A Mixed State



I just couldn’t stop moving. I tossed, I turned, I paced, I jittered. I got up in the night to pace. I wrung my hands and jogged my legs and drove everyone around me up the wall.

“Stop! Tell me what’s bothering you.” Hubster would say. “I don’t know!” I would reply.

“Stop! Take some deep breaths and try to keep still” My doctor would say. “I can’t!” I would say, before pacing around the room again.

It had begun about a week before I was admitted to hospital, and it was unlike anything I had ever experienced before. In my experience, depression is accompanied by lethargy. A complete inertia and apathy towards life itself. You don’t want to *do* anything when you are depressed. Merely getting up in the morning is a mammoth task.

But this wasn’t like that. I was acutely depressed. Suicidal. Hopeless. Yet, for the life of me, and despite the plethora of psychoactive medications I was offered, I just couldn’t stop moving.

I was moved to the most secure room on the ward. The bathroom door had a peep hole. This disturbed me. Though looking back the peep hole should have been the least of my concerns. Under ‘special’ supervision a nurse was required to be present every time I used the bathroom anyway. Although I was admitted to hospital as a voluntary patient, I was informed in no uncertain terms that if I were to attempt to leave the premises I would be sectioned under the Mental Health Act.

One morning I woke up to find three nurses conducting what appeared to be a sweep of my room. “We’re just giving your room a bit of a clean” they told me. “Umm, okay then” I said. I didn’t really think much about it until I had my shower and wanted to dry my hair. My hairdryer was gone, and when I questioned the nurse about it she told me it was for my own protection. On closer inspection I noticed that all my power cords were missing as well as my shaver, scissors and nail clippers (ok fair enough), dressing gown cord (lethal weapon there…) and my shoes (seriously?!). Hubster later told me that women’s bra’s are often removed in institutions. How he knows this I’m not entirely sure. Thankfully my underwear was left safely in my drawer. Small mercies!

Although I understood that the hospital was taking my safety into their own hands, I wasn’t entirely sure why. I mean, I knew I was suicidal. I knew I was severely depressed. But most of the other women in the ward were depressed. Yet they didn’t need a special room, or 24 hour supervision. They were allowed to go for walks alone, and wear dressing gowns with a cord. On a few occasions I felt angry about this perceived inequality, sometimes I felt upset. But mostly I was so depressed that I just didn’t care. I didn’t care that my rights, dignity and privacy had been taken from me. It just gave me one less thing to think about.

All of this happened well over a month before the manic episode that confirmed my diagnosis of bipolar disorder. But at this point in time the doctors were already suspicious that I had bipolar. You see, somewhere in between mania and depression there is a strange phenomenon clinically termed a ‘mixed state’. You have symptoms of depression and of mania at the same time. The agitation of mania without the euphoria. The chronic low mood of depression without the apathy. A mixed state is one of the most dangerous psychological states to be in, and many suicides associated with bipolar disorder occur during a mixed state. Somewhat ironically, the lethargy that accompanies depression acts as a  kind of safety net. A depressed individual may simply not have the energy to execute a suicide attempt. During a mixed state individuals are seriously depressed, but fuelled with energy – a deadly combination.

What I know now is that I was experiencing a mixed state, and this went on for many painful weeks. No amount of anti-psychotic or anti-anxiety medication dampened my agitation. No amount of anti-depressants lessened my depression. I barely slept, despite the copious sleeping pills I was offered.  My son was almost exclusively cared for by the nurses and my husband. To this day I have very few memories of this point in time and rely on my doctor’s and husbands recollections of how I was.

A mixed state is such an appropriate term. Because I really was mixed up, and I really was in a state. I was experiencing symptoms of depression, mania and psychosis all at the same time. I couldn’t explain my past and I couldn’t think about the future. I wanted to live, but I wanted to die. I wasn’t sane but I wasn’t crazy.

While I was in hospital I marvelled at my baby boy’s development. I watched him pull himself along on the floor, start to crawl, and finally pull himself up to stand. And as is the way of things, the mixed state passed, and transformed into something else completely. I was taken off ‘special’ supervision and onto 15 minute checks, and then half hour checks, then hourly. Soon I even got to go for walks, and was moved to a different room (without a peephole!).  Then finally, like my son, and with the encouragement of Hubster and the medical staff, I reached up and stood on my own two feet.


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