What it's like to have Bipolar Disorder
Living with Bipolar Disorder type 2
Bipolar Disorder Basics
The following website is an excellent set of articles that go over the basics of what Bipolar Disorder is. https://www.verywellmind.com/bipolar-disorder-overview-378810. It will give you a really good picture of what Bipolar is, beyond the specific things I struggle with that I'll be writing about here.
Another excellent website that covers just about everything there is to know about Bipolar Disorder Type 2, is https://psycheducation.org. I fell in love with this website immediately. I love that it covers frequent issues that go along with Bipolar 2 such as PCOS and thyroid issues, and how tackling those symptoms can improve how Bipolar medications work for me. There's very little available research on Bipolar 2, so this was a gold mine for me.
I have Bipolar 2, so I experience hypomania rather than full-blown mania. I generally have mixed episodes and rapid cycling. My Depression and hypomanic symptoms are often opposites of each other. I've experienced symptoms since I was very young. Often with BP2, it takes ~10 years for a diagnosis to happen, and it is frequently misdiagnosed as unipolar depression, as was the case for me. SSRIs are known to induce Hypomania/Mania, which is likely why, after five years on an SSRI, my symptoms became worse, and my diagnosis was finally corrected. Generally, my cycles are five days hypomania and 1-2 weeks of depression. Mixed features happen either during my entire cycle or at best for a few days in the transition.
- Most of my hypomanic episodes have been with mixed features, so it's a bit confusing to understand what pure hypomania feels like for me. However, some distinguishing symptoms include:
- When I drive, I see cars and where they're going but also where they will be going in the next ten or so seconds. So, in my mind, they've already gone ahead. This makes driving ridiculously difficult as what my brain thinks has happened hasn't even happened. I also tend to make riskier driving decisions. "I can make this left turn into traffic even though cars are coming from both directions." – a frequent thought I've acted on and somehow survived.
- Everything is brighter and sharper. It's like watching an HD full-color movie when you're used to only watching old black and white VHS movies.
- My bank account empties. I want everything, and I don't care how my wallet feels. I spend more out of excitement/new hobbies.
- My cannabis use goes up to help slow me down and make it less overwhelming. Yep, even though it can increase the length of my episode and the severity, that's how uncomfortable hypomania is.
- Insomnia. Like, horrible insomnia. Staying up till 4 am only to wake up at 6 am feeling so restless it's uncomfortable. Always. Wide. Awake.
- For better or for worse, I tend to be super productive. This worked out great during my last move as I was hypomanic from packing to unpacking. I've never completely moved/unpacked so quickly in my life. My house is super clean when I'm hypomanic, everything I didn't do during my last depressive episode is 100% caught up during hypomania.
- New hobbies. A sure sign of hypomania is multiple unfinished projects/hobbies all over the place.
- I'm almost never hungry, and have no desire to eat.
I've experienced depression as earlier as three years old, so I honestly didn't even know feeling this way wasn't neuro-typical until a year or so ago. I'm still learning what depression causes me to feel because that's how normal it still feels. Often for people with BP2, it can show as unipolar depression for many years before a clear Hypomanic episode.
- When I drive, everything seems a lot slower than it actually is, making it very confusing to drive. Cars come at me way faster than it feels like they should. The confusion can feel debilitating, which is obviously not great when you're driving.
- Everything is blurry and dim.
- My bank account empties. I want everything, and I don't care how my wallet feels. I spend more on what brings me comfort.
- My cannabis use goes up to numb my emotions. Yep, even though it can increase the length of my episode and the severity, that's how uncomfortable it is. Not only that, but it dramatically increases my chance of entering psychosis. As many as 1 in 5 newly diagnosed cases of psychosis appear to be caused by cannabis use. While all this psychosis stuff is also true in mania, it's far more likely to occur during depression since I’m BP2.
- All my PTSD triggers skyrocket when I'm depressed. There are so many things that I have to avoid when I'm depressed, to avoid the risk of flashbacks.
- Memory loss, confusion, and dissociation. All of those are also PTSD symptoms, so while I experience them frequently, they’re way worse when I’m in a depressed episode. What this often looks like for me, is using a GPS literally everywhere I go because I have no idea when I’m going to forget where I am, where I’m going, and how to get there, regardless of how familiar I am with the drive. This can also happen in the middle of a grocery store, which is super embarrassing.
- I eat everything.
Mixed episodes are also known as Dysphoric Mania, and they are generally more common with BP2 than BP1. What it means is that you experience both Depression and Hypomania/Mania at the same time, or it may feel like you switch between the two as frequently as every few minutes. For me, Dysphoric Mania is the best way to describe it. The risk-taking and grandiose/invincible feelings that are common in hypomania are driven by the negative emotions from my depression. I quite literally seek out activities that make my symptoms worse and extend my episode. A couple of examples of what that means for me:
- Visiting my childhood hometown where a majority of my trauma took place. The high risk is running into someone who hurt me or supports someone who hurt me, or people/places that remind me of feeling the emotions I felt while I was being hurt. I specifically take this risk to feel the trauma symptoms they bring on, i.e., negative emotions.
- Watching the Netflix show Unbelievable. Halfway through my second time watching it, I realized I was purposefully inducing trauma symptoms. Did that make me stop? Nope, it just made me focus more on it specifically because of the high risk for the result of negative emotions. This generally applies for anytime I have a strong urge to watch crime / highly intense movies or shows. Since I experience Hypomania rather than Mania, I do have the ability to control what I do; it's just very difficult because my brain tells me I want/need it.
- Purposefully driving reckless because of the combination of thrill and horror it brings.
Since I have only been diagnosed since August of last year, it's difficult for me to look back and determine what my cycles were like pre-diagnosis. However, since my diagnosis I have gone through complete cycles with as few as 0-3 days of downtime between them. It's exhausting with no time to recover between cycles. It feels like brain whiplash, and making plans feels impossible because I have no idea how I'll feel by the time the day comes around.
While not all my cycles have clear triggers / may not have been triggered by an outside factor at all, there are a couple of things that are almost guaranteed to induce a cycle.
- The sun. I found this out during my most recent work trip to LA. It turns out that even sun lamps can trigger hypomania. When I learned that, it made perfect sense. A few years back, I purchased a sun lamp to help my depression. I only used it a couple of times even though it did seem to help because while my depression seemed to lessen, it also made me feel uncomfortable (probably a mixed episode). I now tell my prescribing doctor every time I'm heading somewhere sunny so she can give me a backup medication plan should I start to feel hypomanic symptoms. Side note: Anyone want a sun lamp?
- Not enough sleep.
- All of the kinds of stress. PTSD symptoms, disagreements, work…
- Drugs like alcohol, nicotine, and cannabis. Fun fact: not only can nicotine induce hypomania, but so can quitting it – It's a diabolical example of damned if you do, damned if you don't.
The upside (for me) of rapid cycling, is that it helped find the correct medications faster than normal. The fact that I became clinically stable within four months is close to unheard of. For most people with Bipolar who experience less than four episodes a year, it can take years to figure out what's working / not working. I've met multiple people who have been diagnosed for 10+ years, and they're still not on the rights med combo. Some people have to try many various medications, as not everyone is receptive to all of them. Some people also are not receptive to *any* current medications and have to do things like ECT… one of the most barbaric treatments ever with the terrifying side effect of losing chunks of short- and long-term memory. Better yet, some medications stop working after ~10 years so you have to start the process all over again. I feel incredibly fortunate that my first two medications seem to be working well, so I've only had to increase dosages rather than try new medications. There also isn't a single medication for Bipolar that doesn't have terrifying potential side effects. You've all seen a Latuda commercial and heard the disclaimers, that's one of the good ones too. One of my medications has a super rare side effect of a deadly rash. As rare as it is, I still panic every time I have a rash… which is super common since I'm ridiculously prone to hives. Panic = stress = hypomania trigger. Yay.
Bipolar in Entertainment
While there are way too many horrible examples of media's portrayal of Bipolar Disorder, here are a couple that I love.
- Ian from Shameless – I mean, at one point he becomes the leader of what is basically a cult, and believes he has a direct connection to god. That's such a clear example of full blown Mania. He likely is displaying symptoms of BP1. His Mom in the show is also Bipolar, but it's been a minute since she's been in an episode so I can't really remember how relevant her Bipolar appearance is.
- Carrie from Homeland – I felt like it did a pretty great job showing the importance of medication, and the erratic decisions made while in mania. It's extremely common for people to stop their medications when they level out because it's easy to doubt your diagnosis, think you are cured, or miss the productivity hypomania gives you. However, someone with BP1 is far less likely to stop their medications because manic episodes can be so horrific and life damaging. Often times in Mania one can completely destroy relationships and never get those back. Carrie likely has BP1 since she had to be hospitalized, required someone to force her to get back on meds because she didn't have an awareness that she was in Mania/how bad it was. She's also a great example of the horrible and sometimes irreversible decisions someone with Bipolar can make that can affect all aspects of their life. The biggest part they do get wrong, is her forgiving job. Many people with Bipolar, especially Bipolar 1, lose their jobs so frequently that they'll have multiple jobs each year or end up on SSDI because they d o not have the ability to work.
- Spinning Out – This is just a really great example and has both a Mother and a daughter diagnosed with Bipolar. I'd say they both have BP2.
Other Random Thoughts
- A sobering fact is that life expectancy goes down by 9-20 years for someone with Bipolar Disorder. There is also a high risk of suicide most specifically for those with Bipolar Disorder type 2 due to the extreme depression experience. It's estimated that 25-60% of individuals with bipolar disorder will attempt suicide at least once in their lives and between 4-19% will complete suicide.
- There are more than 3 million cases of Bipolar Disorder each year. In comparison, every year there are 1.8 million cases of all types of cancer combined. If we could spend as much effort raising awareness and finances to research Bipolar Disorder as we do breast cancer alone, I'm near positive we'd see earlier diagnosis, better medications, and eventually a cure.
- 33% of the homeless population is estimated to be bipolar. If I hadn't been fortunate enough to have finished college and obtained a job before my symptoms became out of hand, I likely would have become that psychotic person on the side of the road you've gotten used to running past or avoiding altogether. Combine my Bipolar diagnosis with my high ACE score, and this becomes even more likely.
- Bipolar Disorder causes your blood to, quite literally, poison your brain. It was originally thought that this only occurs during a manic/hypomanic episode, though more research is showing this happens regardless of which type of episode, and possibly even when not in a cycle at all. It’s likely because of this that Bipolar Disorder is considered a progressive or degenerative disease, often becoming worse as you age if you’re not on the correct combination of medication and actively managing symptoms.