Episode less life

When we experience things like psychosis or depression, everyone always uses the term "episode". Like im having a depressive episode. The issue is though, I dont have "episodes". Im pretty much always depressed. Theres times when its not so bad, and times when its a looot worse. But its always there. Always.
Its the same with my hallucinations. I dont have "psychotic episodes". I pretty much see things all the time (thankfully its nothing that makes living impossible. Just things out of the corner of my eye that scare me sometimes..)
But whenever I talk to someone or try looking it up, nothing ever mentions it being constant. Its been like this for most of my life. Is this normal? does anyone else deal with it 24/7 Like I do?

I call them "episode" when they become much worse to the point I can't function anymore.

On normal days I deal with "residual" symptoms (or mild ones).

Crazy, inside and aside

"Outwardly: dumbly, I shamble about, a thing that could never have been known as human, a
thing whose shape is so alien a travesty that humanity becomes more obscene for the vague resemblance."
I have no mouth and I must scream -Harlan Ellison-

I am somewhat hesitant to answer this question. I've had a written response for some time now. I find it difficult to believe that there is anyone alive who suffers from mental illness and doesn't know what it means to have an episode of 'something.' So I'm curious, are you diagnosed with schizophrenia or some other mental illness or are you self-diagnosed?

Everybody has a baseline unique to themselves. Some people may report a higher or lower baseline for happiness, anxiety, hallucinations, paranoia, and other delusions than others; but, nonetheless, we all have a baseline. An episode is nothing more than the interval between an initial deviation from and return to a baseline. You report that your depression is everyday but there are times when it gets a lot worse. The period where it was a lot worse, that is a depressive episode. You report seeing things out of the corner of your eyes everyday, when those things move into your direct vision field, that's an episode.

I have frequently said, with respect to depression, that life is unhappiness interrupted by moments of happiness. My happiness baseline is rather low, but I am all too aware when it gets any lower. I suffer from frequent tactile and auditory hallucinations, and I am very aware when they get worse. I experience paranoia, and I am all too aware when it gets worse. Those periods of worsening are episodes. I even have episodic happiness, though those are much rarer and I wish I would have more. Two days ago, I was hiding from my television under my blankets. You know why? I was certain someone was watching me through the television. I was having an episode of paranoia.

I hope this helps you to understand the term episodes. I think all of us can relate to persistent mental health issues, especially depression. An easy way for you to identify episodes is to make a rating system and rate your emotional state daily. You will find your baseline, and from there you will more easily identify episodes. If you've ever been hospitalized in a psych-ward, you should be familiar with these. Every time I've been in the hospital they have forced me to do daily ratings.

This is a really interesting point, I’ve never thought of it like this. I always assumed my baseline should be completely ‘normal’, but maybe my baseline includes the weirdness that happens outside the worst times.

I don't use the term 'episode'. I find it rather meaningless.

It's hard to pin down the start and end of an episode unless you had no symptoms and then lots of symptoms and then went back to no symptoms again. Otherwise, it gets silly - e.g. if I normally hear 4 people Screaming, but then hear a 5th join in, is that an 'episode'? Add in other experiences and it gets even more complicated! Eg if the Screaming is worse than 'normal' for me, but the Fizzing is better than 'normal', is that an episode or not??

As someone else posted, everyone has ups and downs. Sometimes people post about 'episodes of psychosis' that lasted an hour or so...for me, I would consider that a normal variation because it's so short. Everyone has good days and bad days, but I certainly don't consider an isolated bad day an 'episode'.

As I said, I don't find it a helpful construct for my experiences (although I also reject the illness paradigm as a description for my experiences too), but my pdoc doesn't use it either to describe me because he agrees that I don't have clear cut 'episodes'. It's certainly every waking moment for me, like you describe, which is unfortunate, but not abnormal

*Willow*

I agree that an isolated bad day would not constitute an episode, neither would an hour. Identifying episodes is important to mental health treatment, so I find it unusual that neither you nor your doctor use the term. But, I suppose if you reject the notion of commonly accepted medical models altogether, then all clinical terms become meaningless, or irrelevant at best. Since you don't experience episodes, I can only imagine how difficult it must be to even write a sentence, much less a paragraph, with four or five voices literally screaming into your ear every waking moment of your life, 365 days a year without pause nor reprieve. People with treatment resistant symptoms of such an extreme and violent nature are often either homeless or hospitalized. I commend you for having such a fortitude; it is remarkable and defies logic.

Thank you. It is very difficult, but I try to do the best that I can with what I've got to work with at any given moment. Honestly, and not to get off topic, I see it as further evidence that I don't have schizophrenia. I don't know anybody who manages med-free like I do (meds make things worse and my pdoc agrees, or I'd be court ordered to take meds), so I guess that there must be something qualitatively different about me/my experiences.

I agree that symptom tracking, and relapse/episode signatures are important things for people to be aware of, but I don't have concrete things like that: it is a massive and ever shifting spectrum of severity of experiences, and so my pdoc doesn't use that construct with me. I know that he does use it with other patients who do have more classic 'episodes' away from their baseline though.

As an illustration of what I mean, I started tracking certain experiences using a bullet journal in January. (I do have issues with how meaningful such a subjective tracking system is given that I probably rate things in different ways every day, but it's mostly as a memory record of how I felt at a given time, rather than any attempt to be 'objective' about things.) So the rating system is blank (absent), yellow (mild), orange, red (severe), and then I draw a warning triangle on top of the red if I get particularly distressed by an experience. I haven't had a totally blank day, or even a completely yellow day since January. Some days are more yellow/orange, and some days are mostly red. How would you decide where the 'episode' begins or ends?? I have no idea, and so that is why I don't use the concept as it has no meaning for me. But, obviously, things like this differ for everyone.

All the best,

*Willow*

I do not have constant depression. I have bouts of depression. I also have bouts of paranoia. I do have constant voices, though. I only consider it an episode when the voices get so bad that it interferes greatly with my daily functioning.

I think it's awesome you are able to manage without medications. Perhaps remarkable is a better word. I hope you are able to continue to manage as you have. Being medication free is amazing, and I really wish I could manage without medicine; but, even with medicine I experience issues that become dangerous. I've been hospitalized too many times. Your example demonstrates how unique mental health issues can be and it shows that people do not fit squarely into the neat little boxes doctors try to put us in.

Mine is a little different I don't see but I hear things constantly all day everyday. Just realizing it's going to be the rest of my life sucks. And that even the meds I take don't help. It just keeps me from having total nervous break downs. It's a struggle but with good support from family and friends it becomes tolerable. I wish you the best in your battle.

Thank you

I completely agree.

I read this thing a while ago by the UK's Royal College of Psychiatrists, and it said:

I don't know if I'm reading this right, but it sounds to me like it could mean that 4/5 will experience discrete 'episodes', and 1/5 won't. So, you would be in the minority to have continuous symptoms, but it's still 'normal' IMO

*Willow*