Living with Bipolar Disorder is not fun. There are times when I am convinced I will not overcome a manic low, and other times when I believe the manic high will last forever. Though I know in the end, the manic lows and highs end, it still feels nearly impossible to see that happening.
Bipolar Disorder has taught me a lot; in fact, it has taught me some pretty valuable lessons: how to overcome challenging situations, when to start asking for help or information, and how to analyze my moods so I can best decide how to handle it. Living with it has also taught me the stigma around Bipolar Disorder; it is not bouncing between many emotions within minutes, it is so much more than that.
So... what exactly is Bipolar Disorder?
Bipolar Disorder is defined as a disorder associated with episodes of mood swings ranging from depressive lows to manic highs. This can also cause shifts in activity levels, concentration, and the ability to cary out day to day tasks. There are three main types of Bipolar Disorder, each containing depressive, manic, and hypomanic episodes: Bipolar I Disorder, Bipolar II Disorder, and Cyclothymic Disorder.
Bipolar I Disorder:
Defined by manic episodes that last at least 7 days or by manic symptoms that are so severe that immediate hospitalization is needed. Usually, the depressive episodes will occur, typically lasting about 2 weeks at a time. Mixed episodes, manic and depressive episodes that occur at the same time are also possible.
Bipolar II Disorder:
Defined by a pattern of depressive episodes and hypomanic and manic episodes.
Cyclothymic Disorder (also called Cyclothymia):
Defined by periods of hypomanic symptoms as well as ;;;depressive symptoms lasting for at least 2 year periods. These symptoms, however, do not meet the diagnosis requirements for a hypomanic episode and a depressive episode.
Of these three types of Bipolar Disorder, I have been diagnosed with Bipolar II Disorder. This diagnosis was not easy for me, or my family, to digest. Hearing that I had Bipolar Disorder made me feel isolated and alone. I felt as though I couldn't do anything right and no matter how hard I tried, my manic highs and lows would always get the best of me. Being Bipolar really changed how I viewed myself and those around me.
Then, I started doing my research.
Symptoms of Bipolar Disorder are complicated. This is due to the fact that there are highs and lows associated with the disease that can commonly be associated with regular depression and anxiety.
Manic High Symptoms:
-Feeling very up-beat, "high," "Elated," irritable, or touchy
-Feeling jumpy of wired
-Having a decreased need for sleep
-Loss of appetite
-Talking very fast about a lot of things
-Racing thoughts
-Thinking they can do a lot of things at once
-Doing risky things that show poor judgement (eating and drinking excessively, spending or giving away money, having reckless sex, etc.)
-Feeling as though they are unusually important, talented, or powerful
Manic Low Symptoms:
-Feeling very down, empty, worried, or hopeless
-Feeling slowed down or restless
-Having trouble falling asleep, waking up too early, or sleeping too much
-Experiencing an increased appetite and weight gain
-Talking very slowly, feeling as though they have nothing to say, forgetting a lot
-Having trouble concentrating or making decisions
-Having little interest in almost all activities, a decreased or absent sex drive, or an inability to experience pleasure (anhedonia)
-Thinking about death or suicide
People who have Bipolar Disorder usually experience periods of unusually intense emotions, changes in sleep patters and activity levels (due to depressive and manic/hypomanic episodes), and uncharacteristic behaviors-- often without recognizing their likely harm or unwanted effects. These are called "mood episodes," which very different from the moods and behaviors that are typical for the person. These symptoms can last every day for most of the day during a "mood episode." Episodes may also last for longer periods, such as several days or weeks.
There are some instances when people with Bipolar Disorder experience both manic and depressive symptoms at the same time; this is called an episode with mixed features. During this episode, the person may feel very sad, empty, hopeless, while at the same time feel extremely energized.
There are also other conditions associated with Bipolar Disorder that could allow a medical professional to diagnose you:
Psychosis- sometimes a person who is experiencing episodes of sever mania or depression may experience psychotic symptoms. These psychotic features can include hallucinations (auditory or visual) or delusions. These psychotic symptoms also seem to match the person's extreme mood. For example, someone who is in a manic state while experiencing psychosis might have the unrealistic belief that they are famous, have lots of money, or have special powers. People who are in a depressive episode might falsely believe they are financially ruined, have committed a crime, or have a serious, unrecognized illness. Often times, people with Bipolar Disorder who experience psychotic symptoms are misdiagnosed with schizophrenia.
Anxiety- another extremely common condition that people have when they have Bipolar Disorder is anxiety.
Attention-Deficit Hyperactivity Disorder (ADHD)- ADHD is also common in patients with Bipolar Disorder.
Misuse of Drugs and Alcohol- People who have Bipolar Disorder may use and abuse drugs and alcohol and engage in other high-risk behaviors during times of impaired judgement during manic episodes. While there are the negative effects of drugs and alcohol, most commonly recognized by friends, family, and health care providers, it is important to notice and recognize the presence of an associated mental disorder.
Eating Disorders- In some cases, people also experience eating disorders with Bipolar Disorder. These eating disorders can include binge eating or bulimia.
In addition to having Bipolar Disorder, I also have anxiety and ADHD. I am a junior in college, so hearing that I have anxiety and ADHD, in addition to my new diagnosis of Bipolar Disorder, was nearly devastating. I have always done good in school, in fact, I graduated Valedictorian of my high school class. Once I got to college, all of that changed. It made sense, as all of my symptoms and overall mental health, changed.
There are treatments and therapies that can be used to control the manic, hypomanic, and depressive episodes. For most people, a combination of treatments is needed. Bipolar Disorder is a lifelong illness that has no cure. Typically, overtime, mania and depression come back overtime. Between episodes, some people with Bipolar Disorder are free of mood changes, but some still have the lingering symptoms. Long-term, continuous treatment can help decrease and manage these symptoms.
Treatments for Bipolar Disorder include:
-Medications, such as mood stabilizers and second-generation (atypical) antipsychotics. You can also be put on medications that help with sleep or anxiety. In most cases, health care providers prescribe antidepressants, to help with the depressive episodes, in addition to a mood stabilizer to prevent a manic episode.
-Psychotherapy, also called "talk therapy," can help. Psychotherapy can help a person identify when their mood is changing, and how to navigate challenging situations in both a manic high and manic low. It can also help them control their emotions, thoughts, and even behaviors. Sometimes, the patient works on CBT (cognitive behavioral therapy) and psycho-education.
-Electroconvulsive Therapy, or ECT, is a brain stimulation procedure that can help people get relief from sever episodes associated with Bipolar Disorder. There are a series of treatment sessions over several weeks. This procedure is done under local anesthesia and is safe. Typically, this is used when medication and psychotherapy are not working for the patient.
-Transcranial Magnetic Stimulation, or TMS, is a newer approach to brain stimulation that uses magnetic waves. During the treatment, the patient is awake most days for one month. This is still under study, and less commonly used.
Currently, my treatment plan includes a combination of medication and psychotherapy. I am currently taking a mood stabilizer, an antidepressant, an anxiolytic (anti-anxiety), and a sleeping medication. This, in addition to psychotherapy, has seemed to be working for me. It took me nearly nine months to find a combination of different medications that worked for me. It was the worst time I had, by far. Every time a medication failed for me, I felt like I failed my doctor, family, and friends. All I wanted was for a medication to make me feel somewhat less crazy. Then, we found it. Minor tweaks to dosages, and bam. I found my perfect coctail of medications that worked for me. It took time, but I am happy that I got where I am. As for the psychotherapy, I am currently doing DBT, or dialectic behavioral therapy. For years, I had gone through CBT (cognitive behavioral therapy), and it never worked. I am confident that my current regimen is helping me, and I wouldn't change it unless I absolutely needed to.
Here are some tips on how to help someone with any type of Bipolar Disorder (and maybe even any type of mental health issue):
1. Listen
There are times when we all just want to give someone advice on how they can solve their problems, however, this is not something you should do all the time with someone who has Bipolar Disorder. Reassure your friends or family member you are there for them to talk to whenever they need it. they may not open up all the time, but they will be happy to turn to you when they need it the most.
There are times when we as individuals are asking for help, but there are other times when we just want someone to listen to us. When know that we can have irrational thoughts, so it is important for us to feel as thought we can trust those we talk to.
2. Offer Encouragement
Just cause someone has Bipolar Disorder doesn't mean they can't live successful and full lives. Reassure your friends and family members that Bipolar Disorder does not define them or limit their capabilities in life. This isn't a part of their personality, and it is important to remind them of that when they feel like they cannot handle this diagnosis. Encourage them to get treatment, and assure them that they are not crazy.
My biggest concern with Bipolar Disorder was being portrayed as crazy or manic all the time. the last thing I wanted was for my friends and family to think that I was constantly unstable or unable to do things because of my diagnoses. I have to remind myself daily that I am able to do whatever I want without any limitations; I am Bipolar, but Bipolar is not me.
3. Be Active in Their Treatment
Going to doctors appointments while being diagnosed Bipolar was already a huge task in itself. It can often make you feel alone, too, especially if you are going alone. To avoid this, go with your friend or family member to their appointments; offer to be there for them in anyway they need. In going to their doctors appointments, you can even learn more about their progress, help them find good doctors, and encourage them to take their medications properly.
One of the most important parts of my diagnosis was getting the treatment I needed. In doing this, I often had J at most of my appointments. Having him there was really assured me that I was not alone, and that no matter what I would have a support system. He helped me stay on track and really follow my treatment regimen. Without him, I probably be where I am today.
4. Monitor for Mania and Depressive Episodes
Sometimes, it is difficult to tell whether or not we are going into a high or low. There are many signs that you will eventually learn about your family members and friends to determine whether they are going into a high or low. In being able to identify these signs, you will be able to better attack the high or low and help prevent, or manage, it. Some signs of mania include: sleeping less, talking fast, taking chances (like driving too fast of going on shopping sprees). Bringing this to your friends of family members attention could potentially help prevent a full blown manic attack. Some red flags of a depressive episode are: less interest in socializing, sleep problems (either insomnia of sleeping too much), no energy, tearful or sad, and aches and pains. Encourage your friend or family members to do things, even if they don't want to. This will help prevent a full blown depressive episode.
When J and I started to familiarize ourselves with my different signs of going into a high or low, he was able to situate himself for what I was going through. He started to be more understanding and wasable to help me through my highs and lows. It was very helpful to have that outside perspective, because a lot of the Tim, especially when I was first diagnosed, I couldn't tell whether I was in a high, low, or neutral state.
National Suicide Prevention Lifeline:
1-800-273-8255
Sources:
“Bipolar Disorder.” National Institute of Mental Health, U.S. Department of Health and Human Services, 2020, www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml.
Gann, Carrie. “Expert Answers to Questions About Bipolar Disorder.” WebMD, WebMD, 2020, www.webmd.com/bipolar-disorder/bipolar-life-17/bipolar-disorder-expert-answers.