More on Safety and Bipolar Thoughts (updated)

Please note: This post may trigger people who escalate in thinking from a small manageable thought to large-scale or world-wide impacts and import or grandiosity. The post includes some discussion on the topic of grandiose thinking.

In my last post I talked a lot about anxiety and depression associated with bipolar illness. I concluded that safety is a number one issue for me. Safety that I did not experience as a child. Safety that I did not experience in college.

To be fully transparent about safe and unsafe, I have been exploring my thoughts around safety both physical and mental.

For me, I experience fear pretty readily for things impacting my body like fear of heights, fear of motorcycles, fear of downhill skiing. But my relationship with my own thoughts does not show such a clear division between safe and unsafe thoughts.

As a person with bipolar illness, I have very often “allowed” my thoughts to escalate from a very specific topic to world-wide impacts. I believe it is part of the bipolar disorder to escalate thinking at level 2 or 3 out of 10 up to 11 and beyond. What was an small observation about priorities or concepts at the local level quickly escalates to a topic of global import (in which I perceive I am involved). I believe that tendency is often present in a grandiose thought processes.

Today I want to talk about what those escalating thoughts do to me. While it is my nature to escalate because of the bipolar, I do not always feel safe in doing so and more often than not do not regularly want to escalate. In this post and later posts, I would like to explore my ability to “choose” the extent of escalation in my bipolar thoughts. Upcoming in other posts, I would like to talk about how it may be a choice to a certain extent to let thoughts escalate instead of practicing living in the here and now.

If I can see my pattern of escalation over the years, am I not armed with the ability to leave those initial thoughts alone at a “safe” level and not make everything about a crisis or drama on the worldwide stage?

This is all I have for now on the topic of safety. Will follow-up as this work-in-progress continues in the upcoming weeks.

Addendum: I was often rewarded particularly by one professor in my school work in college for making connections between things that were not necessarily apparent. Seeing these “connections” was at the time part of my academic prowess and landed me graduation with honors. That professor indicated among other things that I had “preternatural abilities” in my observations. As I look back on it now, I see these academic exercises as somewhat a breeding ground to years later experiencing grandiose thinking. If making these connections meant I would get an A or an A+ on a paper in college, that was evidence (to me) that my connections between seemingly disparate concepts were “correct.” I am not really faulting the professor here which I might, but I am saying I got really good positive feedback for making these “connections” while in college. Perhaps if I had gotten C’s on these types of papers or assignments I would not have felt that my escalations of thought were well-grounded in reality nor laudable nor applaudable. Perhaps I would have been less inclined “to go there” in my thoughts. At this day and age some 40 years later, I can usually see when I am escalating in my bipolar thoughts. This escalation does not bring me good grades nor a feeling of well-being or accomplishment or safety, but rather it creates difficulty in managing my bipolar thoughts and my bipolar disorder and might just be what has sent me to the hospital these several/many times over the years. Three cheers for being the B or C student?!?!

My Sojourn through Bipolar Illness – Intermixing with Police and First Responders

I am of the mindset that police and college campus police could do well with more training as to what constitutes a paranoid episode that is largely safe and what constitutes a paranoid episode that is largely unsafe.  I feel that the police serve in a hugely defining role as to whether someone experiencing an episode of bipolar illness should go the hospital or be incarcerated.  There is no such distinction for any other type of intervention that the police are called upon to mediate.  It takes a great amount of training about paranoia and how it operates particularly in the minds of our youth.  If psychiatrists are largely unable to determine when paranoia is linked with violence or not after days or months or years of working with that person, think what a challenge it is for a police man or woman intervening with no case history on the patient while being charged with the safety of that patient and all bystanders.  It is a huge responsibility that falls on the police and college police. 

I have worked through NAMI (the National Alliance on Mental Health) in their In Our Own Voice Program to talk with these First Responders and provide more insight into the patient’s point of view when these incidents occur.  I found the reception at that event quite welcoming as if the police or campus police had never had a conversation with someone prone to paranoia when that person was outside of that paranoia event.

In any case, I find the work of police and campus police to be a gargantuan task.  It almost requires the intervening police officer to be all-knowing and to be able to size up the situation in a matter of minutes as to whether the person before them is paranoid and a danger to others or paranoid, a danger to themselves and needing hospitalization.  I feel that additional training in differentiating these behavioral health outcomes should be mandatory both for crisis interventionists as well as medical and clinical professionals.  As a person who has experienced mania and being a danger to self and perhaps others, I readily do not see a clear line for police to follow from which to determine how best to intervene.  If I am unclear on that intervention after 30 plus years of managing (or trying to) the illness, I would imagine most police and campus police feel that they are overwhelmed and alone as First Responders in assessing the case of a behavioral health incident.

I feel for the police and the campus police and their courage in this line of work and believe that greater training like that of NAMI’s In Our Own Voice Program is extremely important.  I had one first responder come up to me at that In Our Own Voice presentation and thank me.  The officer had never talked to someone with a tendency toward paranoia when they were not in a paranoid state.  All he had ever seen was the patient at the height of a paranoid event – he must have assumed through no fault of his own that that state of paranoia was the norm for that person rather than a state that comes and goes and can be managed for the most part through medications and talk therapy.   

The First Responders should have some sort of script that allows them to assess if the danger is being directed internally toward the patient or if the danger is more generalized to people external to the person experiencing the breach of reality.  I do not claim to have the content to that script in full, but my current thoughts about how questions for this script might go is something like what follows.  This script below should be vetted by a team of first responders, therapists, doctors and other professionals and is only a “strawman” from the point of view of one patient.

 I am going to ask you a series of 20 questions.  I would like for you to respond to each question to the best of your ability. OK, are you ready?  First question: 

          1) What is your name?

2) Are you a student here?

3) Are you feeling OK?

4) What is the date today?

5) Are you feeling suicidal?                

6) Have you ever felt this way before? 

7) Do you have a mood disorder illness?   Have you ever been hospitalized for a mood disorder?

8) Are you hearing voices?

9) What are the voices saying?

10) Are the voices asking you or telling you to harm yourself?

11) Are the voices asking you or telling you to hurt anyone else?

12) Do you have a weapon?  Are you intending to use it? 

13) Where did you get it?  Have you had it on you for several days or just a few hours?

14) How long has it been since you took a shower?

15) How long has it been since you had a full meal?

16) Have you been using any mind-altering, recreational or prescription drugs?

17) If so, what are they?

18) Do you feel safer now that the paramedics are here and we are talking?

19) Is there someone in particular you would like to talk to? Your parent? Your friend? Your psychiatrist? Your therapist?

20) What do you need to feel more calm?    

If there had been such a script available for use by First Responders at the West Ferry airport back in 1985, perhaps my first episode would not have been so cataclysmic.  Perhaps I would not have been plagued by security concerns for several years after this first episode if that episode had been less threatening and less dramatic. 

My Sojourn through Bipolar Illness – Finding the Inner Child

For years I thought that my inner child within [1] was about ten years old.  This is about the time my parents separated for a divorce.  Like most children, I took this news personally and thought that I was personally responsible for their break-up.  I recall the Valentine’s Day after my parents separated I gave them both together a huge Valentine’s heart box filled with Russell Stover candies.  I could tell something was wrong by the look of sheer anxiety on my father’s face.   

In addition to this divorce, my inner child has been somewhat over-shadowed by being the replacement child for my older brother who died as an infant the year before I was born.  At least with my father, I always felt like the replacement child who did not quite measure up.  With my mom, this was not always so much the case.  

Today I feel that my inner child is more like 6 years old (than 10 years old) though I do not know of a specific incident that would have triggered this child within to “stop” at this age.  Perhaps my parents stopped communicating with each other when I turned 6, perhaps I experienced some childhood tragedy that I can no longer recall or name, perhaps this was the beginning of financial differences between my Mom and my Dad and all that that entails.

In any case, this six-year-old child within tends to believe in all sorts of magic just as would a child at six years of age.  She is a matchmaker at heart and seeks continually to imagine people together who might be good with each other – imaginarily or not.  She tends to see things in circular time or dream time often before they occur in linear time.  This early perception is not jarring to her mental health so long as there is not a safety component to it.  If there is a safety component to the perception, my child within seems to turn ten years old and not only feels ”unsafe” but also feels the responsibility for the “unsafe event.” 

I have spent years if not decades trying to understand this child within and her fears for safety.   I have particularly been focused on this child and her safety concerns since becoming a mother 16 years ago.   If I listen closely, it may be that this six-year-old child holds no fears only perceptions of a beautiful place and beautiful planet.  It may be that my true child within is largely guarded from feelings of unsafety, and it is more the child of ten years or the child of divorce or replacement that holds onto those feelings of responsibility and angst and anxiety.

If only I could get the ten-year-old child to listen to the six-year-old child, perhaps I could start to see and hear and experience a world in which everything is whole and in which God is truly in control.  If I am able to honor that six-year-old child fully, I may be able to let go of the ten- year-old child who forever feels responsible for any and almost every calamity that exists.  The ten-year-old feels responsibility for safety of self, safety of community, safety of nation and safety of the world, while the six-year-old appears unencumbered by these rampant safety concerns.  The six-year-old is largely concerned with whether or not people are happy and who might meet whom and what is needed in order to stay happy. 


[1]  I am aware that there are several texts that have been published that address finding the child within and healing the inner child.  I have never read any of these texts but I have worked directly with a therapist over several years in listening to and acknowledging that child.   I would assume that my therapist has read these books and has imparted their knowledge to me.  These books are not included in my Bibliography as I have never read them.