Creative Nonfiction: Unravel This (My Year of Madness)

By Casey Catherine Moore

Our sanity, who art in the clouds, 

shrouded be thy name


Insanity comes, it will be run,

from the souls of your feet

‘til your mind’s undone


Gives us this day our daily drugs


And forgive us for misunderstanding our wrongs,

As we forgive those who misunderstand us


And lead us not into obsession,

but deliver us from oblivion,





Marked from the beginning

I was diagnosed with bipolar disorder the summer after my senior year of high school, after an academically successful but emotionally difficult experience over my time in school. Bipolar disorder is a mood disorder marked by extreme highs (mania) and lows (depression).


a masthead on fire at the top,

an algae-covered anchor buried under the sand

at the bottom of the sea.


However, the illness is more than high and low; its overall mood dysregulation (which can sometimes lead to uncontrollable behavior). I escaped my year of bipolar 1 madness, the school year 2021-2022, and I write to show you what bipolar 1 disorder is beyond highs and lows, how compassion works, such as teaching, can interfere with self-care, and what you might be able to do to support people living with chronic mental illness.


While the exact cause of bipolar disorder is unknown, it appears to be linked to biological differences (physical changes in the brain) and genetics (it can be inherited).


electricity rooted in us like elder laurel trees, mapped,  

predestined with our biology.


Different kinds of bipolar disorder (1, 2, cyclothymic/rapid cycling, and others) present varying symptoms and create different types of cycles. While symptoms vary from person to person, bipolar disorder affects sleep, perception, attention, focus, processing of stimuli, decision-making, energy, and other daily functions. For me, bipolar 1 disorder has made many things difficult: school, the workplace, managing my physical health, and my relationships with others. Bipolar disorder also causes me many sensory issues that can cause overstimulation, leading to agitation and outbursts.


I have a history of psychosis and low-level paranoia. I have had bipolar episodes, some worse than others, which left physical, mental, and financial scars despite always being medicine-compliant. I am more predisposed to mania, and historically, I have not had many issues with suicidal ideation, though I do regularly experience depression. My moods often follow the cycle of the seasons: mania in summer, depression in winter, subdued but pleasant falls, and happy, buzzing spring.


mania and melancholia on a shifting ring.


When you have a chronic illness, if something harmful happens (a tragic event, trauma, an illness, extreme environments), it can amplify the symptoms of your chronic illness (or incite new symptoms). Last year, due to a traumatic event, my bipolar disorder symptoms were louder, more frequent, and more varied, with increased psychotic features that included delusional paranoia and visual and olfactory hallucinations in addition to auditory, all exacerbated by a school environment I felt I could not leave no matter how much of myself I was losing.


I was never in the middle, never in motion, never flying

and drowning at the same time.

Never still.


Trauma pushed out lurking instability

In June of 2021, a man held me at knifepoint on the 9th day of living in my new apartment. It was my first time living alone. He broke in through the window in the middle of the night. Compounded with other trauma, C-PTSD became a super steroid for my bipolar 1. Everything that was already hard was more complicated. I drifted to new, terrifying places. I obliterated some relationships. Some relationships became stronger. My psyche, my word for the combination of my brain and moods, went way up, way down, way up again, then up and down mixed.


driven by excesses,

radiating yellow, midnight black bile,

mania and melancholia.


I hallucinated from the late summer of 2021 through the summer of 2022. At school, I experienced psychosis, sometimes while teaching or interacting with co-workers. Once, when talking to a colleague, I saw their head drift to the ceiling and stared at an open-neck speaking. I finished the conversation, staring past him, headless. Another time, I heard a whispered “hit her hard” alone in an office. I felt breath on my neck. I saw shadows of men looming in my peripheral vision. I smelled my apartment building everywhere. I maintained my eyes and smiled while a side dialog coached me through the psychosis, the unraveling happening while I was acting “normal.”


They admit madness’ power when they can see it: gushing, flaming, rocketing, smashing.


I was convinced that my employer and co-workers were spying on me and that I was constantly in trouble. I got my grading done, went to social events, performed, checked on my friends, and wrote. I was insane, but I was functional. I kept telling myself that it would be better if I just did X (walked more, wrote more, drank more water, found the right therapist, etc.). I kept telling myself that if my work—if my students—did not suffer I was not really sick. I knew there were no substitutes, and I didn’t want to abandon my students. I kept up with grading, made my students laugh, and was involved in school clubs, shows, and committees. I did not ask for help.


. . . my true self lies 

Somewhere safer than the world I wander in:

Somewhere still and wide.

She peeks out through flames in flickers of free verse,

Surfaces from the sea with seaweed and sonnets in her hair,

She lives 

in the center of invalidated tears and the belly 

of forbidden laughter.


The psychosis was worse in the apartment where the break-in happened when I got home at night.


Still, his silhouette and the shadow of the knife follow her all the same,

in unexpected footsteps and voices

within and outside of Psyche’s brain.


I couldn’t move out for six months after and could do so only with help from the DC Tenants’ Rights and Disability Rights Offices. Every day, going in and out of that building, my heart raced, wondering if I’d see him. I heard him and saw him constantly in all the rooms of my house, haunting all the crevices of my mind.


Dymphna comes to visit me

After some challenging days in October 2021, I took a week off work. On my first day off, I dressed up and attended Mass at the Basilica, America's largest Roman Catholic church. An employee, who I thought had a natural sparkle in his eyes like an anime character, realized I was lost. After we clocked each other as queer, which I took to be a divine moment of understanding, I attended Mass. I am not sure what was said in Mass. My ears were so sensitive that the sounds—the priest, the readers, the singers—all mixed and sounded like birds whisper-screaming at me. The cacophony made my chest vibrate; my skin was tingling. I watched the priest’s mouth move, reading his lips to catch pieces of what he was saying. The word I saw the most was “Mary.” It was the Feast of Our Lady of Sorrows, a day focusing on Mary’s suffering during Christ’s suffering and death. Tears and mascara ran down my face.


After Mass, I meandered through the gift shop to look for a prayer card for my Mom. I found one of Mary with billowing red robes and walked to another rack. I immediately drifted to a card with shades of green and yellow and a wan-faced, blonde-haired woman with big eyes. The card was of Saint Dymphna. When I turned the card over, I discovered she was the Irish Catholic saint of “mental and nervous disorders.” Fate.


I obsessed over Dymphna and tried to find as much information about her as possible. She founded a hospital for the mentally ill in Belgium. She had compassion for her mentally ill father until the moment of her death when he decapitated her. She created homes for people with electric brains. This was a sign. I went home, feeling anointed and full of grandiosity, and started writing “Bipolar Lady’s Prayer.”


I carried the Dymphna prayer card in my bra every day for months. At school, I would barely reach into my bra and touch the outer edge of the card when I needed to ask someone to keep me safe or sane. I would feel it with two fingers just slightly, for a second, so no one could see, and ask Dymphna to take away whatever was troubling me: voices, tears, visions. I touched her when I was trying to hold back my acidic tongue. I prayed to Dymphna and hoped she heard me.


I am an atheist, and my behavior was incongruent with who I and others understand myself to be; however, Dymphna was part of what kept me alive.


Danger was everywhere outside and within me

I had makeshift weapons hidden all over my house: a wooden stick in the kitchen, steak knives in the corners of each room, a mace in the closet, and a hammer in my nightstand. One night, I had a psychotic break (the second of three I had over the year) because I thought someone was in my shower, even though I came in through a locked door (like I did the night the knife man was in my home). That night, I thought someone was in my shower solely because my bathroom door was closed when I got home (something I was adamant about not doing). I pushed my furniture in front of my bedroom door and panicked until a loved one came over with a baseball bat to check my bathroom. I always thought the knife guy would be there when I opened any door. It kept happening, but I learned to leave the curtain open or, if I forgot, to throw something at it to make sure no one was behind it. For months, I did the latter in moments of disillusion. I still shower sideways so I can face the door.


My mouth was a stream of anger and resentment. I was hurting inside and pinned the pain on anything outside of myself. I told everyone around me how bad things were in the educational system, the country, and the universe. I felt no one was listening, so I just kept getting louder.


My smoke dam of a hand drops,

I take a shaky breath and exhale.

Smoke pours out first,

then, the liquid, blazing core

shoots from my mouth like meteors on fire.


I thought it was the end of the world for education, myself, and everyone around me. Everything felt like an emergency, and I was Cassandra on the school bus.


A slower version of psychosis comes in winter

I was finally able to move out of my straitjacket-walled apartment in the middle of winter, and, for a moment, I felt like I had the peace and stillness my body needed. I thought everything would dissipate because I was out of that space and physically safe. I thought the fog would lift, but the icy fingers of a heavy depression I haven’t felt the likes of strangled my thoughts and movements. Watery, thick, heavy.


she is the ice age after a hell season of fire. i don’t know her that well, but i know she is pink and fuzzy and moves with measured slowness. she is the monster under the bed and the one who checks for them at the end of summer before she comes to stay in winter.


The usual difficulty waking up and staying awake, slow thoughts and words, and limitless tears, all familiar symptoms, were pervasive, but it was much worse than anything in recent memory.


sometimes she cages me in a coffin. it has enough holes for light but no room for my whole body. she closes the lid anyway. nails come down on the edges, holding in my sadness, which is slightly comfortable in its slow steadiness.


I needed help waking up on time and getting to work in the morning. I would wake up at the alarm, but I couldn’t move for an hour, laying there with leaden limbs trying to will myself out of bed.


I am sailing down watery hallways of tombs of iron,

and her hand is over my forehead, shushing me,

whether I am screaming, whispering,

or mute.


A therapist I briefly saw during this time suggested I play a song that made me peppy to get out of the coffin up. Sometimes, this worked. Sometimes, I threw my phone.


My winter lows are usually not too uncomfortable, and winter depression has often been a soft place to land. A lethargy and quiet I can snuggle into after the summer months of frenzy. This time, though, the psychosis persisted with intensity.


She’s a shaky brain and tightened chest.

And now she starts hearing things.

She says nothing.


I was still jumping at shadows that were not real. I thought everyone hated me, was talking about me, and I would be fired if anyone knew how much I was crying and freaking out at school during the day.


Depression and delusional paranoia are a dangerous combination. I stared at hazardous objects and heard voices garbled by water, footsteps, and doorknobs turning. I hallucinated the knife man at the bottom of the stairs when I was dog-sitting. Sometimes, I floated above my body.


How do I stay grounded?

Tectonic plates shift beneath me,

I’m wearing shoes of different heights.


My psychiatrist and I changed meds, and we had to keep changing meds.


The worst part was the loss of my voice

I came out of the winter slog only to shoot way up again. Then, I simultaneously experienced a back-and-forth of down-up: a mixed episode. All the same hallucinations, aspects of both mania and depression, but now with more extreme paranoid delusions. Everyone in my life was a conspirator: family, lovers, friends, co-workers, supervisors, and strangers.


On the same day I was nominated to be on a school district committee I was excited about and had worked hard to apply for, I was sitting outside Union Market with a friend. I was convinced a random woman was a psychiatric nurse taking notes on my behavior and snapping pictures of me so that I could be taken away—I thought my friend had lured me there for this covert evaluation. Her outfit looked like scrubs but wasn’t scrubs (part of the deception!), and she had the audacity to smirk at her phone. I remember nothing my friend and I discussed, but I do remember her face, the exact purple of her clothing, and the way she held her phone. On the night of our school end-of-year party, I even asked someone in the district office, whom I barely knew, if there was a hit out on me when she said she was keeping her eye out.


I lost my ability to speak or write words correctly, switching up forms of there/their or know/no and misspelling words I knew in my balanced brain. This side effect has lingered despite my mood stabilizing. I was flipping letters of words when I spoke, stuttering, sometimes when I was performing. I am a writer and speaker, and insanity changed my voice as it changed my thoughts. My speech and expression were uncontrollable, outlandish, and excessive; sometimes, my voice was too much and not entirely my own.


Like a scaley, clumsy dragon

I scorch myself

and whoever stands still at my feet.

Ash covers everything around me.


It builds

on tops of homes and hearths until the roofs fall

on tightly curled bodies

that will be frozen in place for millennia.


I said things to co-workers and friends I still cringe about, peddled my conspiracy theories to anyone who would listen, and cussed out strangers in front of museums and on the metro. In retrospect, I maintain they deserved it for racism, sexism, and bigotry, but maybe I did not need to scream so loudly or walk away with my middle finger in the air.


Virginia Woolfing

I obsessed over Virginia Woolf and other dead bipolar writers like Sexton, Plath, and Hemingway. I compulsively read and re-read Sexton’s “Live” and “For the Year of the Insane,” her prayer to Mary asking to be saved from her insanity.


I am Anne Sexton’s eight Dalmatians she didn’t drown.


I re-read most of the writing of the bipolar writers on my shelf. I was trying to see myself in something, in anything. I thought about their suicides, and I counted how many years each was from my age when they killed themselves (so far, I have passed Plath, 30, and am 6 years behind Sexton, 45, and 20 years behind Woolf, 59, and 22 years behind Hemingway, 61).


I feverishly read Woolf’s suicide letter over and over and thought it was the most beautiful and romantic love letter of all time.


Virginia Woolf floats by face down,

I slide an amethyst ring

off her stone finger.


I thought killing herself made pragmatic sense and was the kind, loving, and logical thing to do. It felt inevitable. I called these fixations “Virginia Woolfing” at the time, but it was suicidal ideation and, in some moments, more than ideation. Amid it all, I understood why they gave up because I was so tired of cycling. I was so tired. I’m not ready to talk about everything from those months yet.


The edges of the waves lap my feet until I begin to doze,

unbothered that if I fall asleep, I may drown.


Fall, winter, spring, summer: I would break down during the day and let myself cry hidden somewhere (in a bathroom, behind a building, in a hoodie on the metro, or on a bus).


If my lifetime is one of incinerating and drowning,

of hiding the rusty gears, fireworks,

and whirlpools that power my psyche,

then where beneath the many cracked masks

do the truth and my identity meet?


When the time was up, I would return to whatever I needed to do, burying it, forcing a smile, and moving forward. I would get home, hallucinate, melt down, skip dinner, maybe sleep, and repeat. I was pretending to be okay, masking.


Masking enabled me to keep working and maintaining relationships, to varying levels of success and failure, but it was eroding my health long before now. This time, the moods, the psychosis, the delusions, and the suicidal thoughts were too big to fit under any mask I could construct.


Madness is not something you can bury

cause you will lose yourself in the worry.


I continuously got by between crashing off cliffs and being catapulted into the sun. I didn’t think I had time to take a break. It turns out I didn’t have the time not to take a break.


My student led me away from the fire

In spring, I felt like someone was creeping behind me all the time, that I was in trouble for something I could not remember and would be arrested, and that everyone I knew was conspiring to do terrible things to me. The only people I trusted were my students, who knew me authentically and who saw me more than anyone else.


I have a student who is also neurodivergent, whom I connected with and supported through her struggles with mental illness. She was in our poetry club, and we kept ourselves afloat with poetry. This student is empathetic—she can read where people are emotionally and notices even tiny changes in people. She saw a change in me, and she was worried.


My young poet was indirect, and she made it about herself, saying that she thought she needed help (“Dr. Moore, I think I need to go back to the psych hospital”), but I knew by how she stared at me that she was waiting for me to acknowledge that she was not talking about herself. I had to tell her she had to get help if she felt unsafe, and she knew I could not ask her to get help while not seeking it for myself. “Dr. Moore, I think I am manic.” She is not bipolar.


I cannot lie to my students, and she knew that. I cannot hypocritically talk to them about valuing their mental health and safeguarding it while I am dangerous and not getting help, and she knew that. She checked on me all summer. I am so thankful for her and the relationship we’ve built through poetry and empathy. She saved my life.


And then I committed (to) myself

At the height of my delusions, I thought I’d walk into a space at any moment, and everyone I knew would be there to commit me. Through the haze, somewhere in my brain, I finally thought . . . if that’s the fear, maybe they should?


A big part of my issue was that I didn’t ask for help. Not directly, and not the kind that I needed. I wasn’t honest about where I was. I told some people only pieces, so I didn’t overwhelm anyone. I made jokes about the insane things that happened with my body. No one knew what went on behind that deliberate, steady work. You must perform like you are not different when you are at your best and not insane at your worst.


I left a week before the end of the school year. I taught seniors primarily, and I missed graduation. After fifteen years of teaching at multiple institutions, 2022 is the only graduation I’ve missed. Graduation is my favorite day of the year, and I missed it. The ache in my chest that day as I watched it live on YouTube was like someone took a mallet to my heart. My body radiated sadness for days. I felt like a failure. I remembered my conversation with my student and started looking for psychiatric hospitals.


My shedded skins crunch under my feet

as I walk toward the ocean.


I started a psychiatric partial hospitalization program the week after graduation—intensive outpatient all-day therapy five days a week. The facilitators and the people I met in that group were terrific, and I learned much from them. I learned so much about myself.


I’m an emotional tornado,

but staying alive though,

Sturdy as a six-toed Hemingway cat—

just ruled by an erratic thermostat.


In that space, we were all tied together by ungroundedness, trauma, and a desperate drive to improve. And anger. It was the first time I could see myself in a group of other people in the same room, the first time I could be candid about my psyche’s depths and peaks.


At first, you will feel better, but still bad,

a sturdy girl,

still shaky.


During my second week there, I had a complete rage-filled meltdown, screamed at a facilitator for the grave injustice of turning the lights on, and walked out, but when I came back the next day, it was just—okay. I could be my darkest, and there was never any judgment, no grudges. I could be honest. About all the things that have happened to me; I could be all my selves, even the versions of me I strived so hard to bury. At the end of the program, that same facilitator called me the “pinnacle of mental health.” I could be all the things I am.


I’ve never cared for the term bipolar,

The word supposes there are two of me, instead of a thousand.


I finally found a compatible therapist. The meds started working.



A steady spell that lost its voice through 2,500 years of euthanasia, burnings, electric

eels, bloodletting, sedation, and lobotomies.


I stayed in intensive outpatient care for fourteen weeks and needed every moment there.


I can survive amid summer wildfires.


My work there showed me that what we need most is to be believed, that a job is never worth your health, no matter how tied your heart is, and that I am incredibly resilient and adaptable. I always keep going.


I can survive under winter darkness.


In addition to psychiatric drugs and therapy, some things that helped me


When I think I am lost, I look for trees.


Going outside is medicine. I sit on the ground and feel roots beneath my palms. I take pictures of crepe myrtles in the rain. I listen to the wind passing secrets between leaves. I write under trees, smell flowers, and watch bunnies. I take pictures of everything alive I see to internalize that vigor. Seeing the DC seasons change in ways that mirror my moods reminds me that the next season is always coming and that I will always write a way back to myself if I get help. Take us to the sun.


Now: I fuse my split self back together and

find my bumblebees’ grounded stillness in the hive

within the beginning, mineral water,

and poetry.


I told myself where I was in my own poems—I just couldn’t bear to read it, to hear myself until I took a breath.


Write a poem for each day you thought you wouldn’t make it;

devour them each Sunday like communion.


Poetry, writing, and performance stages are where I can turn this pain and frustration and devastation and hope into words.


Psyche lets the ink spill from her pen onto her roots,

and the page lets out a scream to reverberate bones and shatter glass.


When I am onstage, my brain quiets, and I can speak with clarity that the regular day does not allow.


The times I was on stage during my psychosis were the only times my head was quiet. The stage is a space to be heard when I often feel no one can hear me scream. When I perform poems about my illnesses, at least one audience member usually comes up after to tell me they are thankful someone is talking about this, that they have a psyche different in some way, or that they know someone who does. Sometimes, we cry.


Community. Especially my queer, neurodivergent, and artistic communities. I have amazing friends: some gave me places to stay, some checked closets and behind doors, some found me stages, some recited Dymphna prayers with me or created art or poetry with me, some gave me spaces to cry or laugh, some walked miles with me, and all of them kept me company and kept me talking and helped me get better. It’s so much easier to ask them for help now.


To be mentally ill is to be unseen and conspicuous

The hardest thing about mental illness is its forced invisibility amidst forced demands for visible unraveling.


We have told you:

through words and actions,

whispers and screams,

jokes and admonitions,

that our sanity is not what it seems.


The weight of our own words never heavy enough,

never compelling enough— to convince you

of our mortal miseries.


The nagging other side of mental illness is that while you must work on acting “normal” all the time if you are going to ask for help, concessions, or understanding, you must be visibly “crazy” enough to be believed to be as sick as you say you are.


Only when poisons are

excreted from our pores,

stream from our eyes,

or hemorrhage from our veins;


Only when we turn into tornadoes,

razing relationships, businesses, and everyone’s trust;


Only when comets erupt

from our darting eyes

and howling mouths

and shaky brains;


Only when our fists go through faces

and pretenses and the systems that shame us.


We are using all our energy, suppressing it to function. Believe us, even if you can’t see it. We know ourselves best.


Believe us—before our lives are rubble. We can feel it coming before you see it spilled out everywhere. We can feel it, but something is terrifying about speaking it, naming it. Push loved ones to speak past rote answers when you ask how they are. Pro tip: ask your bipolar friend how they are sleeping.


What you can do as a friend

I was a danger to myself, but I was desperate for no one to know. Delusional paranoia made me constantly afraid that somewhere I would find everyone I knew—lovers, friends, family, co-workers, even people who did not live locally—who would all be there to lock me away in a psychiatric hospital or jail because of my insanity or unknown crime. But this particular delusion also saved my life, like Dymphna.


It was terrifying at that moment, but it was my brain’s way of telling me I was unsafe. If you have a friend with chronic mental illness, my suggestion is: do conspire. Dialog with the other people in your loved ones’ lives if you think something is amiss—we often do not tell one single person the whole picture, especially those of us who are unpartnered. We are too worried about perceived weakness, burning people out, and being too much.


And the final piece of the puzzle was the goodbye I had to make

On the first day of the new school year, I had that same ache I did on graduation and similar tears. But this time, I grieved knowing that leaving the traditional classroom, an unhealthy space for many reasons, was necessary to live, teach in new ways, and give in the ways I wanted to. To stay alive.


I am

I am still

I am still here.


My students deserve my best. More importantly, I deserve my best. I am blessed to have the opportunity and capability to teach again, but in a different way that does not exacerbate my symptoms (there were many teachers in that hospital). Until then, more trees, more poetry, more advocating, and more opening my mouth about where I am and what I need.


Surviving the seasons made me know

the strength of the root.

Casey Catherine Moore (she/her) is a bipolar, bisexual poet, educator, writing coach, and activist. She holds a Ph.D. in Comparative Literature from U of SC focusing on Latin poetry, invective, and gender studies. Casey’s work centers gender, sexuality, and dis/ability and can be found in The Comparatist, Sinister Wisdom, Oyster River Pages, and Samfiftyfour. She co-produces and co-hosts Homo Stanzas, a queer poetry/comedy series, and hosts open mics at Busboys & Poets. Her performance credits include The Kennedy Center, Poetry Out Loud, The Nail Salon, Capturing Fire, and the 2022 Medicare for All Rally in DC.