Living Bipolar (2 page)

What is important for you is to identify with the stories where you can. In each story, you will find examples of yourself. Take what information you need and apply it for your individual situation. Identification is the key which will allow you to unlock the freedom for your illness. Take what you need and store the other information away for future use. No matter what, the feelings will be consistent for everyone, and the experiences will be similar for you.

This book is not intended to diagnose, self-diagnose, or otherwise, take the place of medical opinion. Diagnoses of the Bipolar illness should be determined by a medical professional. Moreover, although the term “manic-depressive illness” has been changed to “Bipolar Disorder” in the DSM-IV TR, it is used interchangeably throughout this book.

The purpose of the book is to provide Bipolar people with a “How to Manual on Recovery with The Bipolar Illness.” While we encourage you to read the entire book, it is designed so if someone is a friend, a parent, or a child of a Bipolar person they can immediately jump to a specific chapter to learn what they can do to recover with that situation. The same is true if a person is Bipolar II and they are only interested in reading about cases dealing with people that are diagnosed as Bipolar II.

To some people the stories might seem sad, negative, and hopeless. The illness is sometimes like this. The stories are set up systematically to show what it was like, what happened, and what it’s like now. The names of the people in the stories have been changed to protect their anonymity.

In the following pages you will find descriptions applicable for everyone. You will gain insight into the thinking, behavior, and feelings of Bipolar people. While you can go on and on describing, diagnosing, and classifying various features of the illness, we intend on making a volume which is easy to digest, yet educational at the same time. Throughout the book notes have been included to help you learn about the illness as you are reading. For example, if a person states in the story they are hypomanic; a note will follow to describe what that entails.

The book
Manic-Depressive Illness
by Frederick K. Goodwin and Kay Redfield Jamison is considered to be "the Bible" in relation to the Bipolar Illness. Therefore, this text is cited repeatedly as it holds the answers too many of the scientific answers we are seeking to learn about the illness. Instead of having to read an academic text containing almost a thousand pages, and searching wildly through the book for answers, this book uses personal examples and then will cite
Manic-Depressive Illness
on relevant information which is key in understanding the illness.

What is the benefit of using personal examples in learning about the Bipolar illness? Let's take a look at what is written in
Manic-Depressive Illness
:

Examining manic-depressive illness from several perspectives gives the truest appreciation of the experience. The exhaustively detailed descriptions of classic psychiatric writing focus on the subject with more care and patience in observation than is found in the contemporary literature. With its emphasis on systematic measurement and analysis, the research that is now most highly valued can objectively examine well-defined, specific questions related to the illness--although weighing the results of that research requires the leaven of wisdom that comes from intense clinical interchange.
Accounts by patients themselves add another dimension, perhaps biased in their own way, yet enriching understanding of the illness as only subjective experience can.

Goodwin and Jamison 1990: 55

This book begins telling Landon’s story, who developed the Bipolar illness late in his teens, and to cope with the illness, he self-medicated with drugs and alcohol. Ultimately, the illness landed him in jail. Next, an interview with a psychiatrist is given discussing issues ranging from how to communicate with a doctor and the most important guidelines to follow aside for medication. Then, Cassandra’s story (Bipolar I) is told from her own experience where the illness struck her early in her teens leading to drug abuse, a suicide attempt, and even upon taking medication the illness became severe to the point where shock treatment was required to get her out of mania.

Following Cassandra’s story, Anne’s story (Bipolar II) is told highlighting hypomania, shame, and the decision of whether or not to have children, choosing the right group of friends, and using the illness as an asset. Ronald’s story follows discussing a suicide attempt, living with suicidal thoughts and inclinations, communicating honestly with your doctor, taking medication as prescribed, and staying in the middle of the road. Then, Jane’s story (Bipolar I) gives an accountant of growing up emotionally disturbed, dealing with issues of self-esteem, finding the right medications, and what questions to ask doctors.

Next, Tristan’s (Cassandra’s husband) story will examine how a spouse can help their Bipolar spouse, the right attitude to maintain in a relationship with a Bipolar person, equipping yourself to deal with the illness, informing yourself about the illness, and then a revealing interview with his wife Cassandra is told. Sally’s story is shown from the angle of a child with a Bipolar mom, and her story shows the anger toward the illness, Sally’s fears of inheritance, her acceptance, and her realization of becoming the best version of herself.

John’s story deals with his best friend Landon, and details life before the illness, witnessing a friend becoming Bipolar, along with the madness which occurs, the decision to continue a friendship after his friend becomes stable on medication, the realization that the illness is not the other person’s fault, and advice on how anyone can remain friends with a Bipolar person. Then, Jane’s Mom Connie provides her experience in raising a Bipolar child, touching on topics, such as, the realization that by her becoming healthy as a mother, in turn, the rest of her family then becomes healthy; her experience in Letting Go and Letting God; and getting support. Next, Donna will give her experience of her sister committing suicide from the Bipolar disorder and she offers ways to get help.

Finally, an interview with Cathy Guyer who is a therapist will show why therapy for Bipolar people is crucial in addition to taking medication to live a full, happy, and lasting life. A concluding chapter will tie everything to together moving forward, and a chapter titled “Tools for Recovery” will follow as a quick reference for Bipolar people in living a functional and fulfilling life.

Thank you for joining us. A new way of life and hope begins now as you read the proceeding pages.

The post psychotic or recovery phase is an important but seldom discussed aspect of manic-depressive illness. The recovery to normal thinking and feeling and the adjustment to the interpersonal, medical, professional, and financial consequences of mania and depression are usually slow, exhausting, frustrating, and partially futile experiences for patients. In the following passage, one patient describes the stages in her recovery from a manic episode:

The first symptom of recovery was a gradually increasing power to direct my thoughts into desired channels. I discovered that what seemed to be facts were in many cases delusions. Suddenly one day a feeling of self-control returned. The rapidity of thought seemed greatly lessened, and I was once more able to concentrate my mind on one subject for more than a few minutes at a time. Then came the feeling that I was well and must go home. Previous to this I realized my abnormal mental condition, and had no desire to see or be seen by my friends. Now I was seized with an eager longing to see my relatives and friends. It was like coming back from the dead. I overcame my restlessness by cleaning, scrubbing, mending and writing. My brain seemed unusually active and clear. I wrote for hours at a time; essays, poems, aphorisms, etc., flowed from my pen with great rapidity. I again began to take an interest in my personal appearance, and gradually returned to my normal mental health state.

-Goodwin and Jamison 1990: 20

Bipolar I

Diagnostic Features

The essential feature of Bipolar I Disorder is a clinical course that is characterized by the occurrence of one or more Manic Episodes or Mixed Episodes. Often individuals have also had one or more Major Depressive Episodes. Episodes of Substance-Induced Mood Disorder (due to the direct effects of a medication, other somatic treatments for depression, a drug of abuse, or toxin exposure) or of Mood Disorder Due to a General Medical condition do not count toward a diagnosis of Bipolar I Disorder. In addition, the episodes are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified. Bipolar I Disorder is sub classified in the fourth digit of the code according to whether the individual is experiencing a first episode (i.e., Single Manic Episode) or whether the disorder is recurrent. Recurrence is indicated by either a shift in the polarity of the episode or an interval between episodes of at least two months without manic symptoms. A shift in polarity id defines as a clinical course in which a Major Depressive Episode evolves into a Manic Episode or a Mixed Episode evolves into a Major Depressive Episode. In contrast, a Hypomanic Episode that evolves into a Manic Episode or a Mixed Episode, or Manic Episode that evolves into a Mixed Episode (or vice versa), is considered to be only a single episode. For recurrent Bipolar I Disorders, the nature of the current (or most recent) episode can be specified (Most Recent Episode hypomanic, Most Recent Episode Manic, Most Recent Episode Mixed, Most Recent Episode Depressed, Most Recent Episode Unspecified)…Bipolar Disorder is associated with Alcohol and other Substance Use Disorders in many individuals. Individuals with earlier onset of Bipolar I Disorder are more likely to have a history of current alcohol or other substance use problems…Other associated mental disorder include Anorexia Nervosa, Bulimia Nervosa, Attention-Deficit/Hyperactivity Disorder, Panic Disorder, and Social Phobia.

Average age at onset is 20 for both men and women.

DSM-IV-TR pgs 382, 383, 384 and 386

Patients “defined as those with a history of mania severe enough to have resulted in treatment (usually hospitalization). Such full-mania usually was accompanied by psychotic features.

-Goodwin and Jamison 1990: 64

Landon’s Story (Bipolar I)

My life would forever change on July 17, 1993 when I was hit by a car. I was struck and thrown thirty feet in the air while I was running one day training for cross-country going into my freshman year in high school. The car accident turned my world upside down at the age of 14, as it brought physical pain, and the accident limited what I could do both in school and with sports. I suffered a traumatic brain injury and I was in a coma for four days. After the car accident I became severely depressed and I wanted to commit suicide. Eventually, depression led me to use drugs and alcohol to cope with my mood when I was 16. The next big change in my life occurred when I went to college, as the Bipolar illness began to emerge in my life.

In my second year in college, I had my first manic episode, and my life quickly spun out of control. I became overly obsessive about things in my life. Mark McGwire was chasing the home run record, and in a sense I was doing it with him. I had pictures plastered all over my wall and his home run record chase became a part of my life.

After the car accident in high school when I came out of the coma, I remember fragments of my life for three or four months. Similarly, when I was in a manic episode I only remember fragments of my life for a few months.

I also remember I felt a strong connection with one of my favorite bands and the song lyrics. I felt the lyrics were speaking to me. I heard things in the songs that were not there, but what I heard was very real to me. I thought I had special powers and talents as a result of the connection I made with the lyrics, and I believed I had unlocked the code to be a member of the band. I was obsessed with the song lyrics and I would spend hours and hours neatly writing down the lyrics. I would crumble the paper and throw it away if it did not look perfect enough. I hung the lyrics all over my wall. The lyrics were a part of me.

It's hard to describe how great I felt, but the feelings I experienced were better than any drug I’ve ever done in my life. In fact, no drug I’ve ever done has come anywhere close to the feelings I’ve had in a manic episode. Everything in my life seemed to connect like never before. I found signs and connections everywhere. I thought everyone was my friend, and it was very easy when I went out to meet new people because I was so talkative, and could start a conversation with anyone.

At some point during my manic episode my parents became afraid because they thought that I was using drugs, and that drug use was that explanation for my erratic behavior.

And this is a point my parents never understood.

When I was in a manic episode I didn't do, nor did I want to do drugs, because I felt so good during the mania that I didn't want to do drugs.

This is an important because my parent's denial about their son having a mental illness and ignorance hindered me getting proper medical help.

So, in the Fall of my second year in college I had to drop out of school. I know my brother came to pick me up and took me to a treatment center to get help in Atlanta. I was put some medications and everything there was a blur. At some point I was released and I went to live with my mom. I became severely depressed and I had a hard time getting out of the house. I slept all the time and I just wanted to die. I had no interest in doing anything at all. I rarely left my mom’s apartment, and I had little contact with other people. The pain and loneliness I experienced was incredible. Most days I would just lie on the couch watching TV, but my mind state was such to where I could not concentrate or comprehend what I was watching. Nothing gave me any release. At times my mom would give me a task to do, but I had trouble doing simple things, such as washing the dishes.