The roots of my manic episode

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Trigger Warning: This narrative contains descriptions of paranoia, psychosis, psychiatric hospitalization, medication interactions, and challenging personal experiences.

Introduction:

2023 marked one of the most challenging years of my life. At 39 years old, I was pursuing my master’s degree in digital culture when a severe manic episode, part of my schizoaffective disorder, turned everything upside down. I had hoped to share an inspirational recovery story, but the truth is, I haven’t fully recovered yet. Currently, I’m grappling with Major Depressive Disorder (MDD) that has proven resistant to medication, accompanied by persistent suicidal thoughts. When Electroconvulsive Therapy (ECT) was suggested as a last resort, I hesitated out of fear it might worsen my cognitive impairments. Instead, I’m now exploring treatment with esketamine.

I am a patient at Kfar Shaul Psychiatric Hospital, where I attend daycare, supported by a case manager and rehabilitation guide. The person I once was seems distant; my life has been reshaped by this illness. Additionally, I’m navigating a midlife crisis, confronting the harsh reality that my mental health struggles have impacted my career, academic aspirations, and personal goals like starting a family. Amidst this turmoil, I find solace in writing. Each day I spend writing is not just a day endured but one of the best days I can have right now.

Loneliness and Isolation

Loneliness and isolation were primary factors contributing to my paranoia, likely emerging during the prodromal stage of my psychosis where early symptoms manifest but aren’t fully developed. Increasing isolation intensified my feelings of suspicion and mistrust.

During this period, my behavior became increasingly strange and bizarre. I would visit the nearest gas station and speak Arabic with the clerks. At Zoom group meetings with unfamiliar people, I felt disconnected and responded with discussions about anti-taxation, much to the dismay of others who wanted to share mundane experiences.

Despite these social challenges, I found solace in a relationship, albeit an unhealthy one. I deeply cared, but my feelings were unreciprocated. We were “friends with benefits,” meeting weekly, ordering food, and watching episodes of “Suits” and Netanyahu’s trials. However, he disappeared when my manic behavior surfaced.

Activism and Political Climate

My involvement in activism, particularly with high-profile pro-Palestinian activists, significantly fueled my paranoia. The increasingly hostile political climate in Israel in 2023 towards left-wing dissidents heightened my internal fears.

During this time, I hesitated to go outside, feeling as though a civil war was underway. News reports exacerbated my sense of persecution, as right-wing protesters labeled left-wing activists as traitors and a fifth column. Roads were blocked, and confrontations with police were aggressive—it felt like the onset of dystopia.

During times of political turmoil, events of collective trauma can open up internal wounds. As a social justice warrior, I have been beaten and arrested many times, experiencing firsthand confrontations with the police, stun grenades, and water cannons. The judicial reform left me feeling that Israel is no longer a democracy but is on the road to becoming a theocracy. I was afraid of losing contact with my family over our differing opinions and the scale of the chaos around me. That stress may have been a significant trigger for my psychotic episode.

see here for more:

Lubell, M. (2023, September 11). Israel edges ahead of Supreme Court session on judicial overhaul. Reuters. Retrieved June 22, 2024, from Reuters

Nilsen, E. (2023, July 23). Israel protests: The military is revolting against Netanyahu’s judicial reforms. Vox. Retrieved June 22, 2024, from https://www.vox.com/2023/7/23/23804795/israel-protests-judicial-reforms-netanyahu-likud-idf

Haaretz Today. (2023, November 9). In War, Israeli Leftists Find Themselves Truly Alone. Haaretz. Retrieved June 22, 2024, from https://www.haaretz.com.

Connections with Iranian Dissidents

As an Israeli citizen, my contact with Iranian dissidents added another layer to my paranoia. I formed a close bond with one person online, spending hours conversing, though I can’t disclose their name. Another individual, recently released from an Iranian prison due to political activism, contacted me soon after, a miraculous yet frightening occurrence due to the strict illegality of such communications.

Medication and Substance Use

Another significant factor was my use of venlafaxine (an antidepressant) and marijuana. My psychiatrist warned me of potential interactions between these substances, which could trigger a psychotic manic episode. This likely intensified my paranoid thoughts, blurring reality and delusion.

Experience in Eitanim Psychiatric Hospital

I was involuntarily committed to the notorious psychiatric hospital “Eitanim.” Despite lacking violence, I was agitated and confrontational, experiencing severe insomnia and accelerated speech, talking incessantly. My time in the closed psych ward was traumatic and degrading. They prescribed a high dose of Abilify, later adding Dekinet to counteract stiffness caused by the former, which didn’t suit me.

Physical conditions were appalling—filthy showers, bathrooms, and dining areas. Staff attitudes ranged from resentful to slightly more compassionate. They dismissed my thoughts as delusional, particularly my belief in being a political activist and understanding Farsi and Arabic. Though not influential, I dedicated years to protests and digital activism, maintaining connections with Palestinian and Iranian individuals.

Therapeutic efforts were minimal, limited to half-hour daily dialogue groups and occupational therapy. I recall an all-night argument with a nurse over a sleeping pill, souring our relationship. They treated us like cattle.

During my stay, I recited Arabic prayers and “converted” to Islam with another patient, believing in a unique Sufi Jewish identity. I made friends, but some were aggressive and scared me. I was restless, unable to sit still for more than five minutes.

Overall, my experience was degrading, and I doubt the effectiveness of their medication and treatments.

Certainly! Here are your strategies for surviving a manic psychotic episode formatted with bullets:

My Strategy to Survive a Manic Psychotic Episode:

  • Get Plenty of Rest: I recognize that my brain is impacted during these episodes, so I prioritize rest to allow it time to recover from phases of hyperactivity.
  • Avoid Being Alone: My amazing friends have been a lifeline. Despite having very few friends, their hospitality, kindness, and generosity have been life-saving. They opened their homes and supported me for almost a year when I struggled to function on my own.
  • Engage in Passive Activities: When my cognition was low, I found solace in watching a lot of TV and movies. It was the most I could manage during those times.
  • Stick to Medication: I adhere closely to my prescribed medication regimen. Taking my pills consistently, following the regimen set by my psychiatrist, is crucial for managing symptoms.
  • Regular Therapy and Professional Support: I am always in therapy or in contact with licensed mental health professionals, whether it’s my case manager, rehabilitation guide, or hospital care when needed. These connections are essential for my ongoing support and stability.

These strategies are not just tips for recovery but essential practices for survival during challenging episodes.

reference for Support Resources:

If you or your loved ones are struggling with psychotic experiences, here’s a list of support resources:

Reference for Support Resources:

If you or your loved ones are struggling with psychotic experiences, here are some valuable support resources:

  • National Alliance on Mental Illness (NAMI)
  • NAMI offers advocacy, education, support groups, and resources for individuals and families affected by mental health conditions, including psychosis.
  • Website: NAMI
  • Psychology Today
  • Psychology Today’s directory allows you to search for therapists, psychiatrists, and support groups specializing in psychosis and related mental health issues. You can filter by location and specialty.
  • Website: Psychology Today
  • Mental Health America
  • Mental Health America provides advocacy, resources, and support for individuals living with mental health conditions, including psychosis. They offer information on treatment options and local support services.
  • Website: Mental Health America
  • International Society for Bipolar Disorders (ISBD)
  • ISBD offers resources, research updates, and support specifically tailored to individuals with bipolar disorder and related conditions that may include psychotic features.
  • Website: ISBD
  • Local Support Groups
  • Contact your community mental health center, hospital, or local chapter of organizations like NAMI to inquire about support groups specifically for individuals experiencing psychosis or related mental health challenges.
  • These groups provide a safe space to share experiences, learn coping strategies, and access peer support.

Additional Note:

If you’re experiencing psychotic episodes or related mental health challenges, it’s crucial to seek help from professional healthcare providers who specialize in mental health. Personalized care and treatment tailored to your specific needs can make a significant difference in managing symptoms and improving quality of life. Don’t hesitate to reach out to local mental health services, community support groups, or trusted healthcare professionals for guidance and support on your journey to recovery.

Certainly! Here’s a list of immediate helplines that individuals can contact for assistance during mental health crises:

These helplines provide immediate support and resources for individuals experiencing mental health crises, suicidal thoughts, or emotional distress. It’s important to reach out for help when needed, as these services are available 24/7.

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