I know I said I’d start this particular blog weeks ago. My sincerest apologies for not having done so. A few days ago, I admitted I’d put this off out of fear, fear that I’d somehow do it wrong, that I’d not convey what needs to be understood about Bipolar Disorder and the people who suffer it’s burden. “People who suffer it’s burden” includes the people who love, and suffer along with, any person diagnosed with this debilitating affliction. I have chosen to also address Clinical Depression, as I have seen numerous pleas in my Facebook stream from folks trying to get someone they love to “do something”, to stop letting their depression continue to destroy their relationship/family.
My primary message to ALL of you: There is no shame in having a medical condition of the mind. There is no shame in going to a doctor, be it your general practitioner or a psychiatrist, for treatment of a medical condition you did not invite, create nor cause. There is no shame in having someone in your family or circle friends with either of these disorders. You deserve to give and receive love unconditionally despite having, or living with a sufferer of, either of the conditions addressed in this blog.
Some of the greatest injustices done to people who suffer from either mental disorder is that it’s: 1) All in their head, 2) All they need to do is change their attitude, 3) It’s their fault for being as they are and 4) “If you really loved me/cared about me, you’d change.” All of these are fallacies. A mental disorder is ‘of the mind’ not ‘in the head’. The difference being that disorders of the mind, like Bipolar Disorder and Clinical Depression have a physical basis somewhere in the brain/body, and they often have a genetic factor involved. Bipolar’s physical cause is most often a chemical imbalance in the brain. Clinical Depression can be from a chemical cause in the brain or from an illness of the body which, in turn, affects the brain’s chemistry. Having physical causes, no one can change their brain or body chemistry just by changing their mind. Having physical causes, it’s no one’s fault, and people cannot change for someone else when a physical cause for their illness won’t allow them to change even for themselves.
I suppose the first order is to differentiate between Bipolar Disorder and Clinical Depression.
Bipolar Disorder is defined as: A mental disorder marked by alternating periods of elation (hyper-activity or elated agitation) and depression or mixed periods. A mixed period is one where the symptoms of both elation and depression are present at the same time. Also called Manic Depression.
Clinical Depression is defined as: Depression that meets the DSM-IV criteria for a depressive disorder. The term is usually used to denote depression that is not a normal, temporary mood caused by life events or grieving. (DSM: Abbreviation for the “Diagnostic and Statistical Manual of Mental Disorders,” a comprehensive classification of officially recognized psychiatric disorders, published by the American Psychiatric Association , for use by mental health professionals to ensure uniformity of diagnosis. DSM-IV denotes the DSM is in it’s 4th edition.)
Now that you have the textbook definition of Bipolar Disorder, it’s time to relate that it’s much more complicated than those words would make it sound. For instance, even if you’re depressed 99% of the time, one period of elation or one mixed episode qualifies as Bipolar. In other words, people with Clinical Depression have no periods of elation or mixed episodes.
There are different types of Bipolar which fall under the heading of Bipolar Spectrum. For a more expansive explanation of the types of Bipolar Disorder, please go to: http://www.webmd.com/bipolar-disorder/guide/bipolar-disorder-symptoms-types. *The following sections on Symptoms, Types, and Complications was taken in it’s entirety from WebMB to which the link above refers with further links to greater information.*
The primary symptoms of bipolar disorder are dramatic and unpredictable mood swings.
Mania symptoms may include excessive happiness, excitement, irritability, restlessness, increased energy, less need for sleep, racing thoughts, high sex drive, and a tendency to make grand and unattainable plans.
Depression symptoms may include sadness, anxiety, irritability, loss of energy, uncontrollable crying, change in appetite causing weight loss or gain, increased need for sleep, difficulty making decisions, and thoughts of death or suicide.
There are several types of bipolar disorder; all involve episodes of depression and mania to a degree. They include bipolar I, bipolar II, cyclothymic disorder, mixed bipolar, and rapid-cycling bipolar disorder.
A person affected by bipolar I disorder has had at least one manic episode in his or her life. A manic episode is a period of abnormally elevated mood, accompanied by abnormal behavior that disrupts life.
Bipolar II is similar to bipolar I disorder, with moods cycling between high and low over time. However, in bipolar II disorder, the “up” moods never reach full-on mania.
In rapid cycling, a person with bipolar disorder experiences four or more episodes of mania or depression in one year. About 10% to 20% of people with bipolar disorder have rapid cycling.
In most forms of bipolar disorder, moods alternate between elevated and depressed over time. But with mixed bipolar disorder, a person experiences both mania and depression simultaneously or in rapid sequence.
Cyclothymia (cyclothymic disorder) is a relatively mild mood disorder. People with cyclothymic disorder have milder symptoms than in full-blown bipolar disorder.
Learn about the bipolar spectrum, what it means, and how bipolar is categorized.
Self-injury, often referred to as cutting, self-mutilation, or self-harm, is an injurious attempt to cope with overpowering negative emotions, such as extreme anger, anxiety, and frustration. It is usually repetitive, not a one-time act.
Learn about the complications of bipolar disorder during pregnancy and what you need to know about your medications and mania.
When a person’s illness follows the classic pattern, diagnosing bipolar disorder is relatively easy. But bipolar disorder can be sneaky. Symptoms can defy the expected manic-depressive sequence.
Suicide is a very real risk for people with bipolar disorder, whether they’re in a manic or depressive episode — 10%-15% of people with bipolar disorder kill themselves. But treatment greatly lowers the risk.*The preceding was taken in it’s entirety from Web MD.
Now, I will not say which site it was, but I did find a site which tried to link sexual orientation to being Bipolar on the grounds that they experience more stress in their environmental situations than others. I found their beliefs to be very distasteful. It niggled in the back of my mind that, not so very long ago, alternate sexual orientations were themselves considered to be a form of mental illness. They aren’t, so let’s not try to saddle them with another mental illness because of “stress” in their environment. The site gave no corroborating evidence, so I’m dismissing it. I only felt it fair to put forward this bit of throwback thinking, so that any who stumble across it might also recognize it for what it is: a smear. While it may be true that stress is a trigger for the onset of Bipolar Disorder, it does not validate the supposition that one’s alternate sexual orientation is more likely to cause one to be Bipolar. I’ve had many gay, lesbian and bisexual friends who were much more stable and sure of their inner identity than I’ve ever been.
Until the previous paragraph, much of what I’ve written has been about what Bipolar Disorder and Clinical Depression are. I have not said what they are not. They do not mean you’re crazy. They are not insurmountable, and they are not something you can “beat” by yourself. In both cases, you do need a qualified physician to work with you, you do need the correct medications for your condition, and you do need to build a strong network of friends who can/will support you. However, simply having a doctor to prescribe pills and friends to moan to is not enough. Just as with any illness, you are responsible for taking control of your treatment. That means: 1) You must acknowledge you have a problem, 2) You must go to your physician and tell them accurately, truthfully, what is going on with you, 3) You must be honest with your loved ones about your medical diagnosis and treatment (If they don’t want to hear it, do not be too dejected. Chances are, especially with parents, there is some level of unnecessary guilt or helplessness regarding your suffering.) 4) You need to be honest with your friends about the possible side effects of your medications, so they will understand if something isn’t going well. Sometimes, your friends know before you do that a medication isn’t working or if it’s causing you more problems. That doesn’t mean you need to tell every Tom, Dick or Harriet who passes through your life in the grocery checkout, 5) You must take all of your medications as prescribed by your physician. They won’t do you any good sitting on a shelf.
Earlier, I directed you to a link to read for yourself the types of Bipolar which create the Bipolar Spectrum. Just so you know my motivations and from whence they come, I will tell you this: I am a Bipolar II, Rapid Cycling with Mixed Periods. Oh, joy! What fun! NOT.
So here I am weeks after writing what is above. I had no idea when I said I’d write this blog just how hard it would be. I cannot speak for other people. I can barely speak for myself. I have been having difficulty for some time now. I can only conclude that my medications, for whatever reason, are no longer working as they should. It happens. One little change in your body chemistry and your medications, which had been working for years, stop working. Sometimes environmental/social situations create enough stress to override you medications. For me, it may be somewhat of both. I’ve gone into early menopause (which is breaking my heart), and my living situation (specifically my relationship with my father) is deteriorating. I’ll admit to having thoughts of purging or cutting. Last week, I was 16 minutes late for my doctor appointment. I waited 22 minutes to find out whether or not he’d still see me. His refusal was both loud and humiliating. He didn’t even care to know why. My next appointment to see him is in three months. That means three more months of sleeping all day, crying for no reason, taking abuse from people because I’m an awful person who doesn’t deserve to be treated kindly, not looking in mirrors because what I see is a hideous, fat, ugly failure and all I want to do is break the mirror.
The people who used to tell me that none of that is true are gone. I can’t say as I blame them. I am well aware that “friendship” with me is quite exhausting. That’s something I hear from folks who are in relationships with people who are either clinically depressed or bi-polar. The constant work to keep someone suffering afloat, from falling into the depression or trying to lift them out of the depression is exhausting. It also often fails, so then comes the cajoling to get them to do something for themselves. That goes right back to my point for this blog. When that doesn’t work, comes the giving up. I have heard from many the same words, “Everyone leaves eventually.”
The despair felt on both sides can be excruciating. That’s why the one afflicted must do something to break the cycle. That means going to your doctor and saying plainly that there is something wrong. That means that loved ones may have to make ultimatums to get the loved one to go to the doctor. It may also mean loved ones telling the the afflicted one’s doctor what’s going on for him/her. My opinion on that is in favor of the tattling. If you won’t take care of yourself, and you’re expecting others to take care of you, well, there you go. They’re looking out for you, taking care of you when you can’t muster the courage and the self-esteem necessary for you to do what you must. Deal with it, and tell your doctor the missing bits from what your loved one knows, because we all have darker thoughts we haven’t let out to loved ones.
To the family and friends, don’t try derision strategies to get your loved one to go to the doctor or change some behavior you don’t like. Certain behaviors are coping mechanisms. The person afflicted needs a behavioral outlet, which may be the one you want stopped. Chances are, all you’ll do is feed into the darker thoughts which may, or may not, have been shared with you. The darker thoughts tend to be along the lines of, “You’d be better off without me.”, or “The world would be better off without me in it.” If someone starts speaking in terms of ending their life, seek help from your doctor or even your pharmacist immediately to find out what your options are to get forced help for your loved one/friend. While it may be commonly accepted as true that people who talk about suicide won’t do it, you never know when they’ll stop talking or how long it will be before they act once they do stop talking. It is also true that many who attempt suicide leave notes behind. If you suspect a loved one or friend is in such a dire condition, look for practice notes, but also be aware that not all leave notes. Watch for the giving away of personal items which you know hold great personal value to them. Again, that may not happen. Listen, listen and listen, and if push comes to shove, get help for yourself. Some people won’t help themselves no matter what you do or say.
Now we’re back to what I said earlier about there being no shame in being afflicted or what the affliction may lead you to do before you finally begin to get the help you need. If you tried and failed, it simply wasn’t your time to die, so use it as a new beginning. Don’t concern yourself with what other people think. If there is someone in your personal circle who looks down on you for attempting to find peace from your daily torment, put them away from you, and don’t waste a moment doing it. They’re more likely to push you back in the direction from which you are trying to escape. Follow your doctor’s orders. Also, understand that finding the medication cocktail that is right for you may take time. Don’t give up. Keep trying. Eventually, there will be success. However, it’s also up to you to find activities that help you to stay focused on the positive. It’s up to you to learn your body’s signals telling you that a down turn is coming. When you can see those warning signs, you will be more able to cope with whatever negative feelings and thoughts do come your way.
Finally, going to a therapist is a really good idea. It’s most likely it will be in those sessions you will discover the signals you’ll need for knowing a spelling is coming, how bad it will be, and what you’ll need to do in order to get through it. Also, sessions with your partner, or even your whole family, may be necessary to heal wounds created before your seeking of treatment. Don’t hide from facing the wounds you inflicted. You’re the only one who can heal them.
In the end, you’re the only one who can heal yourself, save yourself. There is no shame in being a survivor!
(If any of you readers feel I’ve missed something, or that certain aspects should be expanded upon, please let me know in the comments section.)