Ever since my preteens when my various (misdiagnosed or unnoticed) mental health struggles started, I have experienced this thing. This sensation, you could say. I’ve never told anyone about it, none of the various psychiatrists, psychologists or therapists I’ve encountered — not in my teens when everyone was trying to figure out what was wrong with me or in the two decades following the long and arduous bipolar affective disorder screening that finally gave my a correct diagnosis — for fear of either being dismissed or laughed at, or for being taken seriously and have some other diagnosis slapped onto my forehead and be forced-fed a daily diet of more brain-rewiring drugs.
Disclaimer: I’m not advocating for anyone to be or not to be on whatever pharmaceutical. I think everyone is different. Even if we share a diagnosis, the symptoms will likely manifest themselves differently and because we’re different people with different fysiologies as well as different lifestyles we will naturally have different conditions for coping. What works for me will not necessarily work for you, whether we’re talking coping strategies, natural remedies or pharmaceuticals. So I will never judge someone for their choices or coping strategies, and I hope you won’t judge me.
BRIEF BIPOLAR BACKSTORY
When I officially got my diagnosis of bipolar affective disorder at the age of 25, going on 26, they put me on mood stabilisers and that was it. Now, this I do disagree with and will advocate against for the rest of my life. Whether the best choice for you is to be on medication or not, it is scientifically proven that whilst in an episode a combination of medication and therapy is more effective than just medication, and I can tell you from experience that whether we’re talking about staying afloat whilst seriously unwell, getting better or staying well when you’re finally in remission, the most important thing is lifestyle and routine and the second most important is a support network (and if you’re unwell or still working your way back to stability that support network should include some kind of therapy.)
Meds, coming in at number three, is crucial for some and optional for others. For me personally they made things a lot worse. At every medication review with my psychiatrist all that happened was he upped the dose, and eventually he combined the mood stabiliser with an anti-psychotic, and finally, after being on that combo for a while and it still wasn’t worked for me, just before I moved out of the country, the psychiatrist took me off the mood stabiliser altogether and upped the dose on the antipsychotic and sent me on my way. What followed was the worst depression I’ve ever had and, after I weaned off the antipsychotics that seemed to exacerbate the depressive episode, I swung up to experience the most extreme mania and hypomania I’d ever experienced. I then struggled through another three years of really volatile mood episodes, and I don’t think I ever really stabilised between them, I went from highs to lows to mixed consecutively, with constant anxiety and suicidal thoughts and urges. Then, finally, it all settled down again and my mind was back to where it used to be before the antipsychotics and I’ve now been in remission almost two years.
Even in remission I have to constantly be aware of my moods, coping strategies and triggers, because bipolar is a chronic condition and if I don’t live well I get ill. That is just the way it is. I am always going to be more sensitive to stress than most people and need to be super careful about my work life balance. I am never again going to be able to overwork myself, party like crazy or pull all nighters. Even so, I’ll probably still get ill again at some point in my life because there are bipolar triggers that are outside of your control, such as life events, moving houses, having children, experiencing loss, heartbreak, or even happy things like weddings and promotions can be overwhelming and trigger an episode unless you’re very careful. Any hormonal shift can be triggering as well, so for me as a woman, PMS, pregnancy, child birth, early motherhood, peri-menopause and menopause are all triggers.
HERE I AM, NOW.
So right now, here, I am still in remission, I am doing okay, but I have been slightly low and more sensitive to stress and getting overwhelmed for the last couple months now. There have been some physical stress symptoms and more days of being “wobbly” as my partner calls it. It’s nothing compared to the two years when I was really ill with mixed states and compulsive suicidal thoughts, but obviously with that kind of history it’s impossible for me to not get anxious about symptoms even if they’re minor… you can’t not ask yourself: is this it? Am I getting worse again?
I don’t know that I’ll have the strength to go through an episode like that again. I’ll have to find it, obviously. But right now, that’s what I’m thinking, and I’m scared of having to face that challenge. I’m scared of getting bad again.
I’m also scared of being forced to go back on medication.
Which brings me to the actual topic of this blog.
Ever since my preteens I have experienced this thing. This sensation of not fitting in with the picture around me, like the world isn’t real or like I’m watching it from afar, from deep inside my body like I’ve been sucked deeper into the core of my mind and eyes are still where they are and my arms and hands and everything is where they are, but the part of me which is thought sits further away somehow and observing the world through a glass tunnel and not really being part of it. I have memories of being a teenager and reaching out to touch furniture and things to reassure myself of the distance between myself and my surrounds and to ground myself. Sometimes I’d be unsure of what’s real, if I’m dreaming. I’d tell myself it’s nothing, that I just have an overactive imagination and those times when the line between my thoughts and reality got blurred was always when I was manic or sleep-deprived. But, if I told anyone, they might think I was crazy. So I never did.
Even now, I still get that sensation sometimes and now I’m even more scared of telling anyone because what if they think I’m psychotic and section me? What if they think my bipolar diagnosis is wrong and give me a diagnosis of schizoaffective disorder or schizophrenia or something instead? In both those scenarios, they’ll force me back on antipsychotics. And then I’ll lose my mind again.
That’s the thought process in my head every time this happens. Like today. And then I’ll talk myself down from the worry and tell myself it’s nothing, I do know what’s real, I just have to think a little harder about it sometimes but I can always tell once I do.
But obviously there’s a niggling doubt at the back of my mind, and that fear. What if I am going crazy?
My biggest fear in life is being trapped in a psychosis and losing everything I care about. Ironically, I have an equally strong fear of being put on antipsychotics as a preventative measure and it having the same affect: my mind rewiring itself to what it was like a couple of years ago, triggering the same severe mixed states episodes and bringing on the compulsive suicidal ideation from before and then I’ll still lose everything I care about (or kill myself)
So, I don’t want to tell anyone, but I also don’t want to stick my head in the sand. In case it is a worrying symptom. So, I consulted the BipolarUK community forum and Doctor Google. And what do you know… there is a name for exactly what I’ve been experiencing. It can be symptom of anxiety or stress (both of which I’ve been having every time I’ve experienced the sensation) and not psychosis. I feel so relieved right now. I’m not going crazy!
I came across the term in the BipolarUK ecommunity and then googled it wildly. After finding a website dedicated to a disorder that includes wither derealisation or depersonalisation and reading about the conditions, the cause and of course the different symptoms, I was shocked to realise that I have experienced every single symptom on the Derealisation list. But I was also relieved to realise that this is most likely tied to my anxiety and stress, rather than an early symptom of something worse.
Also, the main strategy to cope with it seems to be grounding techniques. Which I’ve intuitively been doing anyway.