The Cage That Soars; The Cage That Sinks.

An image of a black cube of a cage came to mind as I was thinking of ways to describe bipolar disorder. I'll mix my metaphors at bit.

Mania is a cage that soars. The wind blows between the bars. The sunlight is blinding. The air is thin. But the prisoner can touch the clouds.

The person cannot escape what comes hours or months later: the drop. All the organs rise and fight for release. The beautiful landscape is coming too quickly.

And eventually, the cage is in the water. Maybe one fights at first, kicking and biting to escape. Or maybe one is just so tired from the flight. The slow descent shows iridescent and indifferent fish, like other people who are neurotypical and just don't know. The light fades. The bubble stop rushing. This is depression. There is no escape unless someone or something lifts the cage.

Medication can cushion and revive. The truth I'm learning is that medication puts me right on the dock, where I can peer at the sky or the ocean, where I can get sunburned or splashed. It's a parachute; it's CPR.

But I'm still in the cage.

Electric Darkness: The Mixed State.

The new DSM doesn't use the term "mixed state." Instead, it names that state mania or depression and adds "with mixed features." This seems to complicate the situation further, so I'll continue to use the term "mixed state" or "mixed episode."

I think I have spent a great portion of my illness in a mixed state. Maybe all I want to do is sleep, but I'm also bursting with everything I need to say. I might hate myself and have furious, ecstatic hypergraphia. I might believe I'm brilliant and capable of anything, yet I'm paranoid that I'm going to lose everything, which leaves me a weepy mess. I might be on fire with new ideas yet too miserable to speak.

A mixed state is like being in total darkness while the very air issues thousands of tiny, stinging shocks.

It's like standing at the edge of a tar moat that is somehow so smooth that it looks like glass. So I try to step onto that black ice, and I sink. Calling for help doesn't help. Swimming doesn't work. And the sun is blinding.

Mixed episodes may be most dangerous because depression gives one hopelessness, and mania gives one the energy (and, for lack of a better word, creativity) to self-destruct.

I wish I had some advice. But recognizing a mixed episode may help both the person and his or her caregivers. Empathy is first.

A Changed Mind.

As a child, I could memorize easily. I learned every word to my favorite Broadway shows and my favorite movies.

As I grew up, little seemed beyond me. If I could manage my anxiety, I did fine in school. Math, chemistry, and geography challenged me. But when I put in the work, I still got A's and B's.

I rarely lost objects. I didn't forget assignments. I could bask in the glow of a crush without major academic setbacks.

When I underwent psychological testing a few years ago, the puzzles seemed foggy. According to my results, I was a person of average intelligence. What was I supposed to do with that?

Appointments began to disappear from my mind. Reading became slow and difficult. I lost things. I forgot important information. Hours and days disappeared from my memory. And my brain began showing me things that weren't real.

I could no longer trust my mind. It wasn't there to catch me anymore. I don't know what comes from bipolar disorder and what comes from medication. But I miss my sharper, stronger mind.