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Bipolar Disorder

Bipolar is short for Bipolar Disorder, or Manic Depressive Disorder. Bipolarity is another common word to use.

Bipolar II Rant from a Bipolar I

Ranting on Bipolar II

For starters – this is a pure opinion piece.  I am going to rant a bit about Bipolar II.

I read a lot of bipolar “stuff” – articles, study results, chat boards, Facebook pages – a lot.  Recently, once again, I have become irritated by the use of “Bipolar II”.

I recognize that Bipolar II is a DSM diagnosis that indicates that a person has cyclical periods of depression alternating with Bipolarity in Hellhypomania.  I know that is true – and that the diagnosis must fit some people. Bipolar I, on the other hand, is defined as cyclical periods of depression, alternating with manic episodes.  If you are a rapid cycler or have mixed state disorder – you are usually classified as Bipolar I.

My current irritation is with a story – not a celebrity this time – but an apparently real person from a news story.  The article reports that this particular woman had been diagnosed with Bipolar II when she was 20 and now 38, she is stable on a myriad of pharmaceuticals.  Fine.

The article goes on to say that she “experiences the manic phase” but mostly struggles with the severe depression, adding that she also has PTSD, anxiety and has been unemployed most of her life.  Let me repeat, she has manic phases, PTSD, and anxiety. She has always been unemployed (due to her psychiatric condition).  Doesn’t sound very stable to me…and doesn’t sound much like Bipolar II.

I have a problem with the fact that so many stories I read are about people who claim to have Bipolar II, and are careful to clarify that they don’t have Bipolar I.  Naturally, this would be a kinder, gentler form of Bipolar disorder.  A Bipolar disorder where we never bother anyone, get lots of stuff done in an organized fashion but sometimes get depressed.  A Bipolar disorder that makes us “better”.  Better than Bipolar I’s craziness – and even better than regular people.

I don’t live in that world, and I am not truly convinced that it exists.  I have known lots of people with Bipolar disorder – in fact, I used to go to a group just for people with Bipolar disorder.  Every single person there was initially told they were Bipolar II – and then once they got used to that… the real news came out.

Many of us were “high functioning”, many of us had “good jobs”, many of us were “organized”… except when we weren’t.  We didn’t come to the bipolar group because things were going great.  We had all had periods of depression, periods of extreme productivity and periods of crazy when we told the truth.

Bipolar RantIn my experience, people with Bipolar disorder don’t seek help.  They are driven to it – or dragged.  People are driven to help when they are depressed, and they are dragged to help when they are manic.  If they arrive when depressed, they don’t report the mania that gets them a Bipolar II diagnosis.  If they arrive when they are manic – they won’t listen to anything about “crazy manic depression” so they are told about how much better Bipolar II is.  They will take the diagnosis and take the meds.  Either way, the first diagnosis is probably going to be Bipolar II.

I could claim to be Bipolar II.  I could even get a couple of doctors to agree with me.  Most of the time, I am “high functioning” – except when I am not.  Bipolar I won’t ever lose the stigma if Bipolar II continues to be presented as “better” and people continue to be dishonest.

Take your meds!

Melissa Lind

Bipolar Through the Years – Getting Your Diagnosis Right

Difficult to diagnose Bipolar Disorder?

I am not bipolar!  I am (insert other diagnosis here)

I received my first bipolar diagnosis when I was about 30… ish minus a few years.  I am 40… ish plus a few years, so for most of All About Bipolar Disorder20 years (yes I know the math doesn’t work out but this is a true story), I have known that I have Bipolar Disorder.

If you are bipolar yourself you will know that when I say “I have known” it really means “I was told”.  I didn’t believe it at first.  I thought of every other thing it might be and tried really hard to convince the therapist “that isn’t me… not really”.

As an untreated, newly diagnosed bipolar, I felt compelled to express clear objections to specific parts of the diagnosis that did not fit.  I was trapped by the details… a problem which I have often suffered – or more like, caused others to suffer because of.

Over the years and through several different diagnoses and many periods of “those” risky behaviors, going on and off various meds, wrecking certain parts of my life – and recovering once again, I find that those details don’t matter anymore.

I used to have a vitriolic reaction to the suggestion that I should want to be “normal”.  NORMAL, I said… I don’t want to be Bipolar TherapyNORMAL.  Normal is boring.  I was many things but boring was not one of them.

I no longer have that reaction.  My life would have been easier if it were normal.  I would have missed all the bright, scribbly colors.  I would have missed all the scary but fun stuff… but then maybe I wouldn’t have gotten so tired.  Maybe I wouldn’t have had to shut the curtains and hibernate.  Maybe I would have missed all the scary and dark stuff.

Anyway – as usual, I veer off of my topic.  Today, I am 99 percent sure that I am bipolar but I do reserve that remaining 1 percent – just in case.

Over those years – starting before (way before) I was diagnosed as bipolar – I sought treatment.  At 14, I asked my parents to take me to a psychiatrist because there was “something wrong with my brain.” They said “no, there isn’t” effectively telling me that I was just a mouthy, disgruntled, histrionic teenager – which I was, but I was also bipolar.

I often wonder what might have been if I had been treated then and do watch my kids for the same occurrence.  Unfortunately at that time, a proper diagnosis was highly unlikely and probably wouldn’t have changed much.  Except I would have felt heard – and I didn’t.  I do try to hear my kids.

Once I was able to seek treatment for myself, I was diagnosed with several other things long before they hit the jackpot.  The first was “dysthymia” – oddly, this diagnosis came in the middle of a severe depression.

Dysthymia for a bipolar

I was in college, just a hair short of being suicidal, and had to sit down one day and decide if I was going to kill myself – or study.  Serious DoctorLacking concrete plans and lacking a sincere wish to die, I decided to study – but I did go to the student health center the next day where a kindly graduate student decided I was dysthymic and would benefit from group therapy.  Being the mixed-manic that I am, I was in a temporary state of “not so bad” and failed to mention the depth of my despair.

I went to group therapy with a bunch of whining college kids and two well-meaning graduate student supervisors for almost a year.  To be fair, some of these people may have had real problems.  A homosexual boy who was still “in the closet”, a secret cross-dresser, a bulimic, a giant athlete with a sever anger issue and mommy problems… and a couple of other whiners.

I never once mentioned that I was hallucinating at night… or that I couldn’t keep my thoughts going in a straight line….or that I was living in a dark grey fog… or that despite all this, I still wasn’t sleeping.  My dysthymic self simply whined away with the others about parents, childhood, professors…it may have kept me from killing myself but mostly it was just entertainment.  It also kept me from failing out of college, as the dean of my college was informed that I was “in counseling”.

Major Depression for a bipolar

When I finally admitted the hallucinations – that got some real attention.  It also got the notice of a physician – and her medical Medical Doctorstudent who proceeded to ask me stupid questions like “how much LSD have you done?”  I also got a very “fun” visit to a sleep clinic — where the results were inconsequential even though my case was examined by a neuropsychiatrist – or a psychiatric neurologist – whatever that is.

Still, I got the diagnosis of Major Depressive Disorder… I still wasn’t sleeping – and people were literally terrified of me.  Describing me as agitated would be like saying the Niagra River is a stream.  Major Depressive Disorder.  They did give me meds though, stopped the hallucinations and got rid of all that grey fog and I managed to finish college.

Codependent for a bipolar

Moving on a few years on and off antidepressants and anxiety medicines – never feeling right….risky this, risky that….institutionalization (not jail or at least not this time, but still…).  After a particular disturbance, one “therapist” told me I was “codependent”… little did he know how dependent I was…or on what.  I ignored him.

The “intensive treatment” did get me the diagnosis for bipolar disorder which I denied, and did so for many years.  On and off meds, risky this, risky that…back on meds…off…on.

ADHD for a bipolar

A few years later I was pregnant (married too, woo hoo) and had to go off the meds.  After I had my kids – the doctor that I saw said that I was ADHD – not bipolar.  Still not wanting to be bipolar, I took the prescription he gave me….which was of course an amphetamine.  Well that worked well – nuf said.  To be sure, my kids are fine.

Bipolar HeartbeatEventually, I came to reality and the bipolar diagnosis and back to the right meds.   This has required honesty.  Honesty with health professionals and honesty with myself and it requires taking my meds.  I am tired from all the bright squiggles and the darkness.  I do want to be normal.

Now, as a bipolar, I get to watch my kids and see if they have “it” or something else.  Either is scary, both are scary but I hope I will be more help than my parents were.  I still take my meds but I also still retain the right to act on the 1 percent in case something better than bipolar disorder comes up.

“Mania Days” – Movie about Bipolar Disorder

“Mania Days,” Debuts at South by Southwest Film Festival in Austin

Mania Days” is a movie by Paul Dalio, features Katie Holmes and Luke Kirby as two New Yorkers suffering in the various stages of Bipolar DisorderMovie About Bipolar DisorderDalio, who in actual bipolar mode, wrote, directed, produced, edited and unbelievably – “scored” his own movie which is based on his own discovery of his bipolar disorder.

In an interview with the Huffington Post, Dalio describes the Holmes character as what he was like when he had his first episode “really scared and ashamed of it”.  The other character, played by Luke Kirby is based on a period of when he “started to romanticize bipolar disorder” and “embraced lunacy”.

Dalio himself endured three years of bipolar misery but eventually adhered to treatment when he recognized the pain he was causing his family.  Now he credits much of his inner peace to meditation (in addition to medication) and adherence to a routine schedule – including sleep.

The film debuts at the 2015 South by Southwest (SXSW) Music, Film, and Interactive Festival in Austin, Texas which runs a number of independent films.  The film festival coincides with the world famous music festival and an “interactive” conference which includes “gaming” and interactive media.

Katie HolmesKatie Holmes’ presence in the film shows potential for commercial success, but whether it achieves stardom – it is a good thing for bipolar disorder.  Basically, any attention for bipolar disorder is good – even the “bad” of bipolar disorder – as awareness can only reduce bipolar stigma.

I know that in my own journey over 20 plus years, I have gone through many stages.  I don’t much remember being “scared” of the diagnosis – or even of my behavior.  I have chosen to steel myself with “it is what it is”.

I did, however, maintain a long romance with the idea of “crazy” is good.  I spent many years believing (and many hours arguing with my therapist) that being “normal” was boring.  The last thing I wanted to be was “normal”.

I would like to say I was young and stupid – which I was but maybe part of the truth was that I had been crazy for so long that it was “normal”.  Eventually, crazy is exhausting – and you can’t do it anymore.

In most cases – you are eventually stopped from being crazy – up against a wall, sometimes caught by family members but sometimes a lot worse.  You get normal – only to get bored and do it all again.

As much as I would like to say that there is a real way to stop this cycle – in many cases there is not.  Even with medication, the cycle will continue – for a while.  Eventually, hopefully, you just get too tired of doing crazy.  Lost relationships, lost jobs… lost stuff.  It is exhausting.

Today – I am stable on medication.  Like an alcoholic – I say today.  Tomorrow and likely next week I will be stable on medication.  I would like to say forever – but I remember (at least what I do remember) that someday I may not.  The best I can do is to be open and forthright about my disorder so that those around me may know the signs if I decide to do “crazy” again.

Even though, I live near the festival and have many friends who are attendees, musicians, event planners, and sponsors – I won’t be seeing the film in Austin… crowds, excitement, and all that are no longer my thing – but I will see it, and I hope it is good.  Even if it isn’t great, it is another step in the right direction for the disease.

The Movie about Bipolar Disorder, “Mania Days”, Debuts at Film Festival in Austin

Melissa Lind

Woman with Bipolar Disorder Wins Court Case

Future discrimination of people with Bipolar Disorder may be more difficult

Score one (kind of) for Bipolar Disorder.  A federal jury awarded a woman who was fired because she requested time off from work to deal with a manic episode $32.5 thousand.

Bipolar Disorder StigmatizationBipolar disorder (and many other psychiatric illnesses) carries a relatively big stigma in the workplace.  Unless you are in the creative arts, likely, you will not want anyone at your job to know that you have bipolar disorder.

Three years ago, a nursing assistant who worked in an assisted living facility, named Charlotte Massey realized she was in the middle of a manic episode.  Charlotte had been diagnosed with Bipolar Disorder – and kudos to her for recognizing that she needed to do something about it before it spiraled out of control.

When she called her boss, the owner of the facility, her boss not only didn’t give her “kudos”, he gave her a pink slip.  She got fired because she asked to take a leave of absence to deal with her medical issue.

Unlike most people who have been fired for Bipolar Disorder – Charlotte didn’t lose her job because she went wacko.  Instead, she maintained enough mental clarity to notify her employer of her Bipolar Disorder Discriminationdisability and was rewarded with… firing.

It is certain that the owner of the facility was aware of the American with Disabilities Act.  It is likely that he or she was aware that he could not randomly fire employees with physical or obvious mental disabilities. But, it may be that he was unaware that “mental disabilities” includes illnesses such as bipolar disorder.

The ADA bars discrimination against persons with physical or mental disabilities who can perform the essential functions of their job with “reasonable accommodation” and without imposing an “undue hardship” on the employer.

From the outside, some may say… well she wanted to take time off.  In fact, she took a whole five days off, with herself or a family member reporting in each day with the supervisor.  When she returned to work after only a week of absence, she was fired.

Part of the law includes an evaluation of whether the employer would be subjected to “undue hardship”.  Is giving an employee time off to deal with a medical issue, an employee whose shifts could be made up by another person – an undue hardship?

Workplace StigmaThe court thought it was not.  The jury awarded Massey $25,000 in damages for lost wages and benefits and $7,500 in punitive damages.

The employer and his lawyer attempted to have the lawsuit dismissed by claiming that:

•    Charlotte Massey wasn’t fired; she resigned
•    She had a faulty memory of the events due to her disability
•    She never reported her disability to her employer

In fact, none of those were true.  Though the employer’s attorney repeatedly referred to the case as “frivolous”, the jury found otherwise.
This award may be the first of its kind, and it may be small, but it is a groundbreaking case.  With the ability to claim protections of the ADA, future discrimination may be more difficult.

Melissa Lind

More difficult for Bipolar Disorder stigma in the future!

Bipolar Disorder and Exercise

Does Exercise Help with Bipolar Disorder?

Everyone knows that exercise is good for your health.  It is a no-brainer, and it is repeated so often that you have probably gotten tired of it.  I know I should do some physical activity. It is good for my heart, my bones… blah, blah, blah.

Bipolar DepressionOn the other hand, aside from needing to exercise because I am getting old and tired – the idea, that exercise might be good for my Bipolar Disorder, might just motivate me to do it.
Nothing else has.

A research study conducted in 2012 showed that exercise may have positive benefits for people with Bipolar Disorder.  I should have thought of that – but I didn’t (probably because I am bipolar and tend to ignore obvious things that might help me).

When asked – I have given advice to those who have depression (major depressive disorder, clinical depression, situational depression – or even bipolar depression).  What I tell those people is in addition to taking their meds, they should get up.  Get out of bed, get outside, and get some exercise – even if it is just around the kitchen.  Exercise increases the blood supply to your brain and helps to rise your energy levels – even if you don’t want to, it will do you some good.

Bipolar Disorder ShadowI give that advice to people when they are depressed, but I am not usually depressed.  My disorder tends toward mania or at least a mixed mood state.  So I don’t think about the need to increase my energy level.

Evidence has shown that exercise has some positive effects for people with Bipolar Disorder – even those that are not depressed.  In addition to the obvious health benefits, it can help to regulate your mood levels and “bring structure to chaos”.

As “bipolar“, we are often subject to disorderDisordered mind, disordered days, disordered environment.  One of the biggest tools for a bipolar patient to get and keep their body and mind regulated is the establishment of a schedule.

Go to bed at bedtime (and not at 2 am when you fall asleep in front of the TV). Get up in the morning, go to work on time, eat on a schedule – and take your meds when you should.
Establishing a routine does, in fact, help to keep from extreme ups and downs.

Exercise can be a big part of this – and physically reinforce a schedule on your body – that then affects your brain.  Just like getting up at the same time and going to sleep at the same time helps to establish a normal circadian rhythmexercise can reinforce that in a big way.

There are other benefits to exercise as well.  Physical activity naturally increases blood flow to the brain, which gives it the best chance of functioning at optimum level. It also helps to “clear out the cobwebs” that can be especially important if you are teetering on the edge.
Bipolar ExerciseExercise can increase your self-esteem that may have taken many blows in the past.  It can also increase social activity – that is apparently good for you, even if you don’t like people.  I don’t.

In my opinion, the biggest benefit may be “getting in touch” with your body.  When you exercise, you are more likely to stay within yourself.  One of the greatest problems in people with any mental disorder, and one of the reasons why people abuse drugs or perform any other risky behavior is the inability to be comfortable within your skin.  If you are exercising, you don’t really have a choice; you have to stay there.  Over time, you feel better about yourself, you feel more comfortable there, and you learn what is and isn’t “normal” within your body.

Perhaps this can lead you to better response when something is going amiss – when you may be slipping into disorder.

I tend to disregard the advice given by those who are not bipolar experts… either those with Bipolar Disorder or those who know the disease intimately, but this advice looks pretty solid to me.

Exercise and take your medicines!

Melissa Lind

Bipolar Disorder and Exercise as text to speech article

(Mental health video for blind and partially sighted people)

Bipolar Disorder and Suicide Risk

Physical Proof and a Big Shocker – Bipolar Disorder and Suicide Risk

Bipolar HeadI read a lot of news about bipolar disorder and other psychiatric disorders (OCD, ADHD, chronic depression, borderline personality disorder, etc.).  In my reading, I came across an article that describes brain scan abnormalities in teens and young adults who have attempted suicide but I found a lot more.

A study conducted at Yale School of Medicine examined brain scans of 26 young adults and teenagers with bipolar disorder who had attempted suicide.  These were compared with scans of 42 bipolar patients who had not attempted suicide and with 45 non-bipolar subjects.  The results were not really surprising – as many research studies are not.

The bipolar patients, who had attempted suicide, showed abnormalities when compared to the other two groups, specifically in the  which showed “less integrity”.

Frontal lobe animationThis means that the frontal lobe (which controls impulses) is not as “connected” to areas that control emotion, motivation and memory.  Researchers indicate that the brain abnormalities may disrupt the ability of the impulse control mechanism to filter emotion and motivational messages appropriately.

In short this means that those patients can’t stop negative emotions and impulses to do something drastic… like attempt suicide and not surprisingly, less integrity or more abnormality – likely means more suicide attempts.

While it is good that they are discovering some physical proof of actual defect, eventually to move bipolar disorder into a category that can be scientifically documented, it doesn’t offer a lot of real-life solutions.  Most of us who are bipolar or know someone who is bipolar, know that there is something wrong or at least different about our brain…and it only makes sense that a person, who is trying to kill himself, is probably a little worse off.

As usual, I found myself thinking “…and… the point is…” which I often do when I read a synopsis of a largely inconsequential research study but then something caught my eye.  It was something that was a lot worse than I thought – statistics.

About 4 percent of Americans are afflicted with bipolar disorder, though sometimes we feel like it is others who are afflicted.  That is not surprising either.  Some groups show a slightly lower percentage at about 2.6 percent of the population.

Bipolar SuicideWhat surprised me was the statistic regarding suicide.  The article – that is from a reputable source – indicates that 25 to 50 percent of people with bipolar disorder are likely to attempt suicide and that 15 to 20 percent are likely to succeed.  Wow.  I didn’t know that.  Funny thing that I didn’t know since of the 20 or so bipolar people I have been close friends with at one time or another – at least four of them are dead.

When searching for confirmation (which I found from the NIH that about 1 in 5 bipolar patients complete suicide), I also found a number of additional shocking statistics:

  • Bipolar disorder results in a 9.2 year reduction in lifespan
  • Bipolar disorder is the 6th leading cause of disability, worldwide
  • Bipolar disorder is found in all races, ethnicities, ages, genders and socioeconomic groups
  • A child with one bipolar parent has a 15-30% chance of having the disorder
  • A child with two bipolar parents has a 50-75% chance of having the disorder
  • There are 3.4 million CHILDREN with depression in the US but up to one-third of those kids may actually have bipolar disorder
  • Bipolar disorder criteria have likely been met for at least 1 percent of all adolescents

Maybe these aren’t shocking for you.  Maybe you already knew all this – but maybe you didn’t.

I have known I had bipolar disorder for a long time – and have known a lot more people with bipolar disorder and I didn’t know all this stuff or maybe like everything else, I chose not to remember.

Food for thought; Take your medicines!

Melissa Lind