When Things Go South

With mental illness, things can be very mercurial – things can be going relatively well and then tank seemingly overnight. This begs the question: What does one do in the shadow of unpredictable symptomology?

I’ll use myself as an example: life can appear to be going relatively well, and then, BAM! It isn’t. I often fight a fugue I dub “waiting for the other shoe to drop.”  I have often said that being in “limbo” (meaning by all outward signs doing well, sometimes even thriving) can be hard because I know it’s not going to last – hence the other fear of the other shoe dropping. 

In recent years, I have had, on balance, more good days than bad, but there are still plenty of bad days. The one thing I am so very thankful for is that I am not as terrified of the other shoe dropping as I used to be (I consistently come up the other side, so I have some evidence that things WILL get better with time).

That is not to say that I am not sometimes hit upside the head with a full-blown episode seemingly out of nowhere. Now, with decades of experience, I have realized that such episodes do NOT typically come out of the clear blue sky. This realization has enabled me to fight back such episodes more easily – as the saying goes, better the devil you know than the devil you don’t.

I am not, by any means, saying that episodes of depression or mania can’t effectively come out of seemingly nowhere. What I am saying is that, with experience as my guide, I have gotten to know myself better, which has helped me to be able to make sense of seemingly senseless episodes. Yes, there are still times when I literally have not the remotest of a clue as to why an episode has descended upon me. To be honest, I suppose I will always live with the fear of waiting for the other shoe to drop.

I would urge anyone with a mental illness to seek help as fast as possible when they feel as though things are going south, even if it turns out to be a false alarm. This is when it’s really important to be vigilant – caught early on, an episode can be managed and may not turn into anything it doesn’t need to be.

What are the ways that one can seek help? Talking to one’s therapist is an excellent place to start. Hopefully, you will have outlined things that you can do to help when you are symptomatic, and you can (with your therapist’s help) implement them. Talking to your psychiatrist is also extremely important – schedule an emergency appointment if necessary. See if there are med changes/tweaks that could possibly take some of the burden off of you.

Additionally, your psychiatrist may want to increase your antidepressant if you are on one and you are depressed, decrease your antidepressant and/or raise your mood stabilizer if you are showing signs of mania, or increase your anti-psychotic if you are actively hallucinating. Your treatment team is there to support you, and they realize that your illness is cyclical – they know that you are going to have low points.

Don’t try to hide your symptoms. Your treaters cannot help fix what they do not know. You are not doing yourself or anyone else any favors by wearing a mask. And the exhaustion that goes along with hiding symptoms is unbearable.

The only truly predictable thing about mental illness is that it can be very unpredictable. Sometimes I feel the most dread when things are going well – the worry being the higher I get, the further I’ll fall. The beauty of my illness is that sometimes things go very, very well. And that can last a decent amount of time. 

The only way I got here, however, is by walking the walk. I had to learn to ask for help, and then I had to learn to accept and put into motion that help. That took excruciating effort, as I am not by nature someone who is comfortable asking for help. Learning to ask for help, or to accept an extended hand, has not been easy, but has been one of the linchpins in my finding a sense of stability.