I Hate Being Bipolar. It's AWESOME!
Once known as manic depression, bipolar disorder is a serious but treatable mental illness that's become better known in recent years, thanks to the creative geniuses and glamorous stars who have gone public with their diagnoses. However, very few people talk about what it's really like to live with the illness; here are some of the realities that lie behind the romantic illusion.We've been talking a lot about mental illness during this early part of May, which has been designated as Mental Health Awareness Month. Nurses and students with all sorts of psychiatric conditions have been coming "out of the closet" and sharing their stories with candor (and not a small amount of courage). We've welcomed several new members who joined in order to comment and, in some cases, tell a little about their own experiences. And so far, readers have been very gracious and even curious about the various disorders presented here.
As many Allnurses members are aware, I've been very open about my battle with bipolar disorder, formerly known as manic-depressive illness. But how much do you all really know about this complex condition? Here are a few statistics for you from the National Institute of Health:
1) Bipolar disorder affects some six million people in the U.S.
That's somewhere between 2 and 7 percent of the population who suffer from the illness at any given time. This includes patients with classic manic depression, which is called bipolar 1, and those with what's called the 'soft' bipolar diagnoses of BP 2, cyclothymia (AKA 'bipolar lite'), and BP-NOS, which is a provisional diagnosis meaning "We know it's bipolar, we just haven't figured out yet what kind you have".
2) Most people with bipolar disorder are also affected by addiction issues.
Some experts estimate this number to be as high as 60-70% of all people diagnosed with the disorder, making it one of the most common co-morbidities. It is thought that the over-use of alcohol, drugs, and other substances is a form of self-medication. Even compulsive shopping can be a symptom of the illness. And almost all bipolar patients overdo something---even if the activity is ordinarily healthful---such as excessive exercise, attention to diet, volunteer projects, and church attendance.
3) A scary thought: Bipolar disorder carries the highest suicide risk of all the major psychiatric illnesses.
That's 15-20% of all people with the condition who attempt suicide each year. The completion rate averages around 10-12%, but even that number is astronomical.....and tragic.
There are more statistics provided by the National Institute for Mental Illness, the Depression and Bipolar Support Alliance, and other trusted organizations for anyone interested in learning more, and I highly recommend Psych Central and the Healthy Living websites for articles and blogs written by bipolar individuals. But now I'd like to turn the reader's attention to the following list of signs and symptoms as they are experienced by real patients, including myself.
Mania is characterized by feelings of being "speeded-up"---speech becomes rapid-fire and incessant, much to the annoyance of others. Sometimes speech is also pressured and tangential, as if the person is afraid he'll forget what he needs to say next, or because ideas are coming so fast that the 'conversation' sounds like a string of totally unrelated topics.
Someone experiencing mania will often have bursts of physical and mental energy that enable her to create, to perform at a higher level, and to produce great quantities of work. (For example, one time during a manic episode I pressure-washed the front porch. For four hours.) But as good as it feels, this can be very dangerous, as the person may literally stay awake for days at a time and work or exercise to the point of exhaustion.
Unfortunately, mania is a siren song for those who spend more time in depressive episodes, because we feel GRRRRRRREAT! We think grandiose thoughts and experience a heightened awareness of sensory stimuli: I'm the king (queen) of the world! I can do anything and everything I want! And wow, look at all the COLORS!!
There is also a dark side. Some people with BP 1 will experience psychosis along with irritability and even rage, paranoia, and hypersexuality, which can ruin relationships and threaten health. Those with BP 2 experience a condition called hypomania, which contains most of the symptoms of mania but not at the same intensity. The dysphoric symptoms include irritability and irrational bouts of anger, distractibility, restlessness, and psychomotor agitation (which I can best describe as a "jumping-out-of-my-skin" feeling, or like I just can't find a place for myself). And common to both types of mania, we have NO insight that anything is wrong, and wonder why everyone is looking at us so strangely.
Depression is, of course, mania's "polar" opposite (hence the name of the disorder). This can encompass feelings of sadness, hopelessness, despair, and a desire to crawl inside ourselves to shut out the world. Some sufferers sleep or eat too much, others too little; some experience agitation while others can't get out of bed or off the couch. It's like a fog that creeps in until it envelops us in its cold, damp gloom, and sometimes it feels like the only way out is to end it all.
This is by no means a full analysis. Our symptoms and experiences are as different as we ourselves are; but as strange as it may sound to those outside our circle, bipolar disorder often confers on its victims the gifts of creativity and an extraordinary appreciation of life's beauty and grace.
We see the vivid colors of the world and smell its exquisite aromas; we thrill to the sounds of great music and sob inconsolably when a favorite pet passes on. And, as a friend of mine once put it, we see the world and everything in it as poetry: the highs, the lows, the joys, the pain, the wonder, the sheer intensity of it all......sometimes overwhelming, but almost always worthwhile.Last edit by VivaLasViejas on Sep 15, '13
About VivaLasViejas, ASN, RN Guide
VivaLasViejas has '19' year(s) of experience and specializes in 'LTC, assisted living, geriatrics, psych'. From 'The Great Northwest'; 57 Years Old; Joined Sep '02; Posts: 26,100; Likes: 40,856.May 4, '13 by pinkiepieRN, BSN, MSN, RNOh goodness, I do enjoy me some hypomania but I could always do without the "itchy scratchy" feeling of wanting to crawl out of my skin.
And almost all bipolar patients overdo something---even if the activity is ordinarily healthful---such as excessive exercise, attention to diet, volunteer projects, and church attendance.
Thanks for sharing!May 5, '13 by BCgradnurse, MSN, RN, NP GuideAnother great article, Viva! My DSis is bipolar, and I've watched her run the whole spectrum from super manic (boy, is she fun then!) to the lowest of lows. I have to admit a little jealousy at her creativity and productivity when she's hypo manic, as I've only personally experienced the depression. Thanks again for your wonderful writing and bringing greater understadning about MI.May 5, '13 by VivaLasViejas, ASN, RN GuideI find it very interesting that when mood disorders run in families, a lot of the time the siblings tend to have different ones. My sister and I laugh when we talk about being "polar opposites", but it's true.......she got the dysthymia and depression, and I was cursed/blessed with bipolar. Our mother and her brother had a similar situation, even though neither was ever formally diagnosed; he was depressed, and she was undoubtedly BP. And then my kids.......one has episodes of depression and used to cut, another has a drinking problem, still another is bipolar/PTSD, and the last one has shown a tendency toward both bipolar AND a drinking problem. Sheesh!May 5, '13 by LadyFree28, BSN, RNAre you SURE we're not fromthe same family???
Great article...keep shining the light for us!!!May 5, '13 by FuzzyType 1 bipolar here. I so love mania Until the demons come out and get me. That does become a problem.
FuzzyI can imagine.
Now I've got a question. Does anyone know why severe stress tends to cause hypo/manic episodes? Before I was diagnosed, I'd have thought it would send one into a tailspin of depression and despair, but in many cases, including my own, it has the opposite effect. For example, I lost my job last week and after a few days of being all over the map emotionally, I'm suddenly staying up till three A.M. researching stuff on the Internet, and then staring into the dark for 45 minutes waiting for my HS meds to kick in.
I sleep 4-5 hours, and then I hit the floor running and continue to bounce off the walls throughout much of the day. My world is crumbling around me and stupidly, I feel like a million bucks! I'm slinging mud and weeds around in the yard, cleaning the bathrooms (and when you see me cleaning ANYTHING, you know I'm going out of my gourd), sweeping and pressure-washing the front porch. I'm also restless and can't sit still even when I'm sitting still. Can't focus. Get to talking and can't shut up. Don't care. Some of you know the drill.
Needless to say, I've researched this disease long and hard, and continue to learn more every day about how it fouls the atmosphere in my brain. Right now it feels like a chemical soup, like the meds and the neurotransmitters are chasing each other around in there and stirring up all kinds of trouble. And frankly, it's a whole lot easier on me to NOT be depressed when I've got to put on my best face and look for another job. But I do think it's strange that stress seems to spark hypo/manic episodes......guess that's one I need to bring up with my p-doc tomorrow. If anyone else has other insight, that too would be appreciated.May 6, '13 by pinkiepieRN, BSN, MSN, RNMarla, try this on for size.
http://www.psycheducation.org/Bipola...troduction.htmThat is an excellent site. The psychiatrist who runs it is a nationally known expert on bipolar II, and he just happens to work in the same office as MY pdoc. In fact, he recommended the 'dark therapy' treatment for me as I'm very light-sensitive. Let me tell you, those amber glasses make looking at a computer screen quite a trip! (Of course, you're not supposed to be looking at a computer screen at all when you're wearing 'em.....sort of defeats the purpose. But I did have to try it, ya know. LOL)May 6, '13 by NurseRies, BSNGreat read! My husband is bipolar 2 and my Dad is bipolar 1. My dads illness seems to have crippled him a bit more, but I think most of it is due to the non acceptance among his family. He was put on so many meds that he now has no desire to do much of anything and has been that way for 25 years. He is stable and he says he's happy, so that's great! I just wish that the meds didn't suppress his passions and interests as much as they do. He is finally down to the lowest dose of lithium, but he will never be completely off it. My brother and I are both mental illness free so far. I do get depression occasionally, but I don't consider it to be crippling.
My husband is a more milder case, however, he hates the way meds made him feel and so he's been without them for 10 years. I think he does fairly well. He sees his bipolar as an advantage that separates him from others. A lot of people don't understand his logic at times, but his mind just works in a very unique and interesting way. His depressions are deep, but usually only last a few days to a week. His mania is day to day, but has never been severe. When he gets obsessed with new interests, or goes on a diet/workout kick, it is INTENSE. Nothing will stop him. If he has a goal, like before we got married, he would work 70 hours a week without flinching to pay for things be wanted. I know he is manic when he starts talking to people and won't stop. They are polite enough to keep listening, but after 15 minutes and they haven't said a word, I know he's in his own world!
I love both men for who they are and the bipolar is part of what makes them unique. I have learned a couple of things that get me through hard times, " I didn't cause it and I can't change it." Once I realize the depression or outbursts are not my fault, I am ok. I cannot let the moods affect my moods as hard as that is, but I need to move on with my day because I can't fix it, I can't change it. I let my husband know that I am here in the other room if he needs something. I tell him what I'm doing and when ill be back. After a few days when he is better, I tell him I am so thankful he's feeling better and that I missed him, I think when people takes things personally, it makes the bipolar person more upset and agitated. The best thing I can do as a significant other and daughter is to ACCEPT the illness. It cannot be fixed. It cannot be changed. Regardless of that, I am here for both of them and will not run when things get intense. Although my husband thought he would never get married, there are people out there that have the ability to accept this disease and do not make it about them. We have been very happy for over 4 years and he is still incredibly interesting and I am excited to see where life takes us.
One thing I wish: that people didn't freak out when they hear the word BIPOLAR... It does not equal insanity or hallucinations or crazy. My husband is proud of his bipolar, he feels special. Other times he hates his own mind and feels so desperate and helpless. But just like any disease, we have good days and bad days. Like someone with chronic pain or diabetes, we just need to learn how to manage if and need to work together as a family!
And but the way, it's not pretty when I hear nurses at the hospital talking about the "crazy" patient and laughing. It's a disease just like any other and these people that are hospitalized are going through a rough time! Compassion appreciated.
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