I was diagnosed in my late 20s.
I was relieved to learn that with the right treatment,
the vast majority of people with Bipolar Disorder are able,
to varying extents, to live normal and productive lives.
I certainly am.
- Bipolar Disorder can commence in childhood, but onset is more common in the teens or early 20s. Some people develop their first episode in mid-to-late adulthood. Many people go for years before it is accurately diagnosed or treated.
- Occasionally people can experience a mixture of both highs and lows at the same time, or switch during the day, giving a mixed picture.
- A small number of people with Bipolar Disorder (5%) experience only the ‘highs’, whereas the vast majority of Bipolar sufferers alternate between highs and lows.
- Some people may only have one episode of mania once a decade, while others may have daily mood swings. For each individual the pattern is quite distinct.
- People with Bipolar Disorder experience normal moods in between their swings.
- Women and men develop Bipolar I Disorder at equal rates while the rate of Bipolar II is somewhat higher in females.
- Women with Bipolar Disorder have a very high chance of a significant mood disturbance both during pregnancy and in the post-partum period – most commonly in the first four weeks. (Most will have a depressive episode, a significant proportion will have highs, and 10% will have mixed highs and lows.)
Reading the signs
As a relative latecomer to bipolar disorder – around my sixtieth year – I have probably not managed to develop many strategies for dealing with the highs, but those I have may be of relevance to other people with the condition.
During the manic episode my behaviour rapidly escalated to become very noticeably abnormal and socially unacceptable. I left the house and went to the local shopping centre and talked to anyone who crossed my path, demanding their undivided attention and asking constant questions. I was very uncooperative when my wife tried to persuade me to calm down and come home. Even though I never became physically violent, there is no doubt that the police would have needed to intervene to get me to hospital if a good friend had not come to my assistance. This friend, in whom I have always had great confidence, was willing to talk with me, agree with me, humour me and generally cajole me – over a five-hour period – and eventually get me to hospital. I feel that this strategy of employing someone, not a family member, not someone too close, not someone who I saw as a threat, to help me, avoided a lot of trauma which I would have had difficulty dealing with later. It possibly also avoided physical violence in which someone (most likely me) could have been hurt.
I am fortunate to be able to visit both a psychiatrist and a psychologist regularly. The psychiatrist manages my medication, talks to me about my mood and general physical state in relation to the medication, and helps me to understand how I can make the best of the situation, weighing up side-effects in relation to wellness. I find this helps in managing my attitude to side-effects and developing behaviours to minimise them. For instance, I am conscious of maintaining a healthy diet and I do regular exercise to avoid putting on weight and I avoid alcohol and other drugs which may interfere with the prescribed medication. The ‘other drugs’) are not a problem for me, as I have never been personally involved with them and neither have my friends. Avoiding alcohol, however, is not so easy.
Personally, I don’t miss it, but I never cease to be amazed at the reaction of other men. Our social lives seem to be very driven by alcohol and I am constantly pressured, both subtly and overtly, to ‘just have one, just one won’t hurt you’, ‘be in the shout’, and so on, by good friends, sensible, intelligent people who are all aware of what I have been through and what treatment I am having. I acknowledge that it is hard to totally ignore this, especially as it happens very frequently and I do sympathise with younger people for whom the pressure must be even greater. One strategy I have used which worked quite well was to wander around at a New Year’s Eve party with a wine glass filled with dark grape juice – no one batted an eyelid!
I believe another strategy is to try to live your life as normally as possible. I know that to do this, one needs the support of family and friends, and I am fortunate that I am accepted, warts and all. They include me in all the activities in which I wish to participate, and they understand if I indicate that I think something might be too stressful at a particular stage.
With the psychologist, I have been working on cognitive behaviour therapy (CBT). I have found this very helpful, as I believe I had developed a lot of bad “life habits” during the long period when I suffered from depression and anxiety.
I feel very comfortable with her, and she has helped me to understand the thoughts I was having, and to work on changing some of them. She has also helped me to work on a daily timetable which keeps me active both physically and mentally without overdoing things. I enjoy it. I am also exercising to improve my breathing patterns and my flexibility so that I can be more relaxed and deal with the stresses of life more easily.
While I was in hospital and still high, someone suggested I keep a diary of daily events. I did this amazingly well, even though I have very little recollection of doing it, and I actually enjoyed it, so I have kept it up ever since. The daily entries are not necessarily extensive, but I have kept a record of my moods. I find that being able to compare how I have felt from day to day, week to week, has taken the guesswork out of assessing my wellness or otherwise. The fact that I know now that I have felt quite well for five months is starting to restore some of the confidence I had lost and I think it is helping me, along with the CBT, to understand my feelings better. (61)*