Today is World Bipolar Day. A year ago on this day, I broke my silence and told my Bipolar story. I was terrified to share it, to let myself be so vulnerable. I was afraid I would be judged, afraid I would be looked down upon, afraid I would be labeled. And sadly, while there were some that did respond that way, what I learned was that people have so much compassion and love inside them. Some people were brave and shared their own stories of mental health, some shared stories of other medical conditions. And then there were those who had never experienced it for themselves... they were supportive and kind. The outpouring of love and understanding was nothing shy of incredible. To see my world come together, to rise up like it did because I shared my story made it all worth it. It was empowering.
What is Bipolar Disorder?
Bipolar Disorder is a complicated mental health disorder affecting 10 million Americans and is often very misunderstood. When I was diagnosed 5 1/2 years ago, I had a very limited understanding of BD (Bipolar Disorder), and much of what I thought I knew, I really didn't. What I thought was right, mostly wasn't.
Bipolar Disorder is a mood disorder, characterized by unpredictable shifts in mood, energy, and activity levels. These shifts swing (or cycle), sometimes in rapid succession, between acute episodes of mania/hypomania and depression. BD is more of a blanket term as there are four types of the disorder, all varying to some degree from each other and each identified by their patterns of mania and depression.
Bipolar I Disorder: defined by severe manic episodes lasting 7 or more days, and depressive episodes last 2 weeks or more. Episodes of mixed features, mania and depression occurring simultaneously, are possible.
Bipolar II Disorder: defined by a pattern of severe depressive episodes lasting 2 or more weeks and hypomanic episodes lasting 4 days or more. Mixed episodes are also possible.
*It's important to note the major differences between types I and II:
Mania is described as unusual euphoria and high energy. It can include racing thoughts, inflated self-esteem and grandiosity, abnormal exhilaration, impulsivity, hyperactivity, extreme irritability, and emotional dysregulation. Hypomania follows the same patterns of mania but to a less extreme degree, though still at potentially harmful levels. It is the difference of severity between full-mania and hypomania that distinguish the difference between types I and II. Type II is frequently characterized by longer, and more frequent depressive episodes.
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 the manic/hypomanic and depressive episodes of types I & II.
Other specified or unspecified BD 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 a stroke.
Episodes of psychosis can also occur and can sometimes lead to a misdiagnosis of schizophrenia.
My Bipolar Story
For most of my life, mental health has been a very real struggle, beginning around age twelve or thirteen. It seemed to surge in severity while I was in college, and during my sophomore year, I was treated for the first time with an anti-depressant. That medication launched me into my very first hypomanic episode, though I didn't understand at the time that that was what was happening. I learned many years later that anti-depressants can be dangerous to people with BD, often causing cycling.
I went on struggling with my depression, my hypomania showing its ugly head from time-to-time for years. Though if I'm honest, those hypomanic episodes were a welcomed relief. Finally feeling good... and not just good, but incredible... was the most amazing thing - I didn't care about the risks and consequences that came along with feeling that good, I just loved feeling good!
After college, I went on and off many anti-depressants. I seemed to live my life in a rowboat on the ocean, constantly rising and falling in the waves. As time passed, my symptoms only ever worsened, eventually becoming disabling, dramatically impacting my daily life.
The first time Bipolar Disorder was suggested, I thought it was preposterous. My general physician acknowledged that it was not his specialty and referred me to a psychiatrist. It didn't take long after that and I received my diagnosis: Bipolar Disorder type II. It was like the worst sucker-punch and it knocked me to my knees. I was confused and so ashamed. For almost a year after my diagnosis, there were only six people who ever knew the truth (aside from my doctors). The thought of telling anyone else scared me because I didn't want people to see how broken I was. I didn't want to be called crazy. I didn't want to be judged.
After my diagnosis, I set off on two journeys. The first was to learn as much as I could about my disorder. If I thought I knew little about Bipolar, I knew even less about BD type II. I read anything I could get my hands on. The second journey was the complicated search for the right medications that would stabilize me. That proved to be one of the most difficult things I've ever gone through. It was emotional, it was physically exhausting, and took a hard toll on my mind, body, and spirit. I didn't respond well to most medications, the side-effects wreaking major havoc. With some, I experienced severe drowsiness, and not just the I didn't sleep well kind but the drug-hazed I just drove my car in the ditch and remember none of it kind of drowsiness (yes, I really did that). I had meds that caused me to lose my vision, ones that made me chronically vomit, others that made me lactate. Some made me gain excessive amounts of weight, some caused neurological complications. Some made me panicky and anxious, some made me scratch excessively at my skin because I literally couldn't stand having skin on my body. Some made me pace incessantly. And one very horrible medication sent me into a state of psychosis. A time in my life I wish I could forget but I know I never will.
I wanted to give up more times than I can count. But I had three people at home who were depending on me, who needed me to get better. And so I continued to fight - for them. Had it only been for myself, I wouldn't have kept going. My family, my husband and my kids, they are my entire reason for fighting. They are my whole world and I want to give them the strongest, healthiest version of myself that I can.
During the years of medication trial and error (which were mostly error), I was also diagnosed with anxiety disorder, insomnia, and adult ADHD. So while we were trying to regulate my BD, we also had to regulate all of the other stuff. Bipolar and ADHD have a high comorbidity rate. Research suggests that as much as 70% of those with BD also suffer from ADHD. When they co-occur, one often masks the other and it can lead to treatment delays, inaccurate diagnoses, as well as having other dangerous implications. The treatment modalities for BD and ADHD are drastically different from each other and I was very worried one could make the other worse. After my episode of psychosis, I was very gun-shy about starting new meds. But my psychiatrist is very good at what he does. It wasn't until we started treating my ADHD that we started to make progress with my BD treatment, four years after my diagnosis.
That was a year and a half ago. And while it isn't always smooth sailing, this is the longest period of relative regulation that I've had since my college years - 16 years ago.
It took almost 17 years of struggle and inaccurate mental health diagnoses before I finally got my Bipolar diagnosis at age 29. Add another four+ to find a good treatment regimen. And not because I didn't have good doctors. I've had amazing doctors, and they've all done their very best for me over the years. A lack of awareness surrounding BD isn't limited to the public, and healthcare professionals can easily miss the signs. By nature, the symptoms of BD I mania can be severe enough to often warrant hospitalization, making this easier to identify. But when the symptoms don't reach that level of severity, they can go unreported or overlooked, making it difficult for an accurate diagnosis. There were red flags throughout the years for me and it ultimately came down to one woman who had a daughter with BD II to recognize the patterns in me. And I'm so grateful for her, for her knowledge, and for the time she took to try to understand me.
My Bipolar Today
While this has been my journey, I've not once done it on my own. When I was young, it was my mom who helped hold me together, and she was the first person to get me professional help. In college, I had a good group of girlfriends. And while there was no name yet for my struggle, they were always there for me, no matter how ugly things got. Then I married Tim and he has been by my side for all of it, every step I've taken. Between Tim, my best friends, my sister, and my mom, I've never been alone for even one day since my diagnosis. For years, it was Tim and my bf Kristin who saw the changes in me even before I did. And what an amazing thing, to have people that love you and know you well enough to see even the smallest shift in you. They were my guardian angels. I'm here today greatly in part because of them.
A year and a half ago, I met Kim who was very open about her BD I. She was unlike anyone I'd known until that point. Meeting her made me feel less alone in a way I didn't understand until she was in my life. Yes, I have the world's greatest support system, my miracle tribe. But while they are all empathetic, they have never experienced my disorder. She made me feel understood in a way I never had been before. She's been another kind of blessing in my life. It was these people, Tim, Kristin, Kim, my mom, and too many others to name, who gave me the courage to step out from the shadows, to be brave, and to share my story. They taught me I have nothing to be ashamed of. I am not broken. That we're all a little crazy in our own way. That in the eyes of my Father, I have been made exactly how He wanted me.
Today, I'm more knowledgeable. Though I still rely heavily on those closest to me. I'm better at picking up the small signs, seeing them earlier and earlier, catching my cycling in its early(ish) stages. I recognize that I can't fully prevent myself from cycling, that it is the nature of my disorder, no matter how hard I try. But I now understand that I'm not helpless, either. Through diet, sleep, exercise, strict routine, and medication, I can help minimize my episodes, their frequency and their severity.
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| "Stay Wild" - mental health awareness |
So on this day, World Bipolar Day, I share my story to help bring awareness and to educate, to stop the stigma that surrounds Bipolar Disorder. Love and compassion can mean all the difference for someone who is fighting an invisible war. That's what mental health is... an invisible war. Remember, just because someone carries it well, doesn't mean it's not heavy.
Together, we can make a difference.
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