Becoming Okay With Being Bipolar
A bipolar patient's journey of recovering, relapsing, and rebuilding her mental health and well-being before and after diagnosis.
Bipolar disorder, also known as manic-depressive illness, is a mental health disorder that is identified by the severe highs (known as mania) and lows (known as depression) in mood, affecting and causing changes in sleep, energy, cognition and thinking, and behaviour. There are two types of bipolar, type one and two, that are distinguished by the severity of the opposing moods. Those diagnosed with type two, like me, suffer only moderate highs called hypomania, though both mania and hypomania feature symptoms such as irritability, reckless behaviour(s), and risky, impulsive decision-making. Most people with bipolar disorder spend more time dealing with depressive moods than manic or hypomanic symptoms, but it can be debilitating when enduring symptoms of either of the two "poles". The time between the peaks in mood swings is relatively normal for those living with bipolar, which can lead others around the diagnosed to doubt or become frustrated with their seeming on-again-off-again attitude. There is no definitive cause for bipolar - though genes, stress, and brain changes are all considered factors. There is no limitation to those who may be and can be affected by it. Bipolar disorder is usually triggered in adolescence/young adulthood and can be hereditary in families. While both men and women are equally likely to become affected by it, women are more likely to experience rapid cycling (four or more mood episodes within a year) and also, on average, spend more time in depressive states than male counterparts. Many people with the condition abuse alcohol or other drugs when manic or depressed, though this is more prevalent with men, while others also have a significant change (either an increase or decrease) in their sex drive and sexual decisions overall. People with bipolar disorder are more likely to have seasonal depression, co-existing anxiety disorders, post-traumatic stress disorder, and obsessive-compulsive disorder.
The first time I heard that I could be bipolar was in a therapy session. It wasn’t what I was expecting to hear in my first, court-ordered, therapy session, especially as bluntly as it was put. I wasn’t supposed to be the one with a diagnosis – I was only there because my mother’s alcoholism had finally ended in a called-in domestic. She was the one with the disease of addiction, she was the one who had the diagnosis of bipolar. It wasn’t supposed to me, too – regardless of how much I was already like her. This was victim counselling, to deal with the trauma of my mother’s actions that night. This wasn’t supposed to be the start of a seven-year process of dealing with the trauma of that night and the trauma from my childhood – let alone the trauma of receiving and treating my eventual diagnoses. But, as I had unconsciously learned, living with a mentally ill person in childhood is the most consistent predictor of poor mental health in adulthood and so that is exactly what the next seven years of my life became.
I was originally and officially diagnosed in the beginning of December 2013 at the Toronto Western General Hospital Mood Disorders Clinic. I was almost into exams of my first semester at university, where I was pulling an eighty-three percent average, high enough to hold onto part of the scholarship I was awarded upon entry to Trent University. It was a twenty-minute conversation that involved the doctor I had been referred to asking me to describe myself and my past, before turning away from me and dictating my original diagnosis of bipolar two disorder and list of medications for me to try into a phone that recorded it for a written translation that would be faxed later; I froze at the words, and was not warmed by a comforting tone or even the direct face-to-face confirmation of what I had been dreading. Instead, I was sent on my way, told me I could make an appointment if ever need be, and terrified of whether or not I’d ever be my old self again.
I continued analyzing myself and my actions with my therapist past the nine weeks we were allotted from the government; I stayed with this therapist for five years, even seeing her periodically while I attempted to finish university for three more years, two hours away. Looking back now, I think the only reason I stayed as long as I did was because of eventual familiarity, and, if I’m being completely honest, because her answer for “curing” my bipolar (which eventually became officially comorbid - or multiple diagnoses - with post-traumatic stress disorder or PTSD, attention deficit hyperactivity disorder or ADHD – combined presentation, and general anxiety disorder - GAD) was finding the perfect combination of medications; no matter how many, there would be the perfect "cocktail" for me to live my life as normally as I did before this diagnosis. I clung to this idea, the easiest of solutions. And for the longest time, I focused the most on that; I focused on re-becoming the person I was before this "ugly" diagnosis, before I became a raging, sex-driven psychopath. But that type of negative self-talk should’ve been my first sign that something else needed to change, that being me again wouldn’t be the biggest of the challenges I would face in the upcoming years. Successful management of bipolar disorder typically involves individuals undertaking a complex array of self-management tasks (e.g., taking medication and monitoring symptoms with talk-therapy). Many people with this diagnosis doubt they can successfully carry out these tasks and this low sense of self-efficacy can lead to the continuation and preservation of bipolar symptoms, poor quality of life, and low adherence to treatment. For me to be able to truly be "me", I needed to get past the belief that this was only medical, that I all I had to do was take these medications everyday and I would live "normally". I needed to recognize there was more work to do, and that going back to my old self was never supposed to be the goal. This mindset I held about my mental health was my biggest foe that would consistently affect my ability to participate in even the most mundane of routines and tasks. Tasks like getting out of bed, brushing my teeth even once a day, working more than ten hours a week, even staying awake each day without a nap lasting more than two hours became harder and harder as the years went on.
I degraded slowly, still believing achieving the past was feasible and healthy. I won’t go into detail, but from my tentative diagnosis until New Years Eve of 2017, I continued in a spiral of terrible decisions, ranging from cheating on a terrific boyfriend of over two years to everyday decisions of ignoring my medication or skipping therapy. I picked my sexual partners precariously; got myself into situations I still haven’t fully acknowledged happened and have thus felt the shameful and guilty weight of since (despite the years of therapy attempting to battle it); pushed people who I had thought I’d have forever so far away that I haven’t seen them since New Years Day, 2018. That’s because the night before, I reached not only their breaking point – which I don’t blame them for arriving at – but I also reached my own. After a wailing fit to my father via phone call, I checked myself into the hospital for suicidal ideation; depressive symptoms are often a strong and robust predictor of concurrent suicidal ideation and behaviour in bipolar disorder. Suicidal ideation and behaviours are significantly more frequent in women who have also experienced manic symptoms in comparison to men with manic symptoms; patients with bipolar also have an increased risk of suicidal ideation when their diagnosis is comorbid with PTSD, which I had known I was for three years by this point. I stayed overnight in observation by choice, as I was in a city I didn’t live in, five hours away from home, and all the friends I was supposed to be visiting with were out for New Years Eve celebrations; I had taken myself to the hospital in an Uber, too scared to stay at my friend’s apartment where I knew there was a bottle of strong pain killers, and too scared to go out drinking with them that night, which I know I would have been either pressured into or would have made the poor choice to do myself. I remember awaking to an animated text from my mother, who had no idea what was happening to me that night, wishing me a happy New Years. I remember feeling sorry for myself. And most of all I remember thinking that something had to change with me and my diagnoses.
I started the New Year of 2018 with the intent of getting better. I immediately started back up on my daily regimen of medications, I quit smoking marijuana mixed with tobacco, and attempted to get back into the swing of work and home balance again. I kept on this healthier approach to life, for the first time fighting for the healthier life I was started to finally accept I deserved. By the end of 2018, my treatment plan had changed completely, and surprisingly, I was the best I had been in years. After five years of rejecting my recovered mother’s advice of dialectical behavioural therapy (DBT), as well as listening to my gut instinct about the amount of medications I was forcing into myself, I finally conceded. I enrolled in a DBT course, left my therapist, weaned off my five medications and onto one mood stabilizer with a new psychiatrist, got a new therapist, and spoke to a registered nurse regarding the proper usage of marijuana. And the results I saw were extraordinary. Over the following year of 2019, as my mindset started to change for the positive, so did my life; my relationships with my new friends grew into healthy bonds, I destroyed and rebuilt bridges with family on top of our permanent foundations of loyalty and trust, and the most important relationship, the one I had ignored for so long, the relationship with myself, finally started to grow into something beautiful. Yes, I still encountered devastating situations (such as having no contact with my father for five months and totalling my car into a transport truck on the highway), but I was amazed by my newfound strength to "handle" it. These situations no longer broke me, they didn’t shut my cognitions and perspectives into an anxiety-ridden lockdown. I was able to think clearly, to prioritize, multitask – including taking tasks, like making phone calls, that I had previously needed a partner in the room for or to make for me, and even got on top of most of my bills, which for me, had always been one of my hardest necessities of adulthood to meet.
A lot has changed since I started my journey with bipolar. I’m getting married next year. I have a full time, 40k a year job (not that the amount is important, only significant because it’s the biggest job I’ve ever been able to hold onto). I have an apartment with the love of my life. I’m healthy. I’m happy. And I’m still growing. I’m still changing each day. I still deal with obstacles, some more trying than others. Some days are full of light and laughter, and others are numb and dull. But I get through them. With my regimen of medication, and my continued practice of mindfulness and training from my DBT courses, I get through them. It’s not always easy to keep my mind in the present, to take the steps in the moment that I need to take them; sometimes it makes me scream in anger, at myself, my family, my partner. But the days I conquer that urge, the days I can battle my bipolar and win?
That makes everyday worth fighting to be better for.