Bipolar Disorder

[Creed of Heresy]

Well, I finally went to go to see a psychologist. I've been putting it off like so much else, been trying to convince myself it'll go away but, really, after this much time, it's only getting worse. So, I went to see a psychologist, and the general gist of it is, yes. I'm bipolar. Color me unsurprised.

So, I contacted a psychiatrist, and I'm going to set up an appointment, and...we'll see where to go from there. I also have PTSD, and the psychologist is going to help me work through that, too. So, finally, after a long time dealing with this crap, I'm finally going to get it treated. Over the next couple months, I'm probably going to start being less aggressive, and hopefully less emo. Hopefully now I can get my life together, and get on with it.

I know a few people on here have bipolar disorder, I'm just curious how it affects y'all, and how you guys deal with it, and what recommendations anyone might have for me moving forward.

Comments and claims about psychiatric treatment being invalid for whatever stupid reasons anyone might have will be ignored unless viable alternatives can be suggested.

[Jackalope]

I also have a dual-diagnosis of bipolar disorder with PTSD (with a side order of dissociative/depersonalization features). I live a relatively normal / stable existence now, and I'm now asymptomatic for 18 months (except for some dissociative features).

I can't say what will work for you, but I can say what I have learned over the years.

Stick with your treatment, even if you are feeling OK. That includes meds if you go that route.

You don't have to tolerate bad side effects from medication. If your prescriber is unsympathetic or not helpful, find another one.

Don't let your treatment rule your life. Get outside. Do things you enjoy. Exercise. Eat well.

Don't drink alcohol to excess. Your doc will tell you this. They'll tell you to abstain entirely - which may or may not be excessively cautious. I found that occasional drinking - in moderation - did not cause problems.

Attack the problem as a challenge to be overcome, not a problem to be defeated by.

Live in the moment. Be mindful. Don't worry excessively about the past (which you cannot change) or the future (which you cannot control). Concentrate on the now, and the things that you do have control over.

Be self-aware. Learn the clues that your body will give you in the early stages of an episode. It's easier to prevent an episode early than it is to stop one that's started - but you cannot prevent what you cannot see.

Keep a card in your wallet with contact information for your therapist, your prescriber, your emergency contact, and a suicide prevention hotline.

If you feel suicidal, or that you might harm yourself or others, use your resources. Talk to someone you trust. Call a hotline. Go to the emergency room.

Accept that for many people with your diagnosis that occasional inpatient treatment sometimes becomes necessary. Inpatient can be scary, but it is what you make of it.

PM me any time.

[Jackalope]

You also asked about how it affects people - I forgot to touch on that.

My experience has been that my baseline moods were dysthymic (low-grade depression), with frequent more severe depressions, and occasional manic periods and mixed episodes (where both manic and depressed features are present).

I found, perhaps because they were not the norm, that manic and mixed episodes were by far the most destructive and dangerous. Not so at first - the ramp-up feels good, you feel on top of the world, confident, etc. It became difficult to rest or sleep. I felt *driven* - and not in a good way, "compelled" might be a better word - to do things. Something. Anything. I abused cocaine and alcohol. I'd stay out all night, which at the time was no big deal as at one point in the cycle, I stopped sleeping altogether. In my deluded mind, there were no consequences. I could do whatever I wanted. There was no stopping me.

What goes up, must come down, and the crash was always faster and harder than the rise. I became aware of and ashamed of the things I had been doing. I would become suicidal and hostile, and unapproachable by the people who cared about me. Eventually the cycle would complete, and return to baseline.

I lived like this for over 20 years before I was properly diagnosed and treated. I'm thankful that you caught it early.

[Angrboda]

I don't know that I have anything to add. Unless you're experiencing a sudden change due to medication, things don't happen all that quickly in treatment, so you'll have time to adjust. In my experience, it takes 1-3 years for a person to go from the baseline of discovering they have an illness to having the routine of coping down, both emotionally and intellectually. There are a lot of things to learn, and new skills to develop; it just takes time. (It's been analogized, I think accurately so, that being diagnosed with a mental illness is just as traumatic and world altering as any other major trauma, from losing a limb to being diagnosed with cancer. Just like them, finding out you have a mental illness just takes time to work through. Don't rush yourself. And don't beat yourself up for dragging your feet, procrastinating, or "being lazy." You're only human.)

Regarding alcohol, I'd say abstinence is an ideal to shoot for. Me, I'm reckless and self-destructive, so I do whatever the fuck I want and drink like a fish if I feel like it.

I'm probably not someone to model your behavior upon. However, if you do drink while on medication, be knowledgeable about interactions. Some meds are cool with alcohol; some combos are more dangerous. It's the same as with mixing any other two drugs (alcohol is a drug); watch for side effects and interactions. (Last time I was in the hospital, we were discussing medications and one person was alerted to a combo with Xanax that occasionally results in the person stopping breathing. That kind of shit is important to know.)

I've been this way so long that I don't know what it would be to be different, but if you have specific questions, I'll do my best to answer (you can PM if you like). I have schizo-affective disorder, which is basically a mix of schizophrenia and bipolar disorder. However, I have little experience with the manic side, with only isolated and short-lived manic episodes; most of my stuff is depression, delusions, and other psychotic symptoms.

Not sure where I left off here. One thing I suggest you keep in mind, is that living with an illness, especially a mental illness, will put you in situations and times when you feel very vulnerable and helpless. It's natural, especially for men and Americans, to try to "handle things" when that occurs, but I believe you'll cope much better, if you are such, to learn to embrace your vulnerability, and when you are feeling that, to let yourself ask others for help. It's an issue I still deal with, and am not sure I'll ever truly master. Over the years, noticing that my mind and behavior was beyond my abilities to care for, I've had to ask family or friends to look after me until those things pass. I never had too much trouble doing that, but when I lost my fingers in 2008, I was faced with learning a whole new set of vulnerabilities. Things like, being unable to operate a credit card reader, and having to ask a stranger to do it for me. I do my best to avoid such situations, and still struggle with them at times. Being vulnerable is hard.

[John V]

Well, I finally went to go to see a psychologist. I've been putting it off like so much else, been trying to convince myself it'll go away but, really, after this much time, it's only getting worse. So, I went to see a psychologist, and the general gist of it is, yes. I'm bipolar. Color me unsurprised.

So, I contacted a psychiatrist, and I'm going to set up an appointment, and...we'll see where to go from there. I also have PTSD, and the psychologist is going to help me work through that, too. So, finally, after a long time dealing with this crap, I'm finally going to get it treated. Over the next couple months, I'm probably going to start being less aggressive, and hopefully less emo. Hopefully now I can get my life together, and get on with it.

I know a few people on here have bipolar disorder, I'm just curious how it affects y'all, and how you guys deal with it, and what recommendations anyone might have for me moving forward.

Comments and claims about psychiatric treatment being invalid for whatever stupid reasons anyone might have will be ignored unless viable alternatives can be suggested.

Consider a second opinion. Bipolar is frequently misdiagnosed, particularly when the patient self-medicates with recreational drugs. Drug abuse is sometimes misdiagnosed as bipolar, and vice versa. Go to another psychologist and be completely upfront about it - hey doc, I was diagnosed as bipolar, but I use recreational drugs and heard this can cause a misdiagnosis, and see what he says. At worst it's one wasted afternoon, but it could save years of incorrect treatment.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945875/

Bipolar disorder is often misdiagnosed.
Two surveys, one taken in 1994 and one taken in 2000, reveal little change in the rate of misdiagnosis.

As per the survey taken by the National Depressive and Manic-Depressive Association (DMDA), 69 percent of patients with bipolar disorder are misdiagnosed initially and more than one-third remained misdiagnosed for 10 years or more. Similarly, a survey done in Europe on 1000 people with bipolar disorder found a mean time of 5.7 years from the initial misdiagnosis to the correct diagnosis, while another study reported that on average patients remain misdiagnosed for 7.5 years.

Diagnosis of patients with bipolar illness can be challenging as most of these patients seek treatment only for depressive symptoms, and more often than not, the first episode of mood disturbance is depression rather than mania. Two studies in 1999 and 2000 concluded that almost 40 percent of bipolar disorder patients are initially diagnosed with unipolar depression. By DSM-IV criteria, patients need to have an episode of hypomania or mania and an episode of depression in order to be given the diagnosis of bipolar disorder I. The diagnosis of bipolar II disorder can be even more challenging as the criteria in DSM-IV can be overly restrictive, requiring a full symptomatic picture of mania with a duration of four days, while many experts believe that the average duration of the hypomanic state is 1 to 3 days. Furthermore, in bipolar II, it can be difficult to elicit a past history of hypomanic episodes from the patients. An episode of hypomania has a milder presentation than mania and can happen without impairment in functioning at work or in a patient's social life, which may be why hypomanic episodes are unreported by the patients. In other words, the increased energy and heightened activity often experienced during hypomanic episodes may not be considered negative events by the patients who experience them.

High comorbidity of bipolar disorder with other psychiatric and medical diagnoses also makes diagnosis difficult. A study that examined patients with bipolar disorder showed that 46 percent of the patients suffered from alcohol abuse or dependence and 41 percent had comorbid drug abuse and dependence. Some studies have even reported rates of alcohol abuse up to 69 percent and rates of drug abuse as high as 60 percent in patients diagnosed with bipolar disorder. Research also supports high comorbidity of bipolar disorder with panic disorder, obsessive compulsive disorder, social phobia, eating disorders, attention deficit hyperactivity disorder (ADHD), and axis II personality disorders. Association of bipolar disorder with medical conditions like thyroid disease and multiple sclerosis can also complicate the diagnosis.

[NoraBrimstone]

Well done for taking those difficult first steps towards getting help. I wish you the best of luck with whatever treatment options you try out and hope it doesn't take you too long to find one that works for you.

I've suffered from Major Depression on and off since childhood, so I can partially understand from personal experience that it can be hard to deal with mental health issues in general. My Mother suffered from Bipolar Disorder, and so did her Mother, and so does her Father to this day. From their experiences I know that Bipolar Disorder can be particularly fucking nasty, especially when left untreated.

[Jackalope]

Yes, it can be very nasty, for the sufferer as well as everyone around them.

To make matters worse, it can be extraordinarily difficult to get someone to seek treatment, or even recognize that there is a problem.

That the Heretic is young and acknowledges that something is wrong works greatly in his favor.

[Creed of Heresy]

It only took me 11 years, yeah...

A greater understanding recently of mental illnesses helped me take the first steps. I've always felt like something is just...off. But the last four or five years or so it's been getting worse. I've refused to acknowledge something is wrong but...funniest thing, what got me to finally pay attention was the inability to write. During the depression phases [which are the longest-lasting and most persistent], I can't write a fucking thing, and just going to work, or doing anything, is a fucking struggle. My mind constantly works against itself. Last few years I keep abruptly quitting my jobs for no reason despite it putting me and my best friend into shittier and shittier financial straits. She keeps having to cover for me. It isn't normal, I recognize this finally. I want to get treated. I want to not feel like doing anything is a chore and a struggle. I want to write. I want to finally get my life together, I want to get my shit straight. I didn't survive the fucking hell that was my upbringing just to get taken down and perpetually life-cockblocked by my fucking hormonal glands, dammit.

And, after doing some digging in my family's medical history, both sides have issues with bipolarity...and there's a very large number of suicides throughout both family's generations.

Major fucking alarms there.

I appreciate your advice, Cthulhu, Apo, and John, and the encouragement, Nora. I'll take all that's been said in mind going forward. Also, John, I will be getting a second opinion from the psychiatrist when I speak to her, though I am afraid the option of a third opinion is not open to me due to the extreme limitations of choices I have through my insurance provider. I dunno if UHC just plain doesn't believe bipolar disorder is a valid illness or something but the selection of in-network psychiatrists who specialize in bipolar disorder is VERY slim locally, so...just gonna have to cross my fingers and hope.

[NoraBrimstone]

I totally hear you there. As an adult, I avoided going to my Doctor about my mood for years. I thought I could cope. Then I lost the ability to read and write. By which I mean I couldn't use my imagination to write anything that wasn't plain disturbing, or read more than a few lines of a book. I found myself spending up to half an hour reading the same page over and over again without taking any of it in, then giving up trying. Reading and writing are important to me, so that drove me to my GP.

It's one of those things most people don't even know are a symptom of depression, or illnesses featuring depressive episodes.

[Fruity]

Someone from these forums pointed me towards BPD (Borderline Personality Disorder). I talked to the Psych at work and she thinks the same thing. I'm pending an official assessment and diagnosis, but if this is it, then it would explain everything. It makes sense due to my upbringing, oppression of feelings and personality, untreated trauma, severe depression over the years, and so much more. It's not bipolar disorder, but meh! I guess I just wanted to tell.

Good luck, dude. I hope you get treatment right for you.