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I Hate Being Bipolar. It's AWESOME!

How is it like to live with bipolar disorder?

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VivaLasViejas specializes in LTC, assisted living, med-surg, psych.

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.

I Hate Being Bipolar. It's AWESOME!
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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:

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".

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.

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.

I'm a Registered Nurse and writer who, in better times, has enjoyed a busy and varied career which includes stints as a Med/Surg floor nurse, a director of nursing, a nurse consultant, and an assistant administrator. And when I'm not working as a nurse, I'm writing about nursing right here at allnurses.com and putting together the chapters for a future book about---what else?---nursing.

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pinkiepieRN specializes in adult psych, LTC/SNF, child psych.

Oh 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.

That's actually the first symptom that made me realize something wasn't quite matching between how I "do" the world and how other people "do" the world. Especially when I feel more "stable", I have to watch myself as far as my social schedule, going out, spending money, and the like. Moderation, they say. Moderation is something that does not come easy for me and probably never will.

Thanks for sharing!

BCgradnurse specializes in allergy and asthma, urgent care.

Another 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.

VivaLasViejas specializes in LTC, assisted living, med-surg, psych.

I 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!

LadyFree28 specializes in Pediatrics, Rehab, Trauma.

Are you SURE we're not fromthe same family??? ;)

Great article...keep shining the light for us!!! :up:

Type 1 bipolar here. I so love mania Until the demons come out and get me. That does become a problem.


VivaLasViejas specializes in LTC, assisted living, med-surg, psych.

I 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. :yes:

VivaLasViejas specializes in LTC, assisted living, med-surg, psych.

That 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. :up: 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)

NurseRies specializes in Nephrology, Dialysis, Plasmapheresis.

Great 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.

I was dxed with bipolar disorder about 7 years ago and it has been one rough ride since I was a teenager. I go from complete manic states to being so heavily depressed I can barely crawl out of bed. I am in my second semester of nursing school and I am currently not passing due to a personal issue earlier this year that has left me devastated emotionally. My doc tried upping my effexor dose to the max-- it didn't work, she added a mood stabilizer-- it didn't work and now I am gradually making a switch from effexor to zoloft. Xanax works to keep me out of deep states of depression but it is short acting and I try to limit intake of it due to the addictive effects. I have tried Wellbutrin before but it had me so manic that I did not sleep for 7 days straight and developed SOB and heart palpitations. I am afraid Zoloft will fail as well. I saw a psychologist for a couple of months but it was too expensive and I felt it was not working.

I have gone through feelings of suicide, but I would not do it because I have kids to raise and my whole point of nursing school was to get a better job in the medical field to support me and my kids since I am a single mom. I glided through first semester with no issues and usually love school (I have another degree in a different field), but now I have been having a hard time studying and concentrating, all I want to do is sleep or stare into space. The thought of doing the whole semester over again brings me down. I have not had a manic episode in a long time--if I am not just plain depressed, I am apathetic and though I smile and laugh on the outside in front of others I am really dying on the inside. I just feel like time is ticking by and I am only getting older. I have been seeing one of my nursing instructors regarding help studying and the like, but I am afraid to tell her about my disorder because I feel like my mental health will stop me from getting into the nursing field. First semester I felt like a shining star and this semester I feel like nothing but a failure.

I agree with what was said about this running in families. I think just about everyone I know on both my mom and dad's side of the family has some mental affliction or mood disorder. My parents as well. I'm afraid this is something that will pass to my children since their father also has mental and addiction issues. It's a scary thought, but I try to raise them the best I can and have them keep a good head on their shoulders.

Though I would never wish this disorder on anyone, I am glad I am not alone in this and the subject is more widely discussed than it used to be. Thank you!

pinkiepieRN specializes in adult psych, LTC/SNF, child psych.

@Jenna75, you can and will get through this. I was diagnosed in my second to last semester of nursing school and even experienced another traumatic event at the same time just to make things worse. I pulled through, saw a therapist religiously, played medication roulette and ended up making Dean's List for the only time in my college career. I graduated and I've still been struggling on and off, but I'm blessed in that I've had good health insurance and have always advocated for myself. Sometimes, I think having the nursing background helps, even if it makes me a "difficult" patient.

I too, have been diagnosed with bipolar 1 for about 6 years. My husband took the time to research it and took me to my doctors which saved me. I was being reckless and out of control. My problem was sexual in nature. Always had to be center of the conversation and flirting to the point of getting phone numbers and meeting people out for drinks. I owe my husband everything, if it wasn't for him I'd be spiraling out of control. I was seeing a psychiatrist but have been stable for years. I take Effexor, Prozac, and lamictal, which helps with the anger I was experiencing. I would not sleep for days either and trazadone helps with that. I have to say, I do miss mania because from the meds I'm now tired all the time.some days it's even hard to do a load of laundry. But all in all feel great!

@dolcebellaluna Thanks so much for the encouragement! I will get through this...

TerpGal02 specializes in Psych.

Hypomania can be AWESOME. At least in the beginning for me, I feel on top of the world. Then the rage sets it. That's no fun for anyone. My depressions are severe. I have literally laid in bed for DAYS in the past. Not due to laziness but the fact that I simply could not do it. Gone 2 weeks without showering. The mere idea of showering was just exhausting. In fact no one picked up on BP2 until my pdoc now, even after 3 hospitalizations because my main problem has always been depression. Not to mention the fact that SSRIs without a mood stabilizer is bad news bears. Once I was dx'd and still feeling irritable, ky pdoc decreased my Zoloft which I thought was counterintuitive since I had been so depressed. And damn didn't the irritability and insomnia STOP. Since its been light out and warm, I've been getting a little hypo. If it doesn't abate the next step is to stop the Zoloft for the summer.

Dear Vive,

I too am Bipolar. I've experienced all the symptoms that you've so nimbly described and a few more. People with BPD can be VERY fun to be with. For example, I'm told that I am very witty and hilarious things come out of my mouth with very little filter.

Life can be beautiful with Bipolar Disorder as you so aptly described. Colors are richer and more vibrant, things other people take for granted taste, smell, look and feel spectacular to me. But it is the dark side of bipolar disorder, the weeks with 7 hours sleep, the irrational fits of anger, pique and irritability that drive people away from us (even sometimes our own families) that is the rub, and the harder part to deal with (obviously). At the same time, I think the dark times are part of what give us perspective and let us truly enjoy the brightness of mania.

I am blessed with life, I know I am. I believe God had special purpose for me, and that is why he chose me to be bi-polar. I know there are things I have done in episodes that could have changed or ended my life; but I'm here, mostly whole..and blessed.

Do you think it's safe to be openly bi-polar as a nurse as one is openly anything else that used to be taboo. I'm kinda scared to let loose of my MH diagnoses in this field. Should I be? My wife says, "Yes!" What say ye?

I've told my co workers. They all know as well as my family and friends. I don't care if they know or not. I'm a good nurse with a big heart. I'm medicated and when I go over the deep end at least they know why. Lol.


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