I’m sometimes not sure what mental health-related topic to cover on my blog. When this happens, I really only do one thing: ask Twitter!
Everyone I have had the pleasure of meeting and knowing on Twitter is truly wonderful and, even though I’ve never met any of them in person, I still consider them acquaintances, friends, and even colleagues. This may sound silly or bizarre to social butterflies or to people who have thriving social lives, but neither of those describe me at all. Haha.
I’ve been unsure of what to write lately and for the past three weeks I had the unfortunate pleasure of experiencing one of my worst depressive episodes yet, so I did what I always do: turned to Twitter!
A few people mentioned that they were interested in learning more about Bipolar Disorder, as it’s one of my diagnoses, and some people are even interested in learning about what living with Bipolar Disorder is like for me.
I tend to log onto Twitter and tweet when I’m going through a good or bad spell, as it’s readily available and takes less time than typing a blog post, so when I read that particular feedback I realized that I haven’t yet written about my own experiences with Bipolar Disorder.
Before I tell you about my experiences with my manic-depressive illness, I’m going to go over some general information and facts about Bipolar Disorder so that you can have a better understanding of what it is, in case you aren’t already familiar with it.
I usually do research and retrieve most of my information from the National Institute of Mental Health website because it’s one of the most reputable and respected sources out there when it comes to all things mental health. The facts and information included in this post are from their website. Their cited information is at the end of this post if you’d like to check out their article on Bipolar Disorder.
Please bear with me, as this post will be longer than some of my other ones.
General information on Bipolar Disorder
Bipolar Disorder is a mood disorder that causes shifts in moods (in case this wasn’t already clear, haha), energy and activity levels, and the ability to carry out the most basic and mundane of tasks. It was originally called “manic-depressive illness,” and, while that is still an accurate name for the diagnosis, “Bipolar” is the latest terminology.
Some people prefer to refer to it as manic-depressive illness as opposed to Bipolar Disorder, but it’s really just personal preference. Just know that they are both interchangeable names for the illness.
The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, or DSM-5, is the the taxonomic and diagnostic tool published by the American Psychiatric Association. According to the DSM-5, there are four defined types of Bipolar Disorder, all of which have their own features.
The different types of Bipolar Disorder may be treated differently in terms of medication and recovery so it’s important to know which one you’re dealing with.
For example, Lithium is commonly prescribed to help reduce the frequency and severity of mania. That particular medication may not be the best choice for someone like me, who has Bipolar II Disorder, because those of us who have type II tend to struggle more with the depressive part of manic-depressive illness.
I’ll delve more into mania and bipolar depression after I go over the different types of Bipolar Disorder, so stay with me.
In my opinion, type I is the most well-known out of all of the types of Bipolar Disorder. It is defined by “manic” episodes that typically last a week or longer, or by symptoms that are so severe that immediate hospitalization is needed, and by depressive episodes that last a couple of weeks or longer.
It’s possible to experience both mania and depression at the same time.
Type II is notorious for being misdiagnosed as Major Depressive Disorder because it’s more defined by patterns of depressive episodes with less-intense versions of full-blown mania, which is referred to as hypomania.
I received the misdiagnosis of Major Depressive Disorder when, really, I have been living with Bipolar Disorder since I was a teenager.
Cyclothymic Disorder is defined by numerous periods of hypomanic symptoms as well numerous periods of depressive symptoms lasting for at least two years for adults, or one year in children and adolescent, but the symptoms do not meet the diagnostic requirements for neither a full hypomanic episode, nor a full depressive episode.
In my opinion, this is the doctor’s way of saying “Hey, you have symptoms very closely related to Bipolar Disorder, but they aren’t frequent or severe enough to qualify as full and 100% Bipolar.”
In reality, though, if you’re experiencing such symptoms, you have a type of Bipolar Disorder. In my opinion, at least.
Other Specified and Unspecified Bipolar and Related Disorders
This category is defined by symptoms of Bipolar Disorder that do not match the three categories listed above.
As I mentioned in my section above about Cyclothymia, I’m of the opinion that if you experience any type of mania and depression, you have some sort of Bipolar Disorder.
Mania, hypomania, and bipolar depression
Mania is often described as a “high.” Rightfully so. This list doesn’t cover all manic and hypomanic experiences, but I have included the ones that the National Institute of Mental Health recognizes as the most common:
- Feeling very “high” or experiencing a very elated mood.
- Having a lot of energy or increased activity levels
- Feeling “jumpy” or “wired”
- Insomnia or having trouble sleeping
- Being more active than usual
- Racing thoughts, or talking really fast about a lot of different things
- Feeling agitated, irritable, or “touchy”
- Multitasking and doing a lot of things at once (though you often don’t finish them)
- Taking part in risky activities like excessive spending, reckless driving, and unprotected or risky sex
Mania tends to involve the extreme sides of the experiences above, and even ones not listed, while hypomania can include any of the experiences above but on a less intense scale. For instance, you may not feel like you drank ten energy drinks, but you still feel really good and productive and, as I like to say, you “get shit done.”
Bipolar depression is treated differently than clinical, or “unipolar” depression, because Bipolar Disorder involves the drastic changes in moods, as well as mania and hypomania. People who are diagnosed with Bipolar Disorder may not benefit entirely from only an antidepressant, as someone with clinical depression would, because bipolar depression is only part of manic-depressive illness.
Bipolar depression can vary in severity. This list doesn’t cover all depressive experiences, but I have included the ones that the National Institute of Mental Health recognizes as the most common:
- Feeling very sad, down, empty, or hopeless
- Having very little, or no, energy and activity levels
- Having an erratic sleep pattern (sleeping too little or excessively)
- Losing pleasure in activities and hobbies that you usually would enjoy
- Feeling worried or empty
- Having trouble focusing or concentrating
- Experiencing memory issues; being forgetful
- Eating too much or too little
- Feeling tired, “weighted down,” or “slowed down”
- Thinking about death or suicide
Bipolar Disorder and psychosis
A person who has Bipolar Disorder can experience psychosis if their manic or depressive symptoms are severe enough. As a result, some people who have Bipolar Disorder with psychotic features are actually misdiagnosed with schizophrenia.
Psychosis involves hallucinations or delusions, and they tend to match the person’s extreme mood.
Someone having psychotic symptoms during a manic episode may believe she is famous, has a lot of money, or has special powers.
Someone having psychotic symptoms during a depressive episode may believe he is ruined and penniless, or that he has committed a crime. — The National Institute of Mental Health
What causes Bipolar Disorder?
There’s no straight answer to this. Scientists are still studying the possible causes of this and other disorders today, though most agree that there isn’t a single cause. It’s more likely that multiple factors contribute to the predisposition or diagnosis of Bipolar Disorder.
A person’s brain structure and functioning will always be a contributing factor. Genetics and family history also play a role, though. Some research suggests that people with certain genes are more likely to develop the disorder, and research also shows that it tends to run in families. It’s worth noting, though, that most people with a family history of the illness will likely not develop the illness themselves.
It is my own personal opinion that environmental factors also play a role, as with most other mental illnesses.
Treatment options for Bipolar Disorder
There are various ways that someone can maintain their Bipolar Disorder symptoms. There is no cure, but there are ways to help the symptoms become more manageable. Finding that happy medium of symptoms can take time and will require some patience, but the recovery process is ultimately worth it.
An effective treatment plan usually includes a combination of medication and psychotherapy, or talk therapy. Episodes of mania and depression typically come back over time. Between episodes, many people with bipolar disorder are free of mood changes, but some people may have lingering symptoms. Long-term, continuous treatment helps to control these symptoms. — The National Institute of Mental Health
Medications can help control certain symptoms of Bipolar Disorder. For some people, mood stabilizers work very well, but others may do better on antidepressants. For those who experience Bipolar Disorder with psychotic features, atypical antipsychotics may be effective.
When done in combination with medication, psychotherapy can be an effective treatment for those with Bipolar Disorder. Talk therapy can provide you, and even your friends and family members, with the support and guidance you need. Some common psychotherapy treatments include Cognitive Behavioral Therapy (CBT), Family-Focused Therapy and, in severe cases, some people still opt for Electroconvulsive Therapy (ECT).
My Life as a Manic-Depressive
My official diagnosis is Bipolar II Disorder without psychotic features which, as you have learned from the plethora of facts I have provided, is defined by patterns of hypomania and depressive episodes, and does not involve hallucinations or delusions.
I first sought professional help from a mental health professional in March of 2018 when I experienced the worst depressive episode that I had ever experienced to date. I voluntarily admitted myself into the hospital and, as I was there for a depressive episode, I was misdiagnosed with Major Depressive Disorder, or MDD. Read more about Major Depressive Disorder and other forms of depression in this post I wrote about what depression is really like.
I didn’t think to mention anything other than my depressive symptoms to my treating psychiatrist because I thought I was functioning fine when I wasn’t depressed. Turns out, though, that I had been experiencing hypomania.
Hypomania is very easy to miss because people often feel good and perfectly functional. Why would we mention it or seek help when we feel “normal” and are functioning like everyone else, right?
What my hypomania is like
My hypomanic symptoms almost always include feeling productive and like I can take on the day, whether I’m at home or at work. I “get shit done,” though sometimes I’m irritable or easily agitated when I’m interrupted by something or someone. I gotta get my stuff done, right?! Right! So, don’t bug me!
I have some great ideas and racing thoughts when I’m hypomanic. I may come up with a brand new idea for something or think of a new way to solve a problem. This is how The Mental Health Awareness Project was born!
Here’s a glimpse of what my thought process might be like during any given minute:
“Okay, so I’m gonna take care of _______ and _______, and then I’ll start on _______, _______, and _______. I wonder how Nathan (husband) is doing. I’m ready to see him because I want hugs, kisses, and cuddles. What’s for dinner? I’m getting hungry, and I know he will be when he gets off work. He’s probably hungry now. I miss the kitties. They’re probably sleeping. I’m ready to see them and pet them. I wish I could bring one of them to work with me every day. Did I already take care of _______? Yeah, so I guess _______ is next. I really want to check my Twitter. I wish I had a Diet Coke. So, _______ is done now. Only _______ and _______ are left, and then I’m done. I wish it was five o’clock so that I could go home and see Nathan and the cats.”
You get the idea, right? It’s very mentally exhausting. I have yet to experience faster than normal speech, but my thoughts will often race like my example above.
As my brain will sometimes jump from one thought to another when I’m working, I will often start a task and then jump to another one without finishing the first task. Luckily, this hasn’t caused any major issues at work because most of what I do is not contingent on strict time frames. I need to get my work done, of course, but if I run out of time one day and can’t complete a task, taking an additional day to finish up has yet to be an issue.
I often stay up late, upwards of midnight to three o’clock in the morning, when I’m experiencing hypomania. I usually either work on my blog, play a video game, or catch up on my favorite TV shows.
Excessive spending is something that has gotten me into a lot of trouble. When I was a teenager, the first thing I did after I moved out of my parents’ house is open four or five different credit accounts. Sure, this may be typical behavior for some teenagers, but my spending is still an issue today and I’m almost thirty years old. All of my debts have always been sent to collections, and I’ve received plenty of past due notices. I’ve also experienced my fair share of utility disconnections, and even a vehicle repossession and bankruptcy.
Impulsivity is a part of my life as well and, though my excessive spending falls into this category as well, I have a history of other impulsive behaviors.
Without going into too much detail, up until I married my husband in 2015, I had a ten year history with risky sexual behavior.
My hypomania is usually fairly short-lived, lasting no longer than a few days to a week. Kind of a bummer, really.
What my depressive symptoms are like
My depressive symptoms are typically severe. I experience extreme feelings of sadness, worthlessness, hopelessness, and guilt. I often feel like I have no purpose, that I’m a financial and emotional burden to my husband, and that I haven’t and never will accomplish anything worthwhile in life.
I experience fatigue, and I feel like I’m moving in slow motion most of the time. My ability to focus, concentrate and remember things (including tasks I’m asked to do at work), are virtually nonexistent. I have no energy or motivation to do anything, even when it comes to activities that I normally would enjoy.
My appetite is usually affected, but it usually switches between eating too little and overeating.
I sleep excessively, and my self-care and household chores literally tank during these time periods. I’ve stayed in bed for entire days at a time, and I’ve gone over a week without showering and brushing my hair and teeth.
From the time I was eighteen or nineteen to the time I was twenty-four, I went through an impressive drinking spell and, if we had any extra money to spend, I’d likely still be buying alcohol.
About 90% of the time, I experience passive suicidal thoughts and ideations. They are very intrusive and very intense. I also have a history of self-injury.
I have had to call in to work because of how severe my symptoms are. The number of times I’ve called into work is more than I can count over the course of my entire work history, which isn’t at all impressive, mostly because I’ve been experiencing these debilitating symptoms since I was a teenager. I’ve had five jobs before my current one, and all but one of them ended before the year mark. One even ended before my 90 day probationary period.
My depressive episodes can last anywhere from a few days to a few months.
If you suspect that you may have Bipolar Disorder, please consult or seek help from a mental health professional. Please do not attempt to diagnose yourself by using the information in this post. If you experience some or most of these symptoms, the best advice I have for you is to write down all of your experiences and symptoms and consult a mental health professional.
If you experience any of these symptoms, please feel free to share them with me in a comment! I’d love to speak with and connect with you, as I really enjoy connecting with others who are going through what I experience.
National Institute of Mental Health (2016). Bipolar Disorder. Retrieved October 21, 2018, from https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml.