I see so much information available online about the symptoms and diagnosis, and even medicinal treatment of bipolar disorder. This is really useful information, however I find little is said about what it is like living day to day with Bipolar Disorder. Here I will try to explain what it is like for me on a day to day basis.
It’s Not Black and White
The DSM 5 states that Bipolar Disorder is characterised by manic episodes lasting 7 days or more, depressive episodes lasting 14 days or more, and periods of stability in between. The reality of bipolar disorder however is not so black and white. Yes, these episodes are required to identify the diagnosis of Bipolar Disorder against other disorders such as Borderline Personality Disorder, but the symptoms are not always experienced for this duration or the same level of severity.
It is possible, and common among people with Bipolar Disorder to feel a change of symptoms every day, or even more frequently than this. This is known as rapid cycling and can be extremely difficult to cope with. Depression and mania can be faced when they are identified through early warning signs and when preventative steps are taken. With such frequent and severe fluctuations this prevention is impossible to achieve and the changes can be so unexpected that they are exhausting. Particularly when trying to maintain a level of functionality, it takes more energy to achieve normal levels of functioning when you are either depressed and lack the energy or manic and have difficulties focusing and concentrating on boring tasks.
Since going on medication I find my fluctuations in mood to be less severe, which is of course the while aim to taking the medication. They have not however completely disappeared and mild symptoms are still able to come through. In a way I am happy that I have not become completely numb, but it means that facing Bipolar Disorder remains a constant mental battle. Of course there are easy times, great times, but it is tiring constantly checking in on yourself and your mood to make sure you are not going too high or too low. I experience a couple of symptoms of depression, or mania, or even mixed episodes, but not as severely as I used to. Depression for me now tends to involve a decrease in energy and passion, but no impairment on my functionality, a mild increase in sleep and mild changes to my appetite. Mania for me now often lacks the euphoria, and is experienced through a slightly less desire to sleep, feeling more pressure to get things done and anxiety or irritability. This is a little more extreme and I find myself sometimes reaching uncomfortable levels if irritability but I can for the most part combat it.
I find, particularly when manic or hypomanic, that despite being on medication and actively managing my Bipolar Disorder I still feel emotions to an intense degree. I saw a blind man today and was so overwhelmed with sympathy for him and thankfulness that I do not have a physical disability that I almost cried, this is a common occurrence for me when feeling less stable.
Varying levels of Stability
Most people believe you get diagnosed with Bipolar, put on medication and then you’re pretty much sorted for life as long as you keep taking your medication once you have found the right cocktail. Sounds easy right? Unfortunately this is far from the truth.
Firstly, Bipolar Disorder is based on brain chemistry and this will change over time. It is believed this will change more rapidly if you remain unmedicated which is why an early diagnosis is very beneficial despite the belief of some psychiatrists that diagnosing Bipolar Disorder is a negative thing. With the changes in your brain chemistry your level of stability with your moods will vary. This can be mild and therefore manageable or so severe that they can cause manic or depressive episodes that require hospitalisation or a rapid change in medication and lifestyle.
Secondly manic and depressive episodes are often triggered by stress so those of us with stressful lives, which is most if not all I would assume, are at risk of triggering an episode despite taking every precaution and medication at our disposal through the normal stresses and changes in life. This can be quite frustrating if you go from stable to unstable due to situations outside of your control. Not only do you have to deal with the stressor, which can be difficult enough for anybody, but also have to fight off a manic or depressive episode at the same time.
Non Compliance with Treatment
Due to the changing brain chemistry with Bipolar Disorder is it common for us to just suddenly go off all forms of treatment including therapy and medication. We decide we don’t need it or it is not helping and therefore pointless. We don’t mean to sabotage ourselves or go backwards, but our perception and beliefs surrounding our treatment and ourselves change so suddenly that our behaviour does too. Perhaps we have hit depression and cant see how things could possibly get better even with medication, or perhaps we have gone manic and feel far too powerful to need medication!
Non compliance leads to a crash, something I have experienced first hand just recently. I have and still am not taking my full dose of medication, at first I did this to induce mania and I was getting bored. I was successful until this led to a mixing of depressive and manic symptoms which I now experience at varying levels each day. I am experiencing vivid dreams, a lack of need for sleep and have been behaving very recklessly for a while now. I feel invincible but some days I wake up and it is hard to move, to motivate myself to to get anything done and I don’t want to speak to anyone. I am back on the rollercoaster which is what I wanted, I have had a bit of an identity crisis recently which I will write about next time.
Influenced most likely by non compliance of treatment and an increase in stress I have started to experience suicidal thoughts again where I don’t feel so stable. In those difficult moments where my mind starts to race or I feel my mood sinking, my thoughts can go seriously dark and I will think about suicide for a single fleeting moment. It passes very quickly but for that moment there is an intent and desire around the thought. I hate how little it can take to send me to that place in my mind, but this is very common among Bipolar Disorder even whilst experiencing manic and no depressive symptoms, the thoughts are still there sometimes.
If you have Bipolar Disorder, do you feel the same or do you experience it differently to me?