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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.

What Type of Bipolar Disorder Is It?

Each bipolar disorder illness is unique!

Uniqueness of Bipolar DisorderWhen nearly anyone thinks about bipolar disorder, they think of the symptoms of “regular” bipolar disorder.  Not that any person with bipolar disorder is “regular” (and most would not want to be), but there are several different subtypes of bipolar disorder.

One big problem with bipolar disorder is that each illness is unique.  Psychiatrists may classify them into categories – but they don’t always fit.  Here are some case scenarios: (bipolar episodesbipolar groups)

•    Jennifer has episodes where she is extremely agitated and unhappy and never seems to sleep very much.  These periods seem to last for a long period of time – but can alternate with months where she is simply unhappy and doesn’t feel like doing anything.
•    Max has had periods of depression before.  A lot of times, they go away after a couple of months and then he seems normal but recently he “disappeared” for a couple of weeks after some really bizarre behavior.  His friends never knew that he was any kind of bipolar until he told them he had been at the hospital.
•    Ben has periods of depression that can last for several months but when he is not depressed, he is productive and seems quite outgoing.
•    Sandra’s mood state can switch erratically.  One day she is all about shopping and the next time you call her, she is still in bed at noon.   This is a constant issue – and you never know what you are going to get.

These are three examples of bipolar disorder that don’t seem to fit the “normal” pattern.  None of these patients seems to be “regular” bipolar.

Bipolar disorder is defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM) as:

Bipolar Disorder TypeBipolar I Disorder: manic or mixed episodes that last at least 7 days – or if manic symptoms are severe enough to need hospitalization.  This, usually, includes periods of depression that last at least two weeks.
Jennifer and Max both fit into this category.  Even though Max never had a severe manic episode, having a bipolar episode that warrants medical attention, he qualifies for the Bipolar I category.  Jennifer has mixed episodes – rather than euphoria or traditional mania – she has periods of “dysphoria” where she is agitated, irritable and irrational but with an excess of energy.

Bipolar II Disorder: depressive and hypomanic episodes in a pattern – but manic episodes are not severe.
Ben has Bipolar II disorder.  He has periods of depression that are debilitating, but his non-depressed periods are quite productive, and he doesn’t exhibit manic behavior.

Bipolar Disorder Not Otherwise Specified: (Bipolar Disorder NOS) symptoms of illness don’t meet any other group, but the symptoms are clearly not within the standard range.
Sandra has BP-NOS.  She is what is commonly called a “rapid cycler,” meaning that she switches back and forth from mania to depression much faster than other people with bipolar disorder.

There is also a very mild form of bipolar disorder known as cyclothymia.  It is a cyclical pattern of hypomania alternating with periods of mild depression.  Many people would not even realize this is a problem.

Bipolar disorder is hard to classify.  It may be easy to determine that someone has a problem – but the uniqueness of each bipolar case makes it more difficult for even a patient to identify with the diagnosis.  Each type of bipolar disorder is, usually, treated the same medically. With an anti-manic agent (Lithium), anti-epileptic (Lamictal, Depakote) or atypical antipsychotic (Abilify, Zyprexa) – and sometimes with an antidepressant.

Melissa Lind

Borderline Personality Disorder – True Story

A true Borderline Personality Disorder story

BPD – The likeable guy who suddenly isn’t

I once knew a man who I met through a friend.  When I met him, she was already planning on marrying him so I could not say much of anything.  He was an utterly likeable guy who was fun, fun-loving and an all-around joy to be near, but there was something I couldn’t understand.

My friend, due to her previous life experiences involving traumatic loss, was extremely opposed to anyone she loved being in the police service.  Her fiancé had been a marine and had later gone into the military police.  He had retired from the military and was working in his family business as the Vice President but had also grown his hair out, dressed in very casual clothing and loved race-cars.  He swore “blind” that he would never enter the military or law enforcement again.

This fun-loving person with long hair, wearing tank tops and racing cars was the guy I met.  He was also mechanically inept – couldn’t put a shelf on a wall or even put a barbeque grill together with instructions.  After they had got married, my husband and another friend spent many hours doing “fix-it” work around their house – taking things such as grass spreaders and playground sets apart to put them back together correctly.

Borderline Personality Disorder - Swirly MindHe was also very generous – spending money all the time for all and anyone around.  He would take 15 people to see a rock concert or a hockey game, bought the boys new video game systems and video games every weekend, bought garden supplies, supplies to put in a backyard kiln after my friend had said she thought she might want to make a pot, had a pool installed, bought a go-cart and mini-bike for the boys, $3000 vacuum cleaner… He traded her car in for a new, better, bigger car at least once a year, sometimes after only a few months. They were not in financial distress, but he was never concerned with how much money he spent.

I could never reconcile the goofball man with long hair and a beard who used to be a marine and an MP.

Fast forward a few years.  One day, my friend called me, totally hysterical because she came home to find him with a military style haircut, wearing a police uniform with guns and all – preparing to go to a part-time job that he had gotten with a police department in a small town nearby, having done all this in secret.  He swore it was only part-time because they needed the extra income (which they didn’t).

For several months, she expressed her extreme displeasure, fear, hatred.  Each time I would drive to their house, I would think, “What are the police doing here?”

Then I would remember that it was his patrol car.

Fast forward a few more months.  He is now working full-time as a cop – even though he promised it would only be part time.  She hates it.  He is also starting to exhibit bizarre behavior, restrictive rules for the kids, can’t keep from calling her every 10 minutes – even while he is at work, even while she is grocery shopping or picking up kids from school.

Tensions rise, arguments ensue, culminating in an episode involving him threatening to shoot himself in front of the 10 year old who runs from the house in his underwear to hide at the neighbors.

BPD - Borderline Personality DisorderHe eventually calms down and suggests that they need marital counseling – that she needs “help.”  Of course, he says it is “her” that needs help, and he is only going for her problems.

They go to the counseling where the therapist disagrees with his idea that the core issue is her problem.  They are both referred to a psychiatrist.  The psychiatrist diagnoses him with Borderline Personality Disorder – giving him medication and recommends extended therapy.  The psychiatrist gives her a prescription for situational anxiety disorder – as she is having intermittent panic attacks due to his behavior.  He recommends that my friend go to therapy to deal with her emotions surrounding the family issues and for their son to go to therapy to deal with the fact that his father flips out.

She decides to stay – based on his agreement to take medications and go to therapy.  Which he does not.  He does not believe the therapist or the physician were correct.
He then tells her that she needs to go to all of his police and wives functions – and makes plans to join the State Police Controlled Substances Crime division – sponsored by the governor.  Another episode involving a mental breakdown and a couple of loaded firearms occurs.

She puts her kid in the car – and leaves a beautiful home with a pool and all the money she could want, in order to escape.  He calls and calls and appears not to understand what happened, blaming the whole situation on her paranoia.  She never goes back and now lives as a single mom in a low-rent housing unit without financial assistance from him.  Apparently this is much better than dealing with him.

This man, my goofball friend – turned into a raving nutcase and likely it was not the first time (or the last time) he had done so.  He went back to his former wife to marry her for the third time.

Years later, we still get “restricted number” phone calls from him – for no apparent reason other than to check up on her.

Until this experience, I always thought that Borderline Personality Disorder was a fairly benign thing – they were secret manipulators but relatively innocuous – along the same lines as Narcissistic Personality Disorder, which is irritating but not dangerous.  Now I know that is not true, Borderline Personality Disorder, also known as Emotionally UnstablePersonality Disorder is a real and valid psychiatric disorder that should be treated.

It is characterized by:

•    Occupational – Economic issues such as a sudden shift in career field cue to sudden changes in values, self-opinion
•    Antagonism
•    Separation anxiety and abandonment issues
•    Suicidal behavior
•    Multiple separations or divorces
•    Unstable, intense close relationships are vacillating with extreme anger
•    Harmful impulsiveness – including spending, reckless driving, thrill-seeking
•    Physical Violence
•    Chronic feelings of boredom which may contribute to impulsive activities
•    Irresponsibility

The National Institute of Mental Health says that Borderline Personality disorder is likely to last for many years and may be subject to relapse of symptoms which remiss but those core symptoms such as highly changeable moods and impulsive behavior will likely continue.

Melissa Lind

Counseling for Depression

Depression does require medication.

If you suffer from depression, and your doctor has prescribed an antidepressant for you, you will find that, in about three weeks, you are able to function in your life again — even while taking the medication.

Depression MedicationUnfortunately, this gives people a sense of “I’m all better now” that isn’t quite true. You see; depression does require medication, but it also requires counseling. Without proper counseling, you will never get to the root of the problem — what is causing the depression. The medication will not make that go away — it only deals with the symptoms of depression.

Counseling is needed to deal with the cause of the depression.

Counseling for depression may have two parts. The first part may be traditional therapy so that the counselor can help you to discover what the problem is, in the event that you do not already know. Sometimes depression has no visible cause. Other times, it may be caused by a physical condition that does not need any counseling at all — the depression lifts when the condition is treated.

So, traditional therapy may be needed, but that will usually be followed with Cognitive Behavioral Therapy, or CBTCognitive Behavioral Therapy essentially teaches you a new way of thinking — a new way of looking at or approaching a problem, — something that enables you to deal with the problem in a more constructive, timely manner. Once the problem that is causing the depression is taken care of, the depressed state lifts.

CBT can take anywhere from 12-20 weeks. Furthermore, depending on the severity of your depression, your doctor may not feel that counseling should be sought until the medication prescribed has a chance to work. On the other hand, he (or she) may think that the depression warrants immediate counseling. This varies from one individual to another.

Note that most therapists are not licensed to prescribe medication. That requires a medical doctor or a psychiatrist.

Stress Management Ideas

Stress management isn’t as hard as it may actually appear.

However, we can’t accept this next point enough.  If you believe you’ve too much stress in your life, it might be helpful for you to talk with your local mental health connection, doctor or spiritual advisor. Because responses to stress may be a factor in depression, anxiety and other disorders like bipolarity or borderline personality disorder, they might suggest that you visit with a qualified counselor, psychiatrist, psychologist, social worker, or other.
I don’t want to present myself as a medical professional. All I want to do is give you a few tools to apply you in life to help you better cope with those matters that make us overwhelmed and feel out of control.

You might also want to check into time management tools in order to do away with some of your stressors. When we feel like we don’t have enough time to do the matters that need to be done, that brings on more stress and may lead to anxiety. Believe me, you don’t want that!

Stress management ideas are easy cost effective techniques effectively to check stress. They may be practiced anyplace and at any time.  Well, nearly!
If you feel you’re in need of help, don’t hesitate. You may not be correct always.  The cause of your stress may be for no reason at all.

But it may be physical in its origins.  Somebody else may be able to solve it easily. Comprehend your limitations and it may relieve stress to a great extent.

Simsons is StressedStress is a normal part of life for all of us. In little quantities, stress is suitable — it may help you be more productive and motivate you. But, too much stress, or a heavy response to stress, is adverse. It may set you up for particular physical or psychological illnesses like infection, heart conditions, as well as general poor health or depression. Lasting and unforgiving stress frequently leads to anxiety and unhealthy behaviors like binging and abuse of alcohol or drugs.

Just like reasons for stress differ from person to person, what relieves stress isn’t the same for everybody. As a whole, however, making particular lifestyle changes as well as discovering healthy, gratifying ways to cope with stress helps many individuals. I hope that I’ve given you some helpful ways to deal with the stress that we from time to time all feel!

Most importantly, remember that you’re in no way alone in this combat. There are 100s of 1000s of individuals out there who feel deluged and nearly wholly out of control. That’s why it’s necessary for you to find peace inside yourself and realize that we’re all on this gigantic blue marble for a reason.
You are also! Savor it and live life to its best. And when you feel yourself stressed out or upset with a panic attack, slow down, breathe through it, and know there are lots of people who know exactly how you feel.

Dispelling a Few Myths about Bipolar Disorder

Dispelling myths about Bipolar Disorder

Hello again, fellow wackos and electronic rubberneckers!Bipolar?

If you’re here because you’re like me—just a little “off”—then welcome. If you’re here to learn about bipolar disorder, stick around, because I know a thing or two and I like to talk. If you’re here to watch the train wreck happen, hoping I’ll melt down and post something crazy about the talking wombats that live in my refrigerator and their TV viewing habits… well, you’ll probably be a little disappointed. I may be a freak, but I’m not crazy.
Yeah, that’s right. I just called myself a freak. I figure if other people are going to call me that, I can probably get away with saying it myself. Wacko, nutcase, loony, psycho… There are lots of things people say about bipolar disorder, and many of them just aren’t true. Let’s take a look at a few of those things right now.

Bipolar Myth #1People with bipolar disorder aren’t really sick.
Bipolar SkelletonSome people say that bipolar disorder is “all in your head.” They say things like “everyone gets depressed. You just need to suck it up and deal with it like everyone else.” If this is true, then diabetics just need to get over their illness, too. I mean, too much sugar is bad for everyone, right?
Just as a diabetic’s body doesn’t process sugars properly, a person with bipolar disorder’s brain doesn’t process dopamine, serotonin and norepinephrine quite right.
Don’t take my word for it, though. Take it from research scientists at the University of Michigan who’ve studied Abnormal Brain Chemistry Found in Bipolar Disorder. They know what they’re talking about.
I’m just some freak, remember?
So, you can tell me I don’t have a “real” disease and that I just need to deal with it, but first you gotta tell Ms. Diabetic to eat six Twinkies and deal with it. Go ahead. I’ll call 911 while she’s chewing.
This myth is so prevalent that insurance companies are allowed to treat it—or more accurately NOT treat it—like it isn’t a “real” disease. The last health insurance I had would pay for 80% of the bill if I had to have major surgery, but only 50% if I saw a doctor for bipolar disorder. Also, they limited the number of times I could see a doctor for treatment to 12 times a year. Tell you what… let’s limit diabetics to 12 insulin shots per year and see how well they do.
What? We shouldn’t do that because they could get sick and die?
Well, people with bipolar disorder die, too. In fact, without proper treatment, 20% of them commit suicide. That’s one in five, folks. I’d say that constitutes a serious health risk. Maybe this bipolar thing is a real disease after all.

Bipolar Myth #2People with bipolar disorder are beyond hope.
He’s got bipolar disorder. He’s crazy. He can’t be helped. He’s a lost cause. Or is he?
The fact is—he isn’t. Bipolar disorder is one of the EASIEST conditions to treat. There are several effective medications, some of which have been in use for quite a while. Lithium, for example, has been around since the 1950’s. Lithium doesn’t work for everyone, though. That’s why there’s Lamictal, Depakote, Zoloft, Tegretol, Wellbutrin, Prozac, Effexor, and a partridge in a pear tree. A psychiatrist can tinker with medications until he finds a combination that works.
Medications can help, but so can just talking. Talk therapy did me more good than any pill ever did. However, without the pills, I probably wouldn’t have listened to anything when I was at rock bottom.
The point is this: people with bipolar disorder CAN be helped. So if you have bipolar disorder or know someone who does, don’t give up. There is hope.
Well gang, it looks like I’m over word count. I told you I like to talk! We’ll talk some more next time when I dispel a few more myths about bipolar disorder.
So to all my friends and fellow freaks, until next time… keep fighting!

Bruce Anderson

Read more here: Words As Weapons And Another Bipolar Myth Dispelled