An (ab)normal response
A personal example of the hypomanic defense
I know I haven’t written in a while. A lot has happened, and I’m struggling. But I am also handling everything much better than I could have a year ago.
About a week and a half ago, I witnessed someone overdose on heroin. I had been trying to support her in what appeared to be a mental health crisis, but then I found her passed out in the bathroom. This really freaked me out. Initially I thought that she was dead, until someone nearby pointed out that she was subtly breathing. I have developed a certain skill for helping people who are in distress or crisis, but this felt outside of my domain. I hadn’t even seen anyone black out from alcohol before, being avoidant of alcohol-centered spaces.
Luckily, emergency services arrived swiftly, and the person who overdosed was taken to the hospital. I went to accompany her until she woke up. As it was late in the evening, I made sure to take my psych meds early in order to prevent an episode developing from the stress. Very quickly, I recovered from my initial state of shock and took on a sense of responsibility for my acquaintance. I described the whole situation as I understood it to the hospital staff, and I patiently waited for my acquaintance to come to, believing that she might feel a bit more hope in her situation knowing that someone cared.
I told my boss at work what happened, and he was very understanding. In the next few days, he frequently checked in with me in case I was struggling. But strangely, I felt fine, being energetic, motivated, and cheerful for the four days following the incident. I didn’t think much of this, as my affective state was not totally out of the range of my normal. However, now I think that it may have been a mild hypomania considering the circumstance. I mean, why would I feel “fine” after such a traumatizing event? My meds probably significantly restrained the degree of mood fluctuation, but I can still have mood episodes while medicated. (Plus, I accidentally missed a dose a few days before the incident, which caused a two-day period of hypomania and then depression.)
On the fifth day after the incident, I ended up in tears during my canvassing work. I was already feeling low, and then someone chastised me for knocking on her door too loudly. And since then, I’ve been experiencing moodiness, autistic shutdowns, and increased OCD anxieties. Initially I wanted to push through, as technically I’m not supposed to take off from work this close to the election. But after several days of clear distress and dysfunction, I decided to take the day off today to rest. Mental health is far more important.
I just find it very interesting that my psyche processes — or refuses to process — the trauma of the overdose incident in the manner of the hypomanic defense. Initially, I consciously and subconsciously denied the trauma, as I felt “fine” and considered that to be a healthy state. But then, as I could no longer deny and defend against the distress I was experiencing, the chaos came up to the surface and manifested as a variety of psychical ailments. Even then, I didn’t fully grasp that the overdose incident was the source of my unwellness until my psychiatrist and my therapist both pointed out the traumatizing nature of what happened.
It is usually assumed in the psych world that treatment for bipolar disorder centers on medication. But having read some psychoanalytic texts, I think that understanding the dynamics of one’s psyche is also important. By becoming more aware of when I am using the hypomanic defense, I can get more in touch with the parts of myself that are traumatized or grieving and care for them better.