The Other Bipolar Disorder

I have bipolar disorder type 2. This is my story.

First, some background. Bipolar disorder used to be called manic-depressive illness, and many people still know and refer to it that way. The term “bipolar” reflects the concept that there are two extremes to the continuum of mood disorders, and some people swing dramatically from one to the other. According to this definition, clinical depression by itself is “unipolar” – occupying only one end of the spectrum.

Depression is to ordinary grief or sadness as a broken leg is to a splinter. Depression sucks the life from a person, mutes all emotions except misery, denies any possibility of joy or even contentment, makes life seem meaningless or impossible. This is hell.

Mania is to ordinary happiness as diving off a cliff is to diving off a diving board. Mania brings exhilaration, ambition, confidence, abandon, and invincibility, with no brakes. It is hell on wheels.

Oscillating between the two extremes – that’s bipolar disorder, type 1. It is a very serious illness. Left untreated, it can cause destruction of families, careers, and more. It can lead to psychosis or suicide.

The treatments for it are no picnic either. Bipolar disorder that severe often requires hospitalization. If the symptoms can be controlled with medication such as lithium or newer formulations, the patients must have frequent blood tests to assure that the drug is present in the right quantity. Electroshock is also a possibility, especially for deep, drug-resistant depression.

When I was (incorrectly) diagnosed with unipolar depression, I used to wish that I were bipolar, on the theory that at least then I could accomplish something. Boy, was I wrong about that. Plans made in mania never come to fruition. They are started, rethought, abandoned, exchanged for something grander, and ultimately fizzle out when the mania wears off.

My diagnosis actually made some sense at the time, as I never experienced anything like the manic highs. All I got were depressive lows.

This leads us at last to bipolar disorder, type 2. Some people think of bipolar 2 as “Bipolar Lite.” The mood swings are not as extreme, the lows less debilitating, the highs less overwhelming. The person with bipolar 2 stays closer to a baseline of normal mood, but still experiences swings back and forth.

Technically the mini-lows are called dysthymia and the mini-highs are called hypomania. In my case, the lows were just as low as in unipolar depression, but I never got the mini-jags of buoyancy that accompany hypomania. Instead, these feelings, came out sideways – as anxiety.

My brain was still racing with little control but in a different direction. Instead of elation and purpose, I was beset by in worries, fears, and catastrophizing.

One of the difficulties with treating bipolar disorder of either type is trying to find a medication or a combination of medications that will level out the person’s moods. Usually this requires more than one drug, and finding the right mix or cocktail of chemicals takes usually requires more than one drug. It takes a great deal of trial and error. In the meantime, the mood swings continue.

At this point, my bipolar 2 disorder is fairly well controlled on medication. I still have spells of depression, but now they last at most a week, and sometimes just a day or two. Untreated, they could last months or years. I still have anxiety too, but I have the medication I take for that, so that I don’t feel like I’m about to jump out of my own skin.

Most of the time I’m fairly high-functioning. I can write, work, earn a living. I have a great marriage and a number of friends, including some who are closer than family to me. I have never been hospitalized, nor have I had electroshock (though that was a near thing). Before I got my proper diagnosis and treatment, I would have not believed this to be possible. My goal in life was simply to stay out of a psychiatric hospital as long as I could, or at least until I qualified for Social Security Disability.

I’m sharing these experiences with you today because I believe that mental disorders should not be hidden or viewed with shame and horror, as they have been in the past and sometimes still are.

It’s undeniable that there is a stigma associated with having mental illness. Going public with it entails a risk. I’ve seen the fixed-smile-back-away-slowly reaction. I’ve seen sudden turn-arounds in my work performance evaluations. But I’ve also seen the “Me too!” response. There is strength in numbers. As more of us who live with psychiatric conditions talk about it, and share our stories, the more we build understanding and perhaps encourage those who are roller-coastering to seek treatment.

So that’s the nuts and bolts of it: Bipolar disorder type 2 is a mental illness. I have it and live with it every day. I do not go around shooting people or trying to jump off buildings. I take medication for it and know that I will likely have to for the rest of my life. And I’m okay with that. I hope that eventually the rest of the world will be too.

 

11 thoughts on “The Other Bipolar Disorder

  1. “Me too!” Well, not the same diagnosis. I’ve had both major depressive episodes and low level dysthymia for most of my adult life, now mostly tempered with meds. I don’t talk about it a lot, but when someone, especially one of my nieces or nephews, talks to me about a problem they’re having, I’m quick to tell them about what I went through and how much finding the right treatment has helped me.
    My mother went through her whole life with mostly undiagnosed, untreated depression because she just didn’t know it was a real, physical illness. We need to be able to talk about these things so that other folks can say “Me too!” and get help.

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  2. Thank you for writing this. I hope some of the “me too” folks are brave enough to reach out for the help they need as a result.

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  3. Thanks for writing this stuff. I think the more people who are vocal and aren’t ashamed, the better.

    I have bipolar I. There were times in the past, though, that my mania-inspired ambitions did actually come to fruition. I could stay focused and work on things for days without sleeping. If I was working on something else at night, I could still go to class and work the next day without sleeping, or only sleeping an hour or two.

    I stopped therapy last August right smack in the middle of what must have been a psychotic episode. I felt like I’d snorted a kilo of cocaine and I just wanted to crush entire cities underfoot like I was Godzilla. My own problems seem exacerbated by having to be on corticosteroids, though. It just seems like no psych meds at all are strong enough to counteract the steroids, which act like a catalyst for whatever I’m feeling at the time. I just gave up on treatment for the time being and am hoping I can get off the steroids (for my skin). Then this month, they increased the steroids again and I get sort of ‘roid rage and the mania is heightened (wouldn’t call it psychosis, though).

    I talk about these things A LOT, and I know I make some people uncomfortable, but I don’t care. Someone needs to talk about it. And I feel the need to explain why I often don’t feel like doing social things, or if I get irritated or depressed or anxious and leave during social things. (Hopefully, they will understand my explanation as “this is related to bipolar disorder,” etc, rather than thinking “she is a bitch” or “she hates me.”)

    I get some really extreme highs and really extreme lows, but I think I’ve spent much of my life in a state of hypomania. There doesn’t seem to be a lot of literature on the interactions of other meds (like steroids) and bipolar disorder, and this has been a real pain in my ass because no one knows what to do. I’ve been on at least a dozen different psych meds. At the present time, I have decided to just roll with the punches for a while. I mean, I was clearly having manic and depressive episodes before the steroids, but they seem to crank everything up to 11 (I think the list of side effects has it listed as “mood disturbances,” and if they cause that in “normal” people, you can imagine what it could do to a bipolar person).

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      1. Thanks, but they were actually searching the medical journals for me for years and there just isn’t adequate information on these specific interactions, apparently. (Meaning the interactions between the corticosteroids and the drugs while also having bipolar disorder.) I was able to taper my prednisone dose a bit starting this morning though, which is a positive thing.

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  4. Reblogged this on strangelingblog and commented:
    I think it is great that people who have mental illness are willing to share in an effort to help others who struggle. I personally have bipolar 1 disorder which at times can be debilitating. I am currently stable taking a certain mix of medications every day. This person is fortunate that they did not have to be hospitalized. I have graced the psych ward 3 times. I am very grateful for my stability and I do my best not to take it for granted. I just thought this was a good post so I am sharing it with my readers as well.

    Liked by 1 person

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