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Every once in awhile, a train wreck happens. This one came from the collision of stress, insecurity, dysphoria, the wrong prescriptions, and too little time to decompress. Like a train wreck, which you just can’t help watching for much too long, I hope this post keeps you reading, because it’s much too long.

A few weeks back, I was co-hosting a meeting for which a dozen people came from all over the country; it’s part of my duties as co-leader for the group. But I just couldn’t handle it. As the event went on, I started becoming unhinged. Tuesday was alright, but Wednesday started off with me wildly misinterpreting things and getting completely freaked out and stressed out, and it just didn’t improve from there. That evening, I’d had more than my full day’s allotment of Ativan, and pulling out to take guests to dinner, hit a guidepost and busted up my back bumper.

I'm not all here.

I’m not all here.

By Thursday, however, I was loony. I can barely remember the day – I had to ask my supervisor to tell me who was in the group for whom I took notes. I remember snippets and moments, like saying angrily that everyone was shitting on my methods. As it turned out, I’d misunderstood a certain phrase. Oops. I drove home through a haze of tears; I knew it hadn’t gone well but the Ativan had (kindly) relieved me of specific memories of dysfunction. I tried to forget the rest because thinking about it would sicken me with anxiety.

When I met with my supervisor, he said nearly everyone at the meeting asked him if I was OK and of course, he’s not allowed to say anything. So that must have been awkward. He urged me to find a way to talk to others and let them know enough about my situation so that they would understand my “odd behavior.” I do know the kind of behavior that he meant, and even if I can’t remember doing it, I know that it did happen.

Several people also talked to me directly, assuring me that the event was going well. I could acknowledge that much, at least – I realize that I often see things as going much more poorly than they actually are. So I pretended that I understood and agreed with their opinion, the socially appropriate response that I would make if my brain were working right.

I don’t know what part of this is you, or your brain, or what they’re doing to it, but you’ve got to tell people.

Since my doctors can’t even agree on what it is that’s wrong, that makes it hard to know what to say to anyone. I’m not comfortable filling anyone at work in on the various ways that my diagnoses and treatments keep changing, because I see it as a soap opera that I’m compelled to spare others.  He suggested that telling one coworker – the only person who didn’t ask him what was going on with me – might smooth over some communication problems.

My supervisor’s obvious concern is that people will misjudge me and my abilities if they don’t know that I’m sometimes out of my head but just fine the rest of the time. I hardly know how I could begin to have that talk with the people that I know I should open up to.

I didn’t even realize how badly I had flipped out until that little chat. My supervisors had met to consult on how to handle me, which was hard on my ego to find out. So now we’re doing video meetings with both supervisors on a weekly basis – no pressure or anything. Apparently one of the solutions they arrived at is to help me actually take it one thing at a time, which should help because I basically still have to be told which work is most important and am unable to properly distinguish between urgency and importance.

Somewhere during that brain melting meeting I had commented to Mr. Flycatcher that I should give up my post as co-lead and the woman who had taken over for the moment should take on the title. I was only half joking. He wasn’t joking at all when he replied that I didn’t have to be a co-lead to stay in the group.

So during the post-meeting triage, I agreed to drop those duties in order to “streamline” my work demands and “focus on writing papers”. For a lot of reasons, it seems OK to let go – since it’s obvious that it’s not just because I’m incompetent. Still, it was a big blow to the ego, since this was the first responsibility I’ve been asked gently nudged to set aside because I basically can’t handle it.

The whole episode was confusing as hell. I didn’t see it coming, and although by Thursday I had realized that I was in a really bad place, Wednesday had been nearly as bad and I had no clue that anything more than the usual situational stress was at play. Clearly there was more to it than that. It has taken several more weeks to understand how much more was playing into it.

First, I was stressed out before things started. During the meeting, I didn’t get enough sleep, although I slept as much as I could. I didn’t get enough down time away from other people as I needed. Facilitating leads naturally to triggering situations in which things don’t go as I planned and so I get even more stressed. So stressed that I was having heart palpitations and downing Ativan at a much faster rate than usual to calm my freaked out mind and heart.

Plus my hormones were doing funny things; by Thursday morning, I had to excuse myself from the general discussion to go cry in the bathroom. This was one of the harshest dysphoric episodes I can (sort of) remember, in terms of the damage control filter being off and lack of self-awareness. I massively overreacted to trivial things, badly misinterpreted a number of things and therefore reacted inappropriately, and all of that was just my brain responding inappropriately when forced into dealing with the situation.

My reaction, retrospectively, is dismay and humiliation. I wish I had known to recuse myself from the meeting when things started going badly. I wish I’d admitted to at least a couple of friends that I’m struggling with a mood disorder and that constant changes to treatments make me behave strangely at times. Because this was definitely one of those times, and in many ways, it was exactly the incident of work and crazy clashing in a way that can’t be ignored, a nightmare scenario. And now it’s reality; I didn’t end up inpatient, but if things had lasted a couple more days, that would have been a logical choice.

What I think happened was a hormonal dysphoric episode (timing) exacerbated by performance pressure, overstimulating environment, and Yaz. Yaz seems to have been the opposite of helpful – all of my symptoms got worse, and this particular dysphoria was a doozy. Now I’m terrified that I’ll experience another cycle where the bad part gets so bad that it makes me feel that I’m out of my mind. And out of myself – it’s hard to explain just how surreal and nightmarish the experience was for me, but at times I felt almost dissociative, and distinctly emotionally detached from what was going on around me.

You would think for a veteran Crazy Lady like me this would be no big deal. But I have never before felt dissociative, and I’ve never felt that I was literally out of my mind. That I was actually insane. So it was really, really scary. In fact, I have to believe that this episode was exacerbated by meds because I just can’t face the idea that this kind of dysphoric episode could happen again. This is the kind of thing that could cost me my job, and that I’m terrified will ruin my prospects with ill-timed interviews.

It’s been a few weeks, but the train wreck still nags at me. I feel guilty for being badly behaved and worried about what my colleagues must think of me. I don’t know how to prevent it from happening again, or if I even can. I try to ignore it, but it keeps popping back up, as it will continue to do. The problem is unresolved. The problem is me.