I was urged a while back to write this piece on bipolar disorder, a subject on which I feel I have a unique perspective. I have been married to a creative, exciting, and emotional soul for nearly ten years, who also happens to be bipolar. I would like to share with you some little known facts, and some hard earned insights on a disease as difficult to live with, as it is to diagnose or treat. Most importantly, I need to emphasize to those stricken with any mood disorder, and to their loved ones, a diagnoses of clinical depression or bipolar, is the biological equivalent of being diagnosed with diabetes. It won't be willed away with positivity, it won't be waited, or bought out. If you are genetically predisposed (for which there is currently no accepted way of testing for any type of mood disorders) to having bipolar, you have about a 70% chance to show the usually devastating effects of this disease. Personal life circumstance, traumas, and stress can all but assure that you become stricken sooner than later NAMI - bipolar disorder Symptoms, Causes and Diagnosis.
Bipolar disorder is one of the most complex and life altering diseases, but it doesn't have to be as hard for you, as it has been for so many of us. I can assure anyone suffering this disease, that the proper medication will allow you to begin progress through some sort of therapy channel, to work out the underlying trigger/issues that are causing strife, or that have become a problem due to the illness. It is absolutely vital to seek out personal and group therapy, and as much information as this wide world and it's web can offer you on the issue.
I know how hard that can be for anyone in the midst of suffering from the inside out. It can make a huge difference, though, to read about how the average person treated for bipolar is first misdiagnosed for 10 years. It can make you feel part of the world to be in a bipolar group where you can sit at your comfort and just listen if you like, to people describing what it's like for them to experience things you thought were truly manifestations of your broken mind alone. Hearing them speak in anguish of the same lost in the woods, out to sea internal darkness and/or confusion you couldn't imagine anyone else truly understanding. Your family may not, your boss certainly won't get it, and the rest of the world seems as if the word bipolar is worthy of a stigma. One that exists for the same reasons any misconception does, a simple lack of knowledge; or a preponderance of misinformation.
They generally attempt to break it down into two groups, depending on which doctor or patient you ask http://youtu.be/fyJn_3LkE8w. Bipolar 1 and 2, are widely accepted as official mood disorders. Just to show how murky the waters are we now wade, trying to find our way out of the bipolar haze, there is also a school of thought pronouncing a third category; less extreme in it's peaks and valleys, although just as severely crippling to a normal lifestyle as the other two varieties. As well “cycling” episodes consisting of a constant flux between depression, mania, and “normal” spells. No matter which you are deemed to have, the treatment is essentially identical. Find the correct balance of mood stabilizing medication, and personal growth through therapy and education, and one should find themselves able to feel “normal” http://www.mcmanweb.com/bipolarfaq2.html. Easier said than done! The ability to feel happy in a special moment, or deal with a simple change of plans as less than a world devastating circumstance; can sound like a dream come true, or even like a completely unattainable waste of time to someone in the throws of an unmedicated or incorrectly treated episode lasting from agonizingly long minutes to completely lost years.
One of the most intriguing things to me about this disease, is the confusion surrounding it. It is, without a doubt, a horribly misdiagnosed disease, always to the detriment of the patients, and their families. It is one that goes on for years, even decades; untreated, over looked, and almost always initially misunderstood as just depression. This can be attributed to the fact that those suffering with bipolar have alternating moods that can range from the lows of depression to the heights of mania, with sometimes long periods of “normal” moods, or severe irritability in between. This is where the true confusion, and the difficulty for patient and doctor alike comes, in accurately attempting to ascertain that someone has Bipolar as opposed to Depression, ADHD, or Schizophrenia http://www.rxlist.com/bipolar_disorder/article.htm. “Mania” can be characterized by many sometimes unnoticed traits: euphoric moods, excessive talkativeness and activity, silly or oppositional behavior, racing thoughts, impaired judgment, sexual promiscuity, severe irritability, heightened anxiety, irregular sleep patterns, and can sometimes be accompanied with psychotic symptoms, and delusions. Now, these “distorted realities” can range in variety from delusions of grandeur, to a more common, low self worth - feeling assured everyone around them thinks the patient is worthless too - and/or out to get them, and are extremely difficult, if not impossible for the patient to recognize as not reality. Unfortunately, these symptoms can often either be somewhat enjoyable for the patient, or more often, unrealized as anything out of the ordinary, for they have lived with these mindsets and feelings all their lives, stuck in revolving patterns too big or obscure for anyone to put a finger on.
The average patient is misdiagnosed for a span of a decade, after living with the unattended disease for untold years! Who would think to go to a doctor and say I feel too happy and energetic? Why would you think your issues with your children, friends, family, and coworkers could be attributed to your severe irritability, and not them being annoying? Would you attribute the risks you took to become successful or happy, in the past, as part of a greater problem? It is often the patient's family that either identifies the problems, and/or initiates a doctor's visit. In those cases, even, it is usually the down side of the disease that prompts the call, and when speaking with the doctor, can lead to worrying solely about the current depressed state, and therefore omitting or never realizing the information the doctor could use to diagnose bipolar, and simply try a mood stabilizer. This evokes the all too common problem of misdiagnosing a bipolar patient with clinical depression, and starting down a rabbit hole of anti depressants, that can be far more confusing and harmful than anything seen previous.
For some, the miracles of the medical world and the new age of medicating in lieu of hospitalizing mentally ill or mood disorder patients, will take a wonderful course. The SSRI, or SNRI they are prescribed seems to level off their mood, and after certain amounts of time, a few patients will even be able to live a normal life off of the anti depressants. More yet, would find an acceptable level with the medication, and stay on it for an indefinite amount of time. These are indeed those numbered in the lucky, and surely not bipolar. For so many others, including my wife, that was not the case.
After 7 years of trying several anxiety medications, and sleeping pills to accompany the 7 DIFFERENT ANTI DEPRESSANTS, with varying degrees of success, and lengths of usefulness, at least 2 of which caused immediate and sharply negative side effects in mood and behavior, she was for the first time diagnosed by her third doctor as having bipolar. The important thing to note, is the huge possibility of harmful side effects of anti depressants on one who doesn't need them, and how they dwarf the risks encountered when putting a depressed person on a mood stabilizer. A seemingly depressed person, while unknowingly suffering from bipolar, can be truly helped by just mood stabilizers. However, it is extremely rare for a bipolar patient to find solace with an anti depressant alone, and so many times, as with my wife, such a treatment can push the situation to a breaking point. ANTI DEPRESSANTS ALONE CAN DESTROY A BIPOLAR PATIENT. It is seemingly up to the patient, who usually can't determine they are actually bipolar, to demand a shot at the mood stabilizers first, before being subjected to medicines that can quite literally exacerbate the depressed side of bipolar to the point of peril to the patient and those around them.
One is certainly left to wonder, how in these times of mapping the genomes of humans, monkeys, neanderthals, and the woolly mammoth, while searching the cosmos for “dark matter”, and creating an invisible web of universal knowledge accessible in my 7 year old's pocket, the most respected psychiatrist in the region giving a talk on bipolar and depression recently, looked me straight in the eye and very honestly said, “ there is no rhyme or reason, no test to take, no universal standard or consensus whatsoever concerning the best treatment nor way to diagnose those suffering from mood disorders. Finding the correct medication for the correct patient is truly a serendipitous venture.” How depressing a comment is that?!? http://news.msn.com/science-technology/new-mental-health-bible-no-longer-up-to-snuff
When was the last marathon hosted by John Stewart or Glenn Beck, or who cares; that straightforwardly came out and simultaneously made the public aware of the differences between being “mentally ill”, having a “mood disorder”, and being a “psychopath” - while demanding funding and public support for researching a simple across the board test for bipolar or clinically depressed biological precursors? Most importantly, a biannual, universal official medical standard for the post treatment information taught to the patient and family, and ensuring new avenues are sought for methods of behavioral and personal therapy needed to change and maintain a new happier life http://www.webmd.com/anxiety-panic/news/20110221/talk-therapy-may-help-treat-social-anxiety.?
The movie, Silver Linings Playbook, did a hell of a job of capturing real emotions experienced in the lives of so many of us! See Robert De Niro here, leave no doubt as to how powerful a predicament this illness can put anyone in: https://www.youtube.com/watch?feature=player_embedded&v=IxJKp7Qgcls
In summary, I implore anyone suffering, to do two things. Keep the faith – the correct medicine IS out there, and when you find it, your life WILL FEEL better, and therefore BE better! For those family members and sufferers alike, get and stay proactive in seeking out new, accessible, and different ways of experiencing therapy http://www.ncbi.nlm.nih.gov/pubmed/20717121. I have found so much benefit from going to a bipolar/depression group with my wife, hearing about different experiences, medicines, doctors, approaches, and in general, feeling at home with strangers is a comforting feeling for us. Therapy isn't a dirty word either, it can save your life! - waiting for the motivation to come while depressed is a death sentence, it's being active that can give you the motivation to pull yourself up from the depths....
As I do not work for anyone related to this field, I shouldn't hesitate to speak to the effectiveness, or unreliability of any one specific medicine. More importantly, though, everyone seems to react so differently in response to medications treating mood disorders, being such an interwoven matrix of chemistry and personal life experiences and stress, that they struggle to find one medication that works for extended periods for large groups. With that being said, I would be completely remiss if I didn't mention here, my wife's experience in short at least. She has been on Lamictal, a med that has been used in the past for epilepsy patients, but more recently has been shown to be, in fact, the absolute best med available for treating bipolar 2 patients. http://www.crazymeds.us/pmwiki/pmwiki.php/Meds/Lamictal. In the months since she has started it, she has been weened off an anti depressant, an anti psychotic, and is now down to 225mg of lamictal, 10mg of abilify, and a daily anti anxiety med. A big difference, from the huge numbers of anti depressant drugs she had been on, and the accompanying pile of pills and mountain of side effects and struggles she and our family of five have experienced over the years. For some reason, our doctors took years to suggest lamictal, and begrudgingly went to abilify only after my constantly questioning the guy. I hope you don't wait for your doctor to tell you about a life saving med! Be ambitious, look it all up, it's all there, you are not alone, you number in the millions of silent sufferers of a misunderstood disease. Remember the DOCTOR WORKS FOR YOU, make sure they do! Again, the medicine can allow your therapy to actually become a tool for you to change your life with, and just because a therapy or medicine is “new”, doesn't mean it's ineffective. Most importantly, know that YOU ARE LOVED!
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