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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

Mental Health Professionals and Suicide

Suicide – Threat of Liability for Mental Health Professionals

Suicide is the third most common cause of death for young adults – and the ninth highest for the general adult population.  This means that a large percentage of mental health professionals will have a patient that commits suicide. It may be as high as 80 percent of psychiatrists, psychologists, social workers, and other therapists, that eventually have a patient who commits suicide.

Serious Mental Health ProfessionalYou might think that professionals are insulated against emotions that come with the death of a friend or acquaintance – but they aren’t.  Many health professionals report that even when death is expected (natural causes), they spend a great deal of time going over their treatment of the patient. They try to find out if they could have done anything different, (given another treatment) in order to help.

But, what may be surprising is the number of liability lawsuits filed against mental health professionals, when a patient commits suicide.  In fact, it is the number-one cause of responsibility lawsuits brought against mental health providers.
The threat of lawsuits, and also the stigma against people working it in the mental-health profession, has led to many psychiatrists refusals to treat the chronically suicidal. The profession sees it as a failure of the doctorMental health professionals are also less likely to see additional suicidal patients after they have had a patient succeed at suicide.

When a therapist or physician is unable, or unwilling, to treat a suicidal patient – it leaves the patient in the lurch.  It produces feelings of failure and hopelessness, without a doubt, compounding the fact that they are suicidal.  It may also be difficult for an extremely suicidal patient to find a new therapist or doctor.  Many patients report that the mental health professionals suddenly “don’t have time”.

We don’t think much about the way suicide will affect those around us – and certainly the professionals are way down the list of people whose feelings are important.

Mental health professionals also report that there is a lack of training on how to deal with suicidal patients, and processing the death of a patient.  More than half of professionals surveyed also Knocking on Heavens Doorstated that they really don’t believe they can prevent a patient from committing suicide.

Oddly, the complaint process against physicians has been shown to increase the risk of the physician becoming depressed. One of the consequences of this will be a worsening of the situation for mentally ill people. (Chronically suicidal patients)

This is a complicated process with no easy answers, but you should know that it is likely that all psychiatrists, therapists, social workers and other counselors probably need to be in counseling themselves.  When you find a new doctor or therapist – you might want to ask.

Even if you aren’t suicidal, you need to know that your counselor is as mentally healthy as possible, certainly healthier than you.

Melissa Lind

Mental Health Professionals Report a Lack of Training on How to Deal With Suicidal Patients

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)

What NOT to Say to a Bipolar Person

Stupid things said to people with bipolar disorder

Bipolar Disorder has become a bit more recognized lately, most likely due to the “coming out” of celebrities with outrageous behavior.  This has been good in raising awareness about bipolarity somewhat, but it has been bad because a lot of people think they know all about it.

In addition to not completely eradicating the stigma – it is also highly annoying when someone says something mean, wrong, funny, or even just plain stupid about bipolar disorder.  If you aren’t bipolar – don’t give advice to people who are.  Here are some of the things you should not do:

Don’t try to “join in”

Soo DepressedDon’t try to tell me you “know how I feel”.  Don’t relate your stories about how you were soooo depressed when your dog died.  Don’t try to tell me about how bad your insomnia is.  Don’t try to tell me about how you seriously almost destroyed a poster once or how embarrassed you were when…. Don’t.  Unless you are bipolar, you cannot understand the depression, the agitation, the anxiety.  I can understand that you want to show concern and make me feel “normal” but don’t.

Don’t tell me I should do better

Don’t tell me I can fix this.  Don’t tell me that I brought this on myself.  Don’t tell me to try harder.  Don’t tell me that it could be worse.  Don’t tell me that only religion can make me better.  I am doing the best I can; I didn’t want this disease, and frankly, I don’t want to hear it.

Don’t minimize

Don’t tell me to “snap out of it” or “get off my ass.”  Don’t give me platitudes like “this too shall pass” or “cheer up.”  Don’t tell me Not to Bipolar People“tomorrow will be better” or “everyone has a bad day sometimes.”  My disease, my experience is as bad as it is.  You can’t make it go away by acting cheerful or sympathetic.

Don’t try to shame me into being better

Don’t tell me that I am a real downer or that I am “dragging you down.”  Don’t tell me all about my bad behavior and how being around me is so painful – like “walking on eggshells.”  Don’t tell me about life not being fun…I already know.  If you don’t like it, it would be better if you just leave.

Don’t blame every disagreement on my disease

Don’t say anything about bipolar “shit” in the middle of an argument.  Just because I am angry doesn’t mean I am off my meds.  It doesn’t mean I am crazy.  Using my illness to win an argument is just plain wrong.  I have a right to be angry sometimes, and sometimes I am.

These are just a few things you should not do.  We have a lot of rules – some of which change just like us.

Happy Day!

Melissa Lind

Bipolar II – Really?

Is it Bipolar II – or just plain Bipolar Disorder not yet recognized?

Google “Bipolar” on the “news” tab and see what you find.  It is astounding how many semi-celebrities have come out and said “I have Bipolar Disorder”.  Unfortunately, the story is often about Bipolar II, which somehow makes it “better”.

Bipolar Disorder is still a serious stigma – prevents people from getting jobs and such.  Technically, as Bipolar Disorder is considered a disability, an employer who did not hire or fired an admitted bipolar patient based only on that fact would be in violation of the American Disabilities Act, but few people are willing to go to the carpet on that.  Plus there is the little issue of being “able” to perform one’s job.  I can perform a job if I am taking meds.  If I am off of meds, I become highly unreliable with a lot of other liabilities – risky behavior that I have decided not to discuss.

Only a couple of years ago, I was warned by a well-meaning family member against posting too much on social media about Bipolar Disorder – and this in his mind included “liking” too many Bipolar pages.  He was concerned about my ability to obtain a decent job.  I don’t know if I have a “decent “job today – I have made my own way which works out better for me – no boss to annoy, no dress code, nobody else’s time clock.  For the most part, I don’t worry about social media – I don’t think I will ever have a “real” job again – no more frequent flyer miles for me.

Bipolar 2I was once diagnosed as Bipolar II – but really, both the doctor and the therapist thought differently – they both knew that I had regular Bipolar Disorder but wasn’t ready to accept it.  Actually, I am pretty sure my doctor tricked me into taking Lithium for the first time by telling me that it would help boost my antidepressant activity.

In retrospect, I am astounded that I believed him since I know so much about medication – but I took the medication.  How many of these people really have Bipolar I Disorder and just don’t say so.

It is much easier for people to say and accept that they have Bipolar II.  In my opinion (which is obviously vast and knowledgeable – just kidding, no really), Bipolar II is a way of sliding by the real diagnosis.  As in “I have Bipolar Disorder but not really”.  “I have Bipolar Disorder but I am not crazy”.  “I have Bipolar Disorder but I am not dangerous”.  “I have Bipolar Disorder but I won’t embarrass you”.
When it gets down to it…wasn’t that true for all of us at one time?  Or at least didn’t we believe it at one time?  I still fit some of the criteria – I am “functional”, “productive”, “hypomanic” – except when I am not.

I often confuse my doctor when he asks how it is going by saying “good enough”.  What I mean is that I am not manic exactly, I am not depressed.  Actually it works better for me if I am teetering on the edge of mania.  If I am just crazy enough that I know that I am crazy – then I will keep taking my meds.  Because I forget.

I originally sought treatment for severe depressiondepression bad enough that I had to decide whether to kill myself or study (I had a big exam the next day).  In retrospect, I was actually in a mixed episode with plenty of energy but in a really bad mood.  Oh, and then there was the slight issue of the hypnogogic hallucinations which I denied at the time.  See, even if I know that I have Bipolar DisorderManic Depression – I still forget.

It would be easier for me to say that I have Bipolar Disorder but it is “just” Bipolar II.  I thought that too.

Melissa