Sunday, October 16, 2011

What is Bipolar Disorder?


I'd like to ask your help for a moment.  I'm going to write a blog post for this week's Clinical Psychiatry News on Bipolar Disorder.  I'd like to know how you see the term used, or the symptoms that are hallmarks of the illness for you.  If you respond as my favorite commenter, "Anonymous," could I ask that you define yourself...psychiatrist, psychologist, pediatrician, patient with bipolar disorder, friend of someone diagnosed with bipolar disorder....


Also, please just off the top of your head, I can read DSM or Google myself, and I'm more interested in your ideas about what exactly the disorder is.


I may not use your responses (I sort of know what I want to say) but no matter what, I'm curious.  
Thank you so much...

57 comments:

Anonymous said...

I am a the chief nursing officer of a large healthcare facility. I also have bipolar disease, type 1. Disease is how I refer to it--it is so much more than a "disorder". It permeates every thing you are and everything you do. I believe that it is a genetic disorder. My grandfather committed suicide at 24, just after my father was born. My father has Bipolar Disease, type I as well.

In my 18 years as an RN, I have been hospitalized 7 times. Not because I didn't take my meds; each episode was preceded by a life-shaking event. I liken it to a glass that is overfilled with water, the water spilling down over the sides. The glass is my meds, and the water is the disease. Finding the right mix of meds has always been right up there in the most difficult things about this disease.

My disease has cost me marriages, the loss of any custody/visitation rights with my daughter, relationships, jobs, and my house. I've tried to commit suicide, and I've been so manic that I've spent $20K in a few weeks.

Currently, I've been stable on my meds for about 9 months. I am at a new job. My last job knew about my disease. I will not disclose to the new job. I take 5 different meds every day--an antipsychotic, a anticonvulsant, two antidepressants (not SSRIs), and a benzodiazepine.

I would give everything I have to be rid of this disease for good. Pity that it will never happen.

Anonymous said...

Here is a link to an article on a site that does a better job than I could do of describing what bipolar is for me. http://www.mcmanweb.com/bipolar_disorder.html

Aside from that, I do not get why if they changed the name from manic depression, they chose bipolar. Bipolar is used by a lot of people to describe being either very high (manic) or very low (depression). So we get pundits describing stock markets as being bipolar and so on. Personally, i cannot stand that. Lots of twitter comments recently on the use of mental health/illness terms to describe things that have nothing to do with mh or mi. Very confusing to many people who hear the word bipolar and cannot figure out the awfulness of a mixed episode or that you can be manic but NOT at all euphoric, or that the if you are euphoric, that can evaporate while the agitated energy remains and gets worse. Lots of the books on the market about bipolar that are targeted to the lay reader don't do a good job of dispelling the notion that you are either very high or very low.
I have been in hospital with other people who have the bipolar diagnosis but with a different number as in 1 or 2. I have the 1 but had a tough time seeing much of a difference between myself and the 2 people. Maybe they are not supposed to get psychotic at their worst. Not sure. I guess if they do they get their number changed. Quite confusing.
The other thing that bipolar means to me is that part of the time I am a very boring and ordinary car pooling, nagging about homework mom who says you can only take the car if you fill the tank up but also makes sure to tuck an extra few bucks in the kids wallet from time to time to make sure they don't get stuck in a car somewhere and no money for gas. Some other times I am on my way to being out of commission and see the train running away, frightened that nothing will stop it. When the train crashes I am some crazy person, the image of which does not fit well with being a regular boring person. People assume when you are sick that you are always that way and people who do not know about your illness cannot imagine you being anything other than just like them. Bipolar means living in more than one world. It means being frightened of losing it and people knowing and sometimes it means being relieved that some of them do know that it was not a kidney infection that had me gone for so long. It means never knowing if your meds are going to stop working or if they will interact badly with some other thing you might have to take. It means being treated by some people with more compassion than one would have ever dreamed possible and it means being treated as a deviant pariah by others. I think that if I called anything bipolar it would be peoples' reactions to knowing I have this illness, especially those who have seen me both well and unwell.

Anonymous--a) patient diagnosed with bipolar.b) so much more than that.

In the Pink said...

I am a 29 year old female sufferer of Bipolar type one with a most recent episode of depression. What is Bipolar? It is a thief of aspirations, giver of dreams, and an incurable mental illness.

Sometimes I feel tiny butterflies fluttering within my chest that give me cause to great bouts of beloved laughter. I can't breath deep enough when manic and there is no dream I can't achieve. Driving fast tickles the butterflies, playing Russian roulette sounds enticing (just for the experience), and food...oh God food just taste so good.

Sometimes I cry when I wake up...now I am getting depressed. Life hurts because I feel it is passing me by. I sit on the sofa and breath slight shallow breaths while staring at the wall...I am lost and now wanting to face myself in the mirror. Oh how I hate myself at these times...breaking the mirror and slitting my wrist is an option.

That is what my Bipolar Disorder is

rob lindeman said...

Pediatrician.

I couldn't describe BPD better than the sufferers themselves. So let me suggest a few things that BPD is not.

BPD, what ever it is, is not a crime. The State ought not to incarcerate sufferers. The State ought not to coerce sufferers into taking medication with the threat of incarceration.

BPD does not exculpate the sufferer when she does commit a crime.

wv = nelete. Delete in such a way as to negate the very existence of the mis-typed word.

Anonymous said...

Bipolar II is what ruined my career as a lawyer and took away my dreams and aspirations. It is what made me horribly depressed for years, over-sensitive to any perceived criticism, suicidal, and barely able to work. It's what at times makes me hypomanic, too energetic, too happy, too horny, too everything. It's currently under control with Geodon and Lithium, but I worry every day that the meds will stop working and I'll be back on the bipolar roller coaster.

Anonymous said...

Rob writes: BPD does not exculpate the sufferer when she does commit a crime."

Rob, did anyone say that it did? You are right that bipolar is not a crime.I wish there were better alternatives to incarceration for sick people. patients are often treated like criminals by a system that is overburdened.
But Rob, being diagnosed with bipolar does not mean give anyone a free pass to rob a bank or kill their boyfriend. There are plenty of mentally ill people in jail. You seem to be implying that if a person with bipolar commits a crime they expect to be let off. I find it insulting. I have never committed a crime. I have read of mentally ill people who have, but isn't it odd that of all the places I have met people with mental illness, none of them has ever committed a crime? I am not counting bylaw infractions. of the mentally ill who do commit crimes, how many have spent years locked in "treatment" facilities from which they may never emerge? Hell, it would be better to be convicted in a regular court and spend the six months in jail.

rob lindeman said...

Anon,

"Rob, did anyone say that it did?"

Yes, MI used to exculpate any and all bad behaviors from throwing sand in the sandbox ("He has sensory integration! (sic)" the offender's mom screamed. True story), to the commission of capital crimes. Attorneys for a boy with Asperger Syndrome in Sudbury, MA recently defended him, unsuccessfully, against a charge of murder of a classmate, alleging absence of mens rea by reason of insanity.

You're quite right, however that it is far better for the sufferer of BPD to fall into the hands of the criminal justice system than into the hands of the mental health system. The former is FAR more likely to release the offender after she has done her time. If you are guilty merely of having BPD, and someone determines that you are a danger to yourself, you're sore out of luck.

Anonymous said...

Rob,

Your views are so often expressed that I have a hard time believing that you treat any patients with bipolar or that you have a friend or family member with bipolar and since you do not really believe it is real, you probably don't have it yourself. Goodbye Rob, you make my days far worse than they need to be.

Anonymous said...

I have lived with BD type II since I was 18 years old, but was not diagnosed until I was 50.

It's meant I've had a tough adulthood, frequently feeling one down from co-workers and members of my family.

I don't like that many of my physicians seem to treat my medical conditions as if they all have a psychiatric root. For example, one internist "patted" my head telling me my abdominal pain was IBS. Amazing that a female MD, who got past labels, removed a 6 cm ovarian cyst after a second opinion. Thank God it wasn't cancer!

I hate the stigma that a lot of the population attaches to the title "bipolar." My own family will not let me drive their cars, telling me they fear a big lawsuit if I hit someone. Interesting since I've never had an accident!

The workplace was hell for me. I wasn't lazy, I was a person who could not handle high stress. I had a lot of responsibility but no authority.

The happiest years of my adult life have been the last ten on SSDI. Bad days I can stay home; good days I can go swim laps for 45 minutes and help in my grandson's kindergarten class. I nursed my father through his final illness and presently help my 90-year-old mother. None would be possible if I still worked fulltime.

I now feel like a valued member of society. Wish I'd felt that way 35 years ago! I've missed so much of life. BD can rob you of the life other people take for granted.

My biggest psychiatric help has been a clinical psychologist who makes me work hard on CT logs, and knows when to caution and when to encourage. Would have done the final solution long ago without her.

Jen said...

I am a PhD clinician working in a related field. I also spent many years with a diagnosis of BP II. It seems to me that BP I is pretty clear cut in most peoples' minds.

So I'm going to tell you about BP II. In particular, I'm going to tell you what BP II is not. BP II is not unresolved depression that has not been adequately treated with antidepressants. It is not the agitation or inability to concentrate that comes with depression. It is not mania or hypomania caused by excessively high or even average doses of antidepressants, particularly when said hypomania or mania resolves following termination of antidepressant therapy. BP II is not a diagnosis to be applied when the clinician does not know what to do next.

Unfortunately, BP II is also currently a fad diagnosis for exactly those cases for which it should not. The worst part about it is not stigma, but rather that there are so many people out there who do not have BP II, but who are being "treated" for BP II with multiple mood stabilizers and anti psychotics...and who are not being treated with anti-depressants for fear of exacerbating some latent mania.

There needs to be a better algorithm, better clinician education, more awareness. This huge BP II craze is only good when it's accurate, and all too often I'm seeing the opposite - an easy way out. But one that is so unfair to those being treated for a disease they don't have.

Anonymous said...

I'm in my 40s, diagnosed with Bipoar I, and posting as "Anonymous" because I do not wish to leave my fingerprints all around the Internet. This is chiefly because I lost my job due to the symptoms of the disorder (manic--undiagnosed and untreated)and have now had to file a disability discrimination lawsuit against my ex-boss. Simply put, the boss didn't want a crazy person working in the office. Now it is up to me to prove his motive because all he has to do under the law is deny, deny, deny.

The best thing I ever heard about bipolar disorder is that it is a disease of rate. Depressed states find the patient doing everything slowly and heavily and manic ones find the person doing everything fast and amped up. It's not just sadness followed by euphoris or vice versa.

For me, bipolar means living a completely normal life and then once every 4 years or once every 10 years, being unable to concentrate. I remember being in the theater watching Pirates of the Caribbean 2 and spacing out for at least half the movie, looking at my shoes. In hindsight, I should have now something was off with me if I couldn't watch the screen when the extraordinarily handsome Mr. Johnny Depp was on! When manic, I can be so irritable, that if a piece of hair is sticking up a bit and won't go down with my comb, I want to grab the hair and pull it out!

The best television portrayals I have seen of bipolar disorder (and they still leave a lot to be desired) were Sally Field on ER, a guy on House called "Alvie the Manic Hispanic," and Stabler's daughter on Law & Order: SVU. The worst was a couple of weeks ago on "Harry's Law" where the guy was murderous and eccentric his family labelled him "bipolar."

Jane said...

I don't feel comfortable labeling myself...and I have reasons for this. I was ADHD when I was 11, and then I was labeled depressed, and then I was labeled Bipolar. And that was all before finishing high school. In my 20s I went back to ADHD. I was also considered emotionally disturbed in public school after testing LD (they said I scored that way cuz I was emotionally disturbed). I went to college, tested as LD again, and was labeled learning disabled (they said I scored that way cuz I'm learning disabled). I've gone from emotionally disturbed/bipolar to learning disabled/ADHD. And I don't know how I feel about that or how to define myself anymore...

But to answer your question, I actually find that whether it is ADHD or Bipolar there is one thing in common that rings true for me: Bipolar and ADHD people are all on their own schedules. The anonymous poster who spoke of going on SSDI and being able to stay home on bad days and swimming laps on the good days is a good example. He had issues with coworkers, not because he was lazy, but because he doesn't mesh well with stress. That's what I relate to the most. I think of Virgina Woolf, who is believed to have been Bipolar. She operated best on her own schedule, and had her own quiet room. She produced some great literary works as a result. She was lucky because she was very wealthy, did not have to work for anyone but herself, and could produce and work around her own schedule. If she was too moody for something then that was okay. When she was over it, she could take up life as usual.

That's how I see Bipolar people. They are people that flourish best when allowed to thrive on their own schedule and not expected to be as emotionally or mentally consistent as someone else.

Sarebear said...

It's chaos, and I don't handle chaos well.

There are so many things it is; Bipolar is cruel, in how it affects me. As well as and especially how it affects those around me, the ones I love the most, my husband and daughter. I don't have much support beyond them.

Bipolar is isolating. It's a big time-waster. It's full of traps and pitfalls.

At times it's like trying to control a team of wild horses and they are dragging you along behind them and no matter how many years you have, you still think, "I should be strong enough to hold against this."

Bipolar involves failure, and I don't handle failure well at ALL.

Bipolar involves being judged, again which I don't handle well.

Bipolar is confusion, stress, being short with those you'd least want to be short with . . . . it's being things that you don't want to be.

That last sentence, more than anything else, sums it up for me.

Knot Tellin said...

I am a psych NP.

I see bipolar being thrown out as a diagnosis for reasons that escape me. I see the diagnosis being misapplied to adolescents and young people who are obstreperous and moody to extents that surpass those that caregivers are comfortable with. I see it being used as a catch-all diagnosis by busy clinicians who (perhaps) do not take the time to look for more appropriate diagnoses and treatments.

I have disagreed with about 40% of the "bipolar" diagnoses referred to me.

I am also the daughter of a man who was diagnosed with what was then called "manic depression". During manic states, he would dress up in expensive suits and wear an expensive watch and carry a cane and then stroll through ghetto neighborhoods hoping to be jumped so he could get into a fight. He would also hustle pool during those states, again welcoming fights. When he was depressed he attempted suicide more than once, once by taking an OD and then driving on a Los Angeles freeway.

When he was stable, he was a senior civil servant.

Growing up in that atmosphere was chaotic, unstable, terrifying. It took years and my own therapy to be able to form stable relationships with men.

Andrea said...

I am a 41 year old woman with bipolar I disorder. For most of my life, I have been a happy and optimistic person, but because of my disorder, I have also experienced suicidal depressions, overwhelming manias, and psychotic episodes.

In between my breakdowns, I have achieved a lot. I earned a Master of Arts in Teaching and have won numerous awards for athletic performance(I was a college athlete)and excellent work performance.I have a lot of good friends and my family is supportive, but I have probably been hospitalized 10 times in the 20 years since my diagnosis.

When I started treatment, I weighed 130 pounds. Now I weigh 260 pounds. I believe that weight gain from various medications (so much trial and error in psychiatry) is what has caused my weight to double. I eat a healthier diet than most people I know and exercise five days a week. I was diagnosed with high blood pressure last year.

I am divorced and living with my boyfriend. Currently, I am on Social Security and Medicare and am working part time. I have finally admitted to myself that I can't handle a great deal of stress, even with medication, so I'm adjusting my life in ways that help me to reduce stress.

I am a hard worker, but I will not take a job that is overly stressful again. Someday, I hope to be off of Social Security and working hard in a job that is not too stressful, and earning a good living.

I am writing a blog about my experiences with bipolar disorder www.lithiumandlamictal.blogspot.com

Anonymous said...

Bipolar is a robber. I am the sister of a nearly 60 year old brother who as a teen was outgoing, positive, handsome and probably ADHD. He was recently diagnosed by the county psychologist and psychiatrist after I refused to allow him to live with me until he visited them. This was after he showed up homeless and unemployed on my door step after not visiting me for 18 years! He is psychotic and suffers from non-bizarre delusional disorder. He refuses medication. They told me he wasn't schizophrenic since he doesn't have hallucinations nor hears voices. It pains me that I have been robbed of the opportunity to have a brother in my life and to see the shell of a person I once knew.

Maggie said...

I'm somebody without a solid diagnosis of anything.
At this point I'm 95% certain I actually have an autism spectrum disorder. (But just try finding somebody who can identify that in an adult female. My shrink's response was "I'm not a developmental psychiatrist.")

I want to echo what Jen said, and add another one. Bipolar is not a lifelong pattern of insomnia. (Or in my case, a totally botched-or-absent circadian rythem, which became apparent to my mother literally before I was born.) The assumption made by one particularly bad psychiatrist that insomnia = mania still boggles my mind. I've never had a decreased need for sleep.

I don't know if any of this is helpful, but I feel as though there are an awful lot of symptoms that are misinterpreted as bipolar, leaving other probable causes for the symptoms totally unconsidered.

Dinah said...

These are such rich descriptions, really moving. Thank you, all, so much for sharing them.

PDFdoc said...

Wow, there are so many eloquent descriptions of bipolar that have already been posted...I'm not sure if I can add anything helpful...

I too am bipolar, but I don't like that term much. It is too black and white, and doesn't come close to the range of energies and emotions experienced...I feel that manic depressive illness was a better descriptive title, as Kay Redfield Jamison has also commented. I also think that the term disorder is condescending, and implies that it will all go away if we'd just pull our socks up.

In my late teens and early twenties, when the illness was just beginning to take hold, there were times that is was almost helpful. I was a full time medical student and full time national team athlete in one sport as well as a varsity athlete in another. Times of stress, like travelling to big races half a globe away, the excitement, the sleep deprivation, all could push me into (hypo)mania. The resultant energy and drive helped out in more than one race result! Also studying at exam time - who needs sleep?! Of course, the flip side of depression was awful. At that time my docs were all sports med, and called the depressions overtraining, and the high energy periods the result of proper training. In med school I did wonder about the possibility of being bipolar, but discounted this as medical student syndrome (where the student thinks he has every illness studied).

I left a surgical residency 3/4 of the way through because of my first child being born, raging hormones, and post partum depression. I have since carved a niche as jack of all trades at at a local hospital - OR work, floor work, clinic work...and over the years have gotten rid of the dangerous on call.

My definitive diagnosis came with the stress of separation and divorce. I fought the diagnosis - it seemed far too permanent, but since have learned to live with bipolar. I am far more attuned to my body and mind. My bipolar is the warm air that lifts a balloon. When in balance, the various anchors keep the basket on the ground. When I am starting to get manic, the basket lifts just a bit, and jiggles around. I check my senses - colors are bright and multifaceted, music is so exquisite that I almost burst (yes, you all know this). I talk not-stop and am the entertainment in the OR, colleagues look at me sideways. I have let some of my colleagues know of the diagnosis, and have asked them to tell me if I'm getting a bit too hyper (of course, these are surgeons - by telling them that I'm bipolar, I might as well be telling them that I'm a martian)! And who needs more than an hour or two of sleep?!

When I begin to become depressed, my bipolar turns into a heavy wool blanket. Everything is grey, leaden, burdensome. My tongue ceases to work, my legs cease to work, and colleagues look worried.

So, I take my meds (5 for the bipolar), see my psychiatrist, try to minimize stressors (don't see the ex, get some exercise every day, no overnight on calls) and monitor my moods and energies. I've found that it doesn't help to struggle against this illness; rather, I've found that it is best to work with it as one would with an unruly horse - attend to the mood, sit quiet and calm, use aids to gently ease it back. It is a part of me.

Anonymous said...

I'm a pre-med student with either bipolar II or cyclothymia (depends on who you ask).

I don't know how to fully describe my experience with this disorder, so I'm simply going to explain its effect on me in terms of the best and worst aspects.

The worst thing that bipolar has ever done to me is make me feel unreal. You might think that the suicidal thoughts were worse. Well, I don't think that a physical death would be all that bad because my soul was already dead. I was invisible, lifeless, nonexistent.

The best thing that bipolar has given me is a deeper sense of compassion. I'll never forget an incident that happened during my first episode of serious depression. My chem teacher in high school was handing back exams. One girl who had gotten an "A" tried to argue with the teacher over the grading, hoping to secure a few extra points. In my head, I'm screaming "shut up; you got an "A". Don't be greedy!" Truth is, it was an accomplishment for me just to stay awake throughout that exam. In years past, I was the girl who got A's yet argued over points. I also was the girl who judged people who didn't do as well as I did academically. I don't judge such people anymore. I've learned that circumstances outside of intelligence and laziness can affect performance. This is just one example of how bipolar has humbled me, and caused me to be gentler with the rest of humanity.

Anonymous said...

I am an ex-unipolar-turned-bipolar II mishap. For more than a dozen years, I was treated with SSRIs, benzos and sleeping pills for "agitated depression."

Bipolar derailed my scientific career. I had just defended my PhD dissertation and was accepted into a prestigious lab for a postdoctoral fellowship when the bipolar beast spit venom at my naked feet. I fought as hard and as long I could but nothing could prevent the implosion in my brain from occurring. Everything I worked so diligently for, so carefully for, toppled down like dominoes. I am still in the process of picking up the pieces to go play somewhere else.

I honestly do not know what made me more stupid...the drugs or the disease. But when your career hangs on a high functional IQ and you can't think, can't sleep, can't concentrate, well, you just ain't gonna make it as a scientist.

Almost three years have passed. After some drug trials, I have discovered Lithium is my friend. My treatment team and family and friends pulled me through the devastating diagnosis.

Bipolar is a noose around my neck. I can never forget it's there ready to tug tug tug.

Presently, I am returning to school for training in a different career, nursing. I am better though my confidence remains shaky.

Anonymous said...

It sucks.

It sucks because it's never really one thing/symptom, but many at once. It's sort of like spilling mercury and then trying to grab at it and put it back together.

That sucks because people can't really understand that, since diseases aren't so multifaceted in the first place.

It sucks because you cannot ask for accommodations anywhere because you don't want to disclose what you have since there is so much ignorance surrounding manic depression in the first place. Either you are considered a flaky nut-job, creative genius, or unstable. Either way you are better of not saying anything because 95% of the time you will just get discriminated against.

I'm tired of dealing with the ignorance of other people and how it short changes me in the long run.

Anything useful it has provided me has been compounded x10's over by the many other negative things it also has given me.

I hate how I don't drink, never taken street drugs and sleep regularly and have issues getting stable when others with substance abuse issues stabilize so much easier.

Sometimes when I'm high I feel as if my brain overloads with too much information, which is somewhat like how I feel in depression, unable to connect the many inputs I'm getting.

Sometimes, when I feel OK I want to be completely alone. I don't want to speak with anyone and want to enjoy the momentary (always...) lapse of wellness I have without dealing with others. This never lasts, and it's a feeling I try to enjoy as long as possible because it's a sign that another episode is brewing.

It starts with everything being very quiet. No racing thoughts, no jittery anxiety, no mood swings (is this 'normal'?)...everything smells more potent and you can actually hear each individual sound outside separately. Birds, leaves rustling, children laughing, etc.

Then it's back up again. Once the initial buzz wears off you get tired and agitated but burn onward in what feels like a perpetual state of emotional, sexual, cognitive and physical state of arousal.

Every sensation is so perceptually skewed that you can't even explain to people why you would find something as pleasurable as an orgasm painful when the feeling is drawn out over hours.

Meh, It was the best of times, and it was the worst of times.

BPII/ADD/30 something going on 80

Anonymous said...

I am a social worker in a mental health clinic working in the field for over 14 years.

A couple of thoughts. Let's start off with least favorite quotes during an assessment. "I get mood swings." Everybody has mood swings that does not make you bipolar. "I'm bipolar but I don't remember my last manic episode." If you can't remember having a manic episode or at least the damage from the episode you are not bipolar I. "I'm happy one minute sad the next minute." Not bipolar. "I'm bipolar, don't you know what bipolar is? You really don't know how to do your job." That may be the phrase that agitates me the most. If I tell you what your symptoms are then we are no longer having an assessment.

Clearly medication treatment is the most necessary part of treatment. I think as far as therapy is concerned (excluding crisis management), the focus should be primarily be on copings skills, time management, stress management, and early identification of symptoms. Talking about childhood, relational problems with the mother, and other attachment related issues are not therapy for bipolar disorder. I may provide them for my bipolar clients but these elements are not necessarily the core therapy for bipolar disorder.

From my perspective, it is one of the more easily treated disorders. Remember, I'm not a doctor and so I don't have to manage the medication issues. Of course I would work closely with the MD as needed. Medication is the primary form of treatment. Also, all non compliant clients are difficult including bipolar clients. For example a non compliant schizophrenic or borderline is just as difficult to treat.

Other pet peeves are "I'm not doing well, I need the MD to change my meds." How about using active coping skills.

What I love about a bipolar client is they should have large periods of normalcy. It's within reason that their parents were bipolar and raised the client in a chaotic environment but that is not always the case. Hopefully that is the exception rather than the norm. With that I don't have to delve into core beliefs. My depressed client I have to deal with the depressed personality issues that have been there for super long periods of time.

Once we get a client to be able to read stressors, read early manic symptoms, take the appropriate coping steps, change meds as needed. Mania can be manageable for a lot of clients.

Depression for bipolar is generally more severe than depression for a MDD diagnosed person. Coping skills for depression and mania can be different but there are some common elements.

Anyways my 2 cents. If your curious I recommend Monica Bosco's books on bipolar disorder. Good stuff.

Anonymous said...

Bipolar to me means mixed episodes. Being so horribly depressed, you cry incessantly and but also feel spontaneously like driving off a bridge, but at the same time your mind is going a thousand miles a minute. You are depressed but still quite witty in social setting. It also means that everyone around you talks too slow and you are begging them to just spit it out already! At the same time you are crawling out of your skin, curling your toes, clenching your fists and pulling at your hair.

I miss the times when I am just manic and feel like I am getting a ton of things done and I need very little sleep. New hobbies are fantastic. But then I hate the light switch that clicks off and I come crashing down fast into a deep, deep suicidal, anxiety laden depression, that takes forever to come out of.

Bipolar means having to be patient with yourself and your psychiatrist as you try different combinations of meds to find what works for you. It means when you are somewhat stable, you are working hard on those things your therapist has asked you to work on.

Bipolar sucks, but as a spectrum disorder, I've learned that someone always has it much worse than me.

Bipolar also means that most of your family doesn't get it, nor do most of your friends, so it is best to just sit quiet on it. There is nothing like throwing yourself out there and getting a comment like "well, just pull yourself up by the bootstraps," or "suck it up."

I am a bipolar patient.

Anonymous said...

To anonymous social worker in a clinical mental health setting, on eof your big pet peeves are the clients who say , "I'm not doing well, I need the MD to change my meds." You want to know why they don't use active coping skills.
I am the sometimes boring mom who tick a few bucks into the kids' hands after saying sure you can take the car but only if you keep the tank full. What I left out is that you and I used to do the same job you did and trained for several years to get my degrees while the bipolar was really starting to become obvious. One of my pet peeves would have to be anyone else not taking the I am not doing well and need the doctor to change my meds seriously. Telling them to use active coping skills. There are times and it will vary for different people when to quote the song, the drugs don't work. Or they don't work as they should. The medication is no promise that breakthrough episodes do not occur. I have had my meds changed many times, even if sometimes the change was a change in dose. I have had meds changed because what seemed to help was causing dangerous side effects. I do not mean weight gain which is more of a worry over a longer period of time. I have read stories here of all sorts of people including doctors, med students, nurses and so many others. Not a coincidence perhaps that there are so many health or allied health professionals on the blog. Sometimes you need to take into account that these people achieving an awful lot. I think I achieve quite a lot although I have left the field. I am not sure any of these people achieve much without using active coping skills. You didn't so much talk about what bipolar is as much as you listed pet peeves. You are right, bipolar is not a lot of the things you mentioned. My big pet peeve is the term non compliant. We need a better word to describe people who do go off their meds. Why do so many people take med holidays? Not because the highs are so darned great. What makes a person stable on meds one day decide I am going off. We need to understand that better.

Liz said...

i am a shrink (ph.d. psychologist) and simply want to thank the commenters who contend with bipolar disorder....you're descriptions bring this condition to life in a way that no DSM ever could.

http://pocketshrink.blogspot.com

rob lindeman said...

What ever it is, apparently Jared Lee Loungner has it too, in addition to Schizophrenia. Is that possible?

http://www.washingtonpost.com/national/tucson-shooting-rampage-suspects-lawyers-argue-against-his-commitment-at-missouri-facility/2011/10/18/gIQANOaYuL_story.html

"In a court filing late Monday, Jared Lee Loughner’s attorneys said his forced medication to treat bipolar disorder has violated his rights and that there’s no evidence he can be made mentally fit for trial in the next four months."

wv = rationt. A person upon whom rationing is performed, cf. rationer.

Anonymous said...

Thank you, Rob for that public service announcement. I am on the case.

Larissa C

Anonymous said...

This huge BP II craze is only good when it's accurate, and all too often I'm seeing the opposite - an easy way out. But one that is so unfair to those being treated for a disease they don't have.

Anonymous said...

The social worker again.

I did not post a comment about what the diagnosis was because I felt like the descriptions above were really good and probably some of the better descriptions I've heard if not the best. When I hold myself to the above commentators, I feel less qualified to give a description. Again the above descriptions were great.

So I decided to comment more on what is not bipolar disorder because in my setting I see the diagnosis over diagnosed. I was speaking of the dual diagnosed and the attachment related issues that are similar to bipolar but not the same. So I hinted at the difficulties with the diagnosing of bipolar disorder. There are considerable overlap between a borderline pd and substance abuse users with that of a person of bipolar disorder. Many times the borderline pd, a small portion of ex-prison populations, and the substance abuse user desires a bipolar diagnosis. They ask for the diagnosis and are angered when they are told they do not meet the criteria.

As far as coping skills, I speaking of a portion of clients and by no means all of them. From what I read, all the commentators appear to be well educated active problems solvers. I was not making a statement on any of the other commentators I was speaking of the people I see and the calls I get. Specifically the calls I get. I apologize to those that I have offended.

Today during group therapy, I read some of the above descriptions. My clients were able to relate it made them feel less isolated. I thank you guys for sharing what you go through.

ItsTheWooo said...

@anon who was the mom with the boring normal life and used to be a SW

I agree with your response to the first SW. Sounded more like she was venting against her patients. The post was more appropriate for a sw blog.

I don't see what is so wrong with a bipolar patient detecting signs of his or her instability and requesting a med change. What the hell is "coping skills" going to do to head of mania or depression?
Or, are we being paternalistic medical practitioners, arrogantly believing a patient always lacks insight and can not know if he or she needs to change his or her meds *pat on the head* there there take your pills little one.

I mean, I would think after 20 years of mania and depression, some self aware patients would get familiar with the signs/sx of episodes. There is a point where you are starting to get unstable, but not so unstable that you can't help yourself anymore because your mind is gone. An observant self aware patient can go to the doctor and say "I'm exhibiting these behaviors; i need to increase or change meds".

Who the hell are you, a SW, to say "just deal with it use your coping skills".


I don't have BP, I have been diagnosed with it, but I think I just have like cyclothymia or depression with some bipolar-like traits.
I am very self aware and absolutely know the signs/sx of mood changes. I couldn't imagine how frustrating it would be, to know the consequence of not heading off an episode was full blown mania, and to have to deal with these paternalistic morons who tell me to use coping skills, because in their opinion I am stable.

ItsTheWooo said...

PS I do agree bipolar is overdiagnosed.

Everyone with mood instability, regardless of nature or eiology, tends to be diagnosed with it. Bipolar II has become the new "NOS".

ItsTheWooo said...

Just curious who is this rob lindeman guy? It says he is a pediatrician, why does he spend all of his time blogging against mental health treatment for mentally ill people? How is this even related to pediatrics? Why is there even an interest? I mean, I"m genuinely curious.

I suppose I could see an interest in stopping the overuse/abuse of stimulants and antipsychotics in difficult children... but most of his comments seem to be directed at obvious mental illnesses like schizophrenia and bipolar and how medicating these people is wrong. Um wut? Go work in a psych ER and tell me that.

Anonymous said...

Hi Its the Woo,
About once having been "the mom with the boring normal life and used to be a SW". I hope that i conveyed that for me, bipolar does means that my life is, not was, a seesaw from being a mom with a boring old life to being while still a mom, someone who is in no state to be very motherly from the confines of a psych ward. It is not one or the other, it is both and that is partly due to the way meds work or don't work at different times and how it seems that breakthrough episodes do happen especially if not caught in time which is why I feel it so important to be able to say "doc, I think we need to change the meds in some way." Sometimes other people notice first and say, are you on your meds? Or else they think I am drunk, which is not the case.
I did work as a social worker but don't as this time. I guess that I still see myself as an sw since if I ever wanted to go back and was very stable for a a very long time, I do still have the degrees I worked hard for and if a doctor or lawyer or teacher leaves the field for a time, they can still say they are a doctor or lawyer or teacher.
I do agree that bipolar is very overdiagnosed. I do think that it can be confused with bpd. I do think that it has become almost fashionable and that does harm to the people who are living with bipolar. We have to live with a misinformed view of our illness and we also live with the stigma.
To the praticing sw, an awful lot of people with true bipolar do have some degree of substance abuse that stems from using drugs or alcohol to calm the manic periods. of course those make it worse but people do self medicate before they truly get that they need to rely on their doctor issued meds. On that note, a lot of bipolar people have benzos in their cocktail and they are handed out like candy to agitated patients on the ward, on top of the all the other meds. if you get your backside hauled of the ER, often they pump you full of one antipsychotic plus a benzo to get bring you down.
i needed to write this because i do not want to see myself as just a person with bipolar. I don't want that to define me although it has played a major role in my life. When I die i won't be bipolar anymore. I will always be someones' mom.

rob lindeman said...

It's the woo,

lindeman@natickpediatrics.com

Drop a line. We'll chat.

wv = latring. The sound emitted by a flushing electronic toilet

Jane said...

I agree with the people who are miffed about the comment from the sw who finds it annoying when patients think they need a med change cuz she thinks they need to practice better coping skills.

I don't know her background with meds, but I was drugged out of my mind as a kid (thank God nothing much in the adult years), and who the heck wants a med change??? It wasn't until I tried strattera recently, and I felt awful on it in the first week that I realized I had forgotten just how hard it is to be on some of these meds. I don't think I realized just how unwell I felt when I was young until I decided to try medication again. Terrible symptoms can occur when you start, increase dosage, or change meds. Even when your on a consistent dosage you can still have annoying side effects.

I don't think people tend to request a med change unless they think they really need it. Psych meds can be really hard on the body, and I've never met anyone who wanted to be on a high dosage or wanted to change for frivolous reasons. People usually prefer the dosage be as small as possible and also to be on as few meds as possible.

ItsTheWooo said...

@Anon mom/sw
I never insinuated that I perceived you as crazy / unfit some of the time vs stable/loving mom at other times, assuming you take medication and are proactive in stopping episodes.

This would be the case if you were not taking medication, but if posting here (a pscyhiatry blog), it is obvious that you have your BP under control and are treating it. Or trying hard to do so.

I think we need to be realistic about mental illness, and it is absolutely true that a person with untreated severe mental illness can not care for children WHILE they are unstable, OR if they are frequently unstable. I have a ton of mental illness in my family; it is disingenuous to present that mentally ill people who are actively unstable are capable of effectively caring for children. My grandmother was seriously mentally ill, as was my grandfather, they suffered mood disorder and psychotic disorders; neither could care for children, my father was an orphan. Perhaps, today, it might have been different now that we have more effective/tolerable treatments, but at that time, it was residency in the state ward till death (g-ma) // sucking back the newly discovered ineffective tranquilizer med to keep things under wraps, otherwise unable to function (in the case of my g-pa).
More personally, my mother with her depression was completely ineffective to care for us when she was worst. Someone staring at a wall refusing to move or look at you writing suicide notes all day is not someone who can take care of a 9 year old. The rest of the time she was a loving mother, but when she was depressed, she would not respond - I remember my early childhood years with my mother barely acknowledging me. I can look at my father and see the effects of mentally ill parents. HE is the only survivor of his family. His brother killed himself, which may have been because he inhereted the mental disorders, but it also certainly was related to the fact he was an orphan.

As I said in my first post, I have mood disorder myself. I first hand know what it feels like and looks like when you are depressed. I've lost years of my life being miserable for no reason. You can't even take care of yourself, how can you be responsible for a child? I think back to my worst depressions, whole body like lead, mind cotton batting, suicidal thoughts, leaving the house becomes difficult, getting dressed is an effort, everything is an effort. Your thoughts are so horrid, they are overwhelming and you are powerless to think positively and get on as you were.

I've had glimpses of manic-like experiences, they never get worse than me feeling really energized and enthused exalted, feeling pretty much fabulous beyond reason, for a few days, or a few wks. I've also experienced chaotic agitated periods (same energy, but the feelings about it were angry, mental confusion and dysphoric). There have been times it has been quite extreme, albeit for a short period... I can kinda see where that might lead if it was amped up.

This is not the recipe for taking care of children.

I mean if you are able to stop this with medication, then I don't see why you shouldn't be able to have children and take care of them well... but yes, I do think being in the middle of episodes will result in being an unfit parent. I have no reason to believe otherwise, as I think of my experience with my mother and observe my father's damage.


I also think there is something to be said of not having children if you KNOW you have a family history of mental illness. 2/4 of my siblings have biological mood problems. This must be related to the fact half of my grandparents were state psych ward cases and my mother and her father and his family had depression. I'm sure this will be a controversial view, but I don't think it's fair to bring a kid into the world when you know the odds are good it will be born with a brain that causes pain and disability for no reason.

Moody Mommy said...
This comment has been removed by the author.
Moody Mommy said...

And you would propose what? I became pregnant while on birth control. I have bipolar but was quite stable at the time. My daughter's father has severe depression. I should have done what...abort the child that I was being blessed with because she might inherit a mental illness from one or both of us?

Sorry, very sore subject with me. My OB at the time stated I couldn't be a fit parent because I had bipolar...despite the fact that I was stable, had a solid support system in place and my psychiatrist thought I could/would be a great parent. She didn't stay my OB after that visit.

And guess what...I am a great mom. Am I perfect? Of course not, but show me a mom who is and I'll show you someone who is lying. Do I still have mood swings? You bet, but I also have one heck of an incentive to be especially aware of my moods and proactive to get treatment and medication adjustments when I see things seem to get off course and veer toward an unexpalined, seemingly uncontrollable extreme in either direction.

To generalize that people with mental illness should not have children is just insulting!

Anonymous said...

To ItsTheWoo:

I wrote what I did to clarify the point that I did not suddenly switch from boring mom with a career to a person dealing with an illness. I too have a family history of mental illness. My mother did not take care of us so much as we had to take care of her. I know all about growing up with the suicide threats ,the retreat from any sort of life and not having any sense of anyone to take of me as a kid. . My mother refused treatment. I don't. I do take good care of my kids. Moody Mommy is right. All mothers have good days and bad days. I am not perfect. I am also not the kind of mother I grew up with. Given family history alone, some would say no one in my family should ever have had children. Since I do take medication and since I am very well when i am well and that is for long periods of time, i do not think my children have been any more damaged by illness than by having a mother with some other sort of illness that requires other people to step in for a time. I see a shrink so that I do not ever burden the kids with my darkest thoughts. I think that I learned from my early experiences how to take care of people very, very well. Every decision that I have taken together with their father, including whether to have kids, has been planned and well thought out.
While the question of heritability is a good one, we know that most children of one parent with bipolar do not go on to develop it. We also are pretty confident that there is an interplay of genetics and environment when it comes to most illnesses. The switch is there but needs a trigger to set it off kind of thing. I think that is true in many cases, of course not all. My own children are old enough for me to say the kids are alright.

Angela said...

My sister was diagnosed as having Bipolar II D/O. The doc explained to her at the time that he was diagnosing her with that because she didn't show manic symptoms, only depressive symptoms. She has gone years thinking that she has Bipolar II when really she is depressed. I am a therapist and was really surprised to hear that the doc explained the disorder to her in this way.

Sarebear said...

nobody's ever explained my diagnosis to me in any way at all.

No types, not even anything.

Ok, my psychologist HAS described a few things but only things I'd already reported or talked about.

just like nobody ever explained about the long term consequences of any of my meds, nor about stopping benzo's, I didn't even know to think that was an issue until a commenter on here said something about it once.

My GP never explained anything about PCOS, aside from the obvious that it's cysts, interferes with fertility, and is why I have too much chin hair (he said these things, the visual and infertility problems) when saying why he diagnosed it, not to explain anything about it.

I'm tired of docs not explaining anything. My ortho docs aren't great at this either. Maybe it's me, or that I hope for a little bit of info? anyway.

Teufelhunden said...

Only a little over two years out of residency, and I'm losing faith in the specialty I've chosen, and this Bipolar diagnosis issue encapsulates my frustrations with psychiatry and what it's becoming. Of course I believe that, like any disease, there is some variability in severity of bipolar disease. However, we've given the diagnosis such a wide definition that it's become essentially meaningless. You tell me a patient is schizophrenic, and I have a pretty good idea of what I'm going to see. If I hear my new patient has a BP II diagnosis, I have no idea what I'm walking into. Well, not exactly. If I see "Bipolar II" or (God forbid) "Bipoloar NOS" (for those whom Bipolar II is too specific)…if I see either of those diagnoses, I know that the patient is going to be a hot mess. It's the catch all for a difficult patient. More than likely, it's Axis II. But, if you're bioogically oriented, I think there's a bias against having Axis II as the primary dx. Maybe all these ghost-written articles by pharma have gotten into enough throw away journals to convince us all that bipolarity is lurking around every corner (disguised as character pathology), and that the answer is antipsychotics or mood stabilizers.

Anonymous said...

Sarabear,

I think as patients we have to be the ones to ask the questions we need answered. From what you have written, you have PCOS (and I would be asking the doctor about mood issues in PCOS since they can mimic bipolar when if fact the person does not have bipolar). I don't know what your other diagnoses are but I think you mentioned bipolar. It would be great if you could get some clarification as to how your PCOS may be related to your psychiatric concerns. I don't know what meds you take but how can you know if your weight gain is attributable to PCOS or to the meds you take or a combination of the two if you aren't getting clear info from the doctors. Please try making a list of your questions and bringing them in to each of your docs and see what they agree on and what they don't. Investigate further from there.

Sarebear said...

But see, I didn't know there was anything else there was to know about PCOS, so I didn't know to ask anything. Not even the mood thing you mention. Nor what a friend I made later on who had it and said her endicronologist told her it was a pre-diabetic condition and you WOULD get diabetes eventually . . .

I did somehow know enough to mention the sugar pills (glucosomething) prescribed by my gp, to my psychiatrist, because I had read online they can affect mood.

As far as the bipolar, I didn't even know where to begin in asking questions. I think I got a handout once that said 5% of people with depression kill themselves, vs. 17% with bipolar, so there was more to them doing it than just depression, or so it seemed to me from those stats. That's an almost 1 in 6 odds of dying, anyway.

But no, I didn't discuss this sheet with anyone. I didn't know where to start or what to ask, I was just overwhelmed, I can't even remember the early stuff very well, I asked a few thins I think. Then again my first psychiatrist thought I was borderline rather than bipolar yet he prescribed mood stabilizers, which is the reasoning my psychologist used to say that my psychiatrist probably did think i WAS bipolar because it'd be unethical to prescribe stuff if I didn't have the condition it was for . . .

So this added to alot of confusion and not knowing what to ask or where to go with anything. That first psychiatrist was a piece of work; when he actually listened to me, it was an almost brilliant synergy; when I could tell he wasn't, it was awful. Sort of a bipolar relationship, if you like . . . .

Anyway, yes patients should ask questions but shouldn't some MINIMUM of information be given by the doc(s)? It's like they don't like you reading about stuff on the internet but then they don't tell you stuff either.

Jane said...

I sympathize with Sarebear, because she is right that patients don't always know what to ask. I saw an episode of House once where Dr. Chase gets in trouble because he didn't ask a patient about a specific symptom. And he says to House, "Well, she never mentioned it!" And House says something like "It's just a pity that she didn't go to medical school so that she would know to mention it." Without a medical degree, we can't always know what's to ask or mention. You have to know something about a subject first in order to know what to ask and look out for.

Anonymous said...

True enough. As patients we almost certainly know less about our illness than our psychiatrist does. Still, even a well-informed patient will run into mud time and again because the very essence of psychiatry is an inexact science-and that is not the fault of the psychiatrist. The medical literature states: "This drug works for most people," and "Most people under successful treatment do not relapse." My doctor does the best she can. I do my best to make sure my doctor is doing the best she can. I truly wish psychiatry was an exact science and that bipolar disorder could be cured.

Anonymous said...

If a doctor told me I had x diagnosis and therefore required immediate surgery, I would want to know more about x before I consented to the surgery. Same with any other diagnosis that has me taking meds for years. Not being a doctor does not deter anyone from doing some prelim research on their own. A library card can get you access to some real journals as opposed to some of the nonsense on much of the internet. If you really do not know where to begin, begin at the beginning by asking what is that dx, how do you know I have it, why do you think this treatment will work, where can I go if I have more questions and who decides when I am better?

Jane said...

Anon who was talking about prelim research before talking to the doc...

What about the uneducated? Really. I know things have changed in America since the 1950s and before, when there were still one room school houses in some areas. But there are still a lot of uneducated people. Back when my grandpa was growing up (may he rest in peace) high school was optional. He never even went, though he was very bright. He graduated middle school (it went until 9th grade back then), moved out of his parents house, and supported himself. This was all fine back then, and I never heard him speak anything besides Hawaiian Pidgin English. I don't even know he was able to speak regular English (I know he understood it though). He grew up in Hawaii, and he couldn't even hear the difference bettween "eat" and "it." And I know it's different now, but there are still plenty of high school dropouts, dyslexic people, slow learners, etc.

Anonymous said...

The people who are uneducated to the degree you describe are probably not reading this blog either. Are there such people? Of course. Although my grandparents were not educated in the traditional sense,they still asked questions and even argued with their doctors, yes even back a few generations ago.

Alexandra said...

Coming late to the party.

I blog about my struggles with bipolar disorder. They are myriad, and this disease has cost me a great deal - my independence, my education.

Here's a description of suicidality I wrote for my blog today:


Self-murder takes a certain moral clarity, a kind of courage. True, many people kill themselves because they are afraid to remain alive, but it takes courage to live with death for the days, weeks, months, hours leading up to a suicide attempt. When you are suicidal, the thought of suicide becomes a kind of talisman, a comfort, a reassurance that whenever you want to, you can just quit life, leave, abandon everything and everyone. Nobody can force you to live.

Even in hospitals it's possible to kill yourself. People leave windows open sometimes, or else you could hang yourself with your bedsheets, or just bang your head against the wall until you shattered your skull. You could save your plastic utensils, and splinter them into something sharp enough to cut yourself with. When you're suicidal, everything becomes a temptation for self-harm. While I was in the hospital this most recent time, before my meds were changed, I had been cajoled into arts and crafts, which they were calling "occupational therapy" for some reason. As I was sewing up a wallet I'd been given, I kept thinking about stabbing the needle into my eyes. Truly, everything becomes a means of self-harm in the depths of a suicidal depression.

But depression is not the same thing as unhappiness. I found the thought of suicide calming in the days leading up to my move to California. Every time my mind strayed to how much I was losing, how painful it was to be kicked out of school for a second time, to lose my friends and my apartment, I comforted myself with the thought of suicide. I was depressed, but the product of my depression - suicidality - actually made me calmer and happier.

It is very possible to be happy while depressed, and to be sad when your brain is functioning normally. This is what a few hours of happiness while depressed feels like, at least to me: there's a kind of hysterical giddiness to your temporary relief from pain. You know it's only temporary - that when you're alone again, away from the love and laughter of your friends or family, your depression will settle over you like a thick, viscous scum, tainting everything you touch, everything you try to do. At every moment, you feel the depression - like the specter of death - hovering over your shoulder, so close that you almost think you could catch sight of it if you turned around quickly enough. You feel extraordinarily visible, as if everyone can see you, can see that you're a fake, that your happiness isn't real. You laugh too loud, your eyes are a little too wide.

In contrast, I am now normal, and sometimes very sad. I cried two nights ago, silently and spontaneously, out of loneliness for my friends, for the people I left behind in Maryland. But I am alone for much of the day now, and this is no longer an object of terror for me: I go for walks by myself and am not afraid of my thoughts. I had a job interview today, and when I didn't get the job - the hours weren't right - I shrugged my shoulders, said "Oh, well," and enjoyed my day.

I don't know why I've been given this reprieve. I had fully expected the depression I felt this fall to last for months and months. It began lifting the day my meds were changed - and the day my mother reassured me that she loves me. Which was more important? I don't know. But as I said last time, each day now feels very precious to me, and I savor the sun on my shoulders as being especially sweet.

rob lindeman said...

Beautifully-said, Alexandra. Goethe wrote about the comfort of contemplating suicide as well. Google did not help me find it on line. I have the source at home. Email me if you want the source.

lindeman@natickpediatrics.com

Jim G said...

http://broadcastingtoheaven.blogspot.com -- A Patient's Account of Bipolar Disorder I

My explanation for what BP is.

Jim G, Patient

Anonymous said...

Look up a grass - roots support group sponsored by NAMI for depressed people. NAMI trains layman peer counselors to form grous that help newly diagnosed members and their families to stabilized old-timers. All advice is shared , including medications, therapists (who would be a good fit for you, etc.), and experiences. This can be done in an anonymous setting. The only bad experience is that we had a spiteful corporation, an entertainment company, try to video tape our meeting to humiliate an ex-employee, but the group called the police and obtained an out of court settlement (the employee who was stalking/taping was fired).

Kate deGraaff said...

I waas diagnosed with bipolar 20+ years ago. I worker as a psychologist, raised 3 kids, volunteered as appropriate, managed not to make my husband hate me and completed a second postgraduate degree. Although never thrilled with (or accepting of) the diagnosis, I thought I was managing reasonably well. My psychiatris relocated to another country. New psychiatris says I don't have bipolar but schozoaffective disorder. When I protest he says I'm just splitting hairs. If the hairs that are being split are so fine, why change the diagnosis at all? And how about thinking and preparing for some sort of grief reaction? I have fought really hard for a long time, I knew the enemy. Schizoafective disorder is far mor stigmatising then bipolar. Changing psychiatrists is expensive and stressful. Frankly, if I may use a term of art, this sucks.

Anonymous said...

I am Bipolar 1, though I prefer the term Manic Depression. I am in my mid fifties, married, still working though not full time.

I finally have a wonderful doctor who is a neurologist, who did a psyche rotation at the Mayo Clinic. He has a few mentally ill patients to spice up his Neurology practice. I am finally stabilized on a nifty Lithium/Seroquel/Neurontin combo. I pee all the time and have a dry mouth, but otherwise the SE are ok.

Bipolar is a liar and a theif. It will lie to you and tell you to harm yourself, to kill yourself, and other manner of crazy thoughts. A bipolar relative was recently arrested for shoplifting during a manic episode.

I have extreme and intense emotions. Past the norm. I can be hypersensitive, hypersexual, and wound up. I have depressions, especially in the winter but I am more a maniac than a depressive.

During my youth I harnessed hypomania and graduated from high school at 16, graduated from college with honors at 20. I learned a foreign language and lived in Europe for 8 years. But my personal relationships were dramatic and my emotions were too intense. It is torturous actually.

I am grateful for my doctor, lithium, my psychologist who taught me some CBT, and the support of my husband. I also participate in a web site and forum for bipolar. Hopefully I will stay out of the hospital and continue to function in the world. But it makes me tired. And the stigma is awful. I seldom tell people I am bipolar and certainly not clients....unless they reveal that they are bipolar.

I think a dog is a great companion for a bipolar person - unconditional love, loyalty, and you must get up and take them on a walk. I have a poodle and am considering training him as an emotional support animal. Because that is what he is.

Anonymous said...

Just a thought on what might NOT be BPII/mixed state that is maybe oh so misdiagnosed. Has anyone ever been in a 'chronic' situation that is incredibly stressful and that you cannot seem to change? What do you think your reaction would be over time with the chronic high level of stress associated with the situation? And what if you were historically a positive person at heart? Is it entirely possible that, if you didn't fall into a full-blown depression, or even if you did, that your moods would sink and elevate, sink and elevate, as you attempted to deal with a situation you do not know how to 'fix' or are not ready to change or could not change and did not know how to deal with?
I would expect emotions to be all over the place until underlying issues are addressed and resolved or accepted. I think at times, because we are such a quick fix/pharmacology oriented society now, we do not delve deep enough before diagnosing... and then we wonder why nothing seems to work well enough.
I am not saying Bipolar Disorder is not real. I believe it is very real but maybe misdiagnosed or overdiagnosed at times. I am not a physician or psychologist. I am not diagnosed myself but someone in my family is, after being diagnosed as depressed by a primary doc after answering about 5 questions when telling his doc he couldn't sleep (at a time that major issues in his family were affecting him and his adult siblings), then put on an SSRI that really did a number on him and those closest to him, then diagnosed with BPII (mixed state/rapid cycling.. unclear) when he made the mistake of going cold turkey off SSRI's and experienced withrawal/discontinuation syndrome (nobody believed him). I see an individual with major family trauma who did not share with the doctor (doc didn't ask? or he wasn't comfortable sharing?) and who was misprescribed meds and more meds... at this point, his emotional state is so variable who is to say what is what? yikes, so i rambled but my point is that sometimes i really think more needs to be done by the professionals before making life altering diagnoses. Things are not always what they seem at first glance. In my profession, one of our primary objectives is 'Do not Harm the patient'.