I have had depression since my late teens but when I was eventually told that I had Bipolar Disorder, I started on different medication. I have never felt better.
Accurately diagnosing Bipolar Disorder is often not a straightforward matter. Many people go 10 to 20 years before their illness is accurately diagnosed as Bipolar Disorder.
During that time, sufferers can effectively lose years of their life, while there can be considerable collateral damage in terms of work, personal relationships and problems with drugs and alcohol.
There are two starting points for considering whether you may have Bipolar Disorder. Firstly, you must have had episodes of ‘clinical’ depression. Secondly, you must have had ‘highs’ where your mood is more up than usual, or where you feel more ‘wired’ or ‘hyper’.
6 key features which may indicate the presence of mania or hypermania
|High energy levels – with the individual feeling ‘wired’ and ‘hyper’, extremely energetic, experiencing racing thoughts, talking more and talking over people, making decisions in a flash, being constantly on the go, and feeling less need for sleep.|
|Positive mood – feeling confident and capable, optimistic, that one can succeed in everything, more creative, more happy and perhaps feeling ‘high as a kite’.|
|Irritabilility – reflected in irritable, impatient and angry behaviours.|
|Inappropriate behaviour – becoming over involved in other people’s activities, by increased risk taking (i.e: gambling excessively), saying and doing outrageous things, spending more money, having increased libido, dressing more colourfully and with disinhibition.|
|Heightened creativity – experienced as ‘seeing things in a new light’, seeing things vividly and with crystal clarity, finding one’s senses are heightened and feeling quite capable of writing the ‘great Australian novel’.|
|Mystical experiences – can be experienced by believing that there are special connections between events, that there is a higher rate of coincidence between things happening, feeling one with nature and appreciating the beauty and the world around, believing that things have special significance.|
# The personal accounts below, are that of Bipolar I Disorder as distinct from Bipolar II.
How I involve others in managing myself
The tendency of those experiencing bipolar mania is to think nothing is wrong. After all, spirits and self-esteem are high. It is therefore left to close family members to give the alarm. And, to do that, in addition to ensuring ongoing medication and psychotherapy compliance, self-help will be needed.
One way is in the form of adherence to a plan of attack, constructed whilst in the ‘normal’ stage, and with input from anyone who will be affected. It must be a regularly updated working guide that displays flexibility and adaptability as its key ingredients. It needs to be reviewed every day – written, sung or read. Part of the plan should determine what to do once manic symptoms are detected: for instance, the medical practitioner and hospital preferred; a statement of spiritual beliefs; who has the power of attorney over financial matters, especially access to bank accounts; and who will organise recuperation, including time away from work. It should also document a stay-well plan detailing a healthy diet; the need to exercise; how to avoid stress, and the importance of adequate sleep; medication that must be taken; social support available; and ongoing professional help. And how to self-monitor; so that specific symptoms that occur, for instance, any extra “sparkle”, combined with an increased drive to goal-oriented activity, can act as an early warning signal.
Commitments to regular involvement in self-help groups that teach how to recognise manic symptoms make this easier. In addition it must give chosen people permission to say when predetermined symptoms of manic behaviour are being displayed, ergo, behaviour that is sufficiently different, such as increased social need, activity, ego, talkativeness, irritability, substance abuse and sexual drive. The plan also needs to identify specific triggers. Triggers are extremely personal and are often tripped by stress. Major life changes and events, seasonal fluctuations, deprivation of sleep and illness are prime examples. All cause stress but what is stressful for one is not necessarily perceived this way by another. Once identified, triggers are less likely to occur if family and friends are supportive and there is a good network of social interaction, such as in tennis clubs and churches, with members that focus on the abilities rather than the disabilities associated with bipolar disorder. (39)#*
The trouble with the highs is that they feel so good…
I have to weigh up whether to worry that he’s so good or worry that he’ll feel so bad in just a few hours or days. As a mother, I wonder if there is anything worse than seeing my adult son cry. His pain is so intense, I wish it upon myself: his tormented eyes, his forehead heavy with depression.
Then the full-on high will suddenly hit. It always starts with his dark glittering dilated pupils. I know then it’s a day of fast talking, fast spending and even faster and fantastic ideas. He’s feeling great with a capital “G” and there are the most profound and imaginative plots and stories to be told. He can buy a block of land today, build a skateboard park tomorrow; employ everyone he knows there and get famous. He won’t sleep tonight; he will be drawing plans until I beg him to turn out the light.
At first, the laughter is better than the weeping, the excitement better than the anxiety, and the social interaction better than this recluse he’s become. But the escalation and the scale at which this force arrives becomes like a rock careering down a mountainside, destroying everything in its wake. It bounces high and wide without stopping crazy zigzagging and tearing at everything to get to this unknown destination as quickly and as wildly as possible.
I keep one eye on his spending and one eye on the time. Receipts mount up in his waste bin like trophies on a shelf. This one is for a T-shirt costing more than any dress I could ever own, designer jeans and sunglasses at prices you see in the glossy magazines and, my absolute worst nightmare, a motorbike that will give a couple of days’ pleasure before being consigned to the shed to gather dust, before being sold for a song.
So now it’s midnight and he’s at the casino. Do I ask how much he’s spent, or take a back seat where I quietly observe? Do I mind my own business? But then what is my duty? I question how much I should interfere. I question if this is OK or not. I don’t know. How bad does it have to get to be bad?