I spend the early morning hours trying to coax myself back to sleep. The last few days I have had some disrupted sleep, spending the 3-4am hour lying awake and trying desperately to fall back asleep. I despise when my routine is thrown off and my mood starts to shift. Lately I have struggled with some symptoms, namely some negative symptoms of paranoia that have plagued me on and off since 2012. When I was originally diagnosed with Bipolar 1 disorder, I did not have symptoms of paranoia. It was a bonus addition to my illness that developed with the onset of my 2nd serious psychotic break in 2012. I have read over the years material on mental health conditions, and one disheartening study I came across years ago was the notion that with each psychotic break, that the brain tissue becomes more damaged, fragmented or injured due to the massive misfires in the neurons. This study always ruminates in my mind, as soon as I become aware of a change or shift. That I will be proactive at all costs to protect myself, from, er-myself.

So the paranoia. It gets me randomly at different times of the day, a fleeting thought, a random image. It is not always consistent. Sometimes I can challenge the thought quickly and ask myself if this makes sense, is this real or not. Lately the paranoia can set in a little easier. I might get in my mind for example, that someone I recognize is someone famous, or, develop a random conspiracy theory in my head about Russians and Iran attacking. I might make a familiar association, overanalyze, then become anxious about this thought and have difficulty letting it go. To take steps to avoid the paranoia, i keep a stash of 1/2 dose of my atypical antipsychotic medication Vraylar on hand with me. If the fact check back to reality process fails, then I take the half dose of the medication. I might call a friend or practice a mindfulness grounding technique. This is usually enough to ease my unquiet mind.

I try not to remind myself about these challenges. Compartmentalizing is not the healthiest avenue, but at the same time detaching and not feeling guilty could arguably be seen as having its own benefits. In NAMI (National Alliance on Mental Illness), an organization I have been involved with for years, we have a model in Connection Recovery Support Group called the Principles of Support. The first principle is: We will see the person first not the illness. I try to embrace this as a personal mantra, (along with being a sexy beast), that I am more than my illness. That I am Sarah, who lives well in recovery with this condition, and yes I still have my challenges with reality and paranoia. Everyday I am fighting to live each day as someone who is managing and in recovery. Everyday I challenge negative thoughts, paranoid thoughts. I might have times ahead when I might have another break. I often reflect on those memories of my past where my illness raged. What is within my control now—is choosing to live. Choosing to overcome if possible and get back to reality every step of the way, one day at a time.

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