain the untriggered mood swings.

Don’t get me wrong, there are plenty of triggered mood swings too. The smallest thing going wrong will send in the depression – and if I’m in the middle of a manic phase at the time, then I’m fairly screwed because I have to somehow try and manage both completely incompatible moods at the same time, which makes me more dangerous to myself than I tend to be at any other time.
I never really experienced the other side of that until recently – but suddenly I’m in a place where good things happen, and they make me happy and excited and energetic, and that triggers a hypermanic phase – and I can’t yet separate out the difference between the two!
The depressions themselves are, believe it or not, the easy parts. When all I can do is sit in a corner for a few days, feeling like the creeping darkness has swallowed my heart whole, and will never let me go – that’s the least dangerous and easiest version of this to deal with.
At each level there are some constants. I always – always – have some level of paranoia. At worst, I have to do things like take down posters and cover up books or anything that has a person’s face on it, because I will be convinced they are looking at me. At best, there’s simply a constant nagging in the back of my head, telling me that *insert name here* doesn’t like me, wishes I would just go away, and is probably swapping laughter and insults about me with *insert other people here* behind my back.

I always have low-self-worth and self-hatred. One of the symptoms of a manic phase is meant to be a feeling of self-importance, which can lead to self-destructive acts. As I have turned everything, ever, inwards on myself, however, I skip the grand self-importance and follow the paranoia straight to self-hatred. Then comes self-destructive acts. Sometimes because I don’t care, sometimes because I’ve decided I need to be punished. Sometimes because I simply don’t think or realise that what I’m doing is going to be very bad later. Alcohol is the least of the things I get into at this point. Mostly I have learned to simply lock myself away in my room so I can’t do stupid things. Sadly the compulsion to keep talking when manic is something I’ve never learned to control in any way, so various people will tend to get me talking at them. A LOT!! And that cues in more paranoia…so round in circles we go.

Self-harm…I feel like I talk around this a lot. I’ve done the whole damn thing. Cut myself, burned myself, shaved off my eyebrows, taken drugs, drunk myself into a stupor, pushed away the people I cared about, quit stuff and run away, destroyed my writing, slammed myself headfirst into walls, put my fist through walls… Mainly I’ve done the cutting, drugs and alcohol. So let’s talk about those, shall we?

Cutting was always about a few things. Feeling the pain on the outside, trying desperately to remove the anger, the pain, the helplessness, the exploding storm of feelings and thoughts I had no control over. The few seconds of peace when the pain hit and took over from everything else. Punishment, because I deserved it, I should die but I deserved all the punishment so I had to keep living and suffering and hurting myself and letting other people hurt me. Blame – all things that went wrong anywhere near me were probably my fault somehow, and I should be punished more. Yet more punishment simply for feeling the things I felt – the depressions and all, there was something wrong with me and I wasn’t good enough, so more pain was deserved. Crying out for help, without actually being able to ask for it. Hatred. Hatred and hatred. Pain and punishment and hatred of the thing inside my head that I was, and I shouldn’t be and didn’t want to be but was too useless and stupid to make stop.

I wear many of my scars in my arms, upper and lower, top and bottom. They are visible because I hated people staring, and therefore it was an extra punishment to make them and, in summer, wear something which meant people would stare at me. The fucked up freak that I was deserved to be stared at, gossiped over, hated, ridiculed by strangers.

It’s been a few years now, since I’ve cut – just barely. Not easy. Found myself sat there again with a knife or a set of razors. It’s addictive, it’s compulsive. Even after 5yrs sometimes I still long to feel that clean, fresh, sharp, simple pain that the razors gave. After 5yrs sometimes I still hate myself so much I want to take the knife and just hack at myself again, screaming out the anger, the frustration, the hate, damaging myself on the outside the way I’ve damaged myself on the inside.

Somehow I’ve managed to not put metal to flesh again. I’ve learned how to make that the very last thing I do. I have a list, not stuck up on my wardrobe door anymore, but still in my head, of things I will do first, and when I run out of those things I’m allowed to cut, but not before. I’ve not yet reached the end of that list without managing to fight my way through, and part of the reason for that is simply: I know what I’ll do to myself if I let it happen; the cutting again, and then the aftermath; it might kill me, it will certainly result in some serious harm. I’ve done the hospital visits to get stitched back together. I’ve done the accidental-almost-suicide and the nerve and muscle damage from cutting too deep. If I give in again, I will never be ok, I will never forgive myself, and I will probably just give up and stop even fighting.

Mostly nowadays I have another constant. A stream of insults (level of harshness varying moment to moment) being aimed at myself inside my own head. I don’t even think about it, they’re just there, and they’re true, and I am all those things. It’s self-harm every bit as much as cutting ever was, just less visibly and obviously damaging. Which, actually, in some ways makes it more insidious and harmful.

So what happens now? Well…any hope I have ever harboured that there was some way to be “better” is now smashed into tiny pieces. I need to stop hoping that there is some way to fix me.
There’s an antipsychotic med, prescribed often for schizophrenia, which I’m being put on. For someone like me, I can a) act as a mood stabiliser and b) help control psychotic symptoms (remember the whole posters looking at me thing? Stuff like that).

I need to:
do a total redefiniti0n of what words like “OK” and “stable” mean to me, individually, and my life.
find a way to allow myself to go through these mood shifts without beating myself up, trying to force through them without stopping, feeling like I’m pathetic for not being able to control what’s going on in my own head, etc.
keep with the not cutting. I may never find a way out of the mental-insult hole, but I can at least manage that.
tell people who meet me for the very first time that I’m on antipsychotics…because I have to find a way to get SOME funny moments out of this!
keep seeing psychiatrist.
understand that the period of going onto meds, then of adjusting/changing them is going to make an already stressful next few months into my own very special and torturous kind of hell.
be aware that this is…life. I will always need help, I will never be “better”, and I will always spin out of control again and need meds adjusting and mire psychotherapy, etc.
not be ashamed. Maybe even tell those I’m ashamed to tell.
keep talking, keep blogging, keep being open. I need to have some faint hope of the very unlikely possibility that me talking about this, difficult as it is to do, might help someone, somewhere, somehow – and that makes this worth doing.

And so I continue. Welcome to my crazy, screwed up head – now officially confirmed nuts.