Mental Health Awareness Month: Bipolar Disorder

I’m starting my series of essays with something I know on a cellular level: I was diagnosed bipolar II two decades ago, and I’ve spent a lot of time since then trying to learn everything about the illness, how the medical community’s understanding of it is evolving, and how we all can work to manage it both day-to-day and long-term.

Bipolar disorder in general involves one- to two-week swings between two opposite poles of mood, energy, focus and function. The top pole is mania, which manifests itself with elation, irritability, energized behavior and lack of impulse control. People in manic episodes experience racing thoughts; an inability to focus or stay physically still; and delusions and hallucinations that can inspire irrational or risky behaviors including gambling, sexual activity and drug use without regard for what can be catastrophic consequences. 

The bottom pole is depression, which manifests itself with hopelessness, indifference and despondency. People in depressive episodes experience extreme sadness; suicidal ideation and attempts; and difficulty functioning, thinking or experiencing pleasure (which is called anhedonia).

There are three types of bipolar disorder. Bipolar I Disorder involves swings between both poles—sometimes both at once—that are so severe they can require hospitalization. Bipolar II Disorder—sometimes called bipolar depression—involves mild manic episodes (called hypomania) and often more profound depressive episodes. Cyclothymic Disorder, which isn’t as common, involves hypomanic and depressive episodes that last at least two years.

As I’ve said, I’m bipolar II, where my hypomanic episodes involve restlessness, fast (well, faster than normal) talking and thinking, and buying shoes online that I don’t need. I usually post these purchases on here to broadcast that 1) I bought awesome new shoes and 2) I’m currently hypomanic off my ass. My depressive episodes are soul-crushing in their extremity. I can’t think, I struggle to breathe, my vision is blurred, I feel like I’m wrapped in a wet wool blanket that I can’t kick my way out of, I sometimes have visual or aural hallucinations (including seeing people in black clothing lunging at me and hearing stupid, irritating circus music coming from another room), and I often contemplate suicide but I have no energy or initiative to carry it out … I generally feel like everything is completely hopeless and I just want to have never existed. And when I emerge from these episodes I’m exhausted to my core.

Bipolar disorders can be managed with psychotherapy (talking with a therapist), psychiatry (drug therapies) or a combination of both. I’ve never found much benefit from my visits with various psychologists, but I’m a HUGE believer in better living through chemistry. Psych meds (which are awesomely called psychotropics) affect me strongly, for better or worse. They involve a lot of trial and error, but I’ve been highly functional for the last seven years after finally finding a magic cocktail of three psychotropics (there’s that cool word again).

I do want to stress, though, that what works for me is indicative only of what works for ME. If you’re living with a mental illness, don’t abandon a combination of therapies that might be working for you just because someone else is thriving on a different combination of therapies. And for God’s sake, ALWAYS TAKE YOUR MEDS.

Bipolar disorders were classified as manic depression through most of the 1900s. In 1980, the third edition of the Diagnostic and Statistical Manual of Mental Disorders (called DSM-III), officially changed the classification to bipolar disorder to reflect a wider range of nuance and understanding of the disease. This paragraph is a broad generalization of the naming history, but I wanted to explain that manic depression and bipolar disorder are essentially the same thing.

There is a lot more I could discuss here, but I want to keep these essays short(er than this one) and digestible for anyone who cares to read them. Feel free to share this with anyone you think might be interested, and I hope to have another short(er than this one) essay posted soon. Stay healthy!

Of Two Minds

I stumbled on this documentary about bipolar disorder last night on Amazon Prime, and it is so well done that I didn't even pick up my phone as I watched it. Which says A LOT.

The film follows the lives of four people living with bipolar disorder for over a year and veers off once in a while to profile a handful of others, which I think leaves viewers with a robust understanding of the commonalities bipolar people all deal with but really underscores the fact that no two people's experiences are the same. Some people (like me) have hallucinations, some cut themselves, some find manic episodes to be thrilling, some (like me) find them scary and exhausting, some experience functional depression, some (like me) fall into depression so deep that it's past the point of functioning and therefore safely past the point of being capable of self-harm, some attempt and eventually succeed at suicide, some hate taking meds and even refuse to fill their prescriptions, and some (like me) can never forget how awful it is to be off our meds and therefore take them religiously.

The people profiled are straight, gay and bisexual. Some are religious and some are atheists. Some have money and some are struggling so much that they can't afford their meds and rent and seriously consider leaving the United States for a country that can offer them healthcare. They live in cities all over North America. The documentary really does a deep dive into the environments and experiences that shape the way people manage their mental health—though my only criticism is that there are only three people of color, all of whom are just one-off side interviews, which I think really misses an opportunity to paint a more robust picture of experiences and contexts and cultures and personal decisions.

It's edited deftly to be thorough and intimately informational but not overwhelming. I was left feeling emotionally connected to everyone—to the point that I rooted for all of them but ended up angry at one person and genuinely disliking another.

If you or someone you love is living (or struggling) with bipolar disorder, I highly recommend watching this. It's quite beautiful.

Thank you

As anyone who spends more than a few seconds on social media every month probably knows, I'm bipolar. As probably nobody knows, my bipolar depression got so acute and so scary that I spent the week of Christmas in a psych ward. It was there that I decided I needed to move home to Iowa to help take care of my dad—who has lost his sight to macular degeneration—and where my family could take care of me. It was also where I told myself if I really did move to Iowa I'd get involved in the theater again. Now fast-forward four months. I've already done one show, and tonight marks the point where I am for the first time in my life doing two shows simultaneously. I start rehearsals for A Chorus Line tonight and I open Barefoot in the Park this Friday. Plus I have a kick-ass job. Plus my meds are working so well I forget what it's like to be manic until my increasingly rare manic waves hit me. And I honestly can't remember the last depressive episode I had. (Then again, huge chunks of my manic episodes are a blur too. Which is both a blessing and a curse of being bipolar.) I owe A LOT to so many friends and family members and social-media acquaintances who have believed in me and given me encouraging words and friendly hellos—and parts in theatrical productions—and I don't even know how to begin showing my gratitude. Which is a lot to say for a professional writer who usually can't shut up. So I'm showing my gratitude by living my life and enjoying what it brings to me and believing in myself even when I don't really believe in myself. I love my family, I love my friends and I love my life. And I send an epic thank you to everyone who's helped get me here.

BIPOLAR FUN!

Yesterday I was depressed to the point of despondency. Today I'm manic off my ASS. My mind is racing and I'm talking faster than a deranged auctioneer. Let's order a pizza! Don't you love pants? What's your favorite color? Squirrel!