Bipolar Disorder I: Definition and How to Live With It
Introduction to Myself
I am a 23 year old male suffering from Bipolar Disorder 1. I went undiagnosed for 23 years, and have only recently begun to receive treatment, so I am writing this article as not only an informational piece, but as a guide for those who may believe they have this disorder and me urging you to go get that checked out. It will save your life.
I will explain the difference between Bipolar I and Bipolar II in a section below. I will also chronicle my own symptoms of the disorder and other symptoms experienced by my extensive study and observation of other people with this disorder. Thank you for taking the time to read this. This article is for those wanting to know more about the Disorder, people who have been recently diagnosed with this Disorder, and for family member and friends who would like to know how best to interact with someone with this disorder.
Bipolar I versus Bipolar II
Bipolar I and II are closely related but distinctly at the same time. The main difference is severity. Bipolar I is considered more volatile and generally "worse" than Bipolar II. So if your child or friend is diagnosed with Bipolar II, know that they are not innately a danger to themselves or to anyone else. Bipolar I is differentiated by what is called Psychosis. Which is a break in reality, and when this occurs, frightening things can take place, including actions by the sufferer that may harm him or herself, or a nearby person. That's why Bipolar I is considered worse. I'll extrapolate further below.
Mania and Depression Explained
Bipolar can be summed up as Manic-depressive Disorder as well. They are interchangeable terms. But, a patient may experience only mania, and not depression, but in Bipolar, the hallmark symptom is Mania. I'll explain both of these symptoms below.
Full blown mania with psychosis is only seen in Bipolar I and can include aggressive behavior, thoughts of suicide, homicide, fervent unusual behavior, risky behavior, elevated mood, and even euphoria and creativity. A person in a manic episode can feel great about themselves and the world around them, while at the same time not being completely aware of how their actions are affecting those around them, and themselves. This is why psychosis, and having a break in reality and the way we perceive the world can end up in dangerous consequences and in-patient mental ward hospitalizations (I had to be hospitalized).
Hypomania is what is usually seen in Bipolar II patients, and is Mania to a lesser degree. The psychosis is not present, including the homicidal and suicidal behavior. The risky behavior, elevated feelings, and rapid speech, and hyped-up feelings are all still present and can cause the sufferer to have a feeling as if their mind is running out of control (and if anxiety is already present, it is just exacerbated) and they don't feel in control of their urges and have great conflict in their minds. This is when most people seek help from their Psychiatrist, and may or may not be diagnosed.
Depression is more common and therefore many people know more about it than Mania, so I won't spend much time covering it. While I can genuinely say I've been depressed for most of my life, the symptoms aren't always unbearable, but here is how depression can be for Bipolar patients:
There is no wish to live any longer. Everyone around me is meaningless and worthless, and there is no hope of anything in life getting better. Death is the only meaningful thing to me.
It is important to note, that for Bipolar I sufferers, psychosis can occur in Depressive episodes, and Manic episodes can occur at the same time as Depressive episodes.
Yes, that's right folks, you can have both happen at once. That's how I ended up in the hospital. My mind was out of control, and my body had no motivation to live. It was like being torn in half by two opposing forces.
What are Some Common Signs and Symptoms
In both Bipolar I and II, the following symptoms may be seen. I'll place an X next to each symptom I, myself, have experience in the course of my life. And I'll place a Y for symptoms that I still struggle with even during treatment. And finally, I'll place a Z on symptoms that have disappeared during treatment and I no longer deal with.
In a Manic Episode:
XZ - Aggressive Behavior - (picking fights, fantasies of hurting others)
XZ - Erratic Spending - (buying what isn't necessary, and justifying it with RANDOM explanations)
XY - Uncharacteristic Behavior - (this is broad, I know, but behavior that is completely and utterly against something you would do. Like an agoraphobic introvert randomly taking a trip cross-country for no reason)
XY - Racing thoughts (I mean this is the "my mind is flying at the speed of sound" way, not homicidal or suicidal thoughts. This can be likened to anxiety, but also with caffeine thrown in for added fun)
Risky Behavior (some people who suffer from Bipolar engage in behavior such as criminal acts and drug use that would not otherwise be something they would even consider doing during a period of normalcy)
XY - Hurried Speech // Rambling Speech (As in talking more than usual and going on and on and oonnnnnnn about nothing in particular to people you probably wouldn't even normally talk to.)
XZ - Homicidal Behavior (thoughts and intentions to kill others or kill animals)
XZ - Suicidal Behavior (thoughts and intentions to kill oneself)
XZ - Psychosis (breaks in reality, inducing hallucinations and altered personality characteristics. Dangerous dangerous dangerous.)
Depressive Side of Things
XY - Lack of Motivation ("I don't want to do ANYTHING. This bed is quite comfy.....")
XY - Lack of Desire (Low libido/sex drive)
XZ - Low Self-Worth (feeling that you're a sack of crap, or equivalent)
XY - Masochism (Some Bipolar patients can feel the need to hurt themselves in physical ways, called self-injury)
XY - Hygiene and Disarray (One's personal hygiene becomes a non-factor, as well as any sort of cleanliness of the area around them. Part of the "I don't care anymore" effect)
XZ - Crying spells (Crying for no reason, and/or looking for a reason to cry (ie, watching sad movies))
This is not an exhaustive list, but a good starting point for helping you understand what Bipolar Disorder is all about.
What do I do About All This?
If you feel like you fit these symptoms:
Talk to your family doctor and be as explicit as possible. Don't leave anything out. Go back to your distant past and note circumstances that you think apply. There is no definitive test for diagnosing Bipolar, so be ready to bring all your subjective experiences in with you. A trained Psychiatrist will be able to judge if you fit the bill or not, but please, don't hesitate to seek help. It may well save your life, in more ways than one.
If you are a family member of someone suffering from this disorder:
Pay close attention to your loved one who is suffering from this. Note their behavior and with love, let them know when they are starting to display symptoms that you think may be in-line with a manic or depressive episode. If you think they are suicidal or homicidal CALL THE CRISIS HOTLINE. My own life has been saved by this, and the lives of many of my friends. That's why the hotline exists, for people like you who care about your loved one and want the best for them.
Be SENSITIVE to their needs, and know that they honestly CAN'T HELP IT. If they are currently on medication and you notice erratic behavior even when they are supposedly taking their meds, don't automatically accuse them of not taking their medication. Suggest to them that perhaps their dose isn't correct or that they may need to try a different drug. Show the loved one some LOVE. They need it.
If you disagree with the content of this article:
Then you probably know a lot more about Bipolar Disorder than I do, and hats off to you, but this is all from personal experience and observation, which I feel is more exhaustive than the DSM-IV ever could be.
Diagnosis and Treatment
As I said earlier, Diagnosis is not easy, and is resultant of a trained professional taking note of the patient's subjective experiences and making a judgment call on whether or not they fit the criteria. There are other ways of being diagnosed, such as entering the emergency room with full body paralysis, homicidal and suicidal behavior, and feelings as if I was dying, oh and hallucinations. That'll get you a diagnosis pretty quick. Actually, it didn't, but that's a long story.
There are many ways to treat Bipolar. Medicine is usually the first route. They have special types of medicines that are called Mood-Stabilizers and do exactly what they sound like. They remove the peaks and valleys of every day life, and make it more like small hill and small crevice. More manageable that way. Lithium Carbonate is the most commonly used drug and is excellent in my own experience. It has made my life ten thousand times better.
Other Treatment Methods for Bipolar
Learning to recognize when a Manic episode is starting is important. When this occurs, doing any of the following can help to straighten out your mindset and get you on with your day.
- Deep breathing exercises (exercises your sympathetic and parasympathetic nervous symptoms simultaneously and causes relaxation and cessation of the fight-or-flight adrenal response of a manic episode)
- Yoga, or exercise in general (takes that impending energy rush and puts it toward something productive)
-Prayer (for those so religiously inclined, one may pray, as it focuses the mind on a point and can be considered a close cousin of meditation)
-Meditation (during a manic episode, this is the last thing you may feel like you want to do, but if you can just sit still for fifteen minutes and focus on counting sheep or waffles or whatever, it will do you wonders)
Tips for Dealing with the Depressive Phase of Bipolar
Even during treatment with mood stabilizers, there will come days where you won't want to move an inch, won't want to think an iota, and won't want to contribute to society in any way. Here are some methods I've found to alleviate this:
-DBT (Dialectical Behavioral Therapy - Basically focusing on one single task at a time, bringing your full attention to the present, moving one leg after the next, and well, you just need to look into this one to know more about it.)
-Mindfulness (Like DBT, it includes focusing intently on what's going on in the present, and helps with getting "out of your head" and back into the real world. Yeah the real world can suck, but laying in bed doesn't change that.)
-Affirmations ("I am a good person. I am a strong person." Etc. Reaffirming yourself of who you are and what you are good at, and trying to rebuild some self-motivation)
-Talk to a friend (surely you have A friend who is willing to listen to your sad stories of misery without hanging up. Perhaps they can or will have an encouraging word to say to you, as well. And the act of calling them in the first place is a step in a positive direction)
Final Thoughts on Bipolar
There's a lot to be said about this Disorder, and hopefully you've learned something today. Everyone's Bipolar experience is different, but I challenge you to not only manage it, but to channel it. Use your mania to your advantage, and your depression to your advantage. What could I possibly mean by that?
Well, when I'm manic, I'm extremely creative, so I've funneled that into deliberately learning piano, painting, and writing novels. Your mind is elevated at that time and like the high tide in the ocean, the optimal time for certain activities.
Also, when I'm depressive, it's a good time to catch up on some extra sleep! Take some time for myself and relax. Life keeps moving, yes, but I do my best to not let my sleep and relaxing turn into an unscheduled vacation that I can't afford.
The point of this article:
To tell you about Bipolar, but also to hopefully help someone out there. Surely someone suffering from these symptoms will read this article and go and seek help, and that alone makes me happy. Now go in peace, my brothers and sisters, for the days are long, and the nights sadly too short.