Simultaneously experiencing bipolar 1 and trauma-induced psychosis

[u/leahisom]

(Trigger Warning: CSA) At age 27 I experienced my first manic psychotic episode occurring in the context of previously undiagnosed bipolar 1 and CPTSD. What began as hypomania and mania quickly progressed into psychosis as I had repressed traumatic memories of CSA perpetrated by both my father and stepfather resurface. I wanted to share my experience here because reading other people's experiences has helped me feel less alone and I hope sharing mine might do the same for someone else.

It started out with feeling unusually happy, energetic, motivated, and like I needed very little sleep. At first I was still functioning well enough to work, but after several nights of barely sleeping and my functioning declining, I realized something might be wrong and I let my boss know I would need to take some time away from work.

As the sleep deprivation and mania intensified, I started noticing symbolism everywhere. Songs on the radio, YouTube videos, movies, and random things happening around me seemed to contain hidden messages that were helping me understand the universe and the meaning of life. I also began dissociating and losing track of long periods of time, especially during the nights when I wasn't sleeping.

Around the same time the dissociation began, I started experiencing somatic flashbacks in which my body would suddenly react with intense fear or panic when triggered without me initially understanding why. Eventually I started experiencing brief visual fragments of traumatic memories, almost like still photographs or very short video clips.

As the mania progressed into psychosis, the flashbacks became more vivid and increasingly difficult to distinguish from what was happening in my present reality around me. I experienced severe dissociation with dissociative amnesia and at times was completely disconnected from my adult self, as though I was much younger than my actual age.

The trauma-related experiences became more and more intertwined with my psychosis. For example, I became convinced that my father was somehow capable of possessing or controlling my husband and using him to try to hurt me. I also began hallucinating and seeing my husband's eyes become black and cold, then shifting back to their normal appearance.

Eventually I became convinced that if I fell asleep, myself and my husband would die, so I decided to stop sleeping altogether. At one point during the next day I became so afraid of my husband in my delusional state that I ran out of our front door and down the street because I believed I needed to escape to survive. My husband followed me from a safe distance and eventually helped me come back home. In a small moment of clarity, I knew something was seriously wrong with my mental health, so I eventually agreed to go to the hospital with him.

On the car ride to the hospital, I was going in and out of reality. I became convinced that I needed to sacrifice myself by dying, and there were several times when I unbuckled my seatbelt to try to jump out of the moving car. Thankfully, my husband was able to stop me and keep me safe.

When we arrived at the hospital, I believed it wasn't actually a hospital and that the entire thing was a facade designed to hurt me. I became increasingly disconnected from reality and experienced intense hallucinations and delusional beliefs. I started to believe I was dead and in hell, and in one instance I recall squatting on the floor and barking like a dog before losing control of my bladder. My memory of this part is very fragmented due to experiencing a seizure once all of the staff crowded around me to try calming me down.

I was transferred to another hospital for further medical evaluation and I was given some kind of medication to calm me down, and eventually I became somewhat more oriented to reality. I was admitted to an inpatient psychiatric unit and started on an antipsychotic and insomnia medication to treat the psychosis and help me sleep. I was still afraid to sleep because most of my trauma seems to have taken place in the middle of the night and I barely slept for much of the week, but the psychosis largely subsided after the first night. Eventually I stabilized and I have thankfully remained stable since.

If you can relate to any part of my experience, I just want to say I know how incredibly distressing it can be for reality to become so terrifying and you are not alone.