World Bipolar Day

Today, March 30th, is World Bipolar Day- strength for today, hope for tomorrow. The vision for WBD is to bring awareness to the world and to help stop the stigma associated with bipolar disorder.

This is an important day for me, and an important post, as I share with you all that I am bipolar. My diagnosis has been a part of my life that I have kept very private. Until now, it is only my immediate family and closest friends that I have shared this with. But today I step out of the metaphorical closet. I decided that in keeping this a secret I am perpetuating the stigma that surrounds this disorder, and any mental health disorder for that matter. By standing up and owning this part of myself, I take the power away from it, and away from the often negative opinions and understanding people have of the disorder. So, on this global awareness day, I have decided to share my story.

First, let me explain clinically what BD (bipolar disorder) is:
Also known as manic-depressive disorder, BD is a brain disorder that causes unusual, extreme, and unpredictable shifts in mood, energy, and activity levels. These shifts swing (or cycle), sometimes in rapid succession, between acute and severe episodes of highs (mania or hypomania) and lows (depression). BD is a lifelong disorder with no cure, and although it can often be managed through medication and psychotherapy, those with the disorder will always and inevitably cycle.

Approximately 10 million Americans suffer from bipolar disorder.

I was diagnosed with bipolar II over 4 years ago.

There are four known types of BD:
-Bipolar I disorder: defined by severe manic episodes lasting 7 or more days, and severe depressive episodes lasting 2 or more weeks. Episodes of mixed features (both extreme high and extreme low episodes occurring simultaneously) are possible.
-Bipolar II disorder: defined by a pattern of extreme depressive episodes and hypomania (unusual euphoria, but typically never reaching the full height of BD I mania). One major episode of depression and hypomania is required for diagnosis. Episodes with mixed features are possible.
-Cyclothymic disorder: defined by low-level hypomania and depressive episodes lasting for at least 2 years. Symptoms do not meet the same diagnostic requirements for hypomanic and depressive episodes as BD I & II.
-Other specified or unspecified bipolar disorder and related symptoms: defined by BD symptoms that do not match the other three types as they are induced by drugs, alcohol, or medical conditions, such as Cushing's disease, MS, or stroke.

Did you know there were that many types? I didn't until my diagnosis.

Episodes of psychosis can sometimes lead to the misdiagnosis of schizophrenia.

Research shows that as many as 70% of BD patients also suffer from ADHD. Anxiety and insomnia disorders also have a high prevalence with BD. Successful treatment for BD can be difficult when these disorders co-occur with one another, often masking each other.

Due to the less extreme levels of hypomania, BD II often goes misdiagnosed as unipolar depression (depression unrelated to BD). My bipolar went misdiagnosed for nearly 17 years. I was diagnosed in 2014, and approximately two months later I was diagnosed with anxiety disorder. A year following that I was diagnosed with clinical insomnia, and almost 4 years after my initial diagnosis I was also diagnosed with ADHD. I know, I sound like a hot mess.

For many years I was treated for depression, and it wasn't until my BD diagnosis that I learned that some of my extreme episodes were likely induced or exacerbated by the antidepressants that I was taking at the time. Treating a patient with BD with antidepressants can often have an opposite response, causing dangerous cycling. Treating BD is finding a tricky balance, often through mood-stabilizers, anticonvulsants, lithium, and other medication mediums along with psychotherapy because there are essentially two disorders being treated- and they are on opposite sides of the spectrum (high & low). Although my depressive episodes appeared as early as twelve or thirteen years old, it wasn't until my college years that I suffered my first identified hypomanic episode. I just didn't know that that is what it was until years later. Looking back, there were glaring red flags all over my medical history, but my doctors (and they were good doctors) missed it- for nearly 2 decades.

A lack of awareness isn't limited to the general public- doctors often miss the signs, especially outside bipolar I disorder, because of the less extreme highs, which tend to go unreported. Hospitalization and psychosis are less prevalent with the other types of BD, although still possible.

The very first time the idea of BD was floated for me I thought it was completely preposterous. I mean, I was absolutely nothing like Charlie Sheen! I was referred to a psychiatrist and after extensive evaluation, I got my BD II diagnosis. I was crushed. The name alone instilled fear inside of me. I was overwhelmed with shame. I didn't want anyone to know because I thought it meant that I was broken. I thought no one would want anything to do with me. I thought I would lose all credibility and just be another label... she's crazy. I thought that something was wrong with me. After I began to learn more and more about my disorder, the more the lightbulbs turned on. I remember having these Ah-Ha moments when I realized that certain thoughts and behaviors of mine weren't normal for most, and yet they could suddenly be explained.

After my diagnosis, I naively believed that I would start treatment and that I would instantly level-out and stabilize. And oh boy was I wrong. I had read stories of people taking 10 years to find the right medication combination for effective treatment. 10 years? I had already been suffering for 17! My doctor and I began my search for the "perfect" cocktail for my treatment. In four years, I have gone through over a dozen medications, and at least 3x more than that of dosage changes. The side-effects were often as extreme, and sometimes as dangerous, as my episodes and took a very real toll on my body. I've had many, many frustrated and emotional moments just trying to get through... more than once I wanted to give up, but I also wanted, so desperately wanted, to find something that worked for me. Every time I tried something new I was filled with both fear and hope... how terrible would I feel, how would my body tolerate and respond... could this, just maybe, be the one that would change it all? As I sit here now, writing my story, I can say proudly that the regimen I am on is the same one I've been on for 6 months now. I can't emphasize enough what a victory this is for me.

More times than I can count I have cried, completely broken down with frustration and resentment... why me? I felt I was dealt a bad hand. But at the end of the day, I put my head down and forged ahead, even when I felt like there would never be a light at the end of the tunnel. And as much as I wanted to get better for myself, I was that much more determined to get better for my family.

This journey, both before and after my diagnosis, has been a rough one for my family. Nothing about it has been easy. But my amazing husband has stuck by my side every inch of the way. He doesn't look at me and think this is a road I take alone because I'm the one with BD; he looks at the road as something we take together because we're a team. And I never want to be a mom who can't be there for my kids. Everything I do to get better I do for them.

One day, a couple years ago, my C came to me very upset as the realities of his dyslexia were dawning on him- specifically the awareness that there was no cure. So I got brave, and I sat him down and told him about my BD. I didn't give many details, of course. I didn't want to scare him. But I so clearly remember seeing a wave of calm wash over him. Yes, he would be dyslexic forever, but I would be bipolar forever. I took medication to keep me stable, and he got extra help at school and went to a learning center... we both did things to help us manage... we would overcome. It was the first time I looked at my disorder as a gift- I had something to offer because I gave C a confidence that day that he never had before. And he still carries it with him.

A gift... maybe, despite the extreme struggle and the constant fight... maybe my BD was a gift, too. I told Tim when I was working on my latest novel that I had to have a little madness in me to write 130,000+ words in 2 months. There is a high prevalence of artistic qualities linked to bipolar. And I think that I am no exception to this. I really believe that I can do what I do, that I can write what and how I write because of this.

Cycling is hard. Not just on me, but on those closest to me. And despite how stable I can be, I will always cycle. It's the nature of BD. And sometimes I really hate that I'm not allowed to just have a really bad or a really good day without the panic at the idea that I'm going to start cycling. But today, over 4 years later, I'm more aware. I have a better idea of what to watch for. I know some of my biggest triggers. And, most importantly, I have people in my life who know me so well that they pick up on the smallest changes in me. I'm typically the last person to the realization-party when it comes to recognizing my cycling patterns, but I feel so incredibly blessed and fortunate that I have people who have my back.

I get up every day and have to make the conscious decision to be a fighter. The moment I get complacent or begin to think that I can take a mental vacation, that's when I tend to slip. I will share in good humor a little of what hypomania has been like for me... it's reading Jane Eyre, Pride and Prejudice, Sense and Sensibility, The 100, and A Fine Balance in exactly 7 days. It's not sleeping more than a collective 10 hours in an entire week. It's every crafting project for two years completed in two days. It's making so many holiday decorations that I give them away in droves because I can't fit any more in my house. I won't share the dark depressive side of things. It's... well... depressing. It has been crippling at times and is a painful place for me to go to. But even in the lowest, darkest places, I try to hang on to the knowledge that I will eventually come back up... up... up... and up. It's the nature of manic-depression.

It is important to note, however, that most individuals who have manic-depressive illness are normal most of the time; that is, they maintain their reason and their ability to function personally and professionally. - Kay Redfield Jamison, Ph.D. Touched with Fire 

Over 43 million Americans suffer from some form of mental health - or 1 in 5 adults. I am telling this story today to STOP THE STIGMA. I'm not broken. In fact, my BD allows me to truly rock at certain things because my mind thinks in so many different ways. Having bipolar doesn't mean I'm a bad mom, a bad wife, a bad friend. It doesn't mean I'm not good at my job. It doesn't mean I'm lesser. It's how God created me.

Though my soul may set in darkness, it will rise in perfect light; 

I have loved the stars too fondly to be fearful of the night. - Sarah Williams

A huge shout-out to one of my closest, dearest friends. She, too, lives with the curse and gift of bipolar disorder, and she wears it proudly. I've had an amazing support system since day one, but I never realized that I had been an island until someone else showed up in my life with BD. She sings the same tune to her soul, and only we can understand each other the way we do. She is the one who gave me the courage to step out of the shadows and share this with all of you today, not because I'm some epic failure, but because I go out there every day determined to be better than the day before.

Thank you to the many who love and support me, especially my very best friend, Kristin. She and Tim are my tribe. She has stuck by me through absolute thick and thin. Her love for me is truly one of my greatest blessings. I wouldn't be where or who I am without her in my life. She and Tim are everything to me. There are so many others out there who have been there with me through my struggles, and they are too many to name, which makes me all the more blessed. This post is dedicated to you, for all you do for me, in good times and bad. I am grateful beyond words.


Sources:
WebMD
AdditudeMag
Psycom
nimh.nih (national institute of mental health)
Nami (national alliance on mental illness)

*This article has been updated