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The invisible nature of my mental illness

How can something so powerful and destructive go completely unnoticed? Just because a mental illness is invisible, it doesn't mean it doesn't exist.

The thing about mental illness is that a lot of it happens inside a person's head. I don't mean that it's in their imagination, but that the symptoms aren't necessarily on display, and if they are, they may not be that obvious.

It's difficult to explain to somebody that the way I perceive everything, from opportunities and my own achievements, to other people's intentions and even how I perceive myself, can swing the opposite way simply because my mood has switched.

That change in perception may start off as something quite subtle, hardly noticeable at all, but by the end of the day it can lead to destruction and chaos. And all because of a sudden imbalance of chemicals in my brain.

I'm not exactly sure how the science works. Perhaps someone can enlighten me in the comments? Because to me it seems unbelievable that I can go from feeling on top of the world, success at my fingertips, with everything I touch seeming to turn to gold ... the thrill of possibility and change, my seemingly unstoppable capabilities feeling intoxicating ... and then BOOM. It's all gone.

This happened to me recently, and my mood decided to dip on the day of my job interview. How typical!

Warning signs of hypomania missed

Two weeks ago I started to feel irritable.

I could feel it simmering underneath my skin, and I was trying my utmost best to grit my teeth and keep it at bay.

My niece's birthday was approaching, and I had a special day-out planned for her that I didn't want to ruin. It was very important to me, and I had promised myself that I was not going to let her down.

The day came and went, and we had a really great time together.

I didn't realise it then, nobody did, but my mood was already becoming elevated. It may as well have been my birthday.

The destructive nature of hypomania - in action

So when my sister and I fell out the following day, over something quite small to be honest, I exploded.

It was really bad. We're still not talking.

The sad thing is that I don't feel sad. And that's because the empathy is missing – a classic sign of hypomania.

In fact, it feels as though the incident didn't even happen. I'm completely removed from the experience ...

I should at least be feeling sad that the breakup with my sister is also kind of a break up from my niece ... but nope, there's no feeling, at all.

One of the features of hypomania is grandiosity, and with that can come a lack of empathy. I always struggle with empathy when my mood is elevated. It's one of the key things that result in my sister and I falling out.

Still hypomanic and continuing to climb...

Normally, after a spike in my mood like that, I experience a horrible crash. But that didn't happen.

Instead, I got back in touch with my mother, who I had fallen out with the previous week – another explosive row over nothing, sparked by irritability and teamed with reactivity. It's the lethal concoction that causes most of my problems with the people I'm close with.

That would be all forgiven now though, because I was high and I had far too many things to celebrate.

In the ridiculously short time it had taken me to utterly destroy a relationship with my sister – that we had been working on healing for the better part of three years, by the way – I had already come up with a new life plan, and I was half way there to achieving it all.

My mother was the perfect cheerleader. All was forgiven.

Since then my mood has been climbing higher with all the positive feedback and encouragement I've been getting from my mother. It's not her fault. What she sees is a happy daughter who is achieving great things in record time. What's not to be positive about?

It has been two weeks of high achievement, high activity, and high enthusiasm.

The invisibility of my mental illness

The thing is, on the outside, none of this looks out of the ordinary.

In fact, when I'm in an elevated mood, for the most part I can come across as being very much in control. I exude a fairly calm and positive energy, that uplifts anyone who wants to come along for the ride.

Most of the actual chaos is going on inside of my own head, and unless I describe it all verbally, people are none the wiser.

Sometimes I might trip over my words or find myself interrupting during conversations – which can be a sign that hypomania is present – but it's nothing so extreme that it's that noticeable, especially if you're not looking for it.

Inside my head though, and behind closed doors, it's a different story – hypomania is running riot:

I've been reading three books at the same time!

I've been switching from one book to the other and back again because my reading speed couldn't keep up with my enthusiasm.

I honestly couldn't tell you what any of the books are about because in my head I've not only been reading the words on the page ...

At the same time I've also been:

  • replaying conversations I have had with people

  • having new conversations with myself – listing from memory the contents of my fridge, freezer and cupboards

  • engaging in an inner monologue about my meal plans and the food prep that I've been doing

  • explaining to an audience that isn't there how I cured my dog of her skin condition with a special diet that involved an intricate process of food elimination, describing every little detail of the diet and process in my mind's voice...

and generally just hopping about from one thing to the next that pops up to whisk my attention away in a different direction or snatch it back.

Sometimes after interacting with my mother on the phone, or after a day out, I have come away feeling so absolutely exhilarated that my head is literally buzzing, and I'm ready to go again. Perhaps you would liken it to that feeling you get after drinking way too many coffees ...

But she would never know that, unless I told her.

The inevitable come-down from hypomania to depression

During this time I've noticed that I seem to be having mini-crashes.

The first one I had lasted a day and it was mostly just physical. My body was very tired and I needed to have a kip in the middle of the day because I was too tired to focus on anything.

It felt a little bit like the kind of dips I used to have when I was anaemic. I thought the lack of energy was due to me starting my period, and so I practiced some self-care and I had an early night.

I didn't recognise this as a dip in my mood because I wasn't feeling mentally low or negative. At the time I hadn't even recognised that my mood had been particularly elevated, I had felt like I was in a good place.

It also felt too short to be a real mood dip, it was only one day and then I bounced back full of beans.

It's very common for me to be unaware of the fluctuations in my own mood until later on when I can look back on things with a more objective eye. And the thing about cyclothymia is that a mood swing can pop up out of the blue and change back again with the wind.

The following week I had what I considered to be an actual mood dip. The previous day had been a mad one ...

I knew that I had been experiencing symptoms of hypomania, despite my mother telling me that she felt I had a calm and relaxed energy about me. I knew I was hypomanic because of what was going on inside my head all day, and the fact that I felt like an energiser bunny ...

That morning I had walked my dog, then walked to the hospital to have an MRI, which was a last minute cancellation appointment, so the experience has hardly had time to register. I've never had an MRI before, and they're actually rather stressful ...

Then I caught the bus down to the west end where I spent the day with my mother for mother's day. We walked about for hours, chatting non-stop, I felt blissful and interested in everything ...

I came home and felt my head buzzing with happiness and overstimulation when it should have been hitting the pillow, and then I spent the rest of the evening preparing for the interview to a job I had no doubt that I was going to get (because I was hypomanic).

I woke up on Monday morning and I felt very different. I didn't want to get out of bed. Not only was I feeling mentally and physically drained, I was also feeling anxious and unfocused.

It was the day of my interview, I had done so much preparation, but now I couldn't remember anything. When I looked at my notes they made no sense to me, I could barely even recall writing them.

I was frustrated. I had been looking forward to this interview and I had believed that I was going to be awesome in it.

Now I felt the dread in my stomach as I felt like a completely different person, and I could hear the negative spiralling thoughts of an approaching depression start to take over in my head.

Masking the mental illness

I tried not to overthink it. I put on the metaphorical mask that I know too well because I have had to rely on it many times to get me through the day when I was struggling with a dip in my mood. I got through the interview.

But then I spent the whole day in a state of complete paranoia.

I knew it as soon as I left the house to walk my dog because I felt horribly exposed and desperate to get back indoors. I spent the day going through every stupid thing I had said, and all the questions that I didn't answer properly ...

It was hopeless, I had messed it up. I was a fraud and the interviewer must have been able to see right through me. I had no business applying for the job in the first place. I'm never going to get a job.

The day ended with me sobbing wholeheartedly into a pillow, feeling like I had ruined my reputation, my career, my life.

I had a very strong urge to delete all of my social profiles and lock myself away for at least a month. I felt exposed and awful.

Back on the board ...

The following day, the dip in my mood had passed and I felt much more sensible. I was back to what one might consider to be a normal level of mood. Although, I never can quite tell. I could be climbing again ...

I did write and publish a book review on my blog and then get stupidly excited when the author replied to my tweet ...

I did apply to several jobs that I'm not at all qualified for.

I've also been hopping from one task to the next and my laptop browser is suspiciously overflowing with tabs again – one open for every blog I own and every social media profile for each of the blogs. I'm definitely multi-tasking.

Here we go again.

Onlookers don't see what's really happening

To anyone on the outside, I'm just a very organised and productive person, with a positive mental attitude, and I might have had a slight wobble, which was normal because interviews are stressful, but I still performed fairly well.

The thing is, I wasn't stressed about the interview. Not until my mood dipped. I was 200% prepared and raring to go before that.

Nothing could have stopped me from nailing the interview and bagging the job on the spot as far as I had been concerned. Why? Not because I have some great skills and I'd be a great fit for the job, but because the job was perfect and absolutely made for me. Hello grandiosity!

I'm not sure what is going on with me at the moment. I seem to be surfing a very long wave, falling off my board momentarily, and getting straight back on like the fall never happened.

I feel like the people on the shoreline can all see me surfing, and I look like I'm in total control and like I know what I'm doing ...

but what they don't see is the thrill, the excitement, and the exhilaration I'm feeling underneath my outer composure ...

and they don't hear my inner monologue or know about the zillion thoughts and observations I'm juggling in my head all at once in order to keep my balance.

When I do momentarily fall off my board and hop back on again, it's like all the people on the shoreline have blinked and missed it!

They don't hear the chaos in my head and they didn't see the fall, so to them there's no problem, I'm surfing and I look great. It's like that riddle – "If a tree falls in a forest and no one is around to hear it, does it make a sound?"

Is this cyclothymia?

I tend to think that if I were experiencing a proper hypomanic episode, like the kind you have if you're diagnosed with bipolar type 2, I probably wouldn't be aware of what is happening because I'd be lost in the episode.

If I suffered from bipolar type 2, I also think that people would be able to see that something was wrong – surely?

I guess, with cyclothymia, it's not so clear-cut.

The peaks and dips in mood can be imperceptible, and when they're extreme there's always a reasonable-sounding explanation.

I question myself constantly, and it's difficult to know who I actually am and what of my experiences and feelings are real, when my perceptions of everything change with such disorientating frequency.

Maybe I need to start tracking my moods more closely.

Well, whatever my disorder is, at least I'm high-functioning, self-aware, and I can be reflective enough to try to understand what's going on so that I can have some control over what happens in my life.

The extent to which I have control though, I have to say, is questionable.

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