I’m writing from inside of what may be a manic crash. Or it may be incipient psychosis. Or it may be nothing at all. It’s so difficult to tell; it’s always so difficult to tell, even after all the therapy, and even with the medication, even when your symptoms are reduced, even when you’ve been trained to look out for and recognize the signs: it’s so, so hard to tell. People imagine that an “attack” of some psychiatric condition is like the weather, like a gale force wind blowing down, or a hurricane crashing into your life, but it isn’t. Insanity sneaks in the back door and wraps itself around your head and makes you different while making you feel like it’s the world that’s different. You don’t see the signs of the illness. The illness becomes your eyes and you see what it wants you to see, and if you’re lucky, you can tell that something’s off enough to not believe your lying eyes. But then: when you’re looking for the signs—when you’re worried about them—it’s easy to get a false positive. It’s easy to over-interpret blips and noise. It’s hard to say, am I paranoid right now, or am I just paranoid about the possibility of paranoia? I don’t know. I don’t know how I’m doing right now.
In theory, I should be alright. I can tell you a story that adds up to “I’m fine.” I haven’t missed my medication lately. I’ve gotten the work I need to do done every day. I’m not doing anything palpably crazy; I’m not high or gambling or sleeping with strangers or worried whether or not I exist. I think the people immediately around me don’t get the sense that anything is terribly wrong.
But I can also tell you a story that adds up to “something is very wrong.” I know that I didn’t sleep enough for a couple days earlier this week. That can cause problems. I know that I’ve been feeling off—agitated, a little bit scared, some elevated heart rate, some hyperventilating—not too much, nothing extreme—for a few days now. I think, although I’m not entirely sure, that I’ve been alternating between a blunted affect (not much to say, a hard time hearing what other people are saying to me, a feeling like my head is full of fog) and talking too much and too fast and without any focus. I say I’m not sure because from inside it all feels normal in the moment. But when I reflect with enough practiced objectivity, I know that it feels a little wrong. I know that I came to California a few weeks ago, and switching time zones and locations and routines can always be a little rocky; I know that I finished graduate school in May and don’t really know much about the future, and uncertainty doesn’t help my health much either. I know that I don’t see a therapist when I’m out here, and as dull as I find therapy when I’m in it, I know that a week-to-week reality check helps. I haven’t had a reality check in three or four weeks now. Maybe I’ve been drifting off course. It feels a bit like my whole body is buzzing with this low-tone, stifling fuzz sound. I know that I’ve been more sensitive to noise: to traffic, and loud voices, and the worm-writing slurp of people eating. I get that way sometimes, and it doesn’t necessarily mean that I’m on the verge of a crisis—seroquel, even at my dose, can’t fix everything all of the time—but it isn’t necessarily a good sign either.
I know that in the last several days, I’ve gotten into serious fights with two people who I’m close to. I know that ordinarily I do not get into these kinds of fights, and that if there’s more than one going at a time, it can be a sign that I’m off and just can’t see it. But ordinary people get into disagreements too. Neither of these fights have involved yelling, or nasty insults, or anything like that: in both cases, I’ve felt like another person was deeply unkind to me, and I’ve said so, in what feels to me to be a frustrated but not bizarre or furious way. Ordinary people sometimes have inconsiderate friends; ordinary, even healthy people communicate when they feel hurt and then resolve the issue, and this doesn’t mean that they’re insane. I don’t want to talk specifics here—the specifics aren’t the point—but in both cases, I think I can tell a true and reasonable story that sounds like an entirely ordinary interpersonal conflict. The kind that happens all the time to everybody and gets resolved one way or another and then you move on. But I also know that in one of these arguments, part of the inciting incident was me coming to meet a friend somewhere and feeling immediately and inexplicably threatened and terrified by the place that we were. I felt that something I was being asked to do was a trap, that somebody (not my friend) might be trying to poison me. I didn’t so much think these things explicitly in the moment as I did feel them as kind of animal instincts, raw terror and agitation, and so I left in a way that must have seemed inexplicable and strange. That’s not what the fight was about, but the fact that it happened immediately beforehand is another sign: surely, something is wrong. Surely, I ought to reconsider what feels like an ordinary conflict in the context of a day when there’s clear evidence that I’m not thinking straight, that my feelings, as true and simple as they feel to me, might be wrong.
The second fight didn’t involve any overt bouts of paranoia, but as it has wound on into a third day now, it has begun to feel less and less like an actual fight where two people have actually conflicting feelings or interests or stakes, and more like something where I have no idea what is happening anymore. I say what seem to me to be very straightforward things, and am met with either confusion, or with responses which seem to be referring to a different baseline reality, with different facts than the one I’m talking about. Again: this might be nothing. Ordinary, sane people have arguments that seem to be going nowhere, where two people are unable, at least for the moment, to see anything from the other’s perspective, and so wind up talking past each other. Ordinary people fight about the fight, and seem to not be speaking the same language, and lapse out of anger and into mutual frustration and bafflement that the other person seems to be talking about an entirely different chain of events. There is a reason that empathy and mercy and conflict resolution are all hard-won and easily-lost skills. That might be all that’s going on here too. But in a way that’s difficult to describe, it doesn’t feel like that. It feels like either I am being manipulated in a bizarre and out-of-character way by the person who I’m fighting with, or like I am, despite my sense that the situation is very straightforward, actually incredibly confused about what’s going on. The person I’m arguing with has started to say things like, “This feels weird” and “this feels different”, and that they don’t understand, or can’t follow what I’m talking about. That could be a sign that something’s wrong. It’s very, very hard to tell from inside of your own head.
I do worry about being manipulated. Not so much by this person, but in general. It’s happened before, with other people, and I’m sure it will happen again. That isn’t unusual. Other people, even well-intentioned people, will manipulate you because that’s often easier than admitting fault, or not getting what they want. One form of manipulation is what the woke liberal arts world calls “gaslighting”: in short, if you’re familiar, it’s when another person insists so strongly that your memories of what happened in some situation, or even your sense of what’s happening now, that you begin to believe you must be wrong, and if you’re wrong, despite your mind and senses telling you otherwise, then you must be crazy. It’s “Who are you going to believe: me or your lying eyes?”, applied so skillfully that you wind up believing that your eyes are lying. In general, gaslighting discourse can be a little silly—it’s come, in some circles, to mean any time that anybody tells somebody that they’re actually wrong, and I worry sometimes that there’s a point where “my truth is my truth” becomes an alibi for never admitting fault or failure. But the core idea behind “gaslighting” refers to a real phenomenon. Sometimes somebody is trying to get you to stop believing your lying eyes.
The trouble for me is that my eyes are frequently lying. I have a mood disorder. I have a psychotic disorder. The most basic symptoms of those disorders are that I feel things that are not reasonable or justified, and I believe things that are distorted and untrue, and I cannot always tell when that’s happening: it all feels entirely sane and reasonable to me. The idea that gasligthing is a form of manipulation is predicated on the idea that at least most of the time, if you’re very certain about what’s going on, then you’re probably right, and the person insisting you’re wrong—contrary to the evidence of your own heart—is probably trying to pull one over on you. But that’s not necessarily true for me. When somebody tells me that I’m confused, or overreacting, or imagining things, then there’s a decent chance that I am. Is it still gaslighting if you’re actually crazy?
One of the worst and least discussed features of insanity is that below the illness, you’re still an ordinary person with ordinary emotions and perceptions. Yes, you have clinical depression, but sometimes you’re also just sad for reasons that would make anybody sad. Yes, you’re given to manic bursts of energy, but sometimes you’re just in a good mood. Yes, you can get paranoid. But it’s possible that somebody really is watching you. Anybody who has ever been open with their friends or families about their illness is familiar with this dilemma. It’s wonderful to have somebody be understanding when you’re depressed and can’t help it. It’s less wonderful when anytime you’re sad at all, other people attribute it to your depression, and refuse to consider that you might actually have good reason to be sad. It may not be gaslighting if you’re actually crazy. But even a crazy person can be gaslit. The fact that I have to be open to the possibility that I’m not perceiving reality in an accurate way, that my moods, true as they feel to me, might be disordered; that I might, in short, actually be acting crazy makes me worry that I am particularly susceptible to this kind of manipulation. If I’m actually in the right, and actually being reasonable, but somebody who I’m fighting with tells me that I’m nuts, then they know that I’ll probably believe it. They might be right, after all. How would I know? From in here, it all feels the same. But it’s important to know. If I’m being manipulated, I want to know that. But if I’m not, and I really am in the middle of something, I need to know that too. I have destroyed relationships and ruined friendships and hurt people because I was totally unable to see that what felt true and real to me was actually delusion and that my reactions were completely out of line. I wish, in those cases, that somebody had told me that I was acting crazy, and that I’d believed them. But I’ve also been taken advantage of, and treated poorly, and abused by people who knew that I get confused too easily, and who told me that I was crazy to object. I believed them too, and I wish that I hadn’t. It’s so incredibly hard to tell.
I’m going to try to sleep for a long time, but if I still feel wrong tomorrow, then I suppose I’ll find a doctor somewhere here in California. Or I’ll call my doctor back in Iowa. I suppose that’s the fallback plan for all of this. The doctor, at least, can tell you when you’re being a mental hypochondriac, and when something really is going wrong.